No abstract

Doppler velocity measurements made at different fixed insonation angles show considerable differences. In determining ICA stenosis, although optimal thresholds are different, the diagnostic performance is not different. In determining ICA stenosis with color duplex ultrasonography, angle-specific thresholds must be determined, and examinations must be made at a fixed angle.

Previous studies have demonstrated a significant association between red blood cell distribution width (RDW) and acute pulmonary embolism. To the authors' knowledge no study has been reported in patients with deep venous thrombosis (DVT). A total of 431 lower extremity venous duplex examinations were included in the study. Of these, 216 examinations with the diagnosis of DVT were compared to 215 examinations with normal duplex findings with respect to RDW. The two groups were well matched. DVT group had a higher median value and the interquartile range (25th and 75th) of RDW (%) level [14.9 (14.2-16.7)] compared to control group [14.4 (13.6-15.2); P < 0.001], respectively. Patients were divided into tertiles based on RDW. DVT was detected in 42 patients (31.6%) in the lowest tertile, in 81 (53.3%) in the middle tertile, and in 93 (63.7%) in the highest tertile (P < 0.001). In multivariate analysis after adjustment for confounding variables, RDW was the only parameter to predict the presence of DVT [odds ratio (OR) 1.37; 95% confidence interval (CI) 1.21-1.55; P < 0.001]. After removing patients with chronic DVT, the interquartile range (25th and 75th) of the RDW (%) level was also higher in the DVT group [15.0 (14.2-16.7)] compared with the control group [14.4 (13.6-15.2); P < 0.001], respectively. In addition, in proximal DVT, the significant difference continued to be present, although this significance was lost in distal DVT [14.4% (13.6-15.2) vs. 16.1% (15.1-17.4), P < 0.001 and 14.4% (13.6-15.2) vs. 14.3% (14.2-14.7), P = 0.959]. In multivariate analysis, RDW was an independent predictor of risk of proximal DVT (OR 1.60; 95% CI 1.39-1.84; P < 0.001). RDW (%) level was significantly higher in patients with bilateral DVT than in patients with unilateral DVT [16.0 (14.8-17.1) vs. 14.4 (14.2-14.8), P < 0.001, respectively]. In receiver operating characteristics curve analysis, RDW more than 14.9% had 85% sensitivity and 73% specificity in predicting proximal DVT. RDW, an inexpensive and easily measurable laboratory variable, was independently and significantly associated with the presence and severity of DVT, especially nonchronic proximal DVT. The mechanism of association requires, however, further study.

In patients with aortoiliac occlusion, the ITA-IEA collateral pathway is an important route providing lower-extremity perfusion. Additionally, Doppler sonographic flow measurements of the contribution of the ITA-IEA route to lower-extremity perfusion may provide beneficial diagnostic information necessary for the pretreatment work-up of patients with aortoiliac occlusion, especially for whom the ITA is planned to be used as a coronary artery graft.

Objectives The proximal segment of the vertebral artery is a frequent site of obstructive atherosclerosis. The purpose of this study was to determine Doppler criteria for identifying proximal vertebral artery stenosis of 50% or more by comparison with digital subtraction angiography. Methods Forty‐eight patients with vertebral artery stenosis were examined prospectively with color Doppler sonography and digital subtraction angiography. The peak systolic velocity (PSV), end‐diastolic velocity (EDV), peak systolic velocity ratio (PSVr), and end‐diastolic velocity ratio (EDVr) were evaluated by receiver operating characteristic curve analysis for their ability to detect vertebral artery stenosis of 50% or more. The optimal criteria for identifying proximal vertebral artery stenosis of 50% or more were determined. Results For identifying vertebral artery stenosis, the parameter with the highest accuracy was the PSVr (area under the receiver operating characteristic curve, 0.967 [95% confidence interval, 0.899–0.994]). A PSVr of greater than 2.2 was found to be the optimal criterion for identifying proximal vertebral artery stenosis of 50% or more, with sensitivity and specificity of 96% and 89%, respectively. The optimal thresholds for the other Doppler parameters in identifying proximal vertebral artery stenosis of 50% or more were as follows: PSV, greater than 108 cm/s; EDV, greater than 36 cm/s; and EDVr, greater than 1.7. Conclusions Color Doppler sonography is an accurate method for identifying proximal vertebral artery stenosis. The PSVr is superior to other Doppler parameters for detecting vertebral artery stenosis.

No abstract

The distance between the aorta and the SMA significantly correlates with visceral fat area than with BMI. The size of visceral fat area of females and males vary; therefore, the amount of visceral fat area should be considered in the establishing diagnosis of SMA syndrome.

Objective: While the incidence of sarcoidosis peaks between 20 and 39 years, it is comparatively low in elderly subjects. We sought to determine whether there are age-dependent differences in the demographic and laboratory characteristics of patients with sarcoidosis. Materials and Methods: We retrospectively collected information from our database using the International Classification of Disease (ICD) diagnostic code D86 between 2008 and 2014. Patients were divided into three groups: 20-39 years old (Group 1), 40-59 years old (Group 2), and 60-80 years old (Group 3). Results: A total of 3988 patients with code of D86 were included in the study. After the exclusion of noneligible patients, the number of cases in Groups 1, 2, and 3 were 276, 641, and 352, respectively. The groups were compared according to demographic characteristics, ICD diagnostic codes, and laboratory parameters. The ratio of female patients was significantly higher in Group 3 than in Groups 1 and 2 (p=0.000). There was no difference in diagnostic codes of the ICD subgroups between groups (p=0.19). While the level of bloodurea nitrogen was significantly higher in Group 3 patients than in other groups (p=0.000), serum angiotensinconverting enzyme (ACE) values were found to be significantly low in Group 3 (p=0.010). The mean ACE values did not differ between females and males (50.8±39.3 and 59.1±45.5 mg/dL, respectively) (p=0.18). Conclusion:The majority of patients with sarcoidosis were female in all age groups and pulmonary sarcoidosis was the most common presentation of the disease. Elderly patients (≥60 years) with sarcoidosis had lower serum ACE levels than younger patients.