Assessment of left-to-right atrial shunting after percutaneous mitral valvuloplasty by transesophageal color Doppler flow-mapping.

To evaluate left-to-right shunts after percutaneous balloon mitral valvuloplasty, we studied 15 consecutive patients by using transesophageal color Doppler flow-imaging system. Transesophageal color Doppler examinations were performed five times in each patient (before valvuloplasty and 1 day, 1 week, 1 month, and 6 months after valvuloplasty). No shunt flow was observed before valvuloplasty.

Adenomatous hyperplastic nodules in the cirrhotic liver: differentiation from hepatocellular carcinoma with MR imaging.

Differentiation of hepatocellular carcinomas from adenomatous hyperplastic nodules (AHNs) is important for the early and precise detection of hepatocellular carcinoma in the cirrhotic liver. For this purpose, the authors compared findings on magnetic resonance (MR) images of surgically resected AHNs (n = 7) with those of hepatocellular carcinoma (n = 47). AHNs were divided into two histologic groups: those without atypia (n = 5) and those with atypical hepatocytes or malignant foci (n = 2).

Continuous aortic regurgitation in severely dysfunctional native hearts after heterotopic cardiac transplantation.

Doppler techniques were used to investigate the frequency and characteristics of aortic regurgitation (AR) in the severely deteriorated native heart after heterotopic cardiac transplantation. Ten patients were studied in whom the native left ventricular fractional shortening was less than 6%. AR was detected by Doppler in 6 patients.

Noninvasive diagnosis of coronary artery fistula by Doppler color flow mapping.

Sixteen patients with coronary artery fistula proved by coronary angiography or surgery were studied using two-dimensional echocardiography and Doppler color flow mapping. The coronary artery fistula drained into the right atrium in 4 patients, the right ventricle in 2 and the pulmonary artery in 10. The dilated coronary artery was visualized in 7 of the 16 patients with a fistula, as compared with none of the 40 control subjects.

Intrahepatic periportal abnormal intensity on MR images: an indication of various hepatobiliary diseases.

The frequency and degree of intrahepatic periportal abnormal intensity (PAI) on magnetic resonance images in patients with or without various hepatobiliary and pancreatic diseases were analyzed. In 63 patients without hepatobiliary disease, except for a small metastatic liver tumor or cavernous hemangioma, no definite PAI was seen. Definite PAI was seen in all patients with obstructive jaundice, cholangitis, and cholangiocellular carcinoma.

Temporal resolution of mitral regurgitation in patients with mitral valve prolapse: a phonocardiographic and Doppler echocardiographic study.

To assess the timing and duration of mitral regurgitation in mitral valve prolapse, 20 patients with a mid-systolic click or late systolic murmur, or both (Group 1) and 16 patients with a pansystolic murmur with late systolic accentuation (Group 2) were studied with phonocardiography and echocardiography including various Doppler techniques. The subjects' ages ranged from 15 to 73 years. Mitral valve prolapse with mitral regurgitation was observed in 15 of 20 patients in Group 1 and in all 16 patients in Group 2.

[Doppler techniques in the detection of valvular regurgitation: their value and limitations].

To evaluate the clinical value of various Doppler techniques in detecting valvular regurgitation, we compared the sensitivity, timing and duration of regurgitation, and the peak velocity of regurgitant signals among conventional pulsed Doppler, color Doppler, continuous wave Doppler and HPRF Doppler echocardiography. 1. Sensitivity of Doppler techniques in detecting mitral regurgitation: Among fifty patients with mitral regurgitation confirmed by left ventriculography, mitral regurgitation was detected in 48 (96%) using color Doppler and pulsed Doppler echocardiography; in 41 (82%) by HPRF Doppler; and in 37 (74%) by continuous wave Doppler echocardiography.

[Silent severe tricuspid regurgitation: a study by Doppler echocardiography].

Sixty-eight patients with severe tricuspid regurgitation proven by right ventriculography were examined using pulsed and continuous wave Doppler echocardiography and color Doppler flow imaging. Among the 68 patients, there was no tricuspid regurgitant murmur in 16 (24%) in whom laminar regurgitant flow signals were demonstrated by pulsed Doppler echocardiography. The area in which laminar flow was detected ranged from 8 to 46 mm2 (mean 19.

[Transesophageal echocardiographic findings of mitral valve prolapse].

Transesophageal echocardiography (TEE) is a new approach to the investigation of the heart, at a closer range without interference from lung tissue or ribs. In this study, we evaluated 15 patients with mitral valve prolapse by TEE. All patients had a pansystolic murmur and severe mitral regurgitation by left ventriculography.

[Imaging diagnosis of hepatocellular carcinomas].

With the rapid progress of various imaging methods, including ultrasonography (US), computed tomography. (CT), digital subtraction angiography (DSA) and magnetic resonance imaging (MRI), it has become possible to detect small liver cancer less than 2 cm in diameter, and the prognosis of hepatocellular carcinomas is now improving rapidly. However, the accurate detection of smaller lesions about 1 cm in diameter and their differential diagnosis are difficult by conventional imaging methods such as US, CT and arteriography.

Color Doppler evaluation of valvular regurgitation in normal subjects.

To determine prospectively the prevalence of mitral, aortic, tricuspid, and pulmonary regurgitation in normal persons, 211 consecutive, apparently healthy volunteers were examined with a color Doppler flow imaging system. The subjects were divided into five age groups (group 1, 6-9 years old; group 2, 10-19 years old, group 3, 20-29 years old, group 4, 30-39 years old, and group 5, 40-49 years old). The prevalence rate of mitral regurgitation in the normal subjects was 38-45% in each group.

Fatty metamorphosis in hepatocellular carcinoma: radiologic features in 10 cases.

We describe the sonographic, CT and angiographic findings in 10 cases of hepatocellular carcinoma in which extensive fatty metamorphosis occurred within the tumors. Fatty change was diffuse in smaller tumors (less than 3.5 cm) and focal in larger tumors (greater than 3.

Improved diagnosis and characterization of left ventricular pseudoaneurysm by Doppler color flow imaging.

Three patients with a left ventricular pseudoaneurysm are presented. Doppler color flow imaging helped to establish the diagnosis and was able to show additional blood flow abnormalities. The guided continuous wave Doppler interrogation of the shunting blood flow through the communication between the pseudoaneurysm and the left ventricle allowed the identification of a specific diagnostic flow pattern.

[Color Doppler evaluation of a specific left ventricular flow pattern in a case of left ventricular pseudoaneurysm].

This report describes a case of left ventricular pseudoaneurysm examined by phonocardiography, two-dimensional echocardiography, Doppler color flow mapping, continuous wave and conventional pulsed Doppler echocardiography. The patient had early systolic and early diastolic murmurs. The pseudoaneurysm sac and the site of left ventricular rupture were identified by two-dimensional echocardiography.

Problems in the management of elderly patients with valvular heart disease.

One hundred and nine patients over the age of 65 years with valvular heart disease have been reviewed. Of these, 57 patients were treated medically (medical group) and the remaining 52 patients underwent valve surgery (surgical group). Of the 57 patients who were treated medically, 46 (81%) were in NYHA Functional Class I or II, 7 were in Class III, and 4 were in Class IV.

[Ventricular free wall rupture following acute myocardial infarction: a two-dimensional echocardiographic assessment].

To assess the usefulness of two-dimensional echocardiography (2DE) in diagnosing ventricular free wall rupture following acute myocardial infarction, we studied the 2DE findings and the clinical pictures of seven consecutive patients with ventricular free wall rupture confirmed at the time of surgery or autopsy. Three patients had acute rupture; four, subacute rupture. All patients apparently had circulatory collapse despite continuing electrical activity at the onset of cardiac rupture.

[Time analysis of mitral regurgitation in patients with mitral valve prolapse: a study by phonocardiography and Doppler techniques].

To assess the timing and duration of mitral regurgitation (MR) in patients with mitral valve prolapse (MVP), 20 subjects with mid-systolic click(s) and/or a late systolic murmur were studied using phonocardiography, two-dimensional echocardiography (2DE) and Doppler techniques including pulsed Doppler (PD), high pulse repetition frequency Doppler (HPRF), continuous wave Doppler (CW) and M-mode color Doppler (MD) methods and two-dimensional Doppler color flow mapping (2DD). The results were compared with those of 16 patients with a pansystolic murmur having late systolic accentuation. MVP with MR was observed in 15 of the 20 patients with mid-systolic clicks and/or a late systolic murmur and in all of the 16 patients with a pansystolic murmur.

[Late complications of valve replacement: the benefits of non-invasive assessment].

Non-invasive techniques were assessed for their capabilities of detecting prosthetic valve malfunctions in 70 consecutive patients with angiographically-documented or surgically-proven prosthetic valve dysfunction. Their 74 dysfunctioning valves were studied using phonocardiography, M-mode and two-dimensional echocardiography and Doppler methods, including pulsed and continuous wave (CW) Doppler echocardiography and two-dimensional Doppler color flow mapping (2DD). These results were compared among the examinations, and also compared between 43 patients with 44 dysfunctioning mechanical valves and 27 patients with 30 dysfunctioning bioprosthetic valves.

[A new diagnostic criteria of mitral valve prolapse syndrome].

The diagnosis of mitral valve prolapse (MVP) should depend on the presence of significant mitral regurgitation or mitral complex abnormality as far as MVP is a diseased status. Concerning the echocardiographic diagnosis, the site of prolapse is difficult to determine correctly. In this study, Doppler color flow mapping was used to detect mitral regurgitation, and to decide the site of prolapse.

Focal fatty change of the liver adjacent to the falciform ligament: CT and sonographic findings in five surgically confirmed cases.

Five cases of surgically confirmed focal fatty infiltration of the liver were detected by CT and sonography. In all five cases, the abnormality was located at the anterolateral edge of the medial segment of the liver. It was seen as a small area of low attenuation adjacent to the falciform ligament on CT and as an echogenic area next to the ligamentum teres on sonography.

Age-related valvular regurgitation: a study by pulsed Doppler echocardiography.

To assess the prevalence of valvular regurgitation in the aged, we studied 176 apparently healthy volunteers with no history or physical evidence of cardiac abnormality. Their ages ranged from 40 to 90 (66 +/- 14, mean +/- SD) years. We examined these subjects by pulsed Doppler echocardiography combined with two-dimensional echocardiography to determine the prevalence of valvular regurgitation.