RESUMEN
We describe the color Doppler sonographic features of uterine arteriovenous malformations in two cases. In both cases color Doppler imaging demonstrated hypervascularity throughout the arteriovenous malformation. The dominance of pale shades during both systole and diastole represented low-impedance, high-velocity flow within the lesion and a colored mosaic pattern representing turbulent flow was noted. Spectral analysis of the vessels within the lesion confirmed high-velocity flow during both systole and diastole, and a low resistance index. The spectral waveform trace also showed spectral broadening consistent with turbulence and the spectral envelope was irregular. These findings indicated the presence of numerous arteriovenous shunts and marked turbulence within the arteriovenous malformation. Spectral analysis of the venous flow revealed high flow velocities and systolic velocity peaks similar to an arterial pattern. The uterine artery velocity waveforms were characterized by high flow velocity and a low resistance index. The diagnosis of uterine arteriovenous malformation was confirmed by histological examination in both cases. The findings of these two cases suggest that color Doppler sonography may play an important role in the diagnosis of uterine arteriovenous malformations.
Asunto(s)
Malformaciones Arteriovenosas/diagnóstico por imagen , Ultrasonografía Doppler en Color , Útero/irrigación sanguínea , Adulto , Malformaciones Arteriovenosas/diagnóstico , Malformaciones Arteriovenosas/cirugía , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Arteria Ilíaca/anomalías , Arteria Ilíaca/diagnóstico por imagen , Flujo Sanguíneo Regional , Sensibilidad y Especificidad , Hemorragia Uterina/diagnóstico por imagen , Hemorragia Uterina/etiología , Útero/anomalías , Útero/diagnóstico por imagenRESUMEN
OBJECTIVE: To define the light microscopic cytologic changes due to chemotherapy (CT) and/or radiotherapy (RT); to evaluate the differentiation of those changes according to treatment; to find out whether a relation exists between treatment type and its duration and the cytologic findings; and to determine the role of sputum cytology in evaluating efficacy of treatment and follow-up in patients with inoperable lung cancer of various histology. STUDY DESIGN: A total of 1,605 periodic sputum samples from 80 cases of lung cancer obtained during treatment and follow-up were prospectively examined cytologically. The relationship of treatment type and duration to qualitative and semiquantitative data and the definability of the response to treatment as well as the relationship of progression-free survival (PFS) and total survival (TS) rates with cytologic data were evaluated. RESULTS: The majority of therapy-induced cellular changes were in the nucleus and were directly related to the duration of treatment. An increase in minimally affected tumor cells, tumor cells that lost their pathologic features and necrotic cell debris were good indicators of therapeutic efficacy. Cytologic changes did not reflect PFS and TS rates. CONCLUSION: Although light microscopic cytologic changes cannot be attributed objectively to either RT or CT, therapeutic efficacy is shown in follow-up sputum cytology, which can be used in monitoring and planning additional therapy or other therapeutic options in lung cancer patients.