Hostname: page-component-745bb68f8f-kw2vx Total loading time: 0 Render date: 2025-01-15T15:22:29.091Z Has data issue: false hasContentIssue false
  • English
  • Français

3D POWER DOPPLER IN OBSTETRICS

Published online by Cambridge University Press:  03 February 2011

NIA W JONES ,
NICK RAINE-FENNING  and
GEORGE BUGG
NIA W JONES*
Affiliation:
Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus, Nottingham.
NICK RAINE-FENNING
Affiliation:
Division of Human Development, School of Clinical Sciences, University of Nottingham.
GEORGE BUGG
Affiliation:
Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus, Nottingham.
*
Nia Wyn Jones, Obstetrics and Gynaecology Department, Directorate of Family Health, Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus, Derby Road, Nottingham, NG7 2UHUnited Kingdom. Email address: [email protected]
Get access Rights & Permissions [Opens in a new window]

Extract

Flow is defined as the amount of fluid, ordinarily blood, passing per unit time (usually per minute). Perfusion is defined as the volume of blood flowing through a mass of tissue per unit time. The standard measure of perfusion is millilitres of fluid per second per 100 g of tissue (or 100 ml in volume) i.e. the fractional blood volume in an area divided by the mean transit time through the area, where the area is scaled to a 100 ml of tissue. The fractional vascular volume is an index of the physiological vascularity of a region and represents the proportion of tissue occupied by blood. Several ultrasound based techniques have been used in an attempt to quantify perfusion. Vessel dimensions of capillaries and arterioles are below the spatial resolution of even the latest ultrasound machines, and capillary flow is slower than that required to generate a Doppler signal which leads to underestimation of true perfusion. For all ultrasound-based techniques movement artefacts are probably the greatest obstacle to obtain quantitative information on perfusion. This review will discuss the technology and use of the ultrasound mode of three dimensional power Doppler, its benefits and limitations in estimating vascularity focusing on the field of obstetrics.

Type
Research Article
Information
Fetal and Maternal Medicine Review , Volume 22 , Issue 1 , February 2011 , pp. 1 - 24
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1Rubin, J. Flow quantification. Eur Radiol 1999; 9 Suppl 3: S368–371.CrossRefGoogle ScholarPubMed
2Cosgrove, D, Eckersley, R, Blomley, M, Harvey, C. Quantification of blood flow. Eur Radiol 2001; 11: 1338–344.CrossRefGoogle ScholarPubMed
3Sboros, V, Tang, M. The assessment of microvascular flow and tissue perfusion using ultrasound imaging. Proc Inst Mech Eng H 2010; 224: 273–90.CrossRefGoogle ScholarPubMed
4Jansson, T, Persson, H, Lindström, K. Estimation of blood perfusion using ultrasound. Proc Inst Mech Eng [H] 1999; 213: 91–106.CrossRefGoogle ScholarPubMed
5Leotta, D. An efficient calibration method for freehand 3-D ultrasound imaging systems. Ultrasound Med Biol 2004; 30: 999–1008.CrossRefGoogle ScholarPubMed
6Downey, D, Fenster, A, Williams, J. Clinical utility of three-dimensional US. Radiographics 2000; 20: 559–71.CrossRefGoogle ScholarPubMed
7Leotta, D, Detmer, P, Martin, R. Performance of a miniature magnetic position sensor for three-dimensional ultrasound imaging. Ultrasound Med Biol 1997; 23: 597–609.CrossRefGoogle ScholarPubMed
8Prager, R, Rohling, R, Gee, A, Berman, L. Rapid calibration for 3-D freehand ultrasound. Ultrasound Med Biol 1998; 24: 855–69.CrossRefGoogle ScholarPubMed
9Fenster, A, Downey, D. Three-dimensional ultrasound imaging and its use in quantifying organ and pathology volumes. Anal Bioanal Chem 2003; 377: 982–89.CrossRefGoogle ScholarPubMed
10Claudon, M, Tranquart, F, Evans, D, Lefèvre, F, Correas, M. Advances in ultrasound. Eur Radiol 2002; 12: 7–18.CrossRefGoogle ScholarPubMed
11Jedrzejewicz, T. System architecture for various image reconstruction and processing techniques. Eur Radiol 1999; 9 Suppl 3: S334–337.CrossRefGoogle ScholarPubMed
12Fenster, A, Downey, D, Cardinal, H. Three-dimensional ultrasound imaging. Phys Med Biol 2001; 46: R67–99.CrossRefGoogle ScholarPubMed
13Nelson, T, Pretorius, D, Hull, A, Riccabona, M, Sklansky, M, James, G. Sources and impact of artifacts on clinical three-dimensional ultrasound imaging. Ultrasound Obstet Gynecol 2000; 16: 374–83.CrossRefGoogle ScholarPubMed
14Riccabona, M, Nelson, T, Pretorius, D. Three-dimensional ultrasound: accuracy of distance and volume measurements. Ultrasound Obstet Gynecol 1996; 7: 429–34.CrossRefGoogle ScholarPubMed
15Deurloo, K, Spreeuwenberg, M, Rekoert-Hollander, M, van Vugt, J. Reproducibility of 3-dimensional sonographic measurements of fetal and placental volume at gestational ages of 11–18 weeks. J Clin Ultrasound 2007; 35: 125–32.CrossRefGoogle ScholarPubMed
16Kollmann, C, Turetschek, K, Mostbeck, G. Amplitude-coded colour Doppler sonography: physical principles and technique. Eur Radiol 1998; 8: 649–56.CrossRefGoogle ScholarPubMed
17Chen, J, Fowlkes, J, Carson, P, Rubin, J, Adler, R. Autocorrelation of integrated power Doppler signals and its application. Ultrasound Med Biol 1996; 22: 1053–1057.CrossRefGoogle ScholarPubMed
18Wells, P. Ultrasonic colour flow imaging. Phys Med Biol 1994; 39: 2113–145.CrossRefGoogle ScholarPubMed
19Martinoli, C, Derchi, L, Rizzatto, G, Solbiati, L. Power Doppler sonography: general principles, clinical applications, and future prospects. Eur Radiol 1998; 8: 1224–235.CrossRefGoogle ScholarPubMed
20Guo, Z, Fenster, A. Three-dimensional power Doppler imaging: a phantom study to quantify vessel stenosis. Ultrasound Med Biol 1996; 22: 1059–1069.CrossRefGoogle ScholarPubMed
21Rubin, J, Adler, R. Power Doppler expands standard color capability. Diagn Imaging (San Franc) 1993; 15: 66–69.Google ScholarPubMed
22Rubin, J, Adler, R, Fowlkes, J, Spratt, S, Pallister, J, Chen, J et al. Fractional moving blood volume: estimation with power Doppler US. Radiology 1995; 197: 183–90.CrossRefGoogle ScholarPubMed
23Weskott, H. Amplitude Doppler US: slow blood flow detection tested with a flow phantom. Radiology 1997; 202: 125–30.CrossRefGoogle ScholarPubMed
24Evans, D. Colour flow and motion imaging. Proc Inst Mech Eng H 2010; 224: 241–53.CrossRefGoogle ScholarPubMed
25Adler, R. On the relationship between power mode and pressure amplitude decorrelation. Ultrasound Med Biol 2001; 27: 1291–296.CrossRefGoogle ScholarPubMed
26Adler, R, Rubin, J, Fowlkes, J, Carson, P, Pallister, J. Ultrasonic estimation of tissue perfusion: a stochastic approach. Ultrasound Med Biol 1995; 21: 493–500.CrossRefGoogle ScholarPubMed
27Bude, R, Rubin, J. Power Doppler sonography. Radiology 1996; 200: 21–23.CrossRefGoogle ScholarPubMed
28Downey, D, Fenster, A. Vascular imaging with a three-dimensional power Doppler system. AJR Am J Roentgenol 1995; 165: 665–68.CrossRefGoogle ScholarPubMed
29Amso, N, Watermeyer, S, Pugh, N, O'Brien, S, D'Angelo, A. Quantification of power Doppler energy and its future potential. Fertil Steril 2001; 76: 583–87.CrossRefGoogle ScholarPubMed
30Rubin, J, Bude, R, Fowlkes, J, Spratt, R, Carson, P, Adler, R. Normalizing fractional moving blood volume estimates with power Doppler US: defining a stable intravascular point with the cumulative power distribution function. Radiology 1997; 205: 757–65.CrossRefGoogle ScholarPubMed
31Lai, P, Wang, Y, Welsh, A. Reproducibility of regional placental vascularity/perfusion measurement using 3D power Doppler. Ultrasound Obstet Gynecol 2010; 36: 202–209.CrossRefGoogle ScholarPubMed
32Rubin, J, Bude, R, Carson, P, Bree, R, Adler, R. Power Doppler US: a potentially useful alternative to mean frequency-based color Doppler US. Radiology 1994; 190: 853–56.CrossRefGoogle Scholar
33Bude, R, Rubin, J, Adler, R. Power versus conventional color Doppler sonography: comparison in the depiction of normal intrarenal vasculature. Radiology 1994; 192: 777–80.CrossRefGoogle ScholarPubMed
34Rubin, J. Power Doppler. Eur Radiol 1999; 9 Suppl 3: S318–322.CrossRefGoogle ScholarPubMed
35Rubens, D, Bhatt, S, Nedelka, S, Cullinan, J. Doppler artifacts and pitfalls. Radiol Clin North Am 2006; 44: 805–35.CrossRefGoogle ScholarPubMed
36Welsh, A. Quantification of power Doppler and the index ‘fractional moving blood volume’ (FMBV). Ultrasound Obstet Gynecol 2004; 23: 323–26.CrossRefGoogle ScholarPubMed
37Dymling, S, Persson, H, Hertz, C. Measurement of blood perfusion in tissue using Doppler ultrasound. Ultrasound Med Biol 1991; 17: 433–44.CrossRefGoogle ScholarPubMed
38Pairleitner, H, Steiner, H, Hasenoehrl, G, Staudach, A. Three-dimensional power Doppler sonography: imaging and quantifying blood flow and vascularization. Ultrasound Obstet Gynecol 1999; 14: 139–43.CrossRefGoogle ScholarPubMed
39Guimarães Filho, H, da Costa, L, Araújo Júnior, E, Nardozza, L, Nowak, P, Moron, A et al. Placenta: angiogenesis and vascular assessment through three-dimensional power Doppler ultrasonography. Arch Gynecol Obstet 2008; 277: 195–200.CrossRefGoogle ScholarPubMed
40Alcázar, J. Three-dimensional power Doppler derived vascular indices: what are we measuring and how are we doing it? Ultrasound Obstet Gynecol 2008; 32: 485–87.CrossRefGoogle Scholar
41Raine-Fenning, N, Campbell, B, Clewes, J, Kendall, N, Johnson, I. The reliability of virtual organ computer-aided analysis (VOCAL) for the semiquantification of ovarian, endometrial and subendometrial perfusion. Ultrasound Obstet Gynecol 2003; 22: 633–639.CrossRefGoogle ScholarPubMed
42Preidler, K, Szolar, D, Uggowitzer, M, Stiskal, M, Horina, J. Technical note: comparison of colour Doppler energy sonography with conventional colour Doppler sonography in detection of flow signal in peripheral renal transplant vessels. Br J Radiol 1995; 68: 1103–105.CrossRefGoogle ScholarPubMed
43Hernandez-Andrade, E, Jansson, T, Ley, D, Bellander, M, Persson, M, Lingman, G et al. Validation of fractional moving blood volume measurement with power Doppler ultrasound in an experimental sheep model. Ultrasound Obstet Gynecol 2004; 23: 363–368.CrossRefGoogle Scholar
44Jansson, T, Hernandez-Andrade, E, Lingman, G, Marsál, K. Estimation of fractional moving blood volume in fetal lung using Power Doppler ultrasound, methodological aspects. Ultrasound Med Biol 2003; 29: 1551–559.CrossRefGoogle ScholarPubMed
45Hernandez-Andrade, E, Thuring-Jönsson, A, Jansson, T, Lingman, G, Marsál, K. Fractional moving blood volume estimation in the fetal lung using power Doppler ultrasound: a reproducibility study. Ultrasound Obstet Gynecol 2004; 23: 369–73.CrossRefGoogle ScholarPubMed
46Newman, J, Adler, R, Rubin, J. Power Doppler sonography: use in measuring alterations in muscle blood volume after exercise. AJR Am J Roentgenol 1997; 168: 1525–1530.CrossRefGoogle ScholarPubMed
47Schneider, H, Panigel, M, Dancis, J. Transfer across the perfused human placenta of antipyrine, sodium and leucine. Am J Obstet Gynecol 1972; 114: 822–28.CrossRefGoogle ScholarPubMed
48Schulten-Wijman, M, Struijk, P, Brezinka, C, De Jong, N, Steegers, E. Evaluation of volume vascularization index and flow index: a phantom study. Ultrasound Obstet Gynecol 2008; 32: 560–64.CrossRefGoogle ScholarPubMed
49Fraser, K, Poepping, T, McNeilly, A, Megson, I, Hoskins, P. Acoustic speed and attenuation coefficient in sheep aorta measured at 5–9 MHz. Ultrasound Med Biol 2006; 32: 971–80.CrossRefGoogle ScholarPubMed
50Dabrowski, W, Dunmore-Buyze, J, Cardinal, H, Fenster, A. A real vessel phantom for flow imaging: 3-D Doppler ultrasound of steady flow. Ultrasound Med Biol 2001; 27: 135–41.CrossRefGoogle ScholarPubMed
51Veltmann, C, Lohmaier, S, Schlosser, T, Shai, S, Ehlgen, A, Pohl, C et al. On the design of a capillary flow phantom for the evaluation of ultrasound contrast agents at very low flow velocities. Ultrasound Med Biol 2002; 28: 625–34.CrossRefGoogle ScholarPubMed
52Ramnarine, K, Anderson, T, Hoskins, P. Construction and geometric stability of physiological flow rate wall-less stenosis phantoms. Ultrasound Med Biol 2001; 27: 245–50.CrossRefGoogle ScholarPubMed
53Bührer, A, Moser, U, Schumacher, P, Pasch, T, Anliker, M. Subtraction procedure for the registration of tissue perfusion with Doppler ultrasound. Ultrasound Med Biol 1996; 22: 651–58.CrossRefGoogle ScholarPubMed
54Hindle, A, Perkins, A. A perfusion phantom for the evaluation of ultrasound contrast agents. Ultrasound Med Biol 1994; 20: 309–14.CrossRefGoogle ScholarPubMed
55Chen, N, Fowlkes, J, Carson, P, Schipper, M, LeCarpentier, G. Rapid 3-D imaging of contrast flow: application in a perfused kidney phantom. Ultrasound Med Biol 2009; 35: 813–28.CrossRefGoogle Scholar
56Jones, N, Hutchinson, E, Brownbill, P, Crocker, I, Eccles, D, Bugg, G et al. In vitro dual perfusion of human placental lobules as a flow phantom to investigate the relationship between fetoplacental flow and quantitative 3D power Doppler angiography. Placenta 2009; 30: 130–35.CrossRefGoogle ScholarPubMed
57Abramowicz, J, Phillips, D, Jessee, L, Levene, H, Parker, K, Miller, R. Sonographic investigation of flow patterns in the perfused human placenta and their modulation by vasoactive agents with enhanced visualization by the ultrasound contrast agent Albunex. J Clin Ultrasound 1999; 27: 513–22.3.0.CO;2-A>CrossRefGoogle ScholarPubMed
58Raine-Fenning, N, Nordin, N, Ramnarine, K, Campbell, B, Clewes, J, Perkins, A et al. Determining the relationship between three-dimensional power Doppler data and true blood flow characteristics: an in-vitro flow phantom experiment. Ultrasound Obstet Gynecol 2008; 32: 540–50.CrossRefGoogle ScholarPubMed
59Dubiel, M, Hammid, A, Breborowicz, A, Pietryga, M, Sladkevicius, P, Olofsson, P et al. Flow index evaluation of 3-D volume flow images: an in vivo and in vitro study. Ultrasound Med Biol 2006; 32: 665–71.CrossRefGoogle ScholarPubMed
60Raine-Fenning, N, Nordin, N, Ramnarine, K, Campbell, B, Clewes, J, Perkins, A et al. Evaluation of the effect of machine settings on quantitative three-dimensional power Doppler angiography: an in-vitro flow phantom experiment. Ultrasound Obstet Gynecol 2008; 32: 551–59.CrossRefGoogle ScholarPubMed
61Morel, O, Pachy, F, Chavatte-Palmer, P, Bonneau, M, Gayat, E, Laigre, P et al. Correlation between utero-placental three-dimensional power Doppler indices and the uterine real blood flow: Evaluation in a pregnant sheep experimental model. Ultrasound Obstet Gynecol 2010; July (epub ahead of print)CrossRefGoogle Scholar
62Campbell, S. Placental vasculature as visualized by 3D power Doppler angiography and 3D color Doppler imaging. Ultrasound Obstet Gynecol 2007; 30: 917–20.CrossRefGoogle ScholarPubMed
63Pretorius, D, Nelson, T, Baergen, R, Pai, E, Cantrell, C. Imaging of placental vasculature using three-dimensional ultrasound and color power Doppler: a preliminary study. Ultrasound Obstet Gynecol 1998; 12: 45–49.CrossRefGoogle ScholarPubMed
64Kingdom, J, Huppertz, B, Seaward, G, Kaufmann, P. Development of the placental villous tree and its consequences for fetal growth. Eur J Obstet Gynecol Reprod Biol 2000; 92: 35–43.CrossRefGoogle ScholarPubMed
65Macara, L, Kingdom, J, Kaufmann, P, Kohnen, G, Hair, J, More, I et al. Structural analysis of placental terminal villi from growth-restricted pregnancies with abnormal umbilical artery Doppler waveforms. Placenta 1996; 17: 37–48.CrossRefGoogle ScholarPubMed
66Guimarães Filho, H, Mattar, R, Araujo Júnior, E, da Costa, L, de Mello Junior, C, Nardozza, L et al. Reproducibility of three-dimensional power Doppler placental vascular indices in pregnancies between 26 and 35 weeks. Arch Gynecol Obstet 2010; January (epub ahead of print).CrossRefGoogle Scholar
67Merce, L, Barco, M, Bau, S, Kupesic, S, Kurjak, A. Assessment of placental vascularization by three-dimensional power Doppler “vascular biopsy” in normal pregnancies. Croat Med J 2005; 46: 765–71.Google Scholar
68Mercé, L, Barco, M, Bau, S. Reproducibility of the study of placental vascularization by three-dimensional power Doppler. J Perinat Med 2004; 32: 228–33.CrossRefGoogle Scholar
69Guiot, C, Gaglioti, P, Oberto, M, Piccoli, E, Rosato, R, Todros, T. Is three-dimensional power Doppler ultrasound useful in the assessment of placental perfusion in normal and growth-restricted pregnancies? Ultrasound Obstet Gynecol 2008; 31: 171–76.CrossRefGoogle ScholarPubMed
70Raine-Fenning, N, Welsh, A, Jones, N, Bugg, G. Methodological considerations for the correct application of quantitative three-dimensional power Doppler angiography. Ultrasound Obstet Gynecol 2008; 32: 115–17; author reply 117–118.CrossRefGoogle ScholarPubMed
71Noguchi, J, Hata, K, Tanaka, H, Hata, T. Placental vascular sonobiopsy using three-dimensional power Doppler ultrasound in normal and growth restricted fetuses. Placenta 2009; 30: 391–97.CrossRefGoogle ScholarPubMed
72Yu, C, Chang, C, Ko, H, Chen, W, Chang, F. Assessment of placental fractional moving blood volume using quantitative three-dimensional power doppler ultrasound. Ultrasound Med Biol 2003; 29: 19–23.CrossRefGoogle ScholarPubMed
73Lai, P, Wang, Y, Welsh, A. Assessment of the reproducibility of regional placental vascularity/perfusion measurement using 3D power Doppler. Ultrasound Obstet Gynecol 2010; 36: 202–209.CrossRefGoogle ScholarPubMed
74de Paula, C, Ruano, R, Campos, J, Zugaib, M. Quantitative analysis of placental vasculature by three-dimensional power Doppler ultrasonography in normal pregnancies from 12 to 40 weeks of gestation. Placenta 2009; 30: 142–48.CrossRefGoogle ScholarPubMed
75Zalud, I, Shaha, S. Evaluation of the utero-placental circulation by three-dimensional Doppler ultrasound in the second trimester of normal pregnancy. J Matern Fetal Neonatal Med 2007; 20: 299–305.CrossRefGoogle ScholarPubMed
76Jones, N, Raine-Fenning, N, Mousa, H, Bradley, E, Bugg, G. Evaluation of the intraobserver and interobserver reliability of data acquisition for three-dimensional power Doppler angiography of the whole placenta at 12 weeks gestation. Ultrasound Med Biol 2010; 36: 1405–411.CrossRefGoogle ScholarPubMed
77Tuuli, M, Houser, M, Odibo, L, Huster, K, Macones, G, Odibo, A. Validation of placental vascular sonobiopsy for obtaining representative placental vascular indices by three-dimensional power Doppler ultrasonography. Placenta 2010; 31: 192–96.CrossRefGoogle ScholarPubMed
78Negrini, R, de Silva Bussamra, L, da Silva, Valladão, de Freitas, L, Araujo Júnior, E, Piato, S, Nardozza, L et al. Assessment of placental blood flow between 22 and 34 weeks of gestation by 3D-sonography power Doppler vascular indices. Arch Gynecol Obstet 2010; July (epub ahead of print).CrossRefGoogle Scholar
79Costa, J, Rice, H, Cardwell, C, Hunter, A, Ong, S. An assessment of vascularity and flow intensity of the placenta in normal pregnancy and pre-eclampsia using three-dimensional ultrasound. J Matern Fetal Neonatal Med 2010; 23: 894–99.CrossRefGoogle ScholarPubMed
80Rizzo, G, Capponi, A, Pietrolucci, M, Arduini, D. Effects of maternal cigarette smoking on placental volume and vascularization measured by 3-dimensional power Doppler ultrasonography at 11+0 to 13+6 weeks of gestation. Am J Obstet Gynecol 2009; 200: 415.e411–415.CrossRefGoogle ScholarPubMed
81Rizzo, G, Capponi, A, Cavicchioni, O, Vendola, M, Arduini, D. Placental vascularization measured by three-dimensional power Doppler ultrasound at 11 to 13 + 6 weeks’ gestation in normal and aneuploid fetuses. Ultrasound Obstet Gynecol 2007; 30: 259–62.CrossRefGoogle ScholarPubMed
82Zalud, I, Shaha, S. Three-dimensional sonography of the placental and uterine spiral vasculature: Influence of maternal age and parity. J Clin Ultrasound 2008; 36: 391–96.CrossRefGoogle ScholarPubMed
83Sellers López, F, Orozco-Beltran, D, Gil-Guillen, V, Lozano, J, Palacios, A, Bernabeu, R. Analysis of placental vascularization by means of 3D power doppler in women pregnant following oocyte donation. Reprod Sci 2010; 17: 754–59.CrossRefGoogle ScholarPubMed
84Shih, J, Palacios Jaraquemada, J, Su, Y, Shyu, M, Lin, C, Lin, S et al. Role of three-dimensional power Doppler in the antenatal diagnosis of placenta accreta: comparison with gray-scale and color Doppler techniques. Ultrasound Obstet Gynecol 2009; 33: 193–203.CrossRefGoogle ScholarPubMed
85Dubiel, M, Breborowicz, G, Ropacka, M, Pietryga, M, Maulik, D, Gudmundsson, S. Computer analysis of three-dimensional power angiography images of foetal cerebral, lung and placental circulation in normal and high-risk pregnancy. Ultrasound Med Biol 2005; 31: 321–27.CrossRefGoogle ScholarPubMed
86Dubiel, M, Kozber, H, Debniak, B, Breborowicz, G, Marsal, K, Gudmundsson, S. Fetal and placental power Doppler imaging in normal and high-risk pregnancy. Eur J Ultrasound 1999; 9: 223–230.CrossRefGoogle ScholarPubMed
87Bartha, J, Moya, E, Hervías-Vivancos, B. Three-dimensional power Doppler analysis of cerebral circulation in normal and growth-restricted fetuses. J Cereb Blood Flow Metab 2009; 29: 1609–618.CrossRefGoogle ScholarPubMed