title: Three-dimensional power Doppler transanal ultrasonography, to monitor haemorrhoidal blood flow after Doppler-guided ALTA sclerosing therapy.
abstract: OBJECTIVE
  The study aimed to use power Doppler imaging (PDI) transanal ultrasonography to produce three-dimensional power Doppler angiography images of haemorrhoidal tissue and to monitor the effects of Doppler-guided aluminium potassium sulfate and tannic acid (DGALTA) sclerotherapy.
  
  
  METHODS
  Ninety-six haemorrhoids in 43 patients were examined using PDI transanal ultrasonography, and DGALTA sclerotherapy was performed from April 2011 to April 2012. DGALTA sclerotherapy was conducted using a four-step injection process with pulse wave Doppler ultrasound under perianal local anaesthesia.
  
  
  RESULTS
  A three-dimensional power Doppler angiography image of the blood flow in haemorrhoidal tissue was produced using PDI transanal ultrasonography. The cross-sectional area of blood flow in the haemorrhoidal tissue (PDI area) significantly decreased after DGALTA sclerotherapy. The PDI areas in the preoperative state and 1 and 3 months after treatment were 0.35±0.27, 0.03±0.05 and 0.04±0.05 cm(2) (P<0.0001).
  
  
  CONCLUSIONS
  A three-dimensional power Doppler angiography image of the haemorrhoidal tissue was technically possible and showed blood flow in the haemorrhoidal tissue to be significantly decreased after DGALTA sclerotherapy.
authors.affiliation: Department of Proctologic Surgery, Miyamoto Hospital, Tokushima, Japan. hnna@diamond.nmt.ne.jp
authors.forename: H
authors.initials: H
authors.lastname: Miyamoto
authors.forename: M
authors.initials: M
authors.lastname: Asanoma
authors.forename: H
authors.initials: H
authors.lastname: Miyamoto
authors.forename: C
authors.initials: C
authors.lastname: Takasu
authors.forename: M
authors.initials: M
authors.lastname: Shimada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D061865:Hemorrhoidectomy / Q000295:instrumentation* / Q000379:methods; D006484:Hemorrhoids / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery; D012597:Sclerosing Solutions; D015911:Sclerotherapy / Q000295:instrumentation* / Q000379:methods; D018608:Ultrasonography, Doppler / Q000379:methods*
chemical_list: D012597:Sclerosing Solutions