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Hina Shabbir University Institute of Radiological Sciences and Medical Imaging Technology, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan

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Zareen Fatima University Institute of Radiological Sciences and Medical Imaging Technology, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan

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Abdul Wahab University Institute of Radiological Sciences and Medical Imaging Technology, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan

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Kashif Azeem Zafar Department of Radiology, Tehsil Headquarters Hospital, Hasilpur, Pakistan

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Muhammad Ansar University Institute of Radiological Sciences and Medical Imaging Technology, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan

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Mahrukh Latif University Institute of Radiological Sciences and Medical Imaging Technology, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan

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Sabar Butt Sabari Ultrasound Training Institute Faisalabad, Pakistan
Department of Radiology, The University of Faisalabad, Faisalabad, Pakistan

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Open access

Abstract

Objective

Corpus luteum is a transient structure which plays an important role by producing crucial hormones required for conception and pregnancy maintenance. The objective of this study was to compare grey scale morphological appearances and Doppler indices of corpus luteum in normal and abnormal pregnancies during first trimester.

Methodology

A comparative study was carried out after getting approval from Institutional Research Ethical Committee. A total of 156 pregnant women, 78 with normal and abnormal pregnancies each, with gestational age between 5 and 8 weeks were included in the study. Out of the abnormal pregnancies 52 (66.66%) were cases of threatened while 26 (33.33%) had missed abortion. Transvaginal ultrasound was used to assess the corpus luteum on gray scale and Doppler ultrasound.

Results

There was no significant difference between gray-scale sonographic appearances of normal and cases of missed and threatened abortion on Chi-square test. However, PI, RI and SD ratio showed significant difference between normal and cases of missed and threatened abortion on Kruskal- Wallis test.

Conclusion

Doppler indices recorded from the vasculature of corpus luteum can serve as an important indicator of the pregnancy outcome during early pregnancy.

Abstract

Objective

Corpus luteum is a transient structure which plays an important role by producing crucial hormones required for conception and pregnancy maintenance. The objective of this study was to compare grey scale morphological appearances and Doppler indices of corpus luteum in normal and abnormal pregnancies during first trimester.

Methodology

A comparative study was carried out after getting approval from Institutional Research Ethical Committee. A total of 156 pregnant women, 78 with normal and abnormal pregnancies each, with gestational age between 5 and 8 weeks were included in the study. Out of the abnormal pregnancies 52 (66.66%) were cases of threatened while 26 (33.33%) had missed abortion. Transvaginal ultrasound was used to assess the corpus luteum on gray scale and Doppler ultrasound.

Results

There was no significant difference between gray-scale sonographic appearances of normal and cases of missed and threatened abortion on Chi-square test. However, PI, RI and SD ratio showed significant difference between normal and cases of missed and threatened abortion on Kruskal- Wallis test.

Conclusion

Doppler indices recorded from the vasculature of corpus luteum can serve as an important indicator of the pregnancy outcome during early pregnancy.

Introduction

Pregnancy involves not only anatomical but also a myriad of intricate molecular and cellular changes in the maternal body to support this complex physiological process from implantation to the development and growth of the fetus [1]. The corpus luteum is a temporary endocrine structure that develops in the ovary after release of a mature ovum. It plays a crucial role in early pregnancy by keeping the uterine environment favorable for conception, placentation and preservation of pregnancy until the placenta takes over this function. The structural and functional integrity of it, therefore is of paramount importance during the early stages of pregnancy [1–4].

The first trimester of pregnancy is a considered as a very critical period as it is characterized by rapid embryonic growth and organogenesis. Any deviations in the cascade of normal physiological events taking place during this stage can lead to serious complications, including abortions and anembryonic pregnancies. Although fetal chromosomal abnormalities or increasing maternal age have been described as the major risk factors of early spontaneous abortions, it is not uncommon to attribute such adverse event to the corpus luteum insufficiency also known as luteal phase defect [1, 5].

Obstetrical sonographic evaluation has emerged as a valuable tool providing detailed insights into the early stages of pregnancy beside clinical evaluation and biochemical markers which have traditionally been used to assess the viability of pregnancies. This study aimed to compare sonographic characteristics between normal and abnormal pregnancies. There have been a few studies on the topic with contentious findings as some reporting significant differences [6, 7] in sonographic characteristics between normal and abnormal pregnancies while the results of the others suggesting vice versa [8–10]. This study was therefore planned with an intention to reconfirm these controversial findings. Understanding these sonographic differences could provide valuable insights into the early detection and prediction of adverse pregnancy outcomes, allowing for timely clinical interventions and improved patient care.

Materials and methods

Ethical considerations and subject details

A prospective study was carried out after getting approval from Institutional Research Ethical Committee. A total of 156 pregnant women, 78 with normal and abnormal pregnancies each, with gestational age between 5 and 8 weeks were included in the study. Out of the abnormal pregnancies 52 (66.66%) were cases of threatened while 26 (33.33%) had missed abortion. The mean ± SD and range of age of the included patients were 27.20 ± 5.11 and 17–40 years. Similarly, mean ± SD and range of gestational age were 7.89 ± 1.30 and 5–10 weeks. Out of 52 cases of threatened abortion, 33 pregnancies (63.5%) survived, while 19 pregnancies (36.5%) ultimately resulted in abortion. Multiple and molar pregnancies and those with uterine fibroids or other anatomical variations were excluded from the study. All of the included pregnancies were spontaneously conceived and none of them had any history of pelvic surgery.

Sonographic imaging

Aplio 500 Platinum series ultrasound system (Canon Medical Systems Corporation, Ōtawara, Tochigi, Japan) with Doppler features was used to scan the participants. All pregnant women were examined with an empty bladder in the lithotomy position. The transvaginal ultrasound probe (Toshiba PVT- 675 MV Transducer 2.8–7.2 MHz) was gently introduced into the vagina. Routine first trimester obstetrical ultrasound was carried out using the grayscale mode. The gestational age was determined using gestational sac mean diameter (average of the three orthogonal measurements of the gestational sac) or crown rump length. Corpus luteum was then identified and characterized on the basis of appearances described by Durfee et al. [11] either as a simple thin-walled anechoic cyst, thick-walled anechoic cyst with or without internal echoes or as a hypoechoic to isoechoic region in any of the ovaries. Color and spectral Doppler were then used to identify the vascular pattern around it. The sampling gate was placed at the most vivid of the vessels in the ring of fire around corpus luteum to measure Pulsatility Index (PI), Resistive Index (RI) and Systolic to Diastolic (SD) ratio after acquiring more than three consecutive spectra (Fig. 1). Three measurements were recorded for each parameter and average value was then used as representative value.

Fig. 1.
Fig. 1.

Doppler indices were acquired by placing the sample gate in the vessel around corpus luteum in the right ovary of a woman with normal viable pregnancy of 8 weeks

Citation: Imaging 2024; 10.1556/1647.2024.00206

Statistical analysis

MedCalc v22.013 was used for data analysis. Chi- Square test was used to compare sonographic appearances and laterality between the women having normal pregnancy and those with threatened and missed abortion. Kruskal- Wallis test was used to compare PI, RI, SD ratio. Receiver operating characteristic (ROC) curve analysis was also performed to find out the cut-off values of these indices between normal and each of these groups separately.

Results

Corpus luteum was present in all of the normal pregnancies and in 55 of 78 (70.5%) abnormal pregnancies. It wasn't seen in the remaining 23 (29.5%) cases with abnormal pregnancy of which 7 (9%) were of missed while 16 (20.5%) were of threatened abortion. On sonographic assessment, 49 (62.8%) of the normal viable pregnancies it appeared as thick-walled cysts with anechoic center either without (n = 34) or with internal echoes (n = 15), followed by simple cystic or hypoechoic appearances in 17 (21.8%) and 12 (15.4%) cases respectively. There was no significant difference between sonographic appearances of normal with cases of missed and threatened abortion. The details of the sonographic characteristics in each category of subjects are shown in Table 1. PI, RI and SD ratio showed significant difference between normal and cases of missed and threatened abortion (Table 2). On ROC curve analysis PI, RI and SD ratio showed cut-off values of 0.58, 0.49, and 1.9 with P values of <0.0001, 0.002 and 0.006 respectively between normal and missed abortion. The cut – off values in the same order of indices for normal pregnancies and threatened abortion were 0.6, 0.47 and 1.9 with P values of <0.0001 each. See Fig. 2 and Table 3 for the details of ROC analysis.

Table 1.

Sonographic appearances of corpus luteum in normal (n = 78) and abnormal pregnancies

CharacteristicsNormal pregnancyMissedThreatened
PresencePresent78 (100%)19 (73.1%)36 (69.2%)
Absent07 (26.9%)16 (30.8%)
SideLeft45 (57.7%)9 (47.4)26 (72.2%)
Right33 (42.3%)10 (52.6%)10 (27.8)
AppearanceThick- walled cyst49 (62.8%)10 (52.6%)14 (42.4%)
Hypoechoic12 (15.4%)7 (36.8%)14 (42.4%)
Simple cyst17 (21.8 %)2 (10.5%)5 (15.2 %)
Table 2.

Comparison of Doppler indices in the vasculature of the corpus luteum between normal (n = 78) and abnormal pregnancies having missed (n = 19) and threatened abortion (n = 36)

Doppler indexRangeMedianP value
Pulsatility Index (PI)Normal0.09–0.800.55<0.000001*
Missed0.55–1.500.74
Threatened0.20–1.580.68
Resistive Index (RI)Normal0.11–0.670.43<0.000001*
Missed0.38–1.000.55
Threatened0.36–1.100.57
Systolic to Diastolic (SD) RatioNormal0–3.031.700.000003*
Missed0–2.802.00
Threatened0–4.801.99
Fig. 2.
Fig. 2.

Figure shows Areas Under Curve for Pulsatility index between normal pregnancies and cases of missed abortion (A) and threatened abortion (D), for Resistive Index between normal pregnancies and cases of missed abortion (B) and threatened abortion (E) and for SD ratio between normal pregnancies and cases of missed abortion (C) and threatened abortion (F)

Citation: Imaging 2024; 10.1556/1647.2024.00206

Table 3.

Findings of Receiver operating characteristic (ROC) curve analysis

Doppler indexAUC95% CICut-off valueSensitivitySpecificityP value
Normal and MissedPI0.920.85–0.960.5884.287.2<0.0001*
RI0.740.64–0.820.4957.996.20.002*
SD Ratio0.720.62–0.811.957.997.40.006*
Normal and ThreatenedPI0.830.75–0.890.672.291.0<0.0001*
RI0.880.80–0.930.4783.385.9<0.0001*
SD Ratio0.770.68–0.841.958.397.4<0.0001*

Additionally, it was observed that the corpus luteum was absent in 12 (63.2%) out of 19 threatened abortion cases that ultimately did not survive, in contrast to only 4 (12.1%) out of 33 cases that remained viable. The seven remaining non-viable cases, which showed the presence of the corpus luteum, had even higher values of RI (mean = 0.87 vs 0.54) and PI (mean = 0.99 vs 0.71) compared to those in pregnancies that survived.

Discussion

Spontaneous abortions are not very uncommon occurrence with frequency of early pregnancy spontaneous abortions to be up to 15% of known and as high as 30% of the clinically recognized pregnancies [7]. in this study, we sought to discover sonographic and Doppler features of the CL that could be linked to first-trimester spontaneous pregnancy loss. Presence, echogenic characteristics as well as Doppler indices of the corpus luteum were evaluated and compared in both normal and abnormal pregnancies.

Absence of CL in 29.5% of the abnormal pregnancies on the contrary to its presence in 100% of the viable pregnancies was one of the salient features in or study. The finding was in agreement with Nafea et al. [12] who reported presence of CL in all of their controls and absence in 21.4 % of their cases of threatened abortion which later on, upon follow up actually ended up in loss of pregnancy. They did not included cases of missed abortion in their study. Glock et al. [13] also found that five of six (83%) women in their study in whom a corpus luteum was sonographically undetectable resulted in termination of pregnancy.

Rowan K et al. [14] observed that the CL was more common (56%) on the right side. This was in contrast to our study as we noted to be more common on the left side both in normal and abnormal pregnancies without any significant difference in laterality in both of these groups. The frequency of sonographic appearances of the CL we found in our study in normal and in cases of missed abortion are in agreement with Gupta et al. [15] who also reported CL as a thick-walled cyst to be the most frequent appearance. They however found simple cystic appearance only in 12.82 % of the cases in contrast to our study where it was the second most common appearance found in 21.8 % of all the normal pregnancies. They did not report the statistical comparison of these appearances between the two groups. Cases of threatened abortion were not included in their study. Durfee et al. [11] on the other hand found hypoechoic appearance in 34% followed by thick-walled appearance in 27% of the normal viable pregnancies. In short there is no consensus on what is the most common normal sonographic appearance in all of the reported studies or could these predict the viability of pregnancy or not till date. The reason might be explained by the findings of Glock et al. [12], which suggested that the appearance of the CL either cystic or partially cystic did not affect plasma progesterone or 17-hydroxyprogesterone levels nor was predictive of the pregnancy outcome.

In the absence of any remarkable demarcation of the grey-scale features between normal and abnormal pregnancies the Doppler indices (RI, PI and EDV) recorded from the vascular ring around CL were significantly different in normal viable pregnancies than those in cases of both missed and threatened abortion in our study. These findings are in agreement with most of the previously available reports [710, 12, 15] In addition even higher values of RI and PI in cases of aborted cases compared to continued ones are also in agreement with the results of Abd-elfatah et al. [16] Alcazar et al. [17] also compared RI and found increased blood flow impedance in cases of missed abortion but not in threatened abortion and anembryonic pregnancy compared to normal pregnancies used as control. Despite reports of a few other researchers suggesting no significant association between the Doppler flow parameters and poor early pregnancy outcomes [8, 9] it is widely accepted that the rapid growth of blood vessels across the basement membrane between theca and granulosa layers is essential to sustain development and functioning of the CL [6, 18] In other words, adequate perfusion of CL is required for maintaining the serum progesterone levels and thus for viability of the pregnancy. CL gets highest perfusion per unit tissue than any other organ, even accounting for more than 20% of its total volume. It allows it to obtain enough oxygen, nutrients, and hormone precursors necessary to synthesize and release large amounts of progesterone [7, 19, 20].

Small sample size and cross-sectional study design were the limitations of our study. A longitudinal study design with follow up of the subjects included in the normal pregnancy group could have confirmed the preservation of pregnancy afterwards. Additionally, the failure to acquire and incorporate information about genetic testing and hormonal profiles with the sonographic appearances was another limitation; the presence of such information could have added a lot to this study.

However, the findings of study lead us to conclude that the first trimester adverse pregnancy outcomes are associated with differences in blood flow Doppler characteristics of corpus luteum. It is therefore recommended that corpus luteum should be evaluated at least for high-risk pregnancies in first trimester sonography as a routine.

Authors Contribution

Hina Shabbir: Data Collection, manuscript writing; Zareen Fatima: Project development, manuscript writing, data analysis; Abdul Wahab: Data Collection, manuscript writing; Kashif Azeem Zafar: Data Collection; Muhammad Ansar: Manuscript writing; Mahrukh Latif: Manuscript writing; Sabar Butt: Manuscript review.

Funding Resources

No funding disclosure has to be made.

Ethical Statement

The study was carried out after ethical approval from Institutional Research Ethical Committee of The University of Lahore under reference number Ref No: REC-UOL-/120-05/2022. Written informed consents were acquired from all of the participants.

Conflict of Interest

Authors declare no conflicts of interest.

References

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    Shah D, Nagarajan N: Luteal insufficiency in first trimester. Indian Journal of Endocrinology and Metabolism 2013; 17(1): 4449.

  • [2]

    Parsons AK: Imaging the human corpus luteum. J Ultrasound Med 2001; 20(8): 811819.

  • [3]

    Yoshimi T, Strott CA, Marshall JR, Lipsett MB: Corpus luteum function in early pregnancy. J Clin Endocrinol Metabol 1969; 29(2): 225230.

    • Search Google Scholar
    • Export Citation
  • [4]

    Bonde AA, Korngold EK, Foster BR, Fung AW, Sohaey R, Pettersson DR, et al.: Radiological appearances of corpus luteum cysts and their imaging mimics. Abdom Radiol 2016; 41: 22702282.

    • Search Google Scholar
    • Export Citation
  • [5]

    Duncan WC: The inadequate corpus luteum. Reprod Fertil 2021; 2(1): C1C7.

  • [6]

    Dobrokhotova YE, Zubareva EA, Borovikova EI, Zalesskaya SA, Kazantsev SN: Assessment of the functional activity of the corpus luteum in the prediction of early pregnancy complications. Obstet Gynecol 2020 (9): 153158.

    • Search Google Scholar
    • Export Citation
  • [7]

    Han H, Mo X, Ma Y, Zhou Y, Zhang B: The role of blood flow in corpus luteum measured by transvaginal two-dimensional and three-dimensional ultrasound in the prediction of early intrauterine pregnancy outcomes. Front Pharmacol 2019; 10: 767.

    • Search Google Scholar
    • Export Citation
  • [8]

    Pareja OD, Urbanetz AA, Urbanetz LA, Carvalho NS, Piazza MJ: Echographic characteristics of the corpus luteum in early pregnancy: morphology and vascularization. Rev Bras Ginecol Obstet 2010; 32: 549555.

    • Search Google Scholar
    • Export Citation
  • [9]

    Frates MC, Doubilet PM, Durfee SM, Di Salvo DN, Laing FC, Brown DL, et al.: Sonographic and Doppler characteristics of the corpus luteum: can they predict pregnancy outcome? J Ultrasound Med 2001; 20(8): 821827.

    • Search Google Scholar
    • Export Citation
  • [10]

    Salim A, Zalud I, Farmakides G, Schulman H, Kurjak A, Latin V: Corpus luteum blood flow in normal and abnormal early pregnancy: evaluation with transvaginal color and pulsed Doppler sonography. J Ultrasound Med 1994; 13(12): 971975.

    • Search Google Scholar
    • Export Citation
  • [11]

    Durfee SM, Frates MC: Sonographic spectrum of the corpus luteum in early pregnancy: Gray‐scale, color, and pulsed Doppler appearance. J Clin Ultrasound 1999; 27(2): 5559.

    • Search Google Scholar
    • Export Citation
  • [12]

    Aly Abd El-Rahman Nafea A, Wafa AE, El-Saeed Ali O, Refaat Hablas W: Correlation between corpus luteum volume using 2D ultrasound and color-Doppler study of corpus luteum vasculature with maternal serum CA-125 level in prognosis of first trimester threatened abortion. Al-Azhar Med J 2021; 50(4): 24852498.

    • Search Google Scholar
    • Export Citation
  • [13]

    Glock JL, Blackman JA, Badger GJ, Brumsted JR: Prognostic significance of morphologic changes of the corpus luteum by transvaginal ultrasound in early pregnancy monitoring. Obstet Gynecol 1995; 85(1): 3741.

    • Search Google Scholar
    • Export Citation
  • [14]

    Rowan K, Meagher S, Teoh M, Vollenhoven B, Choong S, Tong S: Corpus luteum across the first trimester: size and laterality as observed by ultrasound. Fertility Sterility 2008; 90(5): 18441847.

    • Search Google Scholar
    • Export Citation
  • [15]

    Gupta R, Kochhar S, Devi K, Sehgal A, Malhotra S: Role of ultrasonography and color Doppler in identification of the corpus luteum of early pregnancy. J Diagn Med Sonogr 2004; 20(5): 341346.

    • Search Google Scholar
    • Export Citation
  • [16]

    Abd-elfatah A, Megahid S: Comparative study between corpus luteum changes in normal pregnancy and threatened abortion using transvaginal color Doppler sonography. Al-Azhar Int Med J 2020; 1(1): 154159.

    • Search Google Scholar
    • Export Citation
  • [17]

    Alcázar JL, Laparte C, Lopez-Garcia G: Corpus luteum blood flow in abnormal early pregnancy. J Ultrasound Med 1996; 15(9): 645649.

  • [18]

    Tamanini C, De Ambrogi M: Angiogenesis in developing follicle and corpus luteum. Reprod Domest Anim 2004; 39(4): 206216.

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    Reynolds LP, Redmer DA: Growth and development of the corpus luteum. J Reprod Fertility-Supplement 1999: 181191.

  • [20]

    Fraser HM, Wulff C: Angiogenesis in the corpus luteum. Reprod Biol Endocrinol 2003; 1(1): 18.

  • [1]

    Shah D, Nagarajan N: Luteal insufficiency in first trimester. Indian Journal of Endocrinology and Metabolism 2013; 17(1): 4449.

  • [2]

    Parsons AK: Imaging the human corpus luteum. J Ultrasound Med 2001; 20(8): 811819.

  • [3]

    Yoshimi T, Strott CA, Marshall JR, Lipsett MB: Corpus luteum function in early pregnancy. J Clin Endocrinol Metabol 1969; 29(2): 225230.

    • Search Google Scholar
    • Export Citation
  • [4]

    Bonde AA, Korngold EK, Foster BR, Fung AW, Sohaey R, Pettersson DR, et al.: Radiological appearances of corpus luteum cysts and their imaging mimics. Abdom Radiol 2016; 41: 22702282.

    • Search Google Scholar
    • Export Citation
  • [5]

    Duncan WC: The inadequate corpus luteum. Reprod Fertil 2021; 2(1): C1C7.

  • [6]

    Dobrokhotova YE, Zubareva EA, Borovikova EI, Zalesskaya SA, Kazantsev SN: Assessment of the functional activity of the corpus luteum in the prediction of early pregnancy complications. Obstet Gynecol 2020 (9): 153158.

    • Search Google Scholar
    • Export Citation
  • [7]

    Han H, Mo X, Ma Y, Zhou Y, Zhang B: The role of blood flow in corpus luteum measured by transvaginal two-dimensional and three-dimensional ultrasound in the prediction of early intrauterine pregnancy outcomes. Front Pharmacol 2019; 10: 767.

    • Search Google Scholar
    • Export Citation
  • [8]

    Pareja OD, Urbanetz AA, Urbanetz LA, Carvalho NS, Piazza MJ: Echographic characteristics of the corpus luteum in early pregnancy: morphology and vascularization. Rev Bras Ginecol Obstet 2010; 32: 549555.

    • Search Google Scholar
    • Export Citation
  • [9]

    Frates MC, Doubilet PM, Durfee SM, Di Salvo DN, Laing FC, Brown DL, et al.: Sonographic and Doppler characteristics of the corpus luteum: can they predict pregnancy outcome? J Ultrasound Med 2001; 20(8): 821827.

    • Search Google Scholar
    • Export Citation
  • [10]

    Salim A, Zalud I, Farmakides G, Schulman H, Kurjak A, Latin V: Corpus luteum blood flow in normal and abnormal early pregnancy: evaluation with transvaginal color and pulsed Doppler sonography. J Ultrasound Med 1994; 13(12): 971975.

    • Search Google Scholar
    • Export Citation
  • [11]

    Durfee SM, Frates MC: Sonographic spectrum of the corpus luteum in early pregnancy: Gray‐scale, color, and pulsed Doppler appearance. J Clin Ultrasound 1999; 27(2): 5559.

    • Search Google Scholar
    • Export Citation
  • [12]

    Aly Abd El-Rahman Nafea A, Wafa AE, El-Saeed Ali O, Refaat Hablas W: Correlation between corpus luteum volume using 2D ultrasound and color-Doppler study of corpus luteum vasculature with maternal serum CA-125 level in prognosis of first trimester threatened abortion. Al-Azhar Med J 2021; 50(4): 24852498.

    • Search Google Scholar
    • Export Citation
  • [13]

    Glock JL, Blackman JA, Badger GJ, Brumsted JR: Prognostic significance of morphologic changes of the corpus luteum by transvaginal ultrasound in early pregnancy monitoring. Obstet Gynecol 1995; 85(1): 3741.

    • Search Google Scholar
    • Export Citation
  • [14]

    Rowan K, Meagher S, Teoh M, Vollenhoven B, Choong S, Tong S: Corpus luteum across the first trimester: size and laterality as observed by ultrasound. Fertility Sterility 2008; 90(5): 18441847.

    • Search Google Scholar
    • Export Citation
  • [15]

    Gupta R, Kochhar S, Devi K, Sehgal A, Malhotra S: Role of ultrasonography and color Doppler in identification of the corpus luteum of early pregnancy. J Diagn Med Sonogr 2004; 20(5): 341346.

    • Search Google Scholar
    • Export Citation
  • [16]

    Abd-elfatah A, Megahid S: Comparative study between corpus luteum changes in normal pregnancy and threatened abortion using transvaginal color Doppler sonography. Al-Azhar Int Med J 2020; 1(1): 154159.

    • Search Google Scholar
    • Export Citation
  • [17]

    Alcázar JL, Laparte C, Lopez-Garcia G: Corpus luteum blood flow in abnormal early pregnancy. J Ultrasound Med 1996; 15(9): 645649.

  • [18]

    Tamanini C, De Ambrogi M: Angiogenesis in developing follicle and corpus luteum. Reprod Domest Anim 2004; 39(4): 206216.

  • [19]

    Reynolds LP, Redmer DA: Growth and development of the corpus luteum. J Reprod Fertility-Supplement 1999: 181191.

  • [20]

    Fraser HM, Wulff C: Angiogenesis in the corpus luteum. Reprod Biol Endocrinol 2003; 1(1): 18.

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Chair of the Editorial Board:
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Dávid TÁRNOKI (National Institute of Oncology, Budapest, Hungary)
Ákos VARGA-SZEMES (Medical University of South Carolina, USA)
Hajnalka VÁGÓ (Semmelweis University, Budapest, Hungary)
Jiayin ZHANG (Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China)

International Editorial Board:

Gergely ÁGOSTON (University of Szeged, Hungary)
Anna BARITUSSIO (University of Padova, Italy)
Bostjan BERLOT (University Medical Centre, Ljubljana, Slovenia)
Edoardo CONTE (Centro Cardiologico Monzino IRCCS, Milan)
Réka FALUDI (University of Szeged, Hungary)
Andrea Igoren GUARICCI (University of Bari, Italy)
Marco GUGLIELMO (Department of Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy)
Kristóf HISRCHBERG (University of Heidelberg, Germany)
Dénes HORVÁTHY (Semmelweis University, Budapest, Hungary)
Julia KARADY (Harvard Unversity, MA, USA)
Attila KOVÁCS (Semmelweis University, Budapest, Hungary)
Riccardo LIGA (Cardiothoracic and Vascular Department, Università di Pisa, Pisa, Italy)
Máté MAGYAR (Semmelweis University, Budapest, Hungary)
Giuseppe MUSCOGIURI (Centro Cardiologico Monzino IRCCS, Milan, Italy)
Anikó I NAGY (Semmelweis University, Budapest, Hungary)
Liliána SZABÓ (Semmelweis University, Budapest, Hungary)
Özge TOK (Memorial Bahcelievler Hospital, Istanbul, Turkey)
Márton TOKODI (Semmelweis University, Budapest, Hungary)

Managing Editor:
Anikó HEGEDÜS (Semmelweis University, Budapest, Hungary)

Pál Maurovich-Horvat, MD, PhD, MPH, Editor-in-Chief

Semmelweis University, Medical Imaging Centre
2 Korányi Sándor utca, Budapest, H-1083, Hungary
Tel: +36-20-663-2485
E-mail: maurovich-horvat.pal@med.semmelweis-univ.hu

Indexing and Abstracting Services:

  • WoS Emerging Science Citation Index
  • Scopus
  • DOAJ

2023  
Web of Science  
Journal Impact Factor 0.7
Rank by Impact Factor Q3 (Medicine, General & Internal)
Journal Citation Indicator 0.09
Scopus  
CiteScore 0.7
CiteScore rank Q4 (Medicine miscellaneous)
SNIP 0.151
Scimago  
SJR index 0.181
SJR Q rank Q4

Imaging
Publication Model Gold Open Access
Submission Fee none
Article Processing Charge none
Subscription Information Gold Open Access

Imaging
Language English
Size A4
Year of
Foundation
2020 (2009)
Volumes
per Year
1
Issues
per Year
2
Founder Akadémiai Kiadó
Founder's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 2732-0960 (Online)

Monthly Content Usage

Abstract Views Full Text Views PDF Downloads
Apr 2024 0 0 0
May 2024 0 0 0
Jun 2024 0 0 0
Jul 2024 0 0 0
Aug 2024 0 1181 40
Sep 2024 0 60 7
Oct 2024 0 0 0