Uso de la ultrasonografía doppler para diagnóstico reproductivo en hembras bovinas
El desarrollo de tecnologías de imagen ha contribuido significativamente a los avances en el campo de las ciencias biológicas. La posibilidad de un diagnóstico no invasivo, el enfoque en tiempo real para evaluar tejidos y órganos fue de gran importancia para el estudio de muchos mecanismos fisiológi...
- Autores:
-
Abella Manjarres, Yovanny Alonso
Rojas Plaza, Santiago
- Tipo de recurso:
- Trabajo de grado de pregrado
- Fecha de publicación:
- 2021
- Institución:
- Universidad Cooperativa de Colombia
- Repositorio:
- Repositorio UCC
- Idioma:
- OAI Identifier:
- oai:repository.ucc.edu.co:20.500.12494/34815
- Acceso en línea:
- https://hdl.handle.net/20.500.12494/34815
- Palabra clave:
- Doppler
Ovarios
Folículo
Progesterona
Técnicas
Diagnósticas
Reproducción
Biotecnología
Ultrasonografía
Doppler
Ovaries
Follicle
Progesterone
Reproductive
Diagnostic
Techniques
Biotechnology
Ultrasonography
- Rights
- openAccess
- License
- Atribución
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dc.title.spa.fl_str_mv |
Uso de la ultrasonografía doppler para diagnóstico reproductivo en hembras bovinas |
title |
Uso de la ultrasonografía doppler para diagnóstico reproductivo en hembras bovinas |
spellingShingle |
Uso de la ultrasonografía doppler para diagnóstico reproductivo en hembras bovinas Doppler Ovarios Folículo Progesterona Técnicas Diagnósticas Reproducción Biotecnología Ultrasonografía Doppler Ovaries Follicle Progesterone Reproductive Diagnostic Techniques Biotechnology Ultrasonography |
title_short |
Uso de la ultrasonografía doppler para diagnóstico reproductivo en hembras bovinas |
title_full |
Uso de la ultrasonografía doppler para diagnóstico reproductivo en hembras bovinas |
title_fullStr |
Uso de la ultrasonografía doppler para diagnóstico reproductivo en hembras bovinas |
title_full_unstemmed |
Uso de la ultrasonografía doppler para diagnóstico reproductivo en hembras bovinas |
title_sort |
Uso de la ultrasonografía doppler para diagnóstico reproductivo en hembras bovinas |
dc.creator.fl_str_mv |
Abella Manjarres, Yovanny Alonso Rojas Plaza, Santiago |
dc.contributor.advisor.none.fl_str_mv |
Vasquez, Ricaurte Lopera Bonilla León, Lilian |
dc.contributor.author.none.fl_str_mv |
Abella Manjarres, Yovanny Alonso Rojas Plaza, Santiago |
dc.subject.spa.fl_str_mv |
Doppler Ovarios Folículo Progesterona Técnicas Diagnósticas Reproducción Biotecnología Ultrasonografía |
topic |
Doppler Ovarios Folículo Progesterona Técnicas Diagnósticas Reproducción Biotecnología Ultrasonografía Doppler Ovaries Follicle Progesterone Reproductive Diagnostic Techniques Biotechnology Ultrasonography |
dc.subject.other.spa.fl_str_mv |
Doppler Ovaries Follicle Progesterone Reproductive Diagnostic Techniques Biotechnology Ultrasonography |
description |
El desarrollo de tecnologías de imagen ha contribuido significativamente a los avances en el campo de las ciencias biológicas. La posibilidad de un diagnóstico no invasivo, el enfoque en tiempo real para evaluar tejidos y órganos fue de gran importancia para el estudio de muchos mecanismos fisiológicos y para el diagnóstico de condiciones patológicas. Para estos fines, varias de las tecnologías, de la radiografía a la tomografía computarizada moderna, se han utilizado en medicina humana y veterinaria. Este artículo describe conceptos anatómicos y fisiológicos del tracto reproductivo de la hembra bovina, así como también el uso de la ecografía en el seguimiento de la dinámica ovárica, a través de mediciones del diámetro folicular y el volumen del cuerpo lúteo durante el ciclo estral, relacionando estas variables con la obtención exitosa de una preñez diagnosticada igualmente por medio de ultrasonido. La literatura relacionada, demuestra que la ultrasonografía con Doppler es una herramienta útil para la evaluación, diagnóstico y toma de decisiones con respecto a los eventos reproductivos de la hembra bovina, con potencial para ser usada en conjunto con la aplicación de biotecnologías reproductivas, como la inseminación artificial y la transferencia de embriones con el fin de optimizar su eficiencia. |
publishDate |
2021 |
dc.date.accessioned.none.fl_str_mv |
2021-06-28T15:34:33Z |
dc.date.available.none.fl_str_mv |
2021-06-28T15:34:33Z |
dc.date.issued.none.fl_str_mv |
2021-06-23 |
dc.type.none.fl_str_mv |
Trabajo de grado - Pregrado |
dc.type.coar.none.fl_str_mv |
http://purl.org/coar/resource_type/c_7a1f |
dc.type.driver.none.fl_str_mv |
info:eu-repo/semantics/bachelorThesis |
dc.type.version.none.fl_str_mv |
info:eu-repo/semantics/acceptedVersion |
format |
http://purl.org/coar/resource_type/c_7a1f |
status_str |
acceptedVersion |
dc.identifier.uri.none.fl_str_mv |
https://hdl.handle.net/20.500.12494/34815 |
dc.identifier.bibliographicCitation.spa.fl_str_mv |
Abella Manjarres, Y. A. y Rojas Plaza, S. (2021). Uso de la ultrasonografía doppler para diagnóstico reproductivo en hembras bovinas [Tesis de pregrado, Universidad Cooperativa de Colombia]. Repositorio Institucional UCC. https://repository.ucc.edu.co/handle/20.500.12494/34815 |
url |
https://hdl.handle.net/20.500.12494/34815 |
identifier_str_mv |
Abella Manjarres, Y. A. y Rojas Plaza, S. (2021). Uso de la ultrasonografía doppler para diagnóstico reproductivo en hembras bovinas [Tesis de pregrado, Universidad Cooperativa de Colombia]. Repositorio Institucional UCC. https://repository.ucc.edu.co/handle/20.500.12494/34815 |
dc.relation.references.spa.fl_str_mv |
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Effects of induced endometritis on uterine blood flow in cows as evaluated by transrectal doppler sonography. Journal of Veterinary Science, 17(2), 189–197. https://doi.org/10.4142/jvs.2016.17.2.189 Díaz, P. U., Belotti, E. M., Notaro, U. S., Salvetti, N. R., Leiva, C. J. M., Durante, L. I., Marelli, B. E., Stangaferro, M. L., & Ortega, H. H. (2019). Hemodynamic changes detected by Doppler ultrasonography in the ovaries of cattle during early development of cystic ovarian disease. Animal Reproduction Science, 209(February), 106164. https://doi.org/10.1016/j.anireprosci.2019.106164 Dubuc, J., Houle, J., Rousseau, M., Roy, J. P., & Buczinski, S. (2020). Short communication: Accuracy of corpus luteum color flow Doppler ultrasonography to diagnose nonpregnancy in dairy cows on day 21 after insemination. 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Dinámica folicular y cuantificación de estradiol durante el ciclo estral de vacas criollas de la raza Blanco Orejinegro Follicular dynamics and estradiol quantification during the estrous cycle of creole cows of the Blanco Orejinegro breed. Rev Inv Vet Perú, 31(2), 16186. https://doi.org/10.15381/rivep.v31i2.16186 Kelley, D. E., Galvão, K. N., Mortensen, C. J., Risco, C. A., & Ealy, A. D. (2017). Using Doppler ultrasonography on day 34 of pregnancy to predict pregnancy loss in lactating dairy cattle. Journal of Dairy Science, 100(4), 3266–3271. https://doi.org/10.3168/jds.2016-11955 Kim-Egloff, C., Hässig, M., Bruckmaier, R., & Bleul, U. (2016). Doppler sonographic examination of uterine and placental perfusion in cows in the last month of gestation and effects of epidural anesthesia and isoxsuprine. Theriogenology, 85(5), 986–998. https://doi.org/10.1016/j.theriogenology.2015.11.010 Mebarki, M., Kaidi, R., Azizi, A., & Basbaci, M. (2019). Comparative efficacy of two-dimensional mode and color Doppler sonography in predicting gender of the equine fetus. Veterinary World, 12(2), 325–330. https://doi.org/10.14202/vetworld.2019.325-330 Montero, E. R., Méndez, M. G., López, A. G., de la Campa, B. O., & Meliz, J. L. G. (2015). Utilidad de la ecografía Doppler en el diagnóstico de la trombosis carotidea traumátic. Revista Cubana de Medicina Militar, 44(4), 446–451. Owen, M. P. T., McCarty, K. J., Hart, C. G., Steadman, C. S., & Lemley, C. O. (2018). Endometrial blood perfusion as assessed using a novel laser Doppler technique in Angus cows. Animal Reproduction Science, 190(February), 119–126. https://doi.org/10.1016/j.anireprosci.2018.01.015 Paola Paolinelli, G. (2012). PRINCIPIOS FÍSICOS E INDICACIONES. 1, 10–12. Paola Paolinelli, G. (2013). Principios físicos e indicaciones clínicas del ultrasonido doppler. Revista Médica Clínica Las Condes, 24(1), 139–148. https://doi.org/10.1016/s0716-8640(13)70139-1 Pinaffi, F. L. V., Araujo, E. R., Silva, L. A., & Ginther, O. J. (2017a). Color-Doppler signals of blood flow in the corpus luteum and vascular perfusion index for ovarian and uterine arteries during expansion of the allantochorion in Bos taurus heifers. Theriogenology, 102, 35–43. https://doi.org/10.1016/j.theriogenology.2017.07.008 Pinaffi, F. L. V., Araujo, E. R., Silva, L. A., & Ginther, O. J. (2017b). Color-Doppler signals of blood flow in the corpus luteum and vascular perfusion index for ovarian and uterine arteries during expansion of the allantochorion in Bos taurus heifers. Theriogenology, 102, 35–43. https://doi.org/10.1016/j.theriogenology.2017.07.008 Potočnik, B., Cigale, B., & Zazula, D. (2012). Computerized detection and recognition of follicles in ovarian ultrasound images: A review. Medical and Biological Engineering and Computing, 50(12), 1201–1212. https://doi.org/10.1007/s11517-012-0956-y Pugliesi, G., Scolari, S. C., Mesquita, F. S., Maturana Filho, M., Araújo, E. 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Theriogenology, 81(3), 407–418. https://doi.org/10.1016/j.theriogenology.2013.10.012 Sieme, H., Lüttgenau, J., Sielhorst, J., Martinsson, G., Bollwein, H., Thomas, S., & Burger, D. (2015). Improving the formation and function of the corpus luteum in the mare. Revista Brasileira de Reprodução Animal, 39(1), 117–120. https://doi.org/10.5167/uzh-116508 edad, R. (2011). Universidad de Cuenca Facultad de Ciencias Agropecuarias Escuela de Medicina Veterinaria y Zootecnia. Laminitis Bovina, 17. https://dspace.ucuenca.edu.ec/bitstream/123456789/3051/1/mv168.pdf Symp, X. I. I. (2016). Aplicación de la ecografía reproductiva modo B en vacas de lidia. 73–75. Terzano. (2012). Ultrasonography and Reproduction in Buffalo. Journal of Buffalo Science, January 2012. https://doi.org/10.6000/1927-520x.2012.01.02.06 Viana, J. H. M., Arashiro, E. K. N., Siqueira, L. G. B., Ghetti, A. M., Areas, V. S., & Guimarães, C. R. B. (2013). Doppler ultrasonography as a tool for ovarian management. Animal Reproduction, 10(3), 215–222. Vieira, L. M., Sá Filho, M. F., Pugliesi, G., Guerreiro, B. M., Cristaldo, M. A., Batista, E. O. S., Freitas, B. G., Carvalho, F. J., Guimaraes, L. H. C., & Baruselli, P. S. (2014). Resynchronization in dairy cows 13 days after TAI followed by pregnancy diagnosis based on corpus luteum vascularization by color doppler. Animal Reproduction, 11(3), 378 (abstract). Waldvogel, D., & Bleul, U. (2014). Effect of xylazine, isoxsuprine, and lidocaine on Doppler sonographic uterine and umbilical blood flow measurements in cows during the last month of pregnancy. Theriogenology, 81(7), 993–1003. https://doi.org/10.1016/j.theriogenology.2014.01.031 |
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Vasquez, Ricaurte LoperaBonilla León, LilianAbella Manjarres, Yovanny AlonsoRojas Plaza, Santiago2021-06-28T15:34:33Z2021-06-28T15:34:33Z2021-06-23https://hdl.handle.net/20.500.12494/34815Abella Manjarres, Y. A. y Rojas Plaza, S. (2021). Uso de la ultrasonografía doppler para diagnóstico reproductivo en hembras bovinas [Tesis de pregrado, Universidad Cooperativa de Colombia]. Repositorio Institucional UCC. https://repository.ucc.edu.co/handle/20.500.12494/34815El desarrollo de tecnologías de imagen ha contribuido significativamente a los avances en el campo de las ciencias biológicas. La posibilidad de un diagnóstico no invasivo, el enfoque en tiempo real para evaluar tejidos y órganos fue de gran importancia para el estudio de muchos mecanismos fisiológicos y para el diagnóstico de condiciones patológicas. Para estos fines, varias de las tecnologías, de la radiografía a la tomografía computarizada moderna, se han utilizado en medicina humana y veterinaria. Este artículo describe conceptos anatómicos y fisiológicos del tracto reproductivo de la hembra bovina, así como también el uso de la ecografía en el seguimiento de la dinámica ovárica, a través de mediciones del diámetro folicular y el volumen del cuerpo lúteo durante el ciclo estral, relacionando estas variables con la obtención exitosa de una preñez diagnosticada igualmente por medio de ultrasonido. La literatura relacionada, demuestra que la ultrasonografía con Doppler es una herramienta útil para la evaluación, diagnóstico y toma de decisiones con respecto a los eventos reproductivos de la hembra bovina, con potencial para ser usada en conjunto con la aplicación de biotecnologías reproductivas, como la inseminación artificial y la transferencia de embriones con el fin de optimizar su eficiencia.The development of imaging technologies has contributed significantly to advances in the field of life sciences. The possibility of a non-invasive diagnosis, the real-time approach to evaluating tissues and organs, was of great importance for the study of many physiological mechanisms and for the diagnosis of pathological conditions. For these purposes, several of the technologies, from radiography to modern computed tomography, have been used in human and veterinary medicine. This article describes anatomical and physiological concepts of the reproductive tract of the bovine female, as well as the use of ultrasound in the monitoring of ovarian dynamics, through measurements of the follicular diameter and the volume of the corpus luteum during the estrous cycle, relating these variables with the successful obtaining of a pregnancy also diagnosed by ultrasound. The related literature shows that Doppler ultrasonography is a useful tool for the evaluation, diagnosis, and decision-making regarding the reproductive events of the bovine female, with the potential to be used in conjunction with the application of reproductive biotechnologies, such as the artificial insemination and embryo transfer in order to optimize their efficiency.Yovanny.abellam@campusucc.edu.cosantiago.rojasp@campusucc.edu.co25 p.Universidad Cooperativa de Colombia, Facultad de Ciencias de la Salud, Medicina Veterinaria y Zootecnia, IbaguéMedicina veterinaria y zootecniaIbaguéDopplerOvariosFolículoProgesteronaTécnicasDiagnósticasReproducciónBiotecnologíaUltrasonografíaDopplerOvariesFollicleProgesteroneReproductiveDiagnosticTechniquesBiotechnologyUltrasonographyUso de la ultrasonografía doppler para diagnóstico reproductivo en hembras bovinasTrabajo de grado - Pregradohttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesisinfo:eu-repo/semantics/acceptedVersionAtribucióninfo:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Atkins, J. A., Smith, M. F., Wells, K. J., & Gearyf, T. W. (2010). Factors affecting preovulatory follicle diameter and ovulation rate after gonadotropin-releasing hormone in postpartum beef cows. Part I: Cycling cows. Journal of Animal Science, 88(7), 2300–2310. https://doi.org/10.2527/jas.2009-2531Azawi, O. I., Ahmed, O. S., & Abass, S. F. (2012). Schistosomus reflexus foetus in cross breed iraqi cow: A case report. Iraqi Journal of Veterinary Sciences, 26(2), 103–104. https://doi.org/10.33899/ijvs.2012.67481Batista, E. O. S., Macedo, G. G., Sala, R. V., Ortolan, M. D. D. V., Sá Filho, M. F., Del Valle, T. A., Jesus, E. F., Lopes, R. N. V. R., Rennó, F. P., & Baruselli, P. S. (2014). Plasma antimullerian hormone as a predictor of ovarian antral follicular population in bos indicus (nelore) and bos taurus (holstein) heifers. Reproduction in Domestic Animals, 49(3), 448–452. https://doi.org/10.1111/rda.12304Bollwein, H., Heppelmann, M., & Lüttgenau, J. (2016). Ultrasonographic Doppler Use for Female Reproduction Management. Veterinary Clinics of North America - Food Animal Practice, 32(1), 149–164. https://doi.org/10.1016/j.cvfa.2015.09.005Braun, U., Forster, E., Bleul, U., Hässig, M., & Schwarzwald, C. (2013). B-mode and colour Doppler ultrasonography of the milk vein and musculophrenic vein in eight cows during lactation. Research in Veterinary Science, 94(1), 138–143. https://doi.org/10.1016/j.rvsc.2012.07.034Carvalho, C. F., Chammas, M. C., & Cerri, G. G. (2008). Princípios físicos do Doppler em ultra-sonografia. Ciência Rural, 38(3), 872–879. https://doi.org/10.1590/s0103-84782008000300047Castelló, C. M., Bragato, N., Martins, I., Santos, T. V., & Borges, N. C. (2015). Ultrassonografia Doppler. ENCICLOPÉDIA BIOSFERA, Centro Científico Conhecer, 11(22), 2691–2713.Chamba Ochoa, H. R., Benítez González, E. E., & Pesántez Campoverde, M. T. (2017). 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Effects of induced endometritis on uterine blood flow in cows as evaluated by transrectal doppler sonography. Journal of Veterinary Science, 17(2), 189–197. https://doi.org/10.4142/jvs.2016.17.2.189Díaz, P. U., Belotti, E. M., Notaro, U. S., Salvetti, N. R., Leiva, C. J. M., Durante, L. I., Marelli, B. E., Stangaferro, M. L., & Ortega, H. H. (2019). Hemodynamic changes detected by Doppler ultrasonography in the ovaries of cattle during early development of cystic ovarian disease. Animal Reproduction Science, 209(February), 106164. https://doi.org/10.1016/j.anireprosci.2019.106164Dubuc, J., Houle, J., Rousseau, M., Roy, J. P., & Buczinski, S. (2020). Short communication: Accuracy of corpus luteum color flow Doppler ultrasonography to diagnose nonpregnancy in dairy cows on day 21 after insemination. Journal of Dairy Science, 103(2), 2019–2023. https://doi.org/10.3168/jds.2019-17234Esposito, L., Salzano, A., Russ, M., Nicola, D. de, Alberto Prandi, Bianca Gasparrini, Campanile, G., & Neglia, G. (2020). Corpus Luteum Color Doppler Ultrasound and Transitional Period. Animals, 10, 8–17.Fricke, P. M. (2002). Scanning the future - Ultrasonography as a reproductive management tool for dairy cattle. Journal of Dairy Science, 85(8), 1918–1926. https://doi.org/10.3168/jds.S0022-0302(02)74268-9García-Bracho, D., Hahn, M., Pino, D., Perea, F., & Merlis, L. (2015). Follicle Growth and Dominant Follicle Size in Grazing Crossbred Cows. Revista Cientifica, FCV-LUZ, XXV(3), 219–222.Hansen, P. J. (2020). The incompletely fulfilled promise of embryo transfer in cattle-why aren’t pregnancy rates greater and what can we do about it? Journal of Animal Science, 98(11), 1–20. https://doi.org/10.1093/jas/skaa288Hart, C. G., Voelz, B. E., Brockus, K. E., & Lemley, C. O. (2018). 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Dinámica folicular y cuantificación de estradiol durante el ciclo estral de vacas criollas de la raza Blanco Orejinegro Follicular dynamics and estradiol quantification during the estrous cycle of creole cows of the Blanco Orejinegro breed. Rev Inv Vet Perú, 31(2), 16186. https://doi.org/10.15381/rivep.v31i2.16186Kelley, D. E., Galvão, K. N., Mortensen, C. J., Risco, C. A., & Ealy, A. D. (2017). Using Doppler ultrasonography on day 34 of pregnancy to predict pregnancy loss in lactating dairy cattle. Journal of Dairy Science, 100(4), 3266–3271. https://doi.org/10.3168/jds.2016-11955Kim-Egloff, C., Hässig, M., Bruckmaier, R., & Bleul, U. (2016). Doppler sonographic examination of uterine and placental perfusion in cows in the last month of gestation and effects of epidural anesthesia and isoxsuprine. Theriogenology, 85(5), 986–998. https://doi.org/10.1016/j.theriogenology.2015.11.010Mebarki, M., Kaidi, R., Azizi, A., & Basbaci, M. (2019). Comparative efficacy of two-dimensional mode and color Doppler sonography in predicting gender of the equine fetus. Veterinary World, 12(2), 325–330. https://doi.org/10.14202/vetworld.2019.325-330Montero, E. R., Méndez, M. G., López, A. G., de la Campa, B. O., & Meliz, J. L. G. (2015). Utilidad de la ecografía Doppler en el diagnóstico de la trombosis carotidea traumátic. Revista Cubana de Medicina Militar, 44(4), 446–451.Owen, M. P. T., McCarty, K. J., Hart, C. G., Steadman, C. S., & Lemley, C. O. (2018). Endometrial blood perfusion as assessed using a novel laser Doppler technique in Angus cows. Animal Reproduction Science, 190(February), 119–126. https://doi.org/10.1016/j.anireprosci.2018.01.015Paola Paolinelli, G. (2012). PRINCIPIOS FÍSICOS E INDICACIONES. 1, 10–12.Paola Paolinelli, G. (2013). Principios físicos e indicaciones clínicas del ultrasonido doppler. Revista Médica Clínica Las Condes, 24(1), 139–148. https://doi.org/10.1016/s0716-8640(13)70139-1Pinaffi, F. L. V., Araujo, E. R., Silva, L. A., & Ginther, O. J. (2017a). Color-Doppler signals of blood flow in the corpus luteum and vascular perfusion index for ovarian and uterine arteries during expansion of the allantochorion in Bos taurus heifers. Theriogenology, 102, 35–43. https://doi.org/10.1016/j.theriogenology.2017.07.008Pinaffi, F. L. V., Araujo, E. R., Silva, L. A., & Ginther, O. J. (2017b). Color-Doppler signals of blood flow in the corpus luteum and vascular perfusion index for ovarian and uterine arteries during expansion of the allantochorion in Bos taurus heifers. Theriogenology, 102, 35–43. https://doi.org/10.1016/j.theriogenology.2017.07.008Potočnik, B., Cigale, B., & Zazula, D. (2012). Computerized detection and recognition of follicles in ovarian ultrasound images: A review. Medical and Biological Engineering and Computing, 50(12), 1201–1212. https://doi.org/10.1007/s11517-012-0956-yPugliesi, G., Scolari, S. C., Mesquita, F. S., Maturana Filho, M., Araújo, E. 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Theriogenology, 81(7), 993–1003. https://doi.org/10.1016/j.theriogenology.2014.01.031PublicationORIGINAL2021_Ultrasonografia_ Doppler_Diagnostico.pdf2021_Ultrasonografia_ Doppler_Diagnostico.pdfTrabajo de gradoapplication/pdf473376https://repository.ucc.edu.co/bitstreams/8836bf86-b5db-4df6-a99d-58982619623d/downloade848839256d1e034c86fb0d87daede9cMD512021_Ultrasonografia_ Doppler_Diagnostico-LicenciaUso.pdf2021_Ultrasonografia_ Doppler_Diagnostico-LicenciaUso.pdfLicencia de usoapplication/pdf252404https://repository.ucc.edu.co/bitstreams/597c4783-6f87-43d0-9bd4-810bed098609/download86574385f32fd46e1cfd460bf9d3a12cMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-84334https://repository.ucc.edu.co/bitstreams/31a70492-3552-4237-af88-a99a1d108e0b/download3bce4f7ab09dfc588f126e1e36e98a45MD53THUMBNAIL2021_Ultrasonografia_ Doppler_Diagnostico.pdf.jpg2021_Ultrasonografia_ Doppler_Diagnostico.pdf.jpgGenerated 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