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Sample records for transvaginal ultrasonography assessment

  1. Transvaginal color Doppler ultrasonography in reproductive gynecology.

    PubMed

    Serafini, P; Batzofin, J

    1994-01-01

    Transvaginal color Doppler sonography (TVSCD) is one of the most important recent developments in gynecology. TVSCD provides relevant information on uterine and ovarian blood flow and aids in the identification of pregnancy viability as well as the early diagnosis of ectopic pregnancy. TVSCD also facilitates differential diagnosis of benign and malignant pelvic pathology. PMID:7820158

  2. The accuracy of transvaginal ultrasonography for the diagnosis of ectopic pregnancy prior to surgery

    E-print Network

    The accuracy of transvaginal ultrasonography for the diagnosis of ectopic pregnancy prior and Tom Bourne1 1 Early Pregnancy, Gynaecological Ultrasound and Minimal Access Surgery Unit, St George should be addressed at: Early Pregnancy, Gynaecological Ultrasound and MAS Unit, St George's Hospital

  3. The first three weeks assessed by transvaginal color Doppler.

    PubMed

    Kupesi?, S

    1996-01-01

    Transvaginal color Doppler has made possible to study ovarian and uterine perfusion in non-pregnant and pregnant patients, thus advancing the understanding of the early human development. RI of follicular blood flow starts decreasing prior to ovulation reaching its nadir at ovulation. It is considered that apart from hormonal factors the angiogenesis is also involved. The mature corpus luteum shows increased blood flow velocity in relation to preovulatory follicle. Comparing RI values of luteal blood flow of normal and ectopic pregnancy no difference was found. But in threatened, incomplete and missed abortions the resistance and pulsatility indices were significantly higher than in normal pregnancy. The follow up of the luteal flow might have a prognostic value in a group of patients with threatened abortion. In women with spontaneous cycles the day preceding the ovulation impedance to uterine flow velocity starts decreasing. Alterations in flow velocity patterns of the radial and spiral arteries in spontaneous ovulatory cycles are paralleling blood flow dynamics of the uterine arteries. In stimulated cycles RI increases the day before ovulation in both the uterine arteries and their branches. It seems that endometrial perfusion presents more accurate noninvasive assay of uterine receptivity than uterine artery perfusion alone. Endometrial receptivity is maximum during the time of peak luteal function during which implantation is most likely to occur. During the pregnancy impedance to blood flow decrease from the main uterine to the spiral arteries as well as with the advancing gestational age. The spiral arteries in pregnancy become the vessels with completely different haemodynamic characteristics in relation to other arteries of uteroplacental circulation. Color Doppler adds new information on perfusion and pathophysiological changes connected with the ectopic trophoblast implantation. PMID:8880627

  4. Transvaginal three-dimensional sonographic assessment of the embryonic brain: a pilot study

    PubMed Central

    BOITOR-BORZA, DAN; KOVACS, TUNDE; STAMATIAN, FLORIN

    2015-01-01

    Aims A very good knowledge of human embryology is mandatory not only for the correct sonographic assessment of the developing brain, but also for better understanding the origins of congenital anomalies involving the central nervous system. 3D transvaginal sonography may be an effective technique for imaging the developing brain. The aims of this explorative study are to demonstrate the feasibility of imaging the embryonic brain between 7 and 10 weeks of gestation for clinical studies by using a 3D high-frequency vaginal ultrasound transducer and to provide a reference for the morphology of the brain in the embryonic period. Materials and methods Four embryos of 9 mm, 17 mm, 23 mm and 31 mm crown-rump length respectively were assessed in vivo by transvaginal sonography. We gave a special attention to the embryonic brain. All patients were examined with a Voluson E10, BT 15 ultrasound scanner (GE Healthcare, Zipf, Austria), using a high-frequency 6–12 MHz/ 256-element 3D/4D transvaginal transducer. Three-dimensional sonography was performed routinely as the patients were scanned. The multiplanar display was used after selecting the best volume. The Omni view® software was used for digitally slicing the selected volumes. Results We describe the morphological details of the developing brains of four embryos ranging from 7 to 10 gestational weeks. In the human embryo 9 mm CRL the hypoechogenic cavities of the three primary vesicles (prosencephalon, mesencephalon, rhombencephalon) could be observed on a sagittal section. In the human embryo 17 mm CRL the prosencephalon was divided into the median diencephalon and two telencephalic vesicles, which were partially separated by the falx cerebri. In the human embryo 23 mm CRL the cerebral hemispheres developed and they were completely separated by the falx cerebri. The choroid plexus was evident inside the lateral ventricles and the fourth ventricle. In the human embryo 31 mm CRL the ventral thalamus was evident, and the ganglionic eminence, as the precursor of the basal ganglia, was well seen on the floor of the cerebral hemispheres. Conclusions Studies of embryology are still needed for a complete understanding of the developing brain. 3D sonography using a high-frequency vaginal ultrasound transducer is feasible for imaging the embryonic brain with an acceptable quality for clinical studies. PMID:26528064

  5. MRI versus ultrasonography to assess meniscal abnormalities in acute knees.

    PubMed

    Cook, James L; Cook, Cristi R; Stannard, James P; Vaughn, Gavin; Wilson, Nichole; Roller, Brandon L; Stoker, Aaron M; Jayabalan, Prakash; Hdeib, Moses; Kuroki, Keiichi

    2014-08-01

    While magnetic resonance imaging (MRI) is often considered the "gold standard" diagnostic imaging modality for detection of meniscal abnormalities, it is associated with misdiagnosis in as high as 47% of cases, is costly, and is not readily available to a large number of patients. Ultrasonographic examination of the knee has been reported to be an effective diagnostic tool for this purpose with the potential to overcome many of the shortcomings of MRI. The purpose of this study is to determine the clinical usefulness of ultrasonography for diagnosis of meniscal pathology in patients with acute knee pain and compare its diagnostic accuracy to MRI in a clinical setting. With Institutional Review Board approval, patients (n?=?71) with acute knee pain were prospectively enrolled with informed consent. Preoperative MRI (1.5 T) was performed on each affected knee using the hospital's standard equipment and protocols and read by faculty radiologists trained in musculoskeletal MRI. Ultrasonographic assessments of each affected knee were performed by one of two faculty members trained in musculoskeletal ultrasonography using a 10 to 14?MHz linear transducer. Arthroscopic evaluation of affected knees was performed by one of three faculty orthopedic surgeons to assess and record all joint pathology, which served as the reference standard for determining presence, type, and severity of meniscal pathology. All evaluators for each diagnostic modality were blinded to all other data. Data were collected and compared by a separate investigator to determine sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), correct classification rate (CCR), likelihood ratios (LR[+] and LR[-]), and odds ratios. Preoperative ultrasonographic assessment of meniscal pathology was associated with Sn?=?91.2%, Sp?=?84.2%, PPV?=?94.5%, NPV?=?76.2%, CCR?=?89.5%, LR(+)?=?5.78, and LR(-)?=?0.10. Preoperative MRI assessment of meniscal pathology was associated with Sn?=?91.7%, Sp?=?66.7%, PPV?=?84.6%, NPV?=?80.0%, CCR?=?81.1%, LR(+)?=?2.75, and LR(-)?=?0.13. Ultrasonography was two times more likely than MRI to correctly determine presence or absence of meniscal pathology seen arthroscopically in this study. Ultrasonography is a useful tool for diagnosis of meniscal pathology with potential advantages over MRI. Based on these data and available portable equipment, ultrasonography could be considered for use as a point-of-injury diagnostic modality for meniscal injuries. PMID:24474166

  6. Duplex Ultrasonography in Assessing Restenosis of Renal Artery Stents

    SciTech Connect

    Bakker, Jeannette; Beutler, Jaap J.; Elgersma, Otto E.H.; Lange, Eduard E. de; Kort, Gerard A.P. de; Beek, Frederik J. A.

    1999-11-15

    Purpose: To determine the accuracy and optimal threshold values of duplex ultrasonography (US) in assessing restenosis of renal artery stents. Methods: Twenty-four consecutive patients with 33 renal arteries that had previously been treated with placement of a Palmaz stent underwent duplex US prior to intraarterial digital subtraction angiography (DSA), which was the reference standard. Diagnostic accuracy of in-stent peak systolic velocity (PSV) and reno-aortic ratio (RAR = PSV renal stent/PSV aorta) in detecting > 50% in-stent restenosis were evaluated by the receiver operating characteristic curve. Sensitivity and specificity were determined using the optimal threshold values, and using published threshold values: RAR > 3.5 and in-stent PSV > 180 cm/sec. Results: Six examinations were technically inadequate. Nine stents had residual or restenosis > 50% at DSA. The two duplex parameters were equally accurate since areas under the curves were similar (0.943). With optimal threshold values of 226 cm/sec for PSV and 2.7 for RAR, sensitivities and specificities were 100% and 90%, and 100% and 84%, respectively. Using the published duplex criteria resulted in sensitivities and specificities of 100% and 74% for PSV, and 50% and 89% for RAR. Conclusion: Duplex US is a sensitive modality for detecting in-stent restenosis if laboratory-specific threshold values are used.

  7. Grey-scale ultrasonography for assessment of gynecologic pelvic masses.

    PubMed Central

    Cassoff, J.; Hanna, T.

    1979-01-01

    In a retrospective study the grey-scale ultrasonographic appearance of pelvic masses was correlated with the surgical findings in 93 patients. Of the masses found at the time of laparotomy 95% had been detected preoperatively. In most instances useful information about size, consistency and location of the mass was provided by ultrasonography. Certain pathologic entities produce a characteristic sonographic appearance, but there is a wide overlap for others. Data obtained by history-taking and physical examination must be integrated with the sonographic findings for a correct diagnosis. Images FIG. 1A FIG. 1B FIG. 2 FIG. 3A FIG. 3B FIG. 4 FIG. 5 PMID:761130

  8. Efficiency of three-dimensional Doppler ultrasonography in assessing nodal metastasis of head and neck cancer.

    PubMed

    Hong, San-Fu; Lai, Yu-Shih; Lee, Kwo-Whei; Chen, Mu-Kuan

    2015-10-01

    The aim of this study was to assess the clinical usefulness of three-dimensional (3D) color Doppler ultrasonography with a novel predictive model in the detection of cervical metastasis of untreated head and neck squamous cell carcinoma patients. We assessed cervical lymph node metastasis in 52 head and neck squamous cell carcinoma patients by 3D color Doppler ultrasonography, magnetic resonance imaging, and [(18)F] fluorodeoxyglucose positron emission tomography with computed tomography. Pathologic analysis was used as the gold standard for evaluation of these imaging modalities. The rate of correct N staging was 84.6% on ultrasonography, 55.8% on magnetic resonance imaging, and 71.2% on positron emission tomography/computed tomography. On a level-by-level basis, the ultrasonography had 78.9% sensitivity, 99.0% specificity, 93.8% positive predictive value, 96.0% negative predictive value, and 95.7% accuracy. It also showed the highest agreement to histology results as compared with magnetic resonance imaging and positron emission tomography/computed tomography (kappa value = 0.832, 0.506, and 0.537, respectively). 3D Doppler ultrasonography with our prediction model provides a rapid, low-cost, noninvasive, and reliable method with low inter-observation variations for detecting neck metastasis of head and neck squamous cell carcinoma patients. PMID:25209433

  9. Contrast-enhanced ultrasonography to assess blood perfusion of skeletal muscles in normal dogs.

    PubMed

    Oh, Juyeon; Jeon, Sunghoon; Choi, Jihye

    2015-07-01

    This study evaluated perfusion of skeletal muscle using contrast enhanced ultrasonography in humerus, radius, femur and tibia in normal dogs. Contrast enhanced ultrasonography for each region was performed after injecting 0.5 mL and 1 mL of contrast medium (SonoVue) in every dog. Blood perfusion was assessed quantitatively by measuring the peak intensity, time to the peak intensity and area under the curve from the time-intensity curve. Vascularization in skeletal muscle was qualitatively graded with a score of 0-3 according to the number of vascular signals. A parabolic shape of time-intensity curve was observed from muscles in normal dogs, and time to the peak intensity, the peak intensity and area under the curve of each muscle were not significantly different according to the appendicular regions examined and the dosage of contrast agent administered. This study reports that feasibility of contrast enhanced ultrasonography for assessment of the muscular perfusion in canine appendicular regions. PMID:25754794

  10. Contrast-enhanced ultrasonography to assess blood perfusion of skeletal muscles in normal dogs

    PubMed Central

    OH, Juyeon; JEON, Sunghoon; CHOI, Jihye

    2015-01-01

    This study evaluated perfusion of skeletal muscle using contrast enhanced ultrasonography in humerus, radius, femur and tibia in normal dogs. Contrast enhanced ultrasonography for each region was performed after injecting 0.5 mL and 1 mL of contrast medium (SonoVue) in every dog. Blood perfusion was assessed quantitatively by measuring the peak intensity, time to the peak intensity and area under the curve from the time–intensity curve. Vascularization in skeletal muscle was qualitatively graded with a score of 0–3 according to the number of vascular signals. A parabolic shape of time–intensity curve was observed from muscles in normal dogs, and time to the peak intensity, the peak intensity and area under the curve of each muscle were not significantly different according to the appendicular regions examined and the dosage of contrast agent administered. This study reports that feasibility of contrast enhanced ultrasonography for assessment of the muscular perfusion in canine appendicular regions. PMID:25754794

  11. A Comparison of Conventional Ultrasonography and Arthrosonography in the Assessment of Cuff Integrity after Rotator Cuff Repair

    PubMed Central

    Lee, Kwang Won; Chun, Tong Jin; Bae, Kyoung Wan; Choy, Won Sik; Park, Hyeon Jong

    2014-01-01

    Background This study was designed to perform conventional ultrasonography, magnetic resonance arthrography (MRA) and arthrosonography exams after rotator cuff repair to compare the results of conventional ultrasonography and arthrosonography with those of MRA as the gold standard. Methods We prospectively studied 42 consecutive patients (14 males, 28 females; average age, 59.4 years) who received arthroscopic rotator cuff repair due to full-thickness tears of the supraspinatus tendon from 2008 to 2010. The integrity assessment of the repaired rotator cuff was performed 6 months postoperatively using conventional ultrasonography, MRA, and arthrosonography. Results The diagnostic accuracy of the conventional ultrasonography compared to MRA was 78.6% and the McNemar test results were 0.016 in full-thickness tear and 0.077 in partial-thickness tear. The diagnostic accuracy of arthrosonography compared to MRA was 92.9% and the McNemar test results were 0.998 in full-thickness tear and 0.875 in partial-thickness tear. Conclusions It was found that the integrity assessment of the repaired rotator cuff by ultrasonography must be guarded against and that arthrosonography is an effective alternative method in the postoperative integrity assessment. Also, an arthrosonography seems to be a suitable modality to replace the conventional ultrasonography. PMID:25177461

  12. Hepatocellular Carcinoma Treated with Chemoembolization: Assessment with Contrast-Enhanced Doppler Ultrasonography

    SciTech Connect

    Catalano, Orlando; Esposito, Maria; Lobianco, Roberto; Cusati, Bianca; Altei, Francesco; Siani, Alfredo

    1999-11-15

    Purpose: To report our preliminary experience concerning the use of Doppler ultrasonography (DUS) techniques after intravenous injection of the galactose-based contrast agent Levovist in the assessment of hepatocellular carcinoma (HCC) treated with transcatheter arterial chemoembolization (TACE). The sonographic findings are correlated with those obtained using iodized oil (Lipiodol) helical computed tomography (CT). Methods: For 7 months we studied 28 patients with cirrhosis and HCC (a total of 43 nodules) who had undergone TACE between 18 and 30 days previously. The lesions were investigated with color Doppler ultrasonography (CDUS) and power Doppler ultrasonography (PDUS), before and after infusion of the echo-contrast agent (300 mg/ml, maximum 1 injection for each nodule, administered at constant velocity within 60-90 sec), and with helical Lipiodol-CT (0-7 days after DUS). In the retrospective analysis, special attention was given to the Doppler signals related to pulsatile intra- and perinodular flow and to the detection of new vessels after contrast agent injection. The signal intensity was graded as 0 (absent), 1 (low), 2 (medium), or 3 (high), while its distribution was classified as peripheral, central, or diffuse. Oily agent retention on CT scans was assessed as 0 (absent), I (<10%), II (<50%), III (>50%), or IV (homogeneous). These scores were awarded separately, without knowledge of the other judgments. Results: An hepatic global echo-enhancing effect was identified in all cases and always lasted long enough to allow an accurate analysis of all parenchymal lesions (at least 8 min). The signal scores could be evaluated in 39 of 43 HCCs, as follows: basal CDUS: grade 0 in 17 lesions, grade 1 in 16, grade 2 in 6; contrast-enhanced CDUS: grade 0 in 12 lesions, grade 1 in 10, grade 2 in 14, grade 3 in 3; basal PDUS: grade 0 in 15 lesions, grade 1 in 13, grade 2 in 9, grade 3 in 2; contrast-enhanced PDUS: grade 0 in 11 lesions, grade 1 in 9, grade 2 in 15, grade 3 in 6. Lipiodol-CT scoring was: grade 0 in 1 lesion, grade I in 7, grade II in 11, grade III in 9, grade IV in 11. In all but one nodule the difference between CDUS and PDUS scores, compared both with each other and with nonenhanced and contrast-enhanced examinations, was never greater than one grade. Conclusions: Contrast-enhanced DUS is a simple and fast procedure allowing a valuable, constant echo-enhancing effect of sufficient duration. DUS techniques, especially contrast-enhanced PDUS, offer an effective and realistic analysis of HCC nodules treated with TACE and show more evident agreement with Lipiodol-CT findings than baseline studies.

  13. A Method for Assessing the Microvasculature in a Murine Tumor Model Using Contrast-Enhanced Ultrasonography

    PubMed Central

    Loveless, Mary E.; Li, Xia; Huamani, Jessica; Lyshchik, Andrej; Dawant, Benoit; Hallahan, Dennis; Gore, John C.; Yankeelov, Thomas E.

    2009-01-01

    Objective The purpose of this study was to develop a method for assessing tumor vascularity in a preclinical model of breast cancer using contrast-enhanced ultrasonography. Methods Eight mice were injected with 67NR breast cancer cells on their hind limbs and imaged with ultrasonography 8 days later. Mice were injected with an ultrasound contrast agent (UCA), and a sequence of images of the resultant backscattered echoes was recorded before and after high-power “destruction” pulses for each of multiple parallel planes. From these, data maps of the maximum contrast enhancement (within each time course) were constructed for each pixel, which enabled reconstruction of high-resolution coregistered sections into a 3-dimensional (3D) volume reflecting tumor vascularity. Additional studies were performed to determine the duration and repeatability of image enhancement, and images were correlated with conventional 3D power Doppler measurements. Results The lifetime of the UCA in vivo was found to be 4.3 ± 1.09 minutes (mean ± SD). The 3D contrast-enhanced ultrasonographic technique produced images that correlated well with power Doppler images in specific regions but also depicted additional regions of flow surrounding the power Doppler signal. The mean correlation coefficient between voxel measurements of the central slice for each animal was 0.64 ± 0.07 (P < .01). In addition, sequential studies in each animal were reproducible. Conclusions A method producing high-resolution volumetric assessments of tumor vascularity in a preclinical model of breast cancer is shown that correlates with other ultrasonographic measures of blood flow, which may provide greater sensitivity to the microvasculature. PMID:19022995

  14. Value of ultrasonography in assessment of recent injury of anterior talofibular ligament in children

    PubMed Central

    Ciszkowska-?yso?, Beata; ?migielski, Robert; Zdanowicz, Urszula

    2015-01-01

    Introduction Sprained ankle is a very common injury in children. Proper treatment of ligament injuries enables full recovery. X-ray and US examinations are commonly available diagnostic methods. Material and methods Two hundred and six children (113 girls and 93 boys, mean age 10.6) with recent ankle joint sprain (up to 7 days of injury) were subject to a retrospective analysis. All patients underwent an X-ray and US examination of the ankle joint within 7 days of injury. In 19 patients, anterior talofibular ligament reconstruction was conducted. Results X-ray failed to visualize a pathology in 129 children (63%); in 24 patients (12%), avulsion fracture of the lateral malleolus was found, and in 36 cases (17%), effusion in the talocrural joint was detected. Ultrasonography failed to visualize a pathology in 19 children (9%); in 60 patients (29%), it showed avulsion fracture of the lateral malleolus involving the attachment of the anterior talofibular ligament (ATFL); in 34 cases (17%), complete ATFL tear was detected, and in 51 patients (25%), partial ATFL injury was found. Other injuries constituted 19%. The surgeries conducted to repair the anterior talofibular ligament (19) confirmed the US/X-ray diagnoses in 100% of cases. Avulsion ATFL injury, i.e. the one that involves the ligament attachment site, is usually found in younger children (median: 8 years of age). Complete ATFL tears (not involving the attachment site) concern older children (median: 14 years of age). Conclusions Since X-ray is of limited value in diagnosing ankle joint pathologies in recent sprain injuries in children, soft tissue imaging, i.e. ultrasonography, is the basic examination to assess the ligament complex. Avulsion fractures, which involve the ATFL attachment site and are usually found in younger children, are a consequence of the incomplete ossification and require urgent diagnosis and orthopedic consultation.

  15. Transvaginal Appendectomy: A Systematic Review

    PubMed Central

    Yagci, Mehmet Ali; Kayaalp, Cuneyt

    2014-01-01

    Background. Natural orifice transluminal endoscopic surgery (NOTES) is a new approach that allows minimal invasive surgery through the mouth, anus, or vagina. Objective. To summarize the recent clinical appraisal, feasibility, complications, and limitations of transvaginal appendectomy for humans and outline the techniques. Data Sources. PubMed/MEDLINE, Cochrane, Google-Scholar, EBSCO, clinicaltrials.gov and congress abstracts, were searched. Study Selection. All related reports were included, irrespective of age, region, race, obesity, comorbidities or history of previous surgery. No restrictions were made in terms of language, country or journal. Main Outcome Measures. Patient selection criteria, surgical techniques, and results. Results. There were total 112 transvaginal appendectomies. All the selected patients had uncomplicated appendicitis and there were no morbidly obese patients. There was no standard surgical technique for transvaginal appendectomy. Mean operating time was 53.3 minutes (25–130 minutes). Conversion and complication rates were 3.6% and 8.2%, respectively. Mean length of hospital stay was 1.9 days. Limitations. There are a limited number of comparative studies and an absence of randomized studies. Conclusions. For now, nonmorbidly obese females with noncomplicated appendicitis can be a candidate for transvaginal appendectomy. It may decrease postoperative pain and enable the return to normal life and work off time. More comparative studies including subgroups are necessary. PMID:25614832

  16. Liver Function Assessment Using Parenchyma-Specific Contrast-Enhanced Ultrasonography.

    PubMed

    Park, Jaehyung; Cho, Jinhan; Kwon, Heejin; Kang, Myongjin; Lee, Sangyun; Roh, Young-Hoon; Kim, Kwan Woo; Lee, Sung Wook

    2016-02-01

    The aim of this study was to assess hepatic functional reserve by analyzing the hepatic parenchyma enhancement curve of parenchyma-specific contrast-enhanced ultrasonography (CEUS). Fifty-two patients with cirrhosis who underwent CEUS and indocyanine green tests (ICG) because of a focal liver lesion were enrolled. We evaluated the hemodynamic-related parameters of the time-intensity curve and compared these findings with the ICG retention rate at 15 min (ICG R15). The correlation between the time from peak to one half (s) and ICG R15 was statistically significant and was relatively proportional to the ICG R15. A cut-off value of 149 s was determined for the time from peak to one half for abnormal ICG R15 (>14). The sensitivity and specificity were 85.7% and 92.3%, respectively, for the detection of abnormal ICG R15. In conclusion, the time from peak to one half of the time-intensity curve of parenchyma-specific CEUS of the liver can be a useful parameter to predict the hepatic reserve in liver cirrhosis. PMID:26610713

  17. Endorectal ultrasonography for the assessment of wall invasion and lymph node metastasis in rectal cancer.

    PubMed

    Katsura, Y; Yamada, K; Ishizawa, T; Yoshinaka, H; Shimazu, H

    1992-04-01

    Endorectal ultrasonography (ERUS) with a flexible-type radial scanner (Aloka Co. Ltd., Tokyo, Japan; 7.5 MHz) was applied to 120 patients with rectal cancer for the assessment of wall invasion and pararectal lymph node metastasis. Normal rectal wall was described as a five- or seven-layer structure excluding the lowest part within 3 cm from the anal verge. Loss of normal layers basically indicated the existence of cancer invasion. According to UICC classification, we divided the depth of wall invasion into four ultrasonographic levels (uT1-uT4), and results were correlated with histopathologic findings. Overall accuracy of the assessment was 92.0 percent (103/112). Overestimation occurred in 5 of 60 cases with T3 cancer (8.3 percent), and underestimation occurred in 1 of 19 cases with T2 cancer (5.3 percent) and 3 of 60 cases with T3 cancer (5 percent). Inflammatory cell infiltration was found around the cancer in a considerable number of cases. However, the assessment of wall invasion was hardly affected in our hands. Because the muscularis propria of the rectal wall was often recognized as a three-layer structure, uT2 cancer was subdivided into three subgroups of uPM1, uPM2, and uPM3. The assessment of invasion of sublayers in muscularis propria was possible in 14 of 19 cases (73.7 percent), and correct assessment was achieved in 57 percent of the cases. The ultrasonographic demonstration of pararectal lymph nodes was studied on 98 patients. No swollen lymph nodes were detected ultrasonographically in 35 of 98 cases (35.7 percent), but cancer metastasis was found histopathologically in 5 of these 35 cases (14.3 percent). The metastasis was observed more frequently in lymph nodes with a diameter of more than 5 mm (53.8 percent) and in those with a well-defined boundary and with an uneven and markedly hypoechoic pattern (72.3 percent). Although unable to detect minimal cancer foci. ERUS was considered a very useful tool for the assessment of the depth of cancer invasion in the rectal wall and pararectal lymph node metastasis. PMID:1582359

  18. Lung ultrasonography for the assessment of rapid extravascular water variation: evidence from hemodialysis patients.

    PubMed

    Trezzi, Matteo; Torzillo, Daniela; Ceriani, Elisa; Costantino, Giorgio; Caruso, Sabrina; Damavandi, Parham Tabaee; Genderini, Augusto; Cicardi, Marco; Montano, Nicola; Cogliati, Chiara

    2013-08-01

    Chest ultrasonography is a useful tool to assess extravascular lung water at bedside. In presence of interstitial-alveolar imbibition, vertical artifacts arising from the pleura are detected; these are called B-lines. Although a positive linear correlation between B-lines and extravascular lung water has been shown in symptomatic heart failure patients, the subclinical phase of pulmonary imbibition and the clearance of B-lines after rapid body fluid removal have been less investigated. The aim of this study was to assess if chest ultrasound could detect lung water imbibition and its variations induced by dialysis, an experimental model of controlled rapid fluid loss. Forty-one patients undergoing hemodialysis were studied. Total number of B-lines from ultrasound chest scanning and vena cava diameters were measured before and after treatment. Before dialysis, most of the patients presented ultrasound signs of pulmonary imbibition despite the absence of dyspnea; the number of B-lines was associated with the accumulated weight before treatment (p < 0.05) as well as with the residual weight after dialysis (p < 0.01); B-lines and end-inspiratory and end-expiratory vena cava diameters were also significantly reduced after dialysis. Moreover, B-lines reduction was significantly related to weight loss. Ultrasound performed at the bedside can detect lung water and intravascular overload and their reduction after dialysis in yet asymptomatic patients. These observations add further evidence regarding the use of lung ultrasound and inferior vena cava measurement in estimating volume overload and monitoring the response to therapy both in hemodialysis and congestive heart failure patients. PMID:21590437

  19. Lens thickness assessment: anterior segment optical coherence tomography versus A-scan ultrasonography

    PubMed Central

    Hamzeh, Nikoo; Moghimi, Sasan; Latifi, Golshan; Mohammadi, Massood; Khatibi, Nassim; Lin, Shan C.

    2015-01-01

    AIM To assess lens thickness measurements with anterior segment-optical coherence tomography (AS-OCT) in comparison with A-scan ultrasonography (A-scan US). METHODS There were 218 adult subjects (218 eyes) aged 59.2±9.2y enrolled in this prospective cross-sectional study. Forty-three eyes had open angles and 175 eyes had narrow angles. Routine ophthalmic exam was performed and nuclear opacity was graded using the Lens Opacities Classification System III (LOCS III). Lens thickness was measured by AS-OCT (Visante OCT, Carl Zeiss Meditec, Dublin, CA, USA). The highest quality image was selected for each eye and lens thickness was calculated using ImageJ software. Lens thickness was also measured by A-scan US. RESULTS Interclass correlations showed a value of 99.7% for intra-visit measurements and 95.3% for inter-visit measurements. The mean lens thickness measured by AS-OCT was not significantly different from that of A-scan US (4.861±0.404 vs 4.866±0.351 mm, P=0.74). Lens thickness values obtained from the two instruments were highly correlated overall (Pearson correlation coefficient=0.81, P<0.001), and in all LOCS III specific subgroups except in grade 5 of nuclear opacity. Bland-Altman analysis revealed a 95% limit of agreement from -0.45 to 0.46 mm. Lens thickness difference between the two instruments became smaller as the lens thickness increased and AS-OCT yielded smaller values than A-scan US in thicker lens (?=-0.29, P<0.001) CONCLUSION AS-OCT-derived lens thickness measurement is valid and comparable to the results obtained by A-scan US. It can be used as a reliable noncontact method for measuring lens thickness in adults with or without significant cataract. PMID:26682164

  20. Assessment of the reproductive physiology of the potto (Perodicticus potto) through fecal hormone metabolite analyses and trans-abdominal ultrasonography.

    PubMed

    MacKinnon, Katherine M; Guilfoyle, Michael J; Swanson, William F; Stoops, Monica A

    2015-01-01

    Potto (Perodicticus potto) reproductive biology has been minimally studied. Noninvasive endocrinology and ultrasonography are proven tools for reproductive assessment in other primates. In this study, we used fecal hormone metabolite analysis to monitor one adult male potto and four females at different life stages. Validated testosterone (T), estrone conjugate (EC), and progesterone (P4) enzyme immunoassays (EIA) were used to assess male testicular function and female ovarian and placental activity. The male excreted mean T concentrations of 4.72 (±1.66) ?g/g feces, that did not differ (P?>?0.05) over time or when paired with alternate females. Baseline concentrations of EC (range: 47.93-78.81?ng/g feces) and P4 (range: 2.29-12.46??g/g feces) differed among adult females. Follicular phases averaged 9.1 days (±3.43, n?=?30 phases), whereas luteal phases averaged 19.89 days (±9.49, n?=?19 phases). Gestation length (n?=?2 pregnancies) was 170 days. Gestational EC and P4 concentrations were positively correlated (pregnancy A, r (132)?=?0.71; pregnancy B, r (145)?=?0.76) and returned to non-pregnant luteal phase levels 3-7 days post parturition. Extreme differences between pregnant and non-pregnant EC and P4 concentrations may allow for one-sample pregnancy diagnosis. Trans-abdominal ultrasonography was validated for pregnancy diagnosis with the fetus observed between 100 and 110 days post breeding. To our knowledge, this is the first use of fecal endocrinology and ultrasonography to monitor reproductive function and pregnancy in this species, and the only study in any lorisid to measure progestagens in correlation with reproductive events. PMID:25913627

  1. Small intestine contrast ultrasonography vs computed tomography enteroclysis for assessing ileal Crohn's disease

    PubMed Central

    Onali, Sara; Calabrese, Emma; Petruzziello, Carmelina; Zorzi, Francesca; Sica, Giuseppe; Fiori, Roberto; Ascolani, Marta; Lolli, Elisabetta; Condino, Giovanna; Palmieri, Giampiero; Simonetti, Giovanni; Pallone, Francesco; Biancone, Livia

    2012-01-01

    AIM: To compare computed tomography enteroclysis (CTE) vs small intestine contrast ultrasonography (SICUS) for assessing small bowel lesions in Crohn's disease (CD), when using surgical pathology as gold standard. METHODS: From January 2007 to July 2008, 15 eligible patients undergoing elective resection of the distal ileum and coecum (or right colon) were prospectively enrolled. All patients were under follow-up. The study population included 6 males and 9 females, with a median age of 44 years (range: 18-80 years). Inclusion criteria: (1) certain diagnosis of small bowel requiring elective ileo-colonic resection; (2) age between 18-80 years; (3) elective surgery in our Surgical Unit; and (4) written informed consent. SICUS and CTE were performed ? 3 mo before surgery, followed by surgical pathology. The following small bowel lesions were blindly reported by one sonologist, radiologist, surgeon and histolopathologist: disease site, extent, strictures, abscesses, fistulae, small bowel dilation. Comparison between findings at SICUS, CTE, surgical specimens and histological examination was made by assessing the specificity, sensitivity and accuracy of each technique, when using surgical findings as gold standard. RESULTS: Among the 15 patients enrolled, CTE was not feasible in 2 patients, due to urgent surgery in one patients and to low compliance in the second patient, refusing to perform CTE due to the discomfort related to the naso-jejunal tube. The analysis for comparing CTE vs SICUS findings was therefore performed in 13 out of the 15 CD patients enrolled. Differently from CTE, SICUS was feasible in all the 15 patients enrolled. No complications were observed when using SICUS or CTE. Surgical pathology findings in the tested population included: small bowel stricture in 13 patients, small bowel dilation above ileal stricture in 10 patients, abdominal abscesses in 2 patients, enteric fistulae in 5 patients, lymphnodes enlargement (> 1 cm) in 7 patients and mesenteric enlargement in 9 patients. In order to compare findings by using SICUS, CTE, histology and surgery, characteristics of the small bowel lesions observed in CD each patient were blindly reported in the same form by one gastroenterologist-sonologist, radiologist, surgeon and anatomopathologist. At surgery, lesions related to CD were detected in the distal ileum in all 13 patients, also visualized by both SICUS and CTE in all 13 patients. Ileal lesions > 10 cm length were detected at surgery in all the 13 CD patients, confirmed by SICUS and CTE in the same 12 out of the 13 patients. When using surgical findings as a gold standard, SICUS and CTE showed the exactly same sensitivity, specificity and accuracy for detecting the presence of small bowel fistulae (accuracy 77% for both) and abscesses (accuracy 85% for both). In the tested CD population, SICUS and CTE were also quite comparable in terms of accuracy for detecting the presence of small bowel strictures (92% vs 100%), small bowel fistulae (77% for both) and small bowel dilation (85% vs 82%). CONCLUSION: In our study population, CTE and the non-invasive and radiation-free SICUS showed a comparable high accuracy for assessing small bowel lesions in CD. PMID:23155337

  2. Optimising ultrasonography in rheumatology.

    PubMed

    Keen, H I; Wakefield, R; Conaghan, P G

    2014-01-01

    Ultrasonography is an imaging modality that has been utilised in clinical medicine since the 1950s. However, application to joints and rheumatic disease was delayed until appropriate advances in technology made it feasible. Since the 1990s, rheumatologists have embraced ultrasonography as a useful clinical tool and it has increasingly been applied in routine practice. Initial criticism correctly focused on a lack of validity data, recognition that this modality is highly user-dependent and that reliability was not established. In response, the rheumatological community identified relevant pathologies to study, starting with synovitis in rheumatoid arthritis, and set about defining the ultrasound abnormalities, followed by demonstrating the validity, reproducibility and responsiveness of these measures. Much work is now ongoing in the areas of enthesitis, gout and osteoarthritis. Additionally, the evidence base for ultrasonography in clinical practice is being investigated, in order to understand its appropriate place. Given the sensitivity of ultrasonography over clinical examination for detection of inflammation, this work will focus on its role in optimising diagnosis, directing therapy through accurate assessment of disease activity and understanding the optimal selection of joints for feasible disease monitoring. This review summarises the work undertaken to date, ongoing work and future challenges of optimising the role of ultrasonography in rheumatology. PMID:25365083

  3. Application of B+M-Mode Ultrasonography in Assessing Deglutitive Tongue Movements in Healthy Adults

    PubMed Central

    Li, Changtian; Li, Junlai; Zhang, Changsheng; Cao, Xiaolin; Li, Nan; Song, Danfei; Yu, Tengfei

    2015-01-01

    Background The purpose of this study was to evaluate tongue movements during swallowing in healthy adults using the B+M-mode ultrasonography, and to determine a common feature in the M-mode traces for quantitative measurement and individual comparison of tongue movements. Material/Methods Ninety healthy subjects were divided into 3 groups according to age (20–39, 40–59, and 60–80 years). The tongue movements during 3 saliva swallows were examined using real-time B+M-mode ultrasonography. The M-mode traces of tongue movements were recorded and evaluated. Results Both intra-individual and inter-individual differences were detected in the M-mode traces during the 3 saliva swallows. Characteristic types were seen during the individual swallowing phases of M-mode traces: 2 activity types in phase I, 2 types in phase IIb, and 3 types in phase III. However, no variations were seen during phase IIa, in which all subjects displayed a continuous upsloping trace. The average range of swallow-related tongue radial displacement during phase IIa decreased gradually with age, while the average duration of tongue movement during phase IIa increased gradually with age. These 2 trends were not statistically significant across age groups. However, differences between sexes were found in both the range of tongue radial displacement and the duration of deglutitive lingual actions during phase IIa in all 3 age groups (P<0.05). Conclusions B+M-mode ultrasonography may offer a quick and safe alternative for the preliminary evaluation of deglutitive tongue movements. PMID:26049721

  4. Assessment of hemodynamic disturbances in aphasic patients by transcranial Doppler ultrasonography.

    PubMed

    Pendefunda, L

    1989-01-01

    The author presents a study of Doppler cerebrovascular ultrasonography carried out in 38 aphasie patients (forms ranging from transient speech disturbances to severe, persistent disturbances of motor, sensory or mixed aphasia) after ischemic or hemorrhagic stroke. In these cases, the clinical symptoms were dominated by speech impairment and neurological deficits (mainly pyramidal), of low intensity or transient. The angiographic study revealed stenotic or occlusive disturbances at various levels of the cerebral arterial trunks. The prevalence of some clinical aspects of aphasia correlated with Doppler velocimetric images is discussed and the use of transcranial Doppler method in idiopathic aphasia, possible consequence of a transient ischemic attack, is suggested. PMID:2479971

  5. Spontaneous interstitial pregnancy on a tubal stump after unilateral adenectomy followed by transvaginal colour Doppler ultrasound.

    PubMed

    Bernardini, L; Valenzano, M; Foglia, G

    1998-06-01

    Transvaginal colour and angio Doppler blood flow analysis combined with serial measurement of human chorionic gonadotrophin (HCG) concentration is reported here for the first time to study the local vascularity of a cornual pregnancy and to monitor the effectiveness of medical therapy. Interestingly, a strong relationship between morphological changes of trophoblastic tissue and the intensity of neovascularization was noted. Systemic single-dose methotrexate (MTX) therapy allowed successful treatment of an interstitial ectopic pregnancy involving part of the proximal portion of a tubal stump. We suggest that, by adding colour Doppler to conventional transvaginal ultrasonography, the outpatient surveillance of ectopic pregnancy evolution following MTX therapy is greatly enhanced. This is of particular value in cornual pregnancies which are highly likely to develop harmful complications during surgical intervention or even during puncture for local MTX injection. PMID:9688421

  6. Transvaginal Sonographic Evaluation of the Cervix in Asymptomatic Singleton Pregnancy and Management Options in Short Cervix

    PubMed Central

    Arisoy, Resul; Yayla, Murat

    2012-01-01

    Preterm delivery (PTD), defined as birth before 37 completed weeks of gestation, is the leading cause of perinatal morbidity and mortality. Evaluation of the cervical morphology and biometry with transvaginal ultrasonography at 16–24 weeks of gestation is a useful tool to predict the risk of preterm birth in low- and high-risk singleton pregnancies. For instance, a sonographic cervical length (CL) > 30?mm and present cervical gland area have a 96-97% negative predictive value for preterm delivery at <37 weeks. Available evidence supports the use of progesterone to women with cervical length ?25?mm, irrespective of other risk factors. In women with prior spontaneous PTD with asymptomatic cervical shortening (CL ? 25?mm), prophylactic cerclage procedure must be performed and weekly to every two weeks follow-up is essential. This article reviews the evidence in support of the clinical introduction of transvaginal sonography for both the prediction and management of spontaneous preterm labour. PMID:22523687

  7. Transvaginal colour flow imaging: a possible new screening technique for ovarian cancer.

    PubMed Central

    Bourne, T.; Campbell, S.; Steer, C.; Whitehead, M. I.; Collins, W. P.

    1989-01-01

    OBJECTIVE--To assess whether changes in the intraovarian vasculature or blood flow impedance can be used to identify potentially malignant masses. DESIGN--Open, non-comparative prospective study. SETTING--Ovarian screening clinics at King's College Hospital and the Hallam Medical Centre. SUBJECTS--50 Women selected on the basis of their medical history and the result of a previous transvaginal ultrasound scan. Thirty women (10 premenopausal (scan taken on days 1 to 8 of the menstrual cycle) and 20 postmenopausal) had normal ovaries, and 20 had at least one ovary with an abnormal morphology or volume, or both. INTERVENTIONS--Women with a positive result on screening were referred for laparotomy. MAIN OUTCOME MEASURES--Presence or absence of coloured areas (neovascularisation) and the pulsatility index within each ovary. The pulsatility index is a measure of the impedance to blood flow, a low value indicating decreased impedance and a high value increased impedance to blood flow. RESULTS--Two women with a positive result on screening had hydrosalpinges, 10 a benign tumour or a tumour-like condition, and eight primary ovarian cancers. No areas of neovascularisation were seen in the 30 women with morphologically normal ovaries and the two patients with hydrosalpinges; the pulsatility index ranged from 3.1 to 9.4. Similarly, nine patients (10 affected ovaries) with a non-malignant mass had no signs of neovascularisation and the pulsatility index varied from 3.2 to 7.0. One patient with bilateral dermoid cysts containing nests of thyroid-like cells had vascular changes and pulsatility index values of 0.4 and 0.8. Seven patients (eight ovaries) with primary ovarian cancer (one stage IV, four stage II, and two stage Ia) showed clear evidence of neovascularisation and pulsatility index values were from 0.3 to 1.0. One patient with an intraepithelial serous cystadenocarcinoma in a small ovary (less than 5 ml volume) had no signs of any vascular change and the pulsatility index was 5.5. CONCLUSION--Transvaginal colour flow imaging may be used to identify potentially malignant ovarian masses and help elucidate the early stages of tumorigenesis. The routine application of this technique may reduce the rate of false positive results of an ultrasonography based screening procedure. Images FIG 1 FIG 2 PMID:2513965

  8. Ultrasonography (US) in the assessment of pediatric non traumatic gastrointestinal emergencies

    PubMed Central

    2013-01-01

    Background Non traumatic gastrointestinal emergencies in the children and neonatal patient is a dilemma for the radiologist in the emergencies room and they presenting characteristics ultrasound features on the longitudinal and axial axis. The most frequent emergencies are : appendicitis, intussusceptions, hypertrophic pyloric stenosis, volvulus due to intestinal malrotation. The aim of this article is to familiarize the reader with the US features. Methods A retrospective analysis of 200 ultrasound examinations performed in neonatal and children patients with fever, abdominal pain, leukocytosis, vomiting and diarrhea were evaluated. Results Of 200 exame 50 cases of intussusceptions, 100 cases of appendicitis, 20 cases associated with abscess;10 gangrenous appendicitis with absence a color Doppler , and 10 cases of perforated appendicitis at tomography computer integration and 10 cases of volvulus was found. Conclusions Ultrasonography (US) is therefore rapidly becoming an important imaging modality for the evaluation of acute abdominal pain, particularly in pediatric patients, where satisfactory examination is often not achievable for the attending clinicians. US provides excellent anatomic detail on the longitudinally and axial axis . PMID:23902696

  9. Assessment of cervical lymph node metastasis in esophageal carcinoma using ultrasonography.

    PubMed Central

    Natsugoe, S; Yoshinaka, H; Shimada, M; Shirao, K; Nakano, S; Kusano, C; Baba, M; Fukumoto, T; Takao, S; Aikou, T

    1999-01-01

    OBJECTIVE: To evaluate the efficacy of ultrasonography for the diagnosis of cervical lymph node metastasis in esophageal carcinoma. SUMMARY BACKGROUND DATA: Ultrasound (US) examination is useful for diagnosing lymph node metastasis. However, few reports have examined its role in the decision to perform cervical lymph node dissection in esophageal carcinoma. METHODS: Ultrasound examination was performed to evaluate cervical lymph node metastasis in 519 patients with esophageal carcinoma. The patients were divided into 5 groups according to treatment received: group 1, 153 patients who underwent curative resection of primary tumor by right thoracotomy and complete bilateral cervical lymphadenectomy; group 2, 112 patients who underwent curative resection of primary tumor by right thoracotomy but without cervical lymphadenectomy; group 3, 78 patients who underwent esophagectomy by left thoracotomy or blunt dissection with or without removal of cervical lymph nodes; group 4, 76 patients with palliative resection without cervical lymphadenectomy; and group 5, 100 patients without any surgical treatment. US diagnosis was compared with histologic findings or cervical lymph node recurrence. RESULTS: Lymph node metastasis was detected in 30.8% of patients (160/519). The sensitivity, specificity, and accuracy of US diagnosis in group 1 were 74.5%, 94.1%, and 87.6%, respectively. Cervical lymph node recurrence was seen in 7 patients (4.6%) in group 1, in 4 patients (3.6%) in group 2, and 3 patients (3.8%) in group 3. Although the incidence of cervical lymph node metastasis as determined by US examination was high in groups 4 and 5, almost none of the patients died of cervical lymph node metastasis. CONCLUSIONS: Ultrasound examination plays a useful role in the decision to perform cervical lymph node dissection in patients with esophageal carcinoma, particularly in those with potentially curative dissection. Images Figure 2. Figure 3. Figure 4. PMID:9923801

  10. Assessment of the utility of ultrasonography with high-frequency transducers in the diagnosis of entrapment neuropathies

    PubMed Central

    2014-01-01

    The primary aim of this paper was to assess the relevance of high-frequency ultra-sound examination in qualifying patients for either surgical or conservative treatment of peripheral entrapment neuropathies. The study was conducted in a group of 55 patients aged 7–83 (mean age 43.6), including 28 males and 27 females, who in 2009–2011 were referred to an ultrasound examination due to a clinical suspicion of entrapment neuropathies. For the purposes of the analysis, the patients were divided into four groups: carpal tunnel syndrome (1), ulnar nerve entrapment (2) (cubital tunnel syndrome and Guyon's canal syndrome), posterior interosseous nerve syndrome (3) and other entrapment neuropathies (4). The cases of isolated idiopathic carpal tunnel syndrome were excluded from the analysis. All patients underwent the interview, physical examination and ultrasound examination. Ultrasound examinations were performed with Esaote MyLab 50 and MyLab 60 systems using high-frequency broadband linear transducers: 6–18 MHz. Sixty-seven percent of patients (37 persons) underwent a neurophysiological test. Nerve echostructure, its hyperemia as well as nerve cross-sectional area or, in the case of small nerves, diameter were assessed in all patients. Furthermore, the following were assessed in individual groups: notch sign in group 1, nerve instability in a dynamic ultrasound examination in group 2, nerve angulation in a dynamic ultrasound examination and tenderness on nerve compression at the site of the visualized pathology in group 3. The analyses of the collected material were performed by means of descriptive statistics. The results of clinical and surgical verification were consistent with ultrasound findings in 96.4%. The results indicate that high-frequency ultrasonography is a valuable method in qualifying patients for various types of treatment of peripheral neuropathies resulting from compression.

  11. Transvaginal appendectomy in morbidly obese patient.

    PubMed

    Yagci, Mehmet Ali; Kayaalp, Cuneyt; Ates, Mustafa

    2014-01-01

    Introduction. Laparoscopic appendectomy has significant benefits in obese patients. However, morbid obesity can be accepted as an exclusion criterion for natural orifice transluminal endoscopic surgery (NOTES). Here, we present a transvaginal appendectomy in a 66-year-old morbidly obese (BMI 36 kg/m(2), ASA III) patient. Case and Technique. Acute appendicitis was suspected based on history, physical examination, laboratory tests, and ultrasound findings. During laparoscopic surgery, a 5?mm trocar was inserted through the umbilicus and a 5?mm telescope was placed. A 12?mm trocar and a 5?mm grasper were inserted separately through the posterior fornix of the vagina under laparoscopic guidance. The appendix was divided with an endoscopic stapler through the transvaginal 12?mm trocar and removed from the same trocar. The operating time was 75 minutes with minimal blood loss (<10?mL). The patient was discharged 16 hours after surgery uneventfully and she did not require any analgesic administration. Conclusion. To the best of our knowledge, this is the first clinical case that focuses on the transvaginal appendectomy at morbid obesity. We can say that morbid obesity does not constitute an obstacle for treatment of acute appendicitis by transvaginal endoscopic surgery. PMID:25506028

  12. Assessment of the utility of ultrasonography with high-frequency transducers in the diagnosis of postoperative neuropathies

    PubMed Central

    2015-01-01

    The primary aim of this paper was to assess the relevance of high-frequency ultrasound examination in qualifying patients for either surgical or conservative treatment of postoperative peripheral neuropathies. The study was conducted in a group of 71 patients who in 2009–2011 were referred to ultrasound examinations due to a clinical suspicion of peripheral neuropathies. For the purposes of this analysis, the suspected postoperative neuropathies were divided into three groups: after surgical treatment of the median nerve (1), after surgical treatment of the ulnar nerve (2) and other postoperative neuropathies (3). All patients underwent the interview, physical examination and ultrasound examination. The ultrasound examinations were performed with Esaote MyLab 50 and MyLab 60 systems. Based on the clinical and US examinations, the patients were qualified for either surgical (51 cases) or conservative treatment (20 cases). An EMG examination was also performed in certain patients (60 cases). Mean values of cross-sectional areas and diameters of the nerve trunks were calculated in individual pathology groups. The ultrasound features of the peripheral nerves analyzed in the study, such as echostructure, notch sign, hyperemia and continuity of the transverse ligament, were divided into subgroups. Moreover, the frequency of adhesions between the nerve trunks and adjacent tissues, occurrence of pain on compression with a transducer and instability of the ulnar nerve as well as angulation of the posterior interosseous nerve in a dynamic examination was calculated. The analyses of the collected material were performed by means of descriptive statistics. The results of clinical and surgical verification were consistent with ultrasound findings in 100% of cases. The results indicate that high-frequency ultrasonography is a valuable method in qualifying patients for various types of treatment of peripheral postoperative neuropathies. PMID:26674960

  13. Linear endobronchial ultrasonography: a novelty turned necessity for mediastinal nodal assessment.

    PubMed

    Rintoul, Robert C; Ahmed, Rawya; Dougherty, Brendan; Carroll, Nicholas R

    2015-02-01

    Linear endobronchial ultrasound was first described in 2003. Since then the technique has spread rapidly and has now become an established practice in many centres as the first-line mediastinal investigation for the diagnosis and staging of lung cancer. In combination with endoscopic ultrasound, the majority of the mediastinum can be assessed and this approach has been shown to have equivalent accuracy to surgical staging. This strategy is also cost-effective. New tissue processing techniques using liquid-based thin-layer cytology and cell blocks have increased diagnostic yield using immunohistochemical staining and molecular diagnostics. Several meta-analyses of case series and, more recently, randomised controlled trials have provided high-level evidence of efficacy leading to incorporation into national lung cancer staging guidelines. In addition, linear endobronchial ultrasound is increasingly used in the investigation of mediastinal lymphadenopathy for suspected sarcoidosis, tuberculosis and lymphoma. While undoubtedly endobronchial/endoscopic ultrasound has reduced the need for surgical staging in lung cancer, the latter still has an important role to play in certain scenarios. The challenge now facing clinicians is to learn to apply the appropriate test or sequence of tests in each patient while ensuring that operators are appropriately trained in order to ensure optimal outcomes. PMID:25246665

  14. Assessment of the utility of ultrasonography with high-frequency transducers in the diagnosis of posttraumatic neuropathies

    PubMed Central

    2015-01-01

    The primary aim of this paper was to assess the relevance of high-frequency ultrasound examination in qualifying patients for either surgical or conservative treatment of posttraumatic peripheral neuropathies. The study was conducted in a group of 47 patients aged 16–65 (mean age 33) who in 2009–2011 were referred to ultrasound examinations due to a clinical suspicion of posttraumatic peripheral neuropathies. The group included 30 females and 17 males. The patients examined presented with neuropathies of the following peripheral nerves: median, ulnar, common peroneal, digital, cutaneous in the deltoid area, mental, PIN and RSNR. In 21 patients, nerve injuries were partial, and in 24 – complete. In 2 cases, the nerve was entrapped between bony fragments. 17 of 21 patients with partial nerve injuries (80.95%) underwent an EMG examination. No functional tests were conducted in the cases of complete injuries when ultrasound imaging had confirmed the result of the clinical examination. All patients underwent the interview, physical examination and ultrasound examination. Ultrasound examinations were performed with Esaote MyLab 50 and MyLab 60 systems using high-frequency broadband linear transducers: 6–18 MHz. The nerves were evaluated in the gray-scale and in the power Doppler mode in longitudinal and transverse sections for localization, morphology and the grade of injury as well as for possible anatomic variants of the nerve trunk and pathologies of the adjacent tissues. Moreover, a dynamic examination was performed, and it was attempted to induce pain or paresthesia by palpation at the site of the visualized pathology. Additionally, the motor and sensory–motor nerves were assessed indirectly based on the images of the skeletal muscles innervated by these nerves. The analyses of the collected material were performed by means of descriptive statistics. The results of clinical and surgical verification were consistent with ultrasound findings in 100% of cases. The results obtained indicate that high-frequency ultrasonography is a valuable method in qualifying patients for various types of treatment of peripheral neuropathies resulting from trauma. PMID:26675749

  15. [Transvaginal color Doppler in ovarian neoplasms].

    PubMed

    Martínez, J; Vaccaro, H; Amor, F; Gana, J A; González, E

    1993-01-01

    Thirty one patients with clinical and sonographic diagnosis of ovarian tumor were studied prospectively, with Transvaginal Color Doppler. There were 24 benign and 7 malignant tumors (4 stage I borderline, I stage IA cistoadenocarcinoma and 2 adenocarcinoma stage III). Six malignant tumors had resistance indexes (IR) from 0.17 to 0.55. In one borderline no vascular signal was obtained. The probability of malignancy increased inversely with the IR from 60%, with RI below 0.60 to 100% with IR below 0.4. PMID:7991859

  16. Postoperative ultrasonography of the musculoskeletal system.

    PubMed

    Chun, Kyung Ah; Cho, Kil-Ho

    2015-07-01

    Ultrasonography of the postoperative musculoskeletal system plays an important role in the Epub ahead of print accurate diagnosis of abnormal lesions in the bone and soft tissues. Ultrasonography is a fast and reliable method with no harmful irradiation for the evaluation of postoperative musculoskeletal complications. In particular, it is not affected by the excessive metal artifacts that appear on computed tomography or magnetic resonance imaging. Another benefit of ultrasonography is its capability to dynamically assess the pathologic movement in joints, muscles, or tendons. This article discusses the frequent applications of musculoskeletal ultrasonography in various postoperative situations including those involving the soft tissues around the metal hardware, arthroplasty, postoperative tendons, recurrent soft tissue tumors, bone unions, and amputation surgery. PMID:25971901

  17. Postoperative ultrasonography of the musculoskeletal system

    PubMed Central

    Chun, Kyung Ah; Cho, Kil-Ho

    2015-01-01

    Ultrasonography of the postoperative musculoskeletal system plays an important role in the Epub ahead of print accurate diagnosis of abnormal lesions in the bone and soft tissues. Ultrasonography is a fast and reliable method with no harmful irradiation for the evaluation of postoperative musculoskeletal complications. In particular, it is not affected by the excessive metal artifacts that appear on computed tomography or magnetic resonance imaging. Another benefit of ultrasonography is its capability to dynamically assess the pathologic movement in joints, muscles, or tendons. This article discusses the frequent applications of musculoskeletal ultrasonography in various postoperative situations including those involving the soft tissues around the metal hardware, arthroplasty, postoperative tendons, recurrent soft tissue tumors, bone unions, and amputation surgery. PMID:25971901

  18. Usefulness of Ultrasonography for Diagnosis of Small Bowel Tumors

    PubMed Central

    Fujita, Minoru; Manabe, Noriaki; Honda, Keisuke; Murao, Takahisa; Osawa, Motoyasu; Kawai, Ryosuke; Akiyama, Takashi; Shiotani, Akiko; Haruma, Ken; Hata, Jiro

    2015-01-01

    Abstract Ultrasonography is a standard, noninvasive modality used to evaluate patients with gastrointestinal diseases. This study assessed the usefulness of ultrasonography in the detection of small bowel tumors. This study enrolled 558 consecutive patients (295 males, 263 females; mean age 71.1 years) who underwent ultrasonography before capsule endoscopy and/or balloon-assisted endoscopy. Ultrasonographic detection of small bowel tumors was compared with detection by capsule endoscopy and/or balloon-assisted endoscopy. In addition, factors affecting small bowel tumor detection by ultrasonography and clinical characteristics of patients with small bowel tumors undetected by ultrasonography were evaluated. Ninety-seven tumors (52 benign, 45 malignant) detected by capsule endoscopy and/or balloon-assisted endoscopy were retrospectively analyzed. The sensitivity and specificity of ultrasonography in the detection of small bowel tumors were 50.5% (47/93) and 100% (465/465), respectively. If we restricted patients to those with a tumor >20?mm in size, its detection ratio would become higher (91.7%): the ratio of submucosal tumor >20?mm in size was 85.7% (6/7) and that of partial and circumferential ulcerative tumors >20?mm in size was 96.9% (31/32), respectively. Small bowel tumors detected by ultrasonography (mean 33.2?mm) were significantly larger than those undetected by ultrasonography (mean 8.7?mm). The percentage of small bowel tumors located in the ileum detected by ultrasonography (70.6%) was significantly higher than those undetected by ultrasonography (29.4%). Of the 46 small bowel tumors undetected by ultrasonography, 42 (91.3%) were benign tumors with good clinical prognosis. Ultrasonography is a useful modality for detecting larger small bowel tumors and ulcerative lesions. Ultrasonography should be considered a first-line modality for patients suspected of having small bowel tumors, because most small bowel tumors undetected by ultrasonography were benign tumors with good clinical prognosis. PMID:26448000

  19. Understanding EUS (Endoscopic Ultrasonography)

    MedlinePLUS

    ... Education Videos Questions to Ask Your MD Endoscopy Unit Recognition Program Screen4coloncancer.org About Colonoscopy Facts About Common Colon Cancer Screening Tests PATIENTS Understanding EUS (Endoscopic Ultrasonography) You've been ...

  20. Renal Relevant Radiology: Use of Ultrasonography in Patients with AKI

    PubMed Central

    Patel, Nayana U.; Lockhart, Mark E.; Cadnapaphornchai, Melissa A.

    2014-01-01

    Summary As judged by the American College of Radiology Appropriateness Criteria, renal Doppler ultrasonography is the most appropriate imaging test in the evaluation of AKI and has the highest level of recommendation. Unfortunately, nephrologists are rarely specifically trained in ultrasonography technique and interpretation, and important clinical information obtained from renal ultrasonography may not be appreciated. In this review, the strengths and limitations of grayscale ultrasonography in the evaluation of patients with AKI will be discussed with attention to its use for (1) assessment of intrinsic causes of AKI, (2) distinguishing acute from chronic kidney diseases, and (3) detection of obstruction. The use of Doppler imaging and the resistive index in patients with AKI will be reviewed with attention to its use for (1) predicting the development of AKI, (2) predicting the prognosis of AKI, and (3) distinguishing prerenal azotemia from intrinsic AKI. Finally, pediatric considerations in the use of ultrasonography in AKI will be reviewed. PMID:24235286

  1. Shear Wave Elastography in Head and Neck Lymph Node Assessment: Image Quality and Diagnostic Impact Compared with B-Mode and Doppler Ultrasonography.

    PubMed

    Desmots, Florian; Fakhry, Nicolas; Mancini, Julien; Reyre, Anthony; Vidal, Vincent; Jacquier, Alexis; Santini, Laure; Moulin, Guy; Varoquaux, Arthur

    2016-02-01

    The aim of this study was to assess the diagnostic performance of shear wave elastography (SWE) in comparison to B-mode and Doppler ultrasonography in differentiating benign from malignant head and neck lymph nodes (HNLNs). Sixty-two HNLNs from 56 patients were prospectively examined using B-mode, Doppler and SWE. The standard of reference was histopathology or cytology and follow-up. Qualitative malignant criteria (hilum infiltration, cortical hypo-echogenicity, irregular margins, abnormal vessels) were assessed on a five-point scale. Four quantitative parameters were obtained: long axis length, short axis length, short axis/long axis ratio, resistive index and maximum shear elasticity modulus (?max). Diagnostic performance was analyzed with special emphasis on the sub-centimeter HNLN subgroup. Thirty HNLNs were malignant (48%). ?max intra-observer reproducibility was 0.899 (0.728 in sub-centimeter subgroup). Malignant HNLNs were stiffer (?max = 72.4 ± 59.0 kPa) compared with benign nodes (?max = 23.3 ± 25.3 kPa) (p < 0.001). Among the quantitative criteria, ?max had the highest diagnostic accuracy (area under the curve = 0.903 ± 0.042), especially in the sub-centimeter subgroup (area under the curve = 0.929 ± 0.045; p < 0.001) in which the area under the curve was significantly higher compared with the other quantitative criteria (p < 0.05). The additional use of SWE combined with B-mode tended to improve diagnostic accuracy (p > 0.05). SWE is a promising reproducible quantitative tool with which to predict malignant HNLNs, especially sub-centimeter nodes. PMID:26617244

  2. Ultrasonography of intrauterine devices

    PubMed Central

    Nowitzki, Kristina M.; Hoimes, Matthew L.; Chen, Byron; Zheng, Larry Z.; Kim, Young H.

    2015-01-01

    The intrauterine device (IUD) is gaining popularity as a reversible form of contraception. Ultrasonography serves as first-line imaging for the evaluation of IUD position in patients with pelvic pain, abnormal bleeding, or absent retrieval strings. This review highlights the imaging of both properly positioned and malpositioned IUDs. The problems associated with malpositioned IUDs include expulsion, displacement, embedment, and perforation. Management considerations depend on the severity of the malposition and the presence or absence of symptoms. Three-dimensional ultrasonography has proven to be more sensitive in the evaluation of more subtle findings of malposition, particularly side-arm embedment. Familiarity with the ultrasonographic features of properly positioned and malpositioned IUDs is essential. PMID:25985959

  3. Associations between low back pain, urinary incontinence, and abdominal muscle recruitment as assessed via ultrasonography in the elderly

    PubMed Central

    Figueiredo, Vânia F.; Amorim, Juleimar S. C.; Pereira, Aline M.; Ferreira, Paulo H.; Pereira, Leani S. M.

    2015-01-01

    Background: Low back pain (LBP) and urinary incontinence (UI) are highly prevalent among elderly individuals. In young adults, changes in trunk muscle recruitment, as assessed via ultrasound imaging, may be associated with lumbar spine stability. Objective: To assess the associations between LBP, UI, and the pattern of transversus abdominis (TrA), internal (IO), and external oblique (EO) muscle recruitment in the elderly as evaluated by ultrasound imaging. Method: Fifty-four elderly individuals (mean age: 72±5.2 years) who complained of LBP and/or UI as assessed by the McGill Pain Questionnaire, Incontinence Questionnaire-Short Form, and ultrasound imaging were included in the study. The statistical analysis comprised a multiple linear regression model, and a p-value <0.05 was considered significant. Results: The regression models for the TrA, IO, and EO muscle thickness levels explained 2.0% (R2=0.02; F=0.47; p=0.628), 10.6% (R2=0.106; F=3.03; p=0.057), and 10.1% (R2=0.101; F=2.70; p=0.077) of the variability, respectively. None of the regression models developed for the abdominal muscles exhibited statistical significance. A significant and negative association (p=0.018; ?=-0.0343) was observed only between UI and IO recruitment. Conclusion: These results suggest that age-related factors may have interfered with the findings of the study, thus emphasizing the need to perform ultrasound imaging-based studies to measure abdominal muscle recruitment in the elderly. PMID:25714438

  4. Laparoscopic Management or Laparoscopy Combined with Transvaginal Management of Type II Cesarean Scar Pregnancy

    PubMed Central

    Wang, Huan-Ying; Li, Yan-Na; Wei, Wei; Zhang, Da-Wei; Lu, Yu-Qiu; Zhang, Hao-Feng

    2013-01-01

    Objective: To evaluate the clinical effectiveness of laparoscopic management of cesarean scar pregnancy (CSP) by deep implantation. Background: A pregnancy implanting within the scar from a previous cesarean delivery is a rare condition of ectopic pregnancy. There are two different types of CSPs. Type I is caused by implantation of the amniotic sac on the scar with progression toward either the cervicoisthmic space or the uterine cavity. Type II (CSP-II) is caused by deep implantation into a previous CS defect with infiltrating growth into the uterine myometrium and bulging from the uterine serosal surface, which may result in uterine rupture and severe bleeding during the first trimester of pregnancy. Thus, timely management with an early and accurate diagnosis of CSP-II is important. However, laparoscopic management in CSP-II has not yet been evaluated. Methods: Eleven patients with CSP-II underwent conservative laparoscopic surgery or laparoscopy combined with transvaginal bilateral uterine artery ligation and resection of the scar with gestational tissue and wound repair to preserve the uterus from March 2008 to November 2011. Patients with CSP-II were diagnosed using color Doppler sonography, and the diagnosis was confirmed by laparoscopy. The operation time, the blood loss during surgery, the levels of ?-human chorionic gonadotropin (?-hCG) before surgery, the time taken for serum ?-hCG levels to return to <100 mIU/mL postoperatively, and the time for the uterine body to revert to its original state were retrospectively analyzed. Results: All 11 operations were successfully performed using laparoscopy with preservation of the uterus. One patient underwent a dilation and curettage after laparoscopic bilateral uterine artery ligation. Eight patients were treated solely by laparoscopic bilateral uterine artery ligation and resection of the scar with gestational tissue and wound repair. The remaining two patients underwent laparoscopic bilateral uterine artery ligation and transvaginal resection of the CS with gestational tissue and wound repair because of dense adhesions and heavy bleeding. The average operation time was 85.5 (±17.5) minutes, and the blood loss was 250.0 (±221.4) mL. The blood serum level of ?-hCG returned to <100 mIU/mL in 16.4 (±5.3) days postoperatively. Among the 10 patients who underwent resection of CS and wound repair, the time for the uterus to revert to its original state (judged by ultrasonography) was 10.8 (±3.0) days postoperatively. Conclusions: Laparoscopy can remove ectopic gestational tissue and allow subsequent wound repair, as well as provide diagnostic confirmation. Being a minimally invasive procedure, laparoscopic or laparoscopy combined with transvaginal bilateral uterine artery ligation and resection of the scar with gestational tissue and wound repair can become an effective alternative for the treatment of CSP-II. PMID:23925020

  5. Color Doppler ultrasonography of the abdominal aorta

    PubMed Central

    Battaglia, S.; Danesino, G.M.; Danesino, V.; Castellani, S.

    2010-01-01

    Alterations of the abdominal aorta are relatively common, particularly in older people. Technological advances in the fields of ultrasonography, computed tomography, angiography, and magnetic resonance imaging have greatly increased the imaging options for the assessment of these lesions. Because it can be done rapidly and is also non-invasive, ultrasonography plays a major role in the exploration of the abdominal aorta, from its emergence from the diaphragm to its bifurcation. It is indicated for the diagnosis and follow-up of various aortic diseases, especially aneurysms. It can be used to define the shape, size, and location of these lesions, the absence or presence of thrombi and their characteristics. It is also useful for monitoring the evolution of the lesion and for postoperative follow-up. However, its value is limited in surgical planning and in emergency situations. PMID:23396814

  6. Transvaginal color doppler ultrasound in the conservative treatment and surveillance of three ectopic pregnancies.

    PubMed

    Plancher, S; Conway, C; Zalud, I

    1998-06-01

    We evaluated the role of transvaginal color Doppler ultrasound in the treatment and follow-up after transvaginal instillation of methotrexate in ectopic pregnancy. Three patients diagnosed with ectopic pregnancies were treated with a single 50 mg dose of methotrexate, transvaginally instilled, under direct color sonographic guidance. Inclusion criteria required a gestational age of less than 8 weeks, non-ruptured ectopic pregnancy, gestational sac of less than 4 cm, and compliant patient. b-hCG titers, gestational sac sizes, and Doppler flow waveform analyses were followed at regular intervals. All three patients had falling b-hCG titers, shrinkage of the gestational sacs, and normalization of Doppler flow waveform indices. Transvaginal color Doppler ultrasound appears to be an effective adjunct in the treatment and follow-up of ectopic pregnancies treated with transvaginal instillation of methotrexate. PMID:9575280

  7. [History of neurovascular ultrasonography].

    PubMed

    Baumgartner, R W

    1997-01-01

    History of diagnostic ultrasound begins with the Austrian physicist Christian Doppler, who described in 1842 the Doppler principle. 40 years later, the Curies discovered the reverse piezoelectric effect that produces ultrasound. The first ultrasonic devices were designed at the beginning of the 20th century and were used among other things for detection of submarines. Development during World War II permitted the construction of the first transcranial (1940) and extracranial (1949) ultrasound imaging units. Continuous-wave Doppler sonography was introduced in clinical practice 20 to 30 years later. Due to its high validity, this technique has become the standard method for evaluation of extracranial occlusive cerebrovascular disease. Further ultrasonic developments like duplex and color duplex sonography have increased the diagnostic possibilities but did not replace continuous-wave sonography in many European ultrasound laboratories. Transcranial ultrasound studies are performed by means of pulsed-wave Doppler or color duplex sonography. It is likely that power Doppler and transpulmonary contrast agents will further increase diagnostic confidence in neurovascular ultrasound. The search for a source of arterio-arterial embolism in case of ocular and cerebral ischemia remains the main indication for neurovascular ultrasonography. Additional indications are repetitive studies in dissection, vasospasm, endovascularly treated vascular malformations and stenoses, intracranial pressure monitoring, examination of cerebrovascular reactivity in suspicion of hemodynamic ischemia, and diagnostic work-up of cough syncope, pulsatile tinnitus and cardiac right-left shunt. PMID:9064795

  8. Review of clinical characteristics and applications of contrast-enhanced ultrasonography in dogs.

    PubMed

    Haers, Hendrik; Saunders, Jimmy H

    2009-02-15

    Contrast-enhanced ultrasonography improves detection of the perfusion and vascularity of organs. Its main indication is the assessment of focal lesions in the liver and spleen, particularly with regard to differentiating between benign and malignant processes. Evidence suggests that contrast-enhanced ultrasonography may be a valuable alternative to invasive diagnostic procedures such as fine-needle aspiration and core biopsy. PMID:19222354

  9. Transvaginal sonographic diagnosis of live monochorionic twin ectopic pregnancy.

    PubMed

    Hanchate, Vijay; Garg, Ashwin; Sheth, Rahul; Rao, Jhanavi; Jadhav, Pallavi J; Karayil, Diljit

    2002-01-01

    Ectopic pregnancy is a leading cause of pregnancy-related deaths; its incidence has progressively increased in recent years. Spontaneous twin ectopic pregnancy, however, is extremely rare. Among more than 100 reported cases of twin tubal pregnancies, only 5 cases in which fetal cardiac motion has been visualized in both embryos have been reported. We describe an additional case of a live monochorionic twin ectopic pregnancy in a patient with no predisposing factor. With transabdominal sonography, we initially diagnosed a single ectopic pregnancy, visualized as an ill-defined mass in the left adnexa. However, with transvaginal sonography, we determined the left adnexal mass to contain a single monochorionic gestational sac with 2 embryos, each with cardiac motion. These findings were confirmed with color Doppler sonography and at laparotomy. The introduction of high-resolution transvaginal sonography has resulted in the earlier diagnosis of ectopic pregnancy and has contributed to a recent decrease in the maternal mortality and morbidity associated with this condition. PMID:11807857

  10. Is transabdominal ultrasound scanning of cervical measurement in mid-trimester pregnancy a useful alternative to transvaginal ultrasound scan?

    PubMed Central

    Chaudhury, Kalyansree; Ghosh, Mrinalkanti; Halder, Atin; Senapati, Sourav; Chaudhury, Sudeshna

    2013-01-01

    Objective The aim of this study is to assess the correlation between transabdominal and transvaginal ultrasound measurements of the cervix in pregnancy. If transabdominal ultrasound measurement of cervical length is found to provide effective information, it could be used in patient counselling and when making clinical decisions. Material and Methods One hundred and twenty seven pregnant patients between 18–26 weeks of pregnancy were enrolled in this prospective study for measuring cervical length, both by transabdominal and transvaginal ultrasound scan after bladder emptying. Transabdominal and transvaginal measurements were compared and correlated. Results In patients with transvaginal ultrasound scan (TVS) cervical length ?32 mm, TVS cervical length was found to be shorter than by transabdominal ultrasound scan (TAS). Most of these patients needed >3 cm of vertical pocket of urine in the bladder for adequate visualisation of the cervix. In patients with TVS cervical length >32 mm, the TVS measurement of the cervix was longer than the TAS measurement of the cervix. In these patients, the cervix could be seen by TAS when there was either ?3 cm vertical pocket of urine in the bladder or an empty bladder. Statistical tests showed that there is a significant difference between TAS and TVS cervical measurements and that there is a significant association between these two measurements. Conclusion Most of the patients needed variable degrees of bladder filling for adequate visualisation of the cervix. Although minimal bladder filling does not influence TAS measurements of cervical length, moderate fullness of the bladder does cause an apparent increase in TAS measurements of cervical length. If the cervical length is ?30 mm by TAS, regardless of urine content in the bladder, the patient can be assured vis a vis their risk of preterm labour as far as cervical length is concerned. However, in patients with TAS cervical measurement <30 mm and where the bladder needed a moderate amount of urine for adequate visualisation of the cervix, TVS cervical measurement may be close to the critical value of 25 mm. These patients need to be counselled and offered TVS for better assessment of cervical length. PMID:24592111

  11. Transvaginal Aspiration of Ovarian Cysts: Long-Term Follow-up

    SciTech Connect

    Duke, D.; Colville, J.; Keeling, A.; Broe, D.; Fotheringham, T.; Lee, M.J.

    2006-06-15

    Background and purpose. Transvaginal aspiration of ovarian cysts has been advocated as a viable alternative to surgery in patients who are high-risk surgical candidates. We describe a retrospective study evaluating the results of transvaginal aspirations of benign ovarian cysts in patients at increased surgical risk, focusing on long-term follow-up for recurrence of the cyst and/or development of malignancy. Methods. Twenty-four women with ovarian cysts underwent 34 transvaginal drainages between October 1998 and December 2004. All patients were referred following diagnosis of a persistent ovarian cyst with a benign appearance on ultrasound. All patients were unsuitable candidates for surgery (history of previous pelvic surgery, n = 21; high risk for anesthesia, n = 1; and unsuitable for laparoscopy due to obesity, n = 2). Patients with a history of pregnancy, acute abdominal symptoms, or previous gynecologic malignancy were excluded. A 20G x 20 cm Chiba needle was used for transvaginal aspiration using an endocavity probe (Acuson XP, Mountain View, CA, USA; Siemens Sololine, Erlangen, Germany) and intravenous sedoanalgesia. Cysts were aspirated to dryness. Results. Long-term follow-up of patients was performed and revealed a recurrence rate of 75%. Eighty-three percent of cysts on the left and 42% of those on the right recurred. Nine of 15 (60%) patients with recurrence required further intervention. Two of 9 underwent surgical intervention only, 4 of 9 had repeat transvaginal aspiration(s) performed, and 3 of 9 had a combination of both transvaginal aspiration and surgery. No patient developed ovarian malignancy. Conclusion. Transvaginal cyst aspiration has many advantages including short hospital stay, rapid recovery, excellent patient tolerance, and a low rate of procedure-related complications. Our study demonstrates that ovarian cyst recurrence following transvaginal drainage is a more significant problem than previously documented, especially if the cyst is on the left side. However, when recurrences do occur, repeat transvaginal aspirations may be considered in the symptomatic patient.

  12. Clinical complications after transvaginal oocyte retrieval: a retrospective analysis.

    PubMed

    Siristatidis, C; Chrelias, C; Alexiou, A; Kassanos, D

    2013-01-01

    There are little systematic data reported in the literature on complications observed after transvaginal oocyte retrieval (OR) guided by ultrasound. We report our experience in 542 in vitro fertilisation cycles. The frequency of severe complications in our patients was 0.72%; of these, two cases were bronchospasm during anaesthesia (0.36%) and two were cases of intraperitoneal bleeding (0.36%); minor vaginal bleeding was the most frequent complication (18.08%), which was treated easily. Through this retrospective analysis, it is evident that clinical suspicion is of particular importance in detecting post-OR complications on one hand, but on the other these complications are rare and most are treated conservatively. PMID:23259882

  13. Ultrasonography Performed by Primary Care Residents for Abdominal Aortic Aneurysm Screening

    PubMed Central

    Bailey, Raymond P; Ault, Mark; Greengold, Nancy L; Rosendahl, Thomas; Cossman, David

    2001-01-01

    A prospective pilot study was undertaken to assess a protocol to educate primary care residents in how to personally perform ultrasonography for abdominal aortic aneurysm screening. Resident exams were proctored by a primary care physician trained in ultrasonography and were scored on the level of competence in doing the examination. Patients had ultrasound performed by a resident, followed by repeat examination by the vascular lab. Primary care resident abdominal aortic imaging was achieved in 79 of 80 attempts. Four abdominal aortic aneurysms were identified. There were 75 normal examinations; resident ultrasonography results were consistent with the results of the vascular lab. Ten residents achieved an abdominal aortic ultrasound-independent competence level after an average of 3.4 proctored exams. The main outcome of this study is that a primary care resident, with minimal training in ultrasonography imaging, is able to rapidly learn the technique of ultrasonography imaging of the abdominal aorta. PMID:11903764

  14. Validation of ultrasonography in detecting structural disease of the urogenital tract of the koala, Phascolarctos cinereus.

    PubMed

    Marschner, C; Flanagan, C; Higgins, D P; Krockenberger, M B

    2014-05-01

    A retrospective review of case records of ultrasonography and necropsy outcomes of 62 koalas was used to investigate the accuracy of ultrasonography in assessing koala urogenital tract structural disease at the Port Macquarie Koala Hospital. The results showed high concordance, supporting ultrasonography as an effective tool for evaluating structural disease of the koala urogenital tract, most commonly seen with chlamydiosis. The study also illustrates the advances benefiting animal welfare that can be made by wildlife carer groups through using a scientific, evidence-based approach. PMID:24766049

  15. Follow-up evaluation with ultrasonography of peripheral nerve injuries after an earthquake

    PubMed Central

    Lu, Man; Wang, Yue; Yue, Linxian; Chiu, Jack; He, Fanding; Wu, Xiaojing; Zang, Bin; Lu, Bin; Yao, Xiaoke; Jiang, Zirui

    2014-01-01

    Published data on earthquake-associated peripheral nerve injury is very limited. Ultrasonography has been proven to be efficient in the clinic to diagnose peripheral nerve injury. The aim of this study was to assess the role of ultrasound in the evaluation of persistent peripheral nerve injuries 1 year after the Wenchuan earthquake. Thirty-four patients with persistent clinical symptoms and neurologic signs of impaired nerve function were evaluated with sonography prior to surgical repair. Among 34 patients, ultrasonography showed that 48 peripheral nerves were entrapped, and 11 peripheral nerves were disrupted. There was one case of misdiagnosis on ultrasonography. The concordance rate of ultrasonographic findings with those of surgical findings was 98%. A total of 48 involved nerves underwent neurolysis and the symptoms resolved. Only five nerves had scar tissue entrapment. Preoperative and postoperative clinical and ultrasonographic results were concordant, which verified that ultrasonography is useful for preoperative diagnosis and postoperative evaluation of injured peripheral nerves. PMID:25206859

  16. Admixture of propofol and alfentanil. Use for intravenous sedation and analgesia during transvaginal oocyte retrieval.

    PubMed

    Sherry, E

    1992-06-01

    An admixture of propofol and alfentanil provides adequate sedation and analgesia during transvaginal oocyte retrieval in the absence of a paracervical block. In 100 patients the technique provided haemodynamic stability, sedation which was easily controlled, rapid recovery and universal patient acceptance. PMID:1616081

  17. Persistence of Microbial Contamination on Transvaginal Ultrasound Probes despite Low-Level Disinfection Procedure

    PubMed Central

    M'Zali, Fatima; Bounizra, Carole; Leroy, Sandrine; Mekki, Yahia; Quentin-Noury, Claudine; Kann, Michael

    2014-01-01

    Aim of the Study In many countries, Low Level Disinfection (LLD) of covered transvaginal ultrasound probes is recommended between patients' examinations. The aim of this study was to evaluate the antimicrobial efficacy of LLD under routine conditions on a range of microorganisms. Materials and Methods Samples were taken over a six month period in a private French Radiology Center. 300 specimens derived from endovaginal ultrasound probes were analyzed after disinfection of the probe with wipes impregnated with a quaternary ammonium compound and chlorhexidine. Human papillomavirus (HPV) was sought in the first set of s100 samples, Chlamydia trachomatis and mycoplasmas were searched in the second set of 100 samples, bacteria and fungi in the third 100 set samples. HPV, C. trachomatis and mycoplasmas were detected by PCR amplification. PCR positive samples were subjected to a nuclease treatment before an additional PCR assay to assess the likely viable microorganisms. Bacteria and fungi were investigated by conventional methods. Results A substantial persistence of microorganisms was observed on the disinfected probes: HPV DNA was found on 13% of the samples and 7% in nuclease-resistant form. C. trachomatis DNA was detected on 20% of the probes by primary PCR but only 2% after nuclease treatment, while mycoplasma DNA was amplified in 8% and 4%, respectively. Commensal and/or environmental bacterial flora was present on 86% of the probes, occasionally in mixed culture, and at various levels (10->3000 CFU/probe); Staphylococcus aureus was cultured from 4% of the probes (10-560 CFU/probe). No fungi were isolated. Conclusion Our findings raise concerns about the efficacy of impregnated towels as a sole mean for disinfection of ultrasound probes. Although the ultrasound probes are used with disposable covers, our results highlight the potential risk of cross contamination between patients during ultrasound examination and emphasize the need for reviewing the disinfection procedure. PMID:24695371

  18. Endoanal ultrasonography in fecal incontinence: Current and future perspectives.

    PubMed

    Albuquerque, Andreia

    2015-06-10

    Fecal incontinence has a profound impact in a patient's life, impairing quality of life and carrying a substantial economic burden due to health costs. It is an underdiagnosed condition because many affected patients are reluctant to report it and also clinicians are usually not alert to it. Patient evaluation with a detailed clinical history and examination is very important to indicate the type of injury that is present. Endoanal ultrasonography is currently the gold standard for sphincter evaluation in fecal incontinence and is a simple, well-tolerated and non-expensive technique. Most studies revealed 100% sensitivity in identifying sphincter defect. It is better than endoanal magnetic resonance imaging for internal anal sphincter defects, equivalent for the diagnosis of external anal sphincter defects, but with a lower capacity for assessment of atrophy of this sphincter. The most common cause of fecal incontinence is anal sphincter injury related to obstetric trauma. Only a small percentage of women are diagnosed with sphincter tears immediately after vaginal delivery, but endoanal ultrasonography shows that one third of these women have occult sphincter defects. Furthermore, in patients submitted to primary repair of these tears, ultrasound revealed a high frequency of persistent sphincter defects after surgery. Three-dimensional endoanal ultrasonography is currently largely used and accepted for sphincter evaluation in fecal incontinence, improving diagnostic accuracy and our knowledge of physiologic and pathological sphincters alterations. Conversely, there is currently no evidence to support the use of elastography in fecal incontinence evaluation. PMID:26078826

  19. Endoanal ultrasonography in fecal incontinence: Current and future perspectives

    PubMed Central

    Albuquerque, Andreia

    2015-01-01

    Fecal incontinence has a profound impact in a patient’s life, impairing quality of life and carrying a substantial economic burden due to health costs. It is an underdiagnosed condition because many affected patients are reluctant to report it and also clinicians are usually not alert to it. Patient evaluation with a detailed clinical history and examination is very important to indicate the type of injury that is present. Endoanal ultrasonography is currently the gold standard for sphincter evaluation in fecal incontinence and is a simple, well-tolerated and non-expensive technique. Most studies revealed 100% sensitivity in identifying sphincter defect. It is better than endoanal magnetic resonance imaging for internal anal sphincter defects, equivalent for the diagnosis of external anal sphincter defects, but with a lower capacity for assessment of atrophy of this sphincter. The most common cause of fecal incontinence is anal sphincter injury related to obstetric trauma. Only a small percentage of women are diagnosed with sphincter tears immediately after vaginal delivery, but endoanal ultrasonography shows that one third of these women have occult sphincter defects. Furthermore, in patients submitted to primary repair of these tears, ultrasound revealed a high frequency of persistent sphincter defects after surgery. Three-dimensional endoanal ultrasonography is currently largely used and accepted for sphincter evaluation in fecal incontinence, improving diagnostic accuracy and our knowledge of physiologic and pathological sphincters alterations. Conversely, there is currently no evidence to support the use of elastography in fecal incontinence evaluation. PMID:26078826

  20. Assessment of cross-sectional thickness and activity of masseter, anterior temporalis and orbicularis oris muscles in oral submucous fibrosis patients and healthy controls: an ultrasonography and electromyography study

    PubMed Central

    Bhowate, R R; Sharda, N

    2014-01-01

    Objectives: Oral submucous fibrosis (OSMF) is an insidious chronic disease that is associated with significant functional morbidity and an increased risk for malignancy. It initially affects the lamina propria of the oral mucosa, and, as the disease progresses, it involves the submucosa and deeper tissue, including muscles of the oral cavity, resulting in loss of fibroelasticity. OSMF is a pre-malignant condition mainly caused by areca nut chewing. The aim of this study was to find out the involvement of muscles of mastication and facial expression in patients with OSMF by assessing the cross-sectional thickness and activity of the masseter, anterior temporalis and orbicularis oris muscles by ultrasonography and electromyography and comparing with healthy controls and also to find out any correlation between the ultrasonographic cross-sectional thicknesses of the masseter, anterior temporalis and orbicularis oris muscles with electromyographic activity. Methods: 40 patients with OSMF were included in the study group, and the patients were divided into four groups on the basis of interincisal mouth opening, i.e. Group I (mouth opening >35?mm), Group II (mouth opening between 30 and 35?mm), Group III (mouth opening between 20 and 30?mm) and Group IV (mouth opening <20?mm). Ultrasonographic cross-sectional thickness and electromyographic activity (amplitude and duration) of the masseter, anterior temporalis and orbicualris oris muscles were recorded in patients with OSMF and 20 controls. Intergroup comparison of ultrasonographic cross-sectional thickness and activity (amplitude and duration) was done, and Pearson's correlation coefficient was applied to find out any relation between ultrasonographic and electromyographic findings. Results: Thickness and activity of the masseter muscle was significantly reduced in Group IV (mouth opening <20?mm) when compared with the control group. The anterior temporalis and orbicularis oris muscles remained unaffected. A positive correlation was observed between the thicknesses of the masseter muscle and the amplitude in Groups I, II and III; the anterior temporalis muscle in Group II and the control group; and the orbicularis oris muscle in Groups II, III and IV. Conclusions: It was concluded that, among the muscles studied, there was an early involvement of the masseter muscle in patients with OSMF compared with that of other muscles. PMID:24720604

  1. [Ultrasonography in acute pelvic pain].

    PubMed

    Kupesi?, Sanja; Aksamija, Alenka; Vuci?, Niksa; Tripalo, Ana; Kurjak, Asim

    2002-01-01

    Acute pelvic pain may be the manifestation of various gynecologic and non-gynecologic disorders from less alarming rupture of the follicular cyst to life threatening conditions such as rupture of ectopic pregnancy or perforation of inflamed appendix. In order to construct an algorithm for differential diagnosis we divide acute pelvic pain into gynecologic and non-gynecologic etiology, which is than subdivided into gastrointestinal and urinary causes. Appendicitis is the most common surgical emergency and should always be considered in differential diagnosis if appendix has not been removed. Apart of clinical examination and laboratory tests, an ultrasound examination is sensitive up to 90% and specific up to 95% if graded compression technique is used. Still it is user-depended and requires considerable experience in order to perform it reliably. Meckel's diverticulitis, acute terminal ileitis, mesenteric lymphadenitis and functional bowel disease are conditions that should be differentiated from other causes of low abdominal pain by clinical presentation, laboratory and imaging tests. Dilatation of renal pelvis and ureter are typical signs of obstructive uropathy and may be efficiently detected by ultrasound. Additional thinning of renal parenchyma suggests long-term obstructive uropathy. Ruptured ectopic pregnancy, salpingitis and hemorrhagic ovarian cysts are three most commonly diagnosed gynecologic conditions presenting as an acute abdomen. Degenerating leiomyomas and adnexal torsion occur less frequently. For better systematization, gynecologic causes of acute pelvic pain could be divided into conditions with negative pregnancy test and conditions with positive pregnancy test. Pelvic inflammatory disease may be ultrasonically presented with numerous signs such as thickening of the tubal wall, incomplete septa within the dilated tube, demonstration of hyperechoic mural nodules, free fluid in the "cul-de-sac" etc. Color Doppler ultrasound contributes to more accurate diagnosis of this entity since it enables differentiation between acute and chronic stages based on analysis of the vascular resistance. Hemorrhagic ovarian cysts may be presented by variety of ultrasound findings since intracystic echoes depend upon the quality and quantity of the blood clots. Color Doppler investigation demonstrates moderate to low vascular resistance typical of luteal flow. Leiomyomas undergoing degenerative changes are another cause of acute pelvic pain commonly present in patients of reproductive age. Color flow detects regularly separated vessels at the periphery of the leiomyoma, which exhibit moderate vascular resistance. Although the classic symptom of endometriosis is chronic pelvic pain, in some patients acute pelvic pain does occur. Most of these patients demonstrate an endometrioma or "chocolate" cyst containing diffuse carpet-like echoes. Sometimes, solid components may indicate even ovarian malignancy, but if color Doppler ultrasound is applied it is less likely to obtain false positive results. One should be aware that pericystic and/or hillar type of ovarian endometrioma vascularization facilitate correct recognition of this entity. Pelvic congestion syndrome is another condition that can cause an attack of acute pelvic pain. It is usually consequence of dilatation of venous plexuses, arteries or both systems. By switching color Doppler gynecologist can differentiate pelvic congestion syndrome from multilocular cysts, pelvic inflammatory disease or adenomyosis. Ovarian vein thrombosis is a potentially fatal disorder occurring most often in the early postpartal period. Hypercoagulability, infection and stasis are main etiologic factors, and transvaginal color Doppler ultrasound is an excellent diagnostic tool to diagnose it. Acute pelvic pain may occur even in normal intrauterine pregnancy. This may be explained by hormonal changes, rapid growth of the uterus and increased blood flow. Ultrasound is mandatory for distinguishing normal intrauterine pregnancy from threatened or spontaneous abortion, ectop

  2. Birth of Siberian tiger (Panthera tigris altaica) cubs after transvaginal artificial insemination.

    PubMed

    Chagas e Silva, J N; Leitão, R M; Lapão, N E; da Cunha, M B; da Cunha, T P; da Silva, J P; Paisana, F C

    2000-12-01

    A captive 9-yr-old female Siberian tiger (Panthera tigris altaica) at the Lisbon Zoo was treated with equine chorionic gonadotropin followed 80 hr later by human chorionic gonadotropin to stimulate follicular development and ovulation, respectively. Forty-one hours after the second hormone administration, the tiger was subjected to transvaginal artificial insemination with diluted fresh semen containing 500 x 10(6) motile spermatozoa obtained from an 8-yr-old male Siberian tiger via electroejaculation. After anesthesia, the female tiger was placed in an inclined position with the hind limbs elevated during and after the insemination and was maintained in this position for 15 min to minimize semen reflux. An anesthetic reversal agent was then administered. After a 103-day gestation, the female gave birth to three apparently healthy cubs that survived 24-48 hr. These results demonstrate that transvaginal artificial insemination can be successfully performed in the Siberian tiger to produce full-term offspring. PMID:11428407

  3. Rationale of first-line endoscopy-based fertility exploration using transvaginal hydrolaparoscopy and minihysteroscopy.

    PubMed

    De Wilde, R L; Brosens, I

    2012-08-01

    The transvaginal access for exploration of tubo-ovarian function in women with unexplained infertility has been revived since transvaginal hydrolaparoscopy (THL) was introduced in 1998. One prospective double-blind trial and several reviews have validated the diagnostic value of THL in comparison with laparoscopy for the exploration of women with unexplained infertility. A review of the recent literature confirms the efficacy and safety of the technique for first-line endoscopy-based exploration of fertility. The standard policy of 1-year delay for laparoscopic investigation in unexplained infertility is challenged. In older women and particularly in women experienced in fertility awareness methods, THL and minihysteroscopy can be performed after a waiting period of 6-12 months. PMID:22674201

  4. Transvaginal Liver Surgery Using a Tethered Magnet and a Laparoscopic Rein

    PubMed Central

    Dominguez, Guillermo; Davila, Fausto; Alonso-Rivera, Juan Manuel; Safro, Brad; Tinelli, Andrea

    2013-01-01

    Introduction: A novel technique was used to remove a large liver cyst via culdolaparoscopy. Case Description: We used laparoscopic instruments, a gastroscope, a laparoscopic rein, and magnets. The magnets consist of an external magnet and a specially modified tethered neodymium internal magnet, safe for use in transvaginal endoscopic surgery. Discussion: These technologies offer some advantages when they are used together: magnets and the rein to aid in exposure, traction–retraction, and triangulation. Previous reports have been published on the removal of benign liver lesions transvaginally, but none to date has involved the use of magnets. This article reports on the role of magnets and reins in an incision reduction approach to the removal of a liver cyst. PMID:23743386

  5. Total laparoscopic subtotal gastrectomy with transvaginal specimen extraction is feasible in advanced gastric cancer

    PubMed Central

    Sumer, Fatih; Kayaalp, Cuneyt; Ertugrul, Ismail; Yagci, Mehmet Ali; Karagul, Servet

    2015-01-01

    Purpose Natural orifice specimen extraction (NOSE) is an ever-evolving advanced laparoscopic technique. NOSE minimizes surgical injury, involving a low risk of wound complications, fewer incisional hernias, faster recovery and less postoperative pain. Laparoscopic gastrectomy combined with NOSE is a procedure that can potentiate the advantages of both minimal invasive techniques. We aim to demonstrate the feasibility of laparoscopic subtotal gastrectomy with transvaginal specimen extraction in advanced gastric cancer. Case A 72-year-old woman with a 2 cm adenocarcinoma in gastric antrum was treated by laparoscopic subtotal gastrectomy and lymph node dissection. A totally laparoscopic Roux-en-Y gastrojejunostomy was constructed. Specimen was extracted through the posterior fornix of vagina without difficulty. Histopathology confirmed pT3pN0 tumor. After a 10-month follow-up the patient was asymptomatic and getting adjuvant chemoradiotherapy. Conclusions Transvaginal specimen extraction after laparoscopic gastric resection for advanced gastric cancer is a feasible procedure. It is offered to selected patients and of course only to female patients. Natural orifice surgery may provide faster recovery and decrease the wound related complications which may cause a delay on postoperative adjuvant chemo–radio therapies. We have presented, as far as we know, the first human case of a transvaginal extraction of an advanced gastric cancer after laparoscopic gastrectomy. PMID:26413924

  6. Transvaginal Drainage of Pelvic Abscesses and Collections Using Transabdominal Ultrasound Guidance

    PubMed Central

    Ching, Kevin C.

    2015-01-01

    Objectives. To evaluate clinical outcomes following transvaginal catheter placement using transabdominal ultrasound guidance for management of pelvic fluid collections. Methods. A retrospective review was performed for all patients who underwent transvaginal catheter drainage of pelvic fluid collections utilizing transabdominal ultrasound guidance between July 2008 and July 2013. 24 consecutive patients were identified and 24 catheters were placed. Results. The mean age of patients was 48.1 years (range = 27–76?y). 88% of collections were postoperative (n = 21), 8% were from pelvic inflammatory disease (n = 2), and 4% were idiopathic (n = 1). Of the 24 patients, 83% of patients (n = 20) had previously undergone a hysterectomy and 1 patient (4%) was pregnant at the time of drainage. The mean volume of initial drainage was 108?mL (range = 5 to 570). Catheters were left in place for an average of 4.3 days (range = 1–17?d). Microbial sampling was performed in all patients with 71% (n = 17) returning a positive culture. All collections were successfully managed percutaneously. There were no technical complications. Conclusions. Transvaginal catheter drainage of pelvic fluid collections using transabdominal ultrasound guidance is a safe and clinically effective procedure. Appropriate percutaneous management can avoid the need for surgery. PMID:26113862

  7. Surgical repair of rectocele. Comparison of transvaginal and transanal approach and personal technique

    PubMed Central

    LEANZA, V.; INTAGLIATA, E.; LEANZA, G.; CANNIZZARO, M.A.; ZANGHÌ, G.; VECCHIO, R.

    2013-01-01

    Summary Rectocele is defined as a herniation of the rectal wall inside the vagina due to a defect of the recto-vaginal septum. It is traditionally considered a posterior compartment damage with weakness of posterior vaginal wall support resulting in a bulging of the rectum into the vaginal cavity. One of the main causes of rectal prolapse is the operative vaginal birth, although the evidence of the defect may occur after many years The treatment of rectocele is surgical, and the approach can be transperineal, transvaginal, and transanal or, in selected cases, transperitoneal through open or laparoscopic techniques. In this study we compare two transvaginal surgical techniques - i.e. the perineal body anchorage to the posterior septum and the traditional Denonvilliers’ transversal suture after removing of the vaginal skin, with the mostly performed transanal procedure, the STARR - comparing the data from the literature on their results. Mean hospital stay, rectal symptoms, dyspareunia, quality of life, recurrence rate and postoperative complications have been considered. Both transvaginal and transrectal surgical techniques are effective to solve posterior compartment defect and to improve the quality of life. Vaginal approach may interfere with the sexual activity; furthermore it is associated with minimal postoperative pain than the transanal approach. Better anatomic results are assured after endovaginal surgery, while better rectal function prevail after the transanal approach. Vaginal techniques are more suitable to gynecologists, whereas the transrectal ones are usually performed by colo-proctologists or general surgeons. PMID:24342163

  8. Transvaginal Surgical Management of Cesarean Scar Pregnancy II (CSP-II): An Analysis of 25 Cases

    PubMed Central

    Zhang, Hui; Shi, Junrong; Yang, Yong’An; Liang, Yijuan; Gao, Xinping; Wang, Jing; Liu, Hui; Wu, Bingge; Zhao, Jinhui

    2015-01-01

    Background The aim of this study was to investigate the feasibility and clinical value of transvaginal surgical treatment for cesarean scar pregnancy (CSP-II). Material/Methods This study was a retrospective analysis of 25 CSP-II patients who received transvaginal surgical treatments. These patients were admitted in our hospital between January 2010 and June 2012. Results All surgical treatments were successful without overt complications. The average operation time was 61.5 minutes, the average intraoperative blood loss was 60.5 ml, the average hospital stay was 9.4 days and the average time that blood ?-human chorionic gonadotropin (?-HCG) returned to normal range was 15 days. In all 25 patients, the cesarean scar mass located at the anterior wall of the lower uterine segment disappeared by B-ultrasound examination within 1 or 2 weeks after surgery. Postoperatively, the normal menstrual period started again with an average time of 28.9 days. No menstruation-related abnormalities, such as menstrual dripping or an abnormal amount of blood, were reported after surgery. Conclusions Transvaginal surgery for CSP-II is a novel surgical approach. It has several advantages, including a thorough one-time treatment lesion clearance, short operation time, minimized trauma, minimal intraoperative blood loss, quick reduction of blood ?-HCG, and rapid menstruation recovery. It is a simple and feasible surgical approach of great clinical value and few treatment-related complications. PMID:26520674

  9. Ultrasonography in diagnosing chronic pancreatitis: New aspects

    PubMed Central

    Dimcevski, Georg; Erchinger, Friedemann G; Havre, Roald; Gilja, Odd Helge

    2013-01-01

    The course and outcome is poor for most patients with pancreatic diseases. Advances in pancreatic imaging are important in the detection of pancreatic diseases at early stages. Ultrasonography as a diagnostic tool has made, virtually speaking a technical revolution in medical imaging in the new millennium. It has not only become the preferred method for first line imaging, but also, increasingly to clarify the interpretation of other imaging modalities to obtain efficient clinical decision. We review ultrasonography modalities, focusing on advanced pancreatic imaging and its potential to substantially improve diagnosis of pancreatic diseases at earlier stages. In the first section, we describe scanning techniques and examination protocols. Their consequences for image quality and the ability to obtain complete and detailed visualization of the pancreas are discussed. In the second section we outline ultrasonographic characteristics of pancreatic diseases with emphasis on chronic pancreatitis. Finally, new developments in ultrasonography of the pancreas such as contrast enhanced ultrasound and elastography are enlightened. PMID:24259955

  10. Routine ultrasonography in utero and subsequent handedness and neurological development.

    PubMed Central

    Salvesen, K A; Vatten, L J; Eik-Nes, S H; Hugdahl, K; Bakketeig, L S

    1993-01-01

    OBJECTIVE--To examine any associations between routine ultrasonography in utero and subsequent brain development as indicated by non-right handedness at primary school age and neurological development during childhood. DESIGN--Follow up of 8 and 9 year old children of women who took part in two randomised, controlled trials of routine ultrasonography during pregnancy. SETTING--Clinics of 60 general practitioners in Norway during 1979-81. Maternal and child health centres. SUBJECTS--2161 (89%) of 2428 eligible singletons were followed up, partly through a questionnaire to their parents and partly through information from health centres. MAIN OUTCOME MEASURES--The dominant hand of the child was assessed by 10 questions. Deficits in attention, motor control, and perception were evaluated by five questions. Impaired neurological development during the first year of life was assessed by an abbreviated version of the Denver developmental screening test. RESULTS--The odds of non-right handedness were higher among children who had been screened in utero than among control children (odds ratio 1.32; 95% confidence interval 1.02 to 1.71). No clear differences were found between the groups with regard to deficits in attention, motor control, and perception or neurological development during the first year of life. CONCLUSION--Our data suggest a possible association between routine ultrasonography in utero and subsequent non-right handedness, whereas no association with impaired neurological development was found. As the question on non-right handedness was one of six initial hypotheses, the observed results may be due to chance. None the less, the results suggest that the hypothesis may have some merit and should be tested in future studies. PMID:7688253

  11. Sources of error in emergency ultrasonography

    PubMed Central

    2013-01-01

    Background To evaluate the common sources of diagnostic errors in emergency ultrasonography. Methods The authors performed a Medline search using PubMed (National Library of Medicine, Bethesda, Maryland) for original research and review publications examining the common sources of errors in diagnosis with specific reference to emergency ultrasonography. The search design utilized different association of the following terms : (1) emergency ultrasonography, (2) error, (3) malpractice and (4) medical negligence. This review was restricted to human studies and to English-language literature. Four authors reviewed all the titles and subsequent the abstract of 171 articles that appeared appropriate. Other articles were recognized by reviewing the reference lists of significant papers. Finally, the full text of 48 selected articles was reviewed. Results Several studies indicate that the etiology of error in emergency ultrasonography is multi-factorial. Common sources of error in emergency ultrasonography are: lack of attention to the clinical history and examination, lack of communication with the patient, lack of knowledge of the technical equipment, use of inappropriate probes, inadequate optimization of the images, failure of perception, lack of knowledge of the possible differential diagnoses, over-estimation of one’s own skill, failure to suggest further ultrasound examinations or other imaging techniques. Conclusions To reduce errors in interpretation of ultrasonographic findings, the sonographer needs to be aware of the limitations of ultrasonography in the emergency setting, and the similarities in the appearances of various physiological and pathological processes. Adequate clinical informations are essential. Diagnostic errors should be considered not as signs of failure, but as learning opportunities. PMID:23902656

  12. Use of ultrasonography to make management decisions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Transrectal ultrasonography has been available for making management decisions since the mid 1980’s. This technology allows for the real-time visualization of internal structures (i.e. ovary and fetus) that are otherwise difficult to evaluate. The use of this technology in making reproductive manag...

  13. Intraoperative ultrasonography in surgery for chronic pancreatitis.

    PubMed

    Printz, H; Klotter, H J; Nies, C; Hasse, C; Neurath, M; Sitter, H; Rothmund, M

    1992-12-01

    We report our experience with intraoperative ultrasonography in 49 patients undergoing surgery for chronic pancreatitis. Among drainage procedures, there were 14 laterolateral pancreaticojejunostomies, 15 pseudocystojejunostomies, and 2 pseudocystoduodenostomies. Under the guidance of intraoperative ultrasonography, left sided partial resection of the pancreas was performed in 7 patients, whereas a Whipple-type procedure was necessary in 6 cases. All preoperatively diagnosed pseudocysts, abscess formations, and dilated pancreatic ductal systems could be easily localized with the assistance of intraoperative ultrasound. Additionally to diagnoses already made preoperatively, intraoperative ultrasonography revealed a second, smaller pseudocyst in one patient and pancreaticolithiasis in another case. However, significant assistance and comfort to the operating surgeon was provided in all cases by intraoperative ultrasound imaging. This technique, which is cost effective and minimally invasive, proved to be extremely helpful in localizing pancreatic fluid collections and the course of the pancreatic duct. It facilitates the operation by reducing tissue traumatization and operative time. In experienced hands, intraoperative ultrasonography is a reliable method and a useful adjunct to the surgeon. PMID:1289416

  14. Gynecologic procedures: colposcopy, treatments for cervical intraepithelial neoplasia and endometrial assessment.

    PubMed

    Apgar, Barbara S; Kaufman, Amanda J; Bettcher, Catherine; Parker-Featherstone, Ebony

    2013-06-15

    Women who have abnormal Papanicolaou test results may undergo colposcopy to determine the biopsy site for histologic evaluation. Traditional grading systems do not accurately assess lesion severity because colposcopic impression alone is unreliable for diagnosis. The likelihood of finding cervical intraepithelial neoplasia grade 2 or higher increases when two or more cervical biopsies are performed. Excisional and ablative methods have similar treatment outcomes for the eradication of cervical intraepithelial neoplasia. However, diagnostic excisional methods, including loop electrosurgical excision procedure and cold knife conization, are associated with an increased risk of adverse obstetric outcomes, such as preterm labor and low birth weight. Methods of endometrial assessment have a high sensitivity for detecting endometrial carcinoma and benign causes of uterine bleeding without unnecessary procedures. Endometrial biopsy can reliably detect carcinoma involving a large portion of the endometrium, but is suboptimal for diagnosing focal lesions. A 3- to 4-mm cutoff for endometrial thickness on transvaginal ultrasonography yields the highest sensitivity to exclude endometrial carcinoma in postmenopausal women. Saline infusion sonohysteroscopy can differentiate globally thickened endometrium amenable to endometrial biopsy from focal abnormalities best assessed by hysteroscopy. Hysteroscopy with directed biopsy is the most sensitive and specific method of diagnosing endometrial carcinoma, other than hysterectomy. PMID:23939565

  15. Implications of the FDA statement on transvaginal placement of mesh: the aftermath.

    PubMed

    Koski, Michelle E; Rovner, Eric S

    2014-02-01

    The release of the U.S. Food and Drug Administration (FDA) safety communication on the use of transvaginal mesh (TVM) for pelvic organ prolapse (POP) has resulted in changes in the pelvic reconstruction community. This monograph reviews the implications of the FDA statements over the last 18-24 months. Recent findings show that there have been significant developments in the areas of regulatory mandates, media and medico-legal activity, and statements from surgical societies. In summary, well-publicized communications from the FDA and major medical organizations are defining a change in the use of TVM for POP. PMID:24384996

  16. Transvaginal Resection of a Bladder Leiomyoma Misdiagnosed with a Vaginal Mass: A Case Report and Literature Review

    PubMed Central

    Yin, Fu-Fen; Wang, Ning; Wang, You-Lin; Bi, Xiao-Ning; Xu, Xiao-Hui; Wang, Yan-Kui

    2015-01-01

    Bladder leiomyoma is a rare benign tumor and it could be easily misdiagnosed with many other pelvic diseases, especially obstetrical and gynecological diseases; abdominal, laparoscopic, and transurethral resection of bladder leiomyoma have been reported. Herein, we present a case of bladder leiomyoma misdiagnosed with a vaginal mass preoperatively; the mass was isolated, enucleated from the bladder neck, and removed transvaginally; to the best of our knowledge, this is the first case of intramural leiomyoma of bladder neck that has been enucleated transvaginally only without cystotomy. PMID:26693368

  17. [Chest ultrasonography in pediatric critical care practice].

    PubMed

    Riu, B; Ruiz, J; Mari, A; Silva, S

    2013-12-01

    An increasingly amount of evidence suggests that lung ultrasonography constitutes a relevant complementary diagnostic tool for adults patient in acute respiratory failure. A comprehensive and standardized ultrasonographic semiology has been described, relying on accurate and reproducible data directly obtained at patient's bedside. Therefore, pleural effusion, pneumothorax, pulmonary consolidation and interstitial lung disease can be diagnosed in a critical care environment with a similar level of performance than when reference diagnosis methods such as thoracic CT-scan are employed. Furthermore, lung ultrasonography seems to be able to contribute to an early therapeutic decision based on such online physiopathological data. Pioneers works in this field have suggested an attractive similarity between the ultrasonographic patterns described in adults and children. Nevertheless, the clinical usefulness of lung ultrasonographic approach in the pediatric critical care medicine still needs to be confirmed by specifically designed studies. PMID:24183172

  18. Insulinoma. The value of intraoperative ultrasonography.

    PubMed

    Grant, C S; van Heerden, J; Charboneau, J W; James, E M; Reading, C C

    1988-07-01

    After establishing the diagnosis of an insulinoma, most surgeons prefer preoperative localization. Selective arteriography has long remained the gold standard for this purpose, but its use has been met with variable success. Despite various attempts at localization, insulinomas remain undetected in 10% to 20% of patients, and there may be a postoperative complication rate of at least 10% to 25%. To review the results and surgical implications of current localization techniques, 36 adult patients who were surgically treated for insulinomas at the Mayo Clinic, Rochester, Minn, from July 1982 through June 1987 were studied. The sensitivities of tumor localization using arteriography, computed tomography, and preoperative and intraoperative ultrasonography were 53%, 36%, 59%, and 90%, respectively. A subset of 29 patients underwent intraoperative ultrasonography, and all of these patients' insulinomas were identified with a combination of this technique and intraoperative palpation, with nonpalpable tumors being imaged in four patients. In 18 patients (62%), information obtained from the images appeared to influence the surgical management. While there is no substitute for exploration by an experienced surgeon, exploration appears to be enhanced by the addition of intraoperative ultrasonography, particularly during reoperation. PMID:2838008

  19. Clinical Outcomes and Urodynamic Effects of Tailored Transvaginal Mesh Surgery for Pelvic Organ Prolapse

    PubMed Central

    Chang, Ting-Chen; Hsiao, Sheng-Mou; Chen, Chi-Hau; Wu, Wen-Yih; Lin, Ho-Hsiung

    2015-01-01

    Objective. To evaluate the clinical outcomes and urodynamic effects of tailored anterior transvaginal mesh surgery (ATVM) and tailored posterior transvaginal mesh surgery (PTVM). Methods. We developed ATVM for the simultaneous correction of cystocele and stress urinary incontinence and PTVM for the simultaneous correction of enterocoele, uterine prolapse, vaginal stump prolapse, and rectocele. Results. A total of 104 women enrolled. The median postsurgical follow-up was 25.5 months. The anatomic cure rate was 98.1% (102/104). Fifty-eight patients underwent urodynamic studies before and after surgeries. The pad weight decreased from 29.3 ± 43.1 to 6.4 ± 20.9?g at 3 months. Among the 20 patients with ATVM, 13 patients had objective stress urinary incontinence (SUI) at baseline while 8 patients came to have no demonstrated SUI (NDSUI), and 2 improved after surgery. Among the 38 patients who underwent ATVM and PTVM, 24 had objective SUI at baseline while 18 came to have NDSUI, and 2 improved after surgery. Mesh extrusion (n = 4), vaginal hematoma (n = 3), and voiding difficulty (n = 2) were noted postoperatively. Quality of life was substantially improved. Conclusions. Our findings document the advantages of these two novel pelvic reconstructive surgeries for pelvic organ prolapse, which had a positive impact on quality of life. ATVM surgery additionally provided an anti-incontinence effect. This clinical trial is registered at ClinicalTrials.gov (NCT02178735). PMID:26634203

  20. A novel algorithm for computer-assisted measurement of cervical length from transvaginal ultrasound images.

    PubMed

    Wu, Min; Fraser, Robert F; Chen, Chang Wen

    2004-09-01

    The cervical length measured by transvaginal ultrasound is a proven clinical tool for predicting premature birth. The standard manual measurement of the cervix is limited by variability in the technique. In this research, we develop the first computer algorithm that is able to identify the anatomic landmarks of the cervix on a transvaginal ultrasound image and determine the standard cervical length. The system is composed of four stages: The first stage is adaptive speckle suppression using variable length sticks algorithm. The second stage is the location of the internal cervical opening or "os" using a region-based segmentation. The third stage is delineation of the cervical canal. The fourth stage uses gray level summation patterns and prior knowledge to first localize the tissue boundary of the external cervix, and then use a template to determine the specific location of the external os. The cervical length is determined and calculated to image scale. To validate the proposed algorithm, 101 cervical ultrasound images were selected from a series of 37 examinations performed on 17 patients over an eight-month period. Repeated measurements of cervical length using the computer-assisted method were compared with those carried out by two experienced sonographers. The median intraobserver variability for the 101 images using the computer-assisted method was significantly smaller than that of the manual method by either sonographer. In a pairwise comparison, the mean cervical length for the computer method matches with the mean manual cervical length. PMID:15484439

  1. Comparison of hysterosalpingography and transvaginal hydrolaparoscopy in patients with tubal factor infertility: a prospective cohort study

    PubMed Central

    Uysal, Fatma; Sad?k, Salih; Güler, Ahmet; T?nar, ?ivekar; Ta?k?n, Ömür

    2014-01-01

    Aim To evaluate the usefulness, diagnostic accuracy, and cost-effectiveness of transvaginal hydrolaparoscopy (THL) in infertile women with abnormal hysterosalpingogram (HSG) results without obvious pelvic pathology. Material and methods Thirty infertile women (age: 20–40 years) who had tubal pathology in HSG were enrolled in the study. All patients underwent THL instead of standard laparoscopy. A cost analysis was performed comparing HSG and THL methods. Results In comparison of the HSG of cases by considering the chromopertubation results by THL, the sensitivity and specificity of HSG were 85.1% and 56%, respectively. The reasons for preferring standard laparoscopy rather than THL were: failure in accessing of Douglas (n = 3), insufficient monitoring of pelvis (n = 1), hydrosalpinx (n = 1), and intense peritubal adhesion (n = 1), which were 10%, 3%, 3%, and 3%, respectively. The complication rate was 3.8%. Cost analysis of the procedures showed that the total cost of the THL group was 34.8% lower than the HSG group. Conclusions In the elective patients group, THL is more feasible than HSG. Transvaginal hydrolaparoscopy is effective, simple and safe, avoiding the cost, possible complications, time and postoperative patient discomfort compared to conventional laparoscopy. PMID:25097685

  2. Solitary cold thyroid nodule: cost-ineffectiveness of ultrasonography

    SciTech Connect

    Abdel-Nabi, H.; Falko, J.M.; Olsen, J.O.; Freimanis, A.K.

    1984-09-01

    We reviewed our experience with thyroid sonography of 60 patients with nonfunctioning (cold) solitary thyroid nodules proven by iodine 123 scan. Twenty-two patients had surgery; the remaining 38 had thyroid scan and ultrasound only. In the first group, the echograms did not demonstrate the surgically proven nodules in seven patients (32%). In the second group, the thyroid echograms were reported as negative in 12 patients (32%). Two of these patients had computerized tomography (CT) which confirmed the solitary nodule identified on the 123I scan. As a consequence, we no longer perform or recommend routine thyroid echograms on all scintigraphically cold solitary nodules. We believe that the extra cost of a thyroid echogram is not justified and that the most rational application of thyroid ultrasonography is in assessing the response of a nodule to suppressive hormonal therapy.

  3. Doppler ultrasonography of the pelvis.

    PubMed

    Schiller, V L; Grant, E G

    1992-07-01

    TVS has brought the pelvic organs closer to us than ever before. Color Doppler probes have exposed small vessels that could not be seen with real-time technique alone, and pulsed Doppler is becoming an important adjunct in many physiologic and pathologic states. Vascular changes of the ovary and uterus during the menstrual cycle are now being followed during infertility protocols, are being investigated to determine the viability of an early pregnancy, and may increase our confidence in the diagnosis of an ectopic pregnancy in a few selected cases. Waveform analysis may be useful in discriminating benign from malignant uterine masses, and additional work in the diagnosis of pelvic thrombophlebitis and ovarian torsion is anticipated. Color Doppler sonography has an important role to play in the diagnosis of early ovarian cancer. A large multicenter trial is ongoing in this country to determine if there is a characteristic PI that will determine whether an adnexal mass is benign. While much of this work is preliminary, TV-CDS has tremendous potential in the assessment of pelvic disease. PMID:1631280

  4. Clinical and research applications of real-time ultrasonography in bovine reproduction: a review.

    PubMed Central

    Rajamahendran, R; Ambrose, D J; Burton, B

    1994-01-01

    Transrectal real-time ultrasonography has proved to be a rapid and reliable technique for studying reproductive functions in cattle. Through ultrasonography it is now established that follicular growth occurs in wave-like patterns during each estrous cycle. It has been shown that follicular growth and regression continue during early pregnancy, as well as in the postpartum anestrous period. Ultrasound has also helped us to understand the influence of dominant follicles on medium and small follicles. Among the numerous demonstrated applications of ultrasonography, early pregnancy diagnosis, fetal sexing, and postpartum reproductive management appear to be promising areas for immediate application. The new information that has been generated through ultrasound has thrown light on hitherto poorly understood areas of ovarian follicular dynamics, corpus luteum function, pregnancy establishment, and embryonic development in cattle, thereby opening newer areas for research. Still there is great potential for the continued application of this technology to further our understanding of the reproductive processes and to maximize reproductive efficiency of the bovine species. The significant contributions of real-time ultrasonography to the study of bovine reproduction in general and its practical applications in particular are discussed in this paper. The need for taking up technology assessment studies and for the introduction of low-cost portable equipment are stressed. Literature search for this review was done by scanning Current Contents Series 1991-92, AGRICOLA 1980-92, and MEDLINE 1990-92. PMID:7994719

  5. Effective Date of Requirement for Premarket Approval for Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair. Final order.

    PubMed

    2016-01-01

    The Food and Drug Administration (FDA or the Agency) is issuing a final order to require the filing of a premarket approval application (PMA) or notice of completion of a product development protocol (PDP) for surgical mesh for transvaginal pelvic organ prolapse (POP) repair. PMID:26742183

  6. Transvaginal ultrasound

    MedlinePLUS

    ... In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology . 6th ed. Philadelphia, PA: Elsevier Mosby; 2012: chap 33. Katz VL. Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ...

  7. Adaptive sound speed correction for abdominal ultrasonography: preliminary results

    NASA Astrophysics Data System (ADS)

    Jin, Sungmin; Kang, Jeeun; Song, Tai-Kyung; Yoo, Yangmo

    2013-03-01

    Ultrasonography has been conducting a critical role in assessing abdominal disorders due to its noninvasive, real-time, low cost, and deep penetrating capabilities. However, for imaging obese patients with a thick fat layer, it is challenging to achieve appropriate image quality with a conventional beamforming (CON) method due to phase aberration caused by the difference between sound speeds (e.g., 1580 and 1450m/s for liver and fat, respectively). For this, various sound speed correction (SSC) methods that estimate the accumulated sound speed for a region-of interest (ROI) have been previously proposed. However, with the SSC methods, the improvement in image quality was limited only for a specific depth of ROI. In this paper, we present the adaptive sound speed correction (ASSC) method, which can enhance the image quality for whole depths by using estimated sound speeds from two different depths in the lower layer. Since these accumulated sound speeds contain the respective contributions of layers, an optimal sound speed for each depth can be estimated by solving contribution equations. To evaluate the proposed method, the phantom study was conducted with pre-beamformed radio-frequency (RF) data acquired with a SonixTouch research package (Ultrasonix Corp., Canada) with linear and convex probes from the gel pad-stacked tissue mimicking phantom (Parker Lab. Inc., USA and Model539, ATS, USA) whose sound speeds are 1610 and 1450m/s, respectively. From the study, compared to the CON and SSC methods, the ASSC method showed the improved spatial resolution and information entropy contrast (IEC) for convex and linear array transducers, respectively. These results indicate that the ASSC method can be applied for enhancing image quality when imaging obese patients in abdominal ultrasonography.

  8. High-throughput fiber-array transvaginal ultrasound/photoacoustic probe for ovarian cancer imaging

    NASA Astrophysics Data System (ADS)

    Salehi, Hassan S.; Kumavor, Patrick D.; Alqasemi, Umar; Li, Hai; Wang, Tianheng; Zhu, Quing

    2014-03-01

    A high-throughput ultrasound/photoacoustic probe for delivering high contrast and signal-to-noise ratio images was designed, constructed, and tested. The probe consists of a transvaginal ultrasound array integrated with four 1mm-core optical fibers and a sheath. The sheath encases transducer and is lined with highly reflecting aluminum for high intensity light output and uniformity while at the same time remaining below the maximum permissible exposure (MPE) recommended by the American National Standards Institute (ANSI). The probe design was optimized by simulating the light fluence distribution in Zemax. The performance of the probe was evaluated by experimental measurements of the fluence and real-time imaging of polyethylene-tubing filled with blood. These results suggest that our probe has great potential for in vivo imaging and characterization of ovarian cancer.

  9. Ureteral Injury with Delayed Massive Hematuria after Transvaginal Ultrasound-Guided Oocyte Retrieval

    PubMed Central

    Burnik Papler, Tanja; Vrta?nik Bokal, Eda; Šalamun, Vesna; Gali?, Dejan; Smrkolj, Tomaž; Jan?ar, Nina

    2015-01-01

    We report a case of ureteral injury with delayed hematuria after transvaginal oocyte retrieval. A 28-year-old infertile patient with a history of previous laparoscopic resection of endometriotic nodes of both sacrouterine ligaments presented with abdominal pain one day after oocyte retrieval. Four days after oocyte retrieval, she presented with massive hematuria that reappeared 6 days after oocyte retrieval. Monopolar coagulation with wire electrode and insertion of a double-J-stent was performed during operative cystoscopy. The patient recovered completely after transfusion and had no signs of renal impairment after ureteric stent removal. This is the first report of ureteral injury after oocyte retrieval presenting itself with delayed massive hematuria and no signs of renal dysfunction or urinary leakage into retroperitoneal space. PMID:26146577

  10. [The use of transvaginal sonography (TVS) for preoperative diagnosis of pelvic endometriosis].

    PubMed

    Hudelist, G; Keckstein, J

    2009-05-27

    Endometriosis is one the most challenging gynaecological disorders affecting 10-15% of women in their reproductive years. Considerable diagnostic delay of up to 8 years from presenting symptoms often confers a heavy economic and social price. Over the past years, additional diagnostic tools such as transvaginal scanning (TVS) and/or MRI have been recommended as an appropriate investigation to diagnose ovarian endometriomas or adenomyosis. Several lines of recent evidence strongly suggests that the use of TVS also has an important role in detecting DIE of the pelvis not only involving the ovaries but also structures such as the vagina, the rectovaginal space, the uterosacral ligaments, the bladder or the rectal wall. PMID:19472146

  11. Alternative models in genetic analyses of carcass traits measured by ultrasonography in Guzerá cattle: A Bayesian approach

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective was to study alternative models for genetic analyses of carcass traits assessed by ultrasonography in Guzerá cattle. Data from 947 measurements (655 animals) of Rib-eye area (REA), rump fat thickness (RFT) and backfat thickness (BFT) were used. Finite polygenic models (FPM), infinitesi...

  12. Laryngo-tracheal ultrasonography to confirm correct endotracheal tube and laryngeal mask airway placement

    PubMed Central

    Cattano, Davide

    2014-01-01

    Waveform capnography was recommended as the most reliable method to confirm correct endotracheal tube or laryngeal mask airway placements. However, capnography may be unreliable during cardiopulmonary resuscitation and during low flow states. It may lead to an unnecessary removal of a well-placed endotracheal tube, re-intubation and interruption of chest compressions. Real-time upper airway (laryngo-tracheal) ultrasonography to confirm correct endotracheal tube placement was shown to be very useful in cadaveric models and during emergency intubation. Tracheal ultrasonography does not interrupt chest compressions and is not affected by low pulmonary flow or airway obstruction, but is limited by ultrasonography scattering and acoustic artifacts generated in air – mucosa interfaces. Sonographic upper airway assessment emerges as a rapid and easily available method to predict difficult intubation, to assess the laryngeal and hypopharyngeal size and visualize the position of the laryngeal mask airway in situ. This study demonstrates that the replacement of air with saline in endotracheal tube or laryngeal mask airway cuffs and the use of the contrast agents enables detection of cuffs in the airway. It also allows visualization of the surrounding structures or tissues as the ultrasound beam can be transmitted through the fluid – filled cuffs without being reflected from air – mucosal interfaces. PMID:26672974

  13. Bedside ultrasonography for diagnosis of pneumothorax

    PubMed Central

    Chen, Lin

    2015-01-01

    Ultrasonography (US) has found its way into the critical care and emergency settings for the evaluation of acute respiratory failure conditions in recent years. It is useful for the diagnosis of varieties of abnormalities involving pleura and lung such as pleural effusion, alveolar interstitial syndrome, and pneumothorax (PTX). In addition to its reproducibility and timeliness, US has high sensitivity and specificity for the diagnosis of these conditions. The most widely used method for bedside evaluation of PTX is chest X-ray (CXR). However, the diagnostic sensitivity of CXR in detecting PTX is limited especially in occult PTX and when the patient is assumed supine position. Computed tomography (CT) is the gold standard in the evaluation of PTX, but is limited by its high radiation exposure and safety concerns in transporting critically ill patients. In this paper we review current advances in PTX diagnosis using US. PMID:26435925

  14. Current status of automated breast ultrasonography.

    PubMed

    Shin, Hee Jung; Kim, Hak Hee; Cha, Joo Hee

    2015-07-01

    Breast ultrasonography (US) is currently considered the first-line examination in the detection Epub ahead of print and characterization of breast lesions. However, conventional handheld US (HHUS) has several limitations such as operator dependence and the requirement of a considerable amount of radiologist time for whole-breast US. Automated breast US (ABUS), recently approved by the United States Food and Drug Administration for screening purposes, has several advantages over HHUS, such as higher reproducibility, less operator dependence, and less required physician time for image acquisition. In addition, ABUS provides both a coronal view and a relatively large field of view. Recent studies have reported that ABUS is promising in US screening for women with dense breasts and can potentially replace handheld second-look US in a preoperative setting. PMID:25971900

  15. Current status of automated breast ultrasonography

    PubMed Central

    Shin, Hee Jung; Kim, Hak Hee; Cha, Joo Hee

    2015-01-01

    Breast ultrasonography (US) is currently considered the first-line examination in the detection Epub ahead of print and characterization of breast lesions. However, conventional handheld US (HHUS) has several limitations such as operator dependence and the requirement of a considerable amount of radiologist time for whole-breast US. Automated breast US (ABUS), recently approved by the United States Food and Drug Administration for screening purposes, has several advantages over HHUS, such as higher reproducibility, less operator dependence, and less required physician time for image acquisition. In addition, ABUS provides both a coronal view and a relatively large field of view. Recent studies have reported that ABUS is promising in US screening for women with dense breasts and can potentially replace handheld second-look US in a preoperative setting. PMID:25971900

  16. Usefulness of endoscopic ultrasonography in hepatology

    PubMed Central

    Bissonnette, Julien; Paquin, Sarto; Sahai, Anand V; Pomier-Layrargues, Gilles

    2011-01-01

    Endoscopic ultrasonography (EUS) is used to evaluate patients with hepatobiliary diseases. The technique is useful for the diagnosis of esogastric varices in selected cases of portal hypertension, and to evaluate the pathogenic role and prognostic value of the collateral circulation in patients with this condition. When coupled with the Doppler technique, EUS can be used to guide injection sclerotherapy and to verify the obliteration of varices (particularly fundal varices) after endoscopic treatment. Hemodynamic changes induced in the collateral circulation by vasoactive drugs can also be measured with Doppler-EUS. Fine-needle aspiration under EUS guidance is useful in the diagnosis of focal liver lesions and perihepatic adenopathy, and in the evaluation of biliary tract diseases. New indications can be developed in the future after adequate experimental validation. PMID:22059170

  17. Co-registered spectral photoacoustic tomography and ultrasonography of breast cancer

    NASA Astrophysics Data System (ADS)

    Ke, Haixin; Erpelding, Todd N.; Garcia-Uribe, Alejandro; Jacobs, Eileen; Holley, Susan; Monsees, Barbara; Wang, Lihong V.

    2014-03-01

    Many breast cancer patients receive neoadjuvant treatment to reduce tumor size and enable breast conserving therapy. Most imaging methods used to monitor response to neoadjuvant chemotherapy or hormone therapy depend on overall gross tumor morphology and size measurements, which may not be sensitive or specific, despite tumor response on a cellular level. A more sensitive and specific method of detecting response to therapy might allow earlier adjustments in treatment, and thus result in better outcomes while avoiding unnecessary morbidity. We developed an imaging system that combines spectral photoacoustic tomography and ultrasonography to predict breast neoadjuvant therapeutic response based on blood volume and blood oxygenation contrast. The system consists of a tunable dye laser pumped by a Nd:YAG laser, a commercial ultrasound imaging system (Philips iU22), and a multichannel data acquisition system which displays co-registered photoacoustic and ultrasound images in real time. Early studies demonstrate functional imaging capabilities, such as oxygen saturation and total concentration of hemoglobin, in addition to ultrasonography of tumor morphology. Further study is needed to determine if the co-registered photoacoustic tomography and ultrasonography system may provide an accurate tool to assess treatment efficacy by monitoring tumor response in vivo.

  18. Localization of an occult insulinoma by intraoperative ultrasonography.

    PubMed

    Norton, J A; Sigel, B; Baker, A R; Ettinghausen, S E; Shawker, T H; Krudy, A G; Doppman, J L; Taylor, S I; Gordon, P

    1985-03-01

    Intraoperative ultrasonography has not been used previously to locate an insulinoma that was not surgically palpable or that could not be seen by selective arteriography. In this report we described a patient with an insulinoma localized to the pancreatic head identified by transhepatic portal venous sampling but not by selective arteriography or palpation. At operation intraoperative ultrasonography demonstrated an 8 mm tumor in the pancreatic head and guided the successful enucleation. PMID:2983451

  19. Acute diverticulitis of the terminal ileum: ultrasonography and CT findings.

    PubMed

    Jeong, Jewon; Hong, Seong Sook; Hwang, Jiyoung; Kim, Hyun-Joo; Chang, Yun Woo

    2015-01-01

    We describe a rare case of terminal ileal diverticulitis in a 68-year-old female with a day of history Epub ahead of print of right lower quadrant pain and tenderness, mimicking acute appendicitis. Ultrasonography revealed small sac-like out-pouching lesions with increased echogenicity of surrounding fat in thickened terminal ileum, suggesting inflamed diverticula. We diagnosed terminal ileal diverticulitis primarily by ultrasonography. The diagnosis was confirmed by subsequent computed tomography. PMID:25475648

  20. Diagnostic Accuracy of Optic Nerve Ultrasonography and Ophthalmoscopy in Prediction of Elevated Intracranial Pressure

    PubMed Central

    Golshani, Keihan; Ebrahim zadeh, Mehdi; Farajzadegan, Ziba; Khorvash, Fariborz

    2015-01-01

    Introduction: Elevated intracranial pressure (ICP) is a major and potentially lethal disorder in patients admitted to the emergency department (ED). Several methods are being used to investigate for elevated ICP. Here we assessed and compared the diagnostic accuracy of two existing tools of ophthalmoscopy and optic nerve ultrasonography in detection of elevated ICP. Methods: 131 participants with probable elevation of ICP referred to the emergency department of Al-Zahra Hospital, Isfahan, Iran, from 2012 to 2014, were enrolled. Brain computed tomography (CT) scan, ultrasonography of optic nerve sheath, and ophthalmoscopy were performed for them. The optic nerves sheath with diameter more than 5 millimeters was considered as elevated ICP. Widening of optic nerve, ocular venous engorgement, blurring, hemorrhage over optic disk, elevation of optic disk, and retinal venous tortuosity were recorded as evidences of ICP rising in ophthalmoscopy. Diagnostic accuracy of the two tools in prediction of ICP rising were compared with the results of brain CT scan as a gold standard. Results: The mean age of participants was 46.29 ± 10 years (77% male). The number of diagnosed elevated ICPs with ophthalmoscopy and ultrasound were 98 (74.8%) and 102 (77.9%) cases, respectively. The calculated sensitivity and specificity of ophthalmoscopy and ultrasonography in detection of ICP rising were 100.0% (95% CI: 88.6-100.0) and 35.4% (95% CI: 26.0-46.2), 100.0% (95% CI: 84.0-100.0) and 31.9% (95% CI: 23.0-41.7), respectively. Conclusion: The present study revealed that bedside ultrasonography of optic nerve sheath and ophthalmoscopy have enough accuracy for the screening of patients with probable elevation of ICP. Of course, it should be considered that despite the high sensitivity of both tools, their specificity is low. PMID:26495382

  1. Correlation of findings in clinical and high resolution ultrasonography examinations of the painful shoulder

    PubMed Central

    Kyburz, Diego; Ciurea, Adrian; Dubs, Beat; Toniolo, Martin; Bisig, Samuel Pascal; Tamborrini, Giorgio

    2015-01-01

    Objective High resolution ultrasonography is a non-painful and non-invasive imaging technique which is useful for the assessment of shoulder pain causes, as clinical examination often does not allow an exact diagnosis. The aim of this study was to compare the findings of clinical examination and high resolution ultrasonography in patients presenting with painful shoulder. Methods Non-interventional observational study of 100 adult patients suffering from unilateral shoulder pain. Exclusion criteria were shoulder fractures, prior shoulder joint surgery and shoulder injections in the past month. The physicians performing the most common clinical shoulder examinations were blinded to the results of the high resolution ultrasonography and vice versa. Results In order to detect pathology of the m. supraspinatus tendon, the Hawkins and Kennedy impingement test showed the highest sensitivity (0.86) whereas the Jobe supraspinatus test showed the highest specificity (0.55). To identify m. subscapularis tendon pathology the Gerber lift off test showed a sensitivity of 1, whereas the belly press test showed the higher specificity (0.72). The infraspinatus test showed a high sensitivity (0.90) and specificity (0.74). All AC tests (painful arc IIa, AC joint tendernessb, cross body adduction stress testc) showed high specificities (a0.96, b0.99, c0.96). Evaluating the long biceps tendon, the palm up test showed the highest sensitivity (0.47) and the Yergason test the highest specificity (0.88). Conclusion Knowledge of sensitivity and specificity of various clinical tests is important for the interpretation of clinical examination test results. High resolution ultrasonography is needed in most cases to establish a clear diagnosis.

  2. Design of miniaturized illumination for transvaginal co-registered photoacoustic and ultrasound imaging

    PubMed Central

    Salehi, Hassan S.; Wang, Tianheng; Kumavor, Patrick D.; Li, Hai; Zhu, Quing

    2014-01-01

    A novel lens-array based illumination design for a compact co-registered photoacoustic/ultrasound transvaginal probe has been demonstrated. The lens array consists of four cylindrical lenses that couple the laser beams into four 1-mm-core multi-mode optical fibers with optical coupling efficiency of ~87%. The feasibility of our lens array was investigated by simulating the lenses and laser beam profiles using Zemax. The laser fluence on the tissue surface was experimentally measured and was below the American National Standards Institute (ANSI) safety limit. Spatial distribution of hemoglobin oxygen saturation (sO2) of a mouse tumor was obtained in vivo using photoacoustic measurements at multiple wavelengths. Furthermore, benign and malignant ovaries were imaged ex vivo and evaluated histologically. The co-registered images clearly showed different patterns of blood vasculature. These results highlight the clinical potential of our system for noninvasive photoacoustic and ultrasound imaging of ovarian tissue and cancer detection and diagnosis. PMID:25401021

  3. Robotic gastrectomy with transvaginal specimen extraction for female gastric cancer patients

    PubMed Central

    Zhang, Shu; Jiang, Zhi-Wei; Wang, Gang; Feng, Xiao-Bo; Liu, Jiang; Zhao, Jian; Li, Jie-Shou

    2015-01-01

    AIM: To describe the application of complete robotic gastrectomy with transvaginal specimen extraction (TVSE) for gastric cancer patients. METHODS: Between July and November 2014, eight female patients who were diagnosed with gastric adenocarcinoma underwent a TVSE following a full robot-sewn gastrectomy. According to the tumor location, the patients were allocated to two different groups; two patients received robotic total gastrectomy with TVSE and the other six received robotic distal gastrectomy with TVSE. RESULTS: Surgical procedures were successfully performed in all eight cases without conversion. The mean age was 55.3 (range, 42-69) years, and the mean body mass index was 23.2 (range, 21.6-26.0) kg/m2. The mean total operative time and blood loss were 224 (range, 200-298) min and 62.5 (range, 50-150) mL, respectively. The mean postoperative hospital stay was 3.6 (range, 3-5) d. The mean number of lymph nodes resected was 23.6 (range, 17-27). None was readmitted within 30 d of postoperation. During the follow-up, no stricture developed nor was any anastomotic leakage detected. CONCLUSION: It is possible to perform a TVSE following a full robot-sewn gastrectomy with standard D2 lymph node resection for female gastric cancer patients. PMID:26715817

  4. A transvaginal ultrasonic approach to elimination of singleton pregnancy in the mare: application to reduction of twin pregnancy 

    E-print Network

    Macpherson, Margo Lee

    1994-01-01

    transrectal ultrasonography for one week following treatment and weekly for three additional weeks. Intrauterine endoscopic examinations were performed on all mares with non-viable fetuses 30 days following treatment to identify and retrieve mummified fetuses...

  5. Evaluation of bovine luteal blood flow by using color Doppler ultrasonography.

    PubMed

    Lüttgenau, J; Bollwein, H

    2014-04-01

    Since luteal vascularization plays a decisive role for the function of the corpus luteum (CL), the investigation of luteal blood flow (LBF) might give valuable information about the physiology and patho-physiology of the CL. To quantify LBF, usually Power mode color Doppler ultrasonography is used. This method detects the number of red blood cells moving through the vessels and shows them as color pixels on the B-mode image of the CL. The area of color pixels is measured with computer-assisted image analysis software and is used as a semiquantitative parameter for the assessment of LBF. Although Power mode is superior for the evaluation of LBF compared to conventional color Doppler ultrasonography, which detects the velocity of blood cells, it is still not sufficiently sensitive to detect the blood flow in the small vessels in the center of the bovine CL. Therefore, blood flow can only be measured in the bigger luteal vessels in the outer edge of the CL. Color Doppler ultrasonographic studies of the bovine estrous cycle have shown that plasma progesterone (P4) concentration can be more reliably predicted by LBF than by luteal size (LS), especially during the CL regression. During the midluteal phase, cows with low P4 level showed smaller CL, but LBF, related to LS, did not differ between cows with low and high P4 levels. In contrast to non-pregnant cows, a significant rise in LBF was observed three weeks after insemination in pregnant cows. However, LBF was not useful for an early pregnancy diagnosis due to high LBF variation among cows. When the effects of an acute systemic inflammation and exogenous hormones on the CL are examined, the LBF determination is more sensitive than LS assessment. In conclusion, color Doppler ultrasonography of the bovine CL provides additional information on luteal function compared to measurements of LS and plasma P4, but its value as a parameter concerning assessment of fertility in cows has to be clarified. PMID:24856468

  6. The role of ultrasonography and automatic-needle biopsy in outpatient percutaneous liver biopsy.

    PubMed

    Lindor, K D; Bru, C; Jorgensen, R A; Rakela, J; Bordas, J M; Gross, J B; Rodes, J; McGill, D B; Reading, C C; James, E M; Charboneau, J W; Ludwig, J; Batts, K P; Zinsmeister, A R

    1996-05-01

    The risk of complications from percutaneous liver biopsy is low, but discomfort is common and complications require hospitalization in approximately 4% of patients. The optimal method of performing these biopsies is unknown. The goal of our study was to determine whether the use of ultrasonography in the biopsy room immediately prior to or during the procedure would lessen the risk of complications and to compare the safety and efficacy in obtaining tissue by use of a Trucut needle versus an automatic biopsy needle. Between 1992 and 1994, 836 patients were entered into a randomized study (489 in Rochester, MN; 347 in Barcelona, Spain). Patients were randomized immediately prior to liver biopsy into four groups: Trucut needle, or automatic biopsy needle, and with or without ultrasonography. Fisher's Exact Test and a logistic regression model were also used to assess the effect of needle and ultrasonography on the odds for complications. The four biopsy groups were well-matched at entry with respect to age, sex, underlying liver disease, hemoglobin, prothrombin time, and platelet count. The use of ultrasound was associated with a decreased rate of hospitalization for pain, hypotension, or bleeding (2 vs. 9, P < .05). No difference in safety was found between the two types of needles. The number of passes needed to obtain specimens was similar for all four groups. The average length of the specimen was slightly greater with ultrasonographic-guided biopsies (1.7 mm vs. 1.6 mm, P < .05) and with biopsies obtained using the automatic biopsy needle when compared with the Trucut needle (1.7 mm vs. 1.5 mm, P < .05), but this did not seem to be clinically important. The addition of ultrasonography reduces complications in patients undergoing percutaneous liver biopsy. The type of needle appears to offer little difference in safety or yield of diagnostic tissue. The use of ultrasonography for guidance of percutaneous liver biopsy will lead to a lower rate of complications. The value of this benefit must be weighed against the added cost of ultrasonographic guidance. PMID:8621137

  7. Transvaginal cholecystectomy vs conventional laparoscopic cholecystectomy for gallbladder disease: A meta-analysis

    PubMed Central

    Xu, Bin; Xu, Bo; Zheng, Wen-Yan; Ge, Hai-Yan; Wang, Li-Wei; Song, Zhen-Sun; He, Bin

    2015-01-01

    AIM: To compare the results of transvaginal cholecystectomy (TVC) and conventional laparoscopic cholecystectomy (CLC) for gallbladder disease. METHODS: We performed a literature search of PubMed, EMBASE, Ovid, Web of Science, Cochrane Library, Google Scholar, MetaRegister of Controlled Trials, Chinese Medical Journal database and Wanfang Data for trials comparing outcomes between TVC and CLC. Data were extracted by two authors. Mean difference (MD), standardized mean difference (SMD), odds ratios and risk rate with 95%CIs were calculated using fixed- or random-effects models. Statistical heterogeneity was evaluated with the ?2 test. The fixed-effects model was used in the absence of statistically significant heterogeneity. The random-effects model was chosen when heterogeneity was found. RESULTS: There were 730 patients in nine controlled clinical trials. No significant difference was found regarding demographic characteristics (P > 0.5), including anesthetic risk score, age, body mass index, and abdominal surgical history between the TVC and CLC groups. Both groups had similar mortality, morbidity, and return to work after surgery. Patients in the TVC group had a lower pain score on postoperative day 1 (SMD: -0.957, 95%CI: -1.488 to -0.426, P < 0.001), needed less postoperative analgesic medication (SMD: -0.574, 95%CI: -0.807 to -0.341, P < 0.001) and stayed for a shorter time in hospital (MD: -1.004 d, 95%CI: -1.779 to 0.228, P = 0.011), but had longer operative time (MD: 17.307 min, 95%CI: 6.789 to 27.826, P = 0.001). TVC had no significant influence on postoperative sexual function and quality of life. Better cosmetic results and satisfaction were achieved in the TVC group. CONCLUSION: TVC is safe and effective for gallbladder disease. However, vaginal injury might occur, and further trials are needed to compare TVC with CLC. PMID:25954114

  8. Risk stratification of thyroid nodules on ultrasonography with the French TI-RADS: description and reflections.

    PubMed

    Russ, Gilles

    2016-01-01

    The widespread use of ultrasonography places it in a key position for use in the risk stratification of thyroid nodules. The French proposal is a five-tier system, our version of a thyroid imaging reporting and database system (TI-RADS), which includes a standardized vocabulary and report and a quantified risk assessment. It allows the selection of the nodules that should be referred for fine-needle aspiration biopsies. Effort should be directed towards merging the different risk stratification systems utilized around the world and testing this unified system with multi-center studies. PMID:26324117

  9. Correlation between enhanced intensity of atherosclerotic plaque at contrast-enhanced ultrasonography and density of histological neovascularization.

    PubMed

    Sun, Jie; Liu, Kun; Tang, Qiao-ying; Zhang, Wei; Deng, You-bin

    2013-06-01

    The feasibility of contrast-enhanced ultrasonography in the assessment of atherosclerotic plaque neovascularization and its relation to histological findings were investigated. Abdominal aortic atherosclerotic plaque model was induced in 25 New Zealand white rabbits by a combination of high cholesterol-rich diet and balloon aortic denudation. Standard and contrast-enhanced ultrasonography was performed at the 16th week of the model induction period. The plaques were classified as echogenic plaques or echolucent plaques according to their echogenicity at standard ultrasonography. The maximum thickness of plaque was measured in the longitudinal section. Time intensity curve was used to quantify the enhanced intensity of the plaque. Animals were euthanized and abdominal aortas were harvested for histological staining of CD31 to evaluate the neovascularization density of atherosclerotic plaque. The results showed that the echolucent plaques had higher enhanced intensity during contrastenhanced ultrasonography and higher neovascularization density at CD31 staining than the echogenic plaques. The enhanced intensity of atherosclerotic plaque and its ratio to lumen were well correlated with histological neovascularization density (r=0.75, P<0.001; r=0.68, P<0.001, respectively). However, the maximum thickness of plaque was not correlated with neovascularization density (r=0.235, P=0.081). These findings demonstrated that the enhanced intensity in the plaque and ratio of enhanced intensity to that in the lumen of abdominal aorta may be more accurate in the evaluation of plaque neovascularization than maximum thickness. Our study indicates that contrast-enhanced ultrasonography provides us a reliable method for the evaluation of plaque neovascularization. PMID:23771675

  10. Importance of the Ultrasonography in Diagnosis of Ileal Duplication Cyst

    PubMed Central

    Gebesce, Arzu; Korkmaz, Mevlit; Keles, Esengul; Korkmaz, Feride; Mahmutyaz?c?oglu, Kamran; Yazgan, Hamza

    2013-01-01

    Gastrointestinal duplication cysts are rare congenital anomalies that can be seen in anywhere of the gastrointestinal system from the mouth to the anus. These are prenatally diagnosed through antenatal ultrasonography. However, attention must be paid since these formations might be confused with ovarian or mesenteric cysts. Our patient, who had been diagnosed with ovarian cyst on the ultrasonography performed in another center and with mesenteric cyst based on the abdominal MRI carried out at fifth month of life, presented to our clinic with the only complaint of constipation at 9th month of life. The diagnosis was set through double wall appearance of duplication cyst on the abdominal ultrasonography. The patient's cyst was resected. PMID:24302931

  11. Laparoscopic Intraoperative Ultrasonography, Color Doppler, and Power Flow Application.

    PubMed

    Jakimowicz; Stultiëns

    1997-06-01

    The applications of color Doppler and power flow imaging for laparoscopic intraoperative ultrasonography (LIOU) are discussed. Basic principles concerning Doppler, color Doppler imaging (CDI), and power flow (PF) are briefly reviewed, and a number of representative examples of imaging are provided. LIOU is progressively gaining importance, not only for screening of the biliary tract, but in particular, for staging laparoscopy in patients with gastrointestinal cancer. The CDI technology that was developed relatively quickly is now in widespread use in diagnostic ultrasound, particularly for vascular surgery. CD options are no longer restricted to the expensive high-end ultrasound scanners, but are available in the majority of modest duplex systems with limited additional costs. Ongoing developments in ultrasound technology have resulted in the introduction of an alternative option to mean frequency-based CD ultrasound, ie, the PF. There are several advantages that emanate from the combination of B-mode ultrasound with CDI and/or PF. These include (1) rapid identification of anatomical structures, ie, vessels, ducts, tissue spaces, and cysts; (2) detection of small vessels that are difficult or impossible to recognize by B-mode scanning alone; (3) more accurate assessment of vascular encasement/involvement by tumor and a precise display of major vessels anatomically related to the tumor; (4) real-time guidance for safe parenchymal dissection of solid organs with identification and preservation of blood supply; (5) precise guided needle biopsy or puncture; and (6) visualization of bile flow in common bile by PF. This has the potential to enable dynamic flow studies of the function of the papilla of Vater in the near future. PMID:10401148

  12. Ultrasonography of the tongue in macroglossia – a case report

    PubMed Central

    Kyrcz-Krzemie?, S?awomira; Cie?lik, Pawe?; Urba?ska-Krawiec, Dagmara

    2013-01-01

    This paper is an attempt to assess the usefulness of ultrasonography in the diagnosis of the enlargement of the tongue (macroglossia). The role of sonography in diagnosing local pathologies of the tongue, such as neoplasms, abscesses or granulomas, has been well-established for 20 years. Rarely is its usefulness considered with respect to diagnosing macroglossia with concomitant systemic diseases. The starting point of these considerations was the presented case of a 59-year-old patient with considerably enlarged tongue. The patient had difficulty speaking and ingesting meals. Moreover, he complained about swelling and pain in the carpal and proximal interphalangeal joints. Tongue ultrasound examination revealed blurred lingual structure with evident, irregular vascular pattern in the color Doppler. The obtained image helped to rule out local pathology of the tongue and directed our diagnostic considerations towards immunoglobulin-related diseases (deposition diseases). We believe that the presented ultrasound image of the tongue was helpful in the diagnostic process. Establishing the final, correct diagnosis was a particularly strenuous process. The suspicion of a deposition disease had been rejected during two previous stays in two hospitals. This was the consequence of a negative diagnostic test of staining tissue deposits with Congo red. An accurate diagnosis occurred to be a rare form of a deposition disease: lambda light chain disease with symptoms of amyloidosis. Such a diagnosis was based on a thorough hematological analysis. A high level of free lambda light chains in the serum was detected and the bone marrow biopsy showed 13% of plasma cells. The patient underwent chemotherapy.

  13. Ultrasonography guided percutaneous radiofrequency ablation for hepatic cavernous hemangioma

    PubMed Central

    Cui, Yan; Zhou, Li-Yan; Dong, Man-Ku; Wang, Ping; Ji, Min; Li, Xiao-Ou; Chen, Chang-Wei; Liu, Zi-Pei; Xu, Yong-Jie; Zhang, Hong-Wen

    2003-01-01

    AIM: Hepatic cavernous hemangioma (HCH) is the most common benign tumor of the liver and its management is still controversial. Recent success in situ radiofrequency ablation of hepatic malignancies has led us to consider using this technique in patients with HCH. This study was to assess the efficacy, safety, and complications of percutaneous radiofrequency ablation (PRFA) under ultrasonography guidance in patients with HCH. METHODS: Twelve patients (four men and eight women, age ranged 33-56 years, mean age was 41.7 years) with 15 hepatic cavernous hemangiomas (2.5 cm to 9.5 cm) were treated using the RF-2000 generator and 10-needle LeVeen electrode percutaneously guided by B-ultrasound. Lesions larger than 3 cm were treated by multiple overlapping ablations that encompass the entire lesion as well as a rim of normal liver tissue (approximately 0.5 cm). RESULTS: All the patients who received PRFA therapy had no severe pain, bleeding or bile leakage during and after the procedures. Nine to 34 months’ follow-up (mean, 21 months) by ultrasound and/or spiral CT scan demonstrated that the ablated lesions in this group were shrunk remarkably, and the shrunken range was 38%-79% (mean, 67% per 21 months). The contrast enhancement was disappeared within the tumor or at its periphery in all cases on spiral CT scans obtained 3 to 6 months after treatment. CONCLUSION: The results of this study suggest that PRFA therapy is a mini-invasive, simple, safe, and effective method for the treatment of selected patients with HCH. PMID:12970923

  14. Multifocal Insulinoma in Pancreas and Effect of Intraoperative Ultrasonography

    PubMed Central

    Borazan, Ersin; Aytekin, Alper; Yilmaz, Latif; Elci, Muhsin; Karaca, Mehmet Salih; Kervancioglu, Selim; Balik, Ahmet Abdulhalik

    2015-01-01

    Insulinoma is the most frequently seen functional pancreatic neuroendocrine tumor. The incidence of multifocal insulinoma is lower than 10%. Its treatment is direct or laparoscopic excision. The present case was examined with the findings of hypoglycemia and hypercalcemia, and as there was high insulin and C-peptide levels the initial diagnosis was insulinoma. The case was investigated in terms of MEN 1. During preoperative screening for localization, there was one focus in the head of the pancreas in the abdominal tomography and two foci in endoscopic ultrasonography. No other focus was detected through intraoperative visual or manual palpation. However, five foci were detected during operation by intraoperative ultrasonography. The relation of masses with the main pancreatic canal was evaluated and they were excised by enucleation method. There was no recurrence during the postoperative 18-month follow-up of the patient. As a result, during treatment for insulinoma, it should be kept in mind that there might be multifocal foci. In all insulinomas, the whole pancreas should be evaluated with intraoperative ultrasonography because none of the current preoperative diagnostic methods are as sensitive as manual palpation of pancreas and intraoperative ultrasonography. The intraoperative detection of synchronous five foci in pancreas is quite a rare condition. PMID:26295000

  15. Ultrasonography of the spleen. Life-threatening splenic disorders.

    PubMed

    Wrigley, R H

    1991-12-01

    Diagnosis of splenic disease in small animals is often difficult unless a mass is palpable. The physical signs and hematological changes are often variable and non-specific. Radiographic examination may also be unrewarding, especially if concurrent abdominal effusion is present. Splenic ultrasonography is easily performed, sensitive but often non-specific because many disorders have overlapping ultrasonographic patterns. PMID:1802270

  16. Systematic analysis of the safety and benefits of transvaginal hybrid-NOTES cholecystectomy

    PubMed Central

    Bulian, Dirk R; Knuth, Jurgen; Lehmann, Kai S; Sauerwald, Axel; Heiss, Markus M

    2015-01-01

    AIM: To evaluate transvaginal hybrid-NOTES cholecystectomy (TVC) during its clinical establishment and compare it with the traditional laparoscopic technique (LC). METHODS: The specific problems and benefits of TVC were reviewed using a registry analysis, a comparative cohort study and a randomized clinical trial. At first, feasibility, safety and specific complications of the TVC were analyzed based on the first 488 data sets of the German NOTES Registry (GNR). Hereafter, we compared the early postoperative results of our first 50 TVC-patients with those of 50 female LC-patients matched by age, BMI and ASA classification. The same cohort was contacted an average of two years later to evaluate long-term results concerning pain and satisfaction with the aesthetic results and the overall postoperative results as well as sexual intercourse by means of two domains of the German version of the Female Sexual Function Index (FSFI-d). Consequently, we performed a randomized clinical trial comparing 20 TVC-patients with 20 needlescopic/3-trocar cholecystectomies (NC) also concerning the early postoperative results as well as pain, satisfaction and quality of life by means of the Eypasch Gastrointestinal Quality of Life Index (GIQLI) in the later course. Finally, we discussed the results in accordance with other published studies. RESULTS: The complication (3.5%) and conversion rates (4.1%) for TVC were low in the GNR and comparable to those of the LC. Access related intraoperative complications included injuries to the bladder (n = 4; 0.8%) and bowel (n = 3; 0.6%). The study cohort revealed less postoperative pain after TVC comparing to the LC-patients on the day of surgery (NRS, 1.5/10 vs 3.1/10, P = 0.003), in the morning (NRS, 1.9/10 vs 2.8/10, P = 0.047) and in the evening (NRS, 1.1/10 vs 1.8/10, P = 0.025) of postoperative day (POD) one. The randomized clinical trial consistently found less cumulative pain until POD 2 (NRS, 8/40 vs 14/40, P = 0.043), as well as until POD 10 (NRS, 22/190 vs 41/190, P = 0.010). Furthermore, the TVC-patients had a better quality of life on POD 10 than did the LC-patients (GIQLI, 124/144 vs 107/144, P = 0.028). The complication rates were comparable and no specific problems were detected in the long-term follow-up for sexual intercourse for either group. The TVC-patients were more satisfied with the aesthetic result in the long-term course in the matched cohort analysis (1.00 vs 1.88, P < 0.001) as well as in the randomized clinical trial (1.00 vs 1.70, P < 0.001) when compared with the LC-patients. CONCLUSION: TVC is a feasible procedure with a high safety profile and has advantages in regard to postoperative pain and aesthetic results when compared with LC or NC. PMID:26478683

  17. Endoscopic ultrasonography and somatostatin receptor scintigraphy in the preoperative localisation of insulinomas and gastrinomas.

    PubMed Central

    Zimmer, T; Stölzel, U; Bäder, M; Koppenhagen, K; Hamm, B; Buhr, H; Riecken, E O; Wiedenmann, B

    1996-01-01

    BACKGROUND: Endoscopic ultrasonography (EUS) and somatostatin receptor scintigraphy (SRS) can detect a high percentage of gastroenteropancreatic neuroendocrine tumours especially in the upper gastrointestinal tract. The ability of these procedures to localise primary tumour lesions and metastases of gastrinomas and insulinomas was evaluated in comparison with transabdominal ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI). PATIENTS AND METHODS: In a prospective trial, patients with gastrinomas (n = 10) and insulinomas (n = 10) diagnosed by clinical signs and laboratory tests were assessed by EUS, SRS, US, CT and MRI. RESULTS: In 10 patients with gastrinoma and 10 patients with insulinoma, a total of 14 separate primary tumour lesions were histologically confirmed for each of the tumour entities. The mean diameter was 2.1 cm for gastrinomas and 1.5 cm for insulinomas. All insulinomas and nine gastrinoma lesions were located in the pancreas. Three gastrinomas were found in the duodenal wall, one in a periduodenal lymph node, and one in the liver, For gastrinomas, sensitivities were 79% with EUS, 86% with SRS and 29% with CT, US, and MRI. For insulinomas, sensitivities were 93% with EUS, 14% with SRS, 21% with CT and 7% with US and MRI. CONCLUSIONS: EUS is of high value for localising primary lesions of both tumour entities. SRS is a very sensitive procedure for diagnosing of gastrinomas but not insulinomas. CT, US and MRI are primarily useful for visualising metastases. Images Figure 1 Figure 2 PMID:8944566

  18. Magnetic Resonance Arthrography of the Glenohumeral Joint: Ultrasonography-Guided Technique Using a Posterior Approach

    PubMed Central

    Ogul, Hayri; Bayraktutan, Ummugulsum; Yildirim, Omer Selim; Suma, Selami; Ozgokce, Mesut; Okur, Adnan; Kantarci, Mecit

    2012-01-01

    Objective: The purpose of this study was to assess the efficacy and feasibility of ultrasound (US)-guided magnetic resonance (MR) arthrography of the glenohumeral joint via a posterior approach. Materials and Methods: Thirty-four patients (18 males and 16 females) who were suspected to have glenohumeral joint pathology were examined using MR arthrography. The patients ranged in age from 21 to 85 years, and the average age was 45±15.9 years. A Toshiba Xario US unit was utilized. Ultrasonography examinations were conducted using a broad-band 5–12 MHz linear array transducer. Gadolinium was injected into the shoulder joint using an 18–20 gauge needle. MR imaging was performed within the first 30 min after the injection. Results: The injection of gadolinium into the shoulder joint was successfully accomplished in all 34 patients. Major contrast media extravasation outside the joint was depicted in only two patients (5.9%). No major complications were encountered. Conclusion: Ultrasonography is an effective alternate guidance technique for the injection of gadolinium into the glenohumeral joint for MR arthrography. US-guided arthrography via a posterior approach to the glenohumeral joint is safe, accurate, well tolerated by patients and easy to perform with minimal training. PMID:25610213

  19. Serial limited versus single complete compression ultrasonography for the diagnosis of lower extremity deep vein thrombosis.

    PubMed

    Guanella, Raphael; Righini, Marc

    2012-04-01

    The diagnostic approach to deep vein thrombosis (DVT) has evolved during the last 3 decades. Contrast venography has been replaced by noninvasive tests. Compression ultrasonography (CUS) is currently the most widely used diagnostic test. Whereas CUS has a high accuracy for proximal DVT (thrombosis of the popliteal and more proximal veins), it has been shown to lack sensitivity and specificity for distal DVT. Ultrasonography can either be limited to the proximal veins and repeated within 1 week (serial limited CUS) or extended to both proximal and distal veins and performed on one occasion (single complete CUS). Both strategies are reliable diagnostic options for the management of patients with suspected DVT. The main limitation of proximal CUS is the need to repeat the test once in patients with initial negative findings. Conversely, complete CUS detects many distal DVTs for which systematic anticoagulation therapy is debatable and exposes patients to potentially unnecessary anticoagulation. Incorporation of D-dimer testing and clinical pretest probability assessment in the diagnostic algorithm is beneficial because it allows excluding DVT without the need for diagnostic imaging in about a third of patients. PMID:22648486

  20. Contrast-enhanced harmonic ultrasonography of medial iliac lymph nodes in healthy dogs.

    PubMed

    Gaschen, Lorrie; Angelette, Nik; Stout, Rhett

    2010-01-01

    Herein, we describe the normal contrast-enhanced harmonic, color, and power Doppler ultrasonographic characteristics of the medial iliac lymph nodes in healthy dogs. Contrast-enhanced harmonic ultrasonography of the medial iliac lymph nodes was performed on 14 healthy dogs after intravenous administration of the lipoprotein-bound inert gas-filled microbubble contrast media Definity. Time-pixel intensity curves were generated for 1-min postinjection. Quantification of these curves was performed using Philips QLab software. Non-contrast-enhanced power and color Doppler examinations were performed in each node to assess vascular patterns subjectively. Normal lymph nodes exhibited a mean contrast wash-in phase beginning at 6.3 s from the time of injection with mean peak pixel intensity at 12.1s. Angioarchitecture was best visualized with contrast-enhanced harmonic ultrasound compared with power and color Doppler. Normal lymph nodes in dogs have a central artery with a centrifugal and uniform branching pattern. Contrast-enhanced harmonic ultrasonography is a noninvasive examination that demonstrates improved visibility of the intranodal architecture of healthy medial iliac lymph nodes in dogs compared with conventional, non-contrast-enhanced Doppler methods that may have future clinical applications. PMID:21158236

  1. Using Ultrasonography to Define Fetal–Maternal Relationships: Moving from Humans to Mice

    PubMed Central

    Zhang, Jianhong; Croy, B Anne

    2009-01-01

    Ultrasound scanning is a noninvasive, accurate, and cost-effective method to create images of the female reproductive tract clinically and in research. Ultrasonography is particularly valuable for studying the dynamic relationships among mother, placenta, and fetus during pregnancy because this modality does not disturb the ongoing course of gestation. Importantly, the complex vascular changes in the mother induced by pregnancy and the vascular system generated to support placental function can be assessed quantitatively and functionally by ultrasonography. Many mouse models are available that address aspects of human placental function and dysfunction, but high-quality microultrasound technology suitable for use in pregnant mice has become widely available only recently. This technical advance now enables real-time recording of maternal–fetal interactions in pregnant rodents. The ability to perform microultrasonic analyses of parameters such as uterine arterial remodeling, hemodynamic changes, placental development, and fetal growth in mice now permits research that uses the same imaging platform as that for human patients. This capability will enhance the translation of information derived from rodent studies to the clinic. PMID:20034427

  2. Transvaginal/Transumbilical Hybrid—NOTES—Versus 3-Trocar Needlescopic Cholecystectomy: Short-term Results of a Randomized Clinical Trial

    PubMed Central

    Knuth, Jürgen; Cerasani, Nicola; Sauerwald, Axel; Lefering, Rolf; Heiss, Markus Maria

    2015-01-01

    Objective: For cholecystectomy, both the needlescopic cholecystectomy (NC) 3-trocar technique using 2 to 3 mm trocars and the umbilical-assisted transvaginal cholecystectomy (TVC) technique have found their way into clinical routine. This study compares these 2 techniques in female patients who are in need of an elective cholecystectomy. Background: Natural orifice transluminal endoscopic surgery (NOTES) is a surgical concept permitting scarless intra-abdominal operations through natural orifices, such as the vagina. Because of the lack of an adequately powered trial, we designed this first randomized controlled study for the comparison of TVC and NC. Methods: This prospective, randomized, nonblinded, single-center trial evaluates the safety and effectiveness of TVC (intervention), compared with NC (control) in female patients with symptomatic cholecystolithiasis. The primary endpoint was intensity of pain until the morning of postoperative day (POD) 2. Secondary outcomes were among others intra- and postoperative complications, procedural time, amount of analgesics used, pain intensity until POD 10, duration of hospital stay, satisfaction with the aesthetic result, and quality of life on POD 10 as quantified with the Eypasch Gastrointestinal Quality of Life Index (GIQLI). Results: Between February 2010 and June 2012, 40 patients were randomly assigned to the interventional or control group. All patients completed follow-up. Procedural time, length of postoperative hospital stay, and the rate of intra- and postoperative complications were similar in the 2 groups. However, significant advantages were found for the transvaginal access regarding pain until POD 2, but also until POD 10 (P = 0.043 vs P = 0.010) despite significantly less use of peripheral analgesics (P = 0.019). In the TVC group, patients were significantly more satisfied with the aesthetic result (P < 0.001) and had a significantly better GIQLI (P = 0.028). Conclusions: Although comparable in terms of safety, TVC caused less pain, increased satisfaction with the aesthetic result, and improved postoperative quality of life in the short term. PMID:24108196

  3. Prediction and validation of total and regional skeletal muscle volume using B-mode ultrasonography in Japanese prepubertal children.

    PubMed

    Midorikawa, Taishi; Ohta, Megumi; Hikihara, Yuki; Torii, Suguru; Sakamoto, Shizuo

    2015-10-28

    Very few effective field methods are available for accurate, non-invasive estimation of skeletal muscle volume (SMV) and mass in children. We aimed to develop regression-based prediction equations for SMV, using ultrasonography, in Japanese prepubertal children, and to assess the validity of these equations. In total, 145 healthy Japanese prepubertal children aged 6-12 years were randomly divided into two groups: the model development group (sixty boys, thirty-seven girls) and the validation group (twenty-nine boys, nineteen girls). Reference data in the form of contiguous MRI with 1-cm slice thickness were obtained from the first cervical vertebra to the ankle joints. The SMV was calculated by the summation of digitised cross-sectional areas. Muscle thickness was measured using B-mode ultrasonography at nine sites in different regions. In the model development group, strong, statistically significant correlations were observed between the site-matched SMV (total, arms, trunk, thigh and lower legs) measured by MRI and the muscle thickness×height measures obtained by ultrasonography, for both boys and girls. When these SMV prediction equations were applied to the validation groups, the measured total and regional SMV were also very similar to the values predicted for boys and girls, respectively. With the exception of the trunk region in girls, the Bland-Altman analysis for the validation group did not indicate any bias for either boys or girls. These results suggest that ultrasonography-derived prediction equations for boys and girls are useful for the estimation of total and regional SMV. PMID:26337709

  4. Ultrasonography managed by internists: the stethoscope of 21st century?

    PubMed

    Beltrán, L M; García-Casasola, G

    2014-04-01

    Ultrasonography in the hands of the internist can answer important clinical questions quickly at the point of patient care. This technique "enhances" the senses of the physicians and improves their ability to solve the problems of the patient. Point of care ultrasonography performed by clinicians has shown good accuracy in the diagnosis of diverse cardiac, abdominal and vascular pathologic conditions. It may also be useful for evaluation of thyroid, osteoarticular and soft tissue diseases. Furthermore, the use of ultrasound to guide invasive procedures (placement of venous catheters, thoracentesis, paracentesis) reduces the risk of complications. We present 5 cases to illustrate the usefulness of this technique in clinical practice: (i) peripartum cardiomyopathy; (ii) subclinical carotid artery atherosclerosis; (iii) asymptomatic abdominal aortic aneurysm; (iv) tendinitis of long head of biceps brachii and supraspinatus, and (v) spontaneous soleus muscle hematoma. PMID:24529607

  5. Transrectal ultrasonography of anorectal diseases: advantages and disadvantages

    PubMed Central

    2015-01-01

    Transrectal ultrasonography (TRUS) has been widely accepted as a popular imaging modality for Epub ahead of print evaluating the lower rectum, anal sphincters, and pelvic floor in patients with various anorectal diseases. It provides excellent visualization of the layers of the rectal wall and of the anatomy of the anal canal. TRUS is an accurate tool for the staging of primary rectal cancer, especially for early stages. Although magnetic resonance imaging is a modality complementary to TRUS with advantages for evaluating the mesorectum, external sphincter, and deep pelvic inflammation, three-dimensional ultrasonography improves the detection and characterization of perianal fistulas and therefore plays a crucial role in optimal treatment planning. The operator should be familiar with the anatomy of the rectum and pelvic structures relevant to the preoperative evaluation of rectal cancer and other anal canal diseases, and should have technical proficiency in the use of TRUS combined with an awareness of its limitations compared to magnetic resonance imaging. PMID:25492891

  6. Transrectal ultrasonography of anorectal diseases: advantages and disadvantages.

    PubMed

    Kim, Min Ju

    2015-01-01

    Transrectal ultrasonography (TRUS) has been widely accepted as a popular imaging modality for Epub ahead of print evaluating the lower rectum, anal sphincters, and pelvic floor in patients with various anorectal diseases. It provides excellent visualization of the layers of the rectal wall and of the anatomy of the anal canal. TRUS is an accurate tool for the staging of primary rectal cancer, especially for early stages. Although magnetic resonance imaging is a modality complementary to TRUS with advantages for evaluating the mesorectum, external sphincter, and deep pelvic inflammation, three-dimensional ultrasonography improves the detection and characterization of perianal fistulas and therefore plays a crucial role in optimal treatment planning. The operator should be familiar with the anatomy of the rectum and pelvic structures relevant to the preoperative evaluation of rectal cancer and other anal canal diseases, and should have technical proficiency in the use of TRUS combined with an awareness of its limitations compared to magnetic resonance imaging. PMID:25492891

  7. Diagnostic ultrasonography in cattle with abdominal fat necrosis

    PubMed Central

    Tharwat, Mohamed; Buczinski, Sébastien

    2012-01-01

    This study describes the ultrasonographic findings in 14 cows with abdominal fat necrosis. Ultrasonography of the abdomen revealed the presence of heterogeneous hyperechoic masses and hyperechoic omentum with localized masses floating in a hypoechoic peritoneal fluid. A hyperechogenic rim was imaged around both kidneys. The intestines were coated with hyperechoic capsules and the intestinal lumens were constricted. Ultrasonographic examination of the pancreatic parenchyma showed an overall increased echogenicity which was homogenously distributed in 3 cases. A diagnosis of abdominal fat necrosis was made with ultrasound-guided biopsy of the echogenic masses, and thereafter at postmortem examination. Results from this study demonstrate the efficacy of ultrasonography as an imaging modality for antemortem diagnosis of abdominal lipomatosis in cattle. To the authors’ knowledge, this study is the first that illustrates ultrasonographic findings in cattle affected with abdominal lipomatosis. PMID:22753961

  8. [Ultrasonography in chronic inflammatory rheumatic and connective tissue disorders].

    PubMed

    Mérot, O; Le Goff, B

    2014-08-01

    Musculoskeletal ultrasonography is now widely used by almost all rheumatologists thanks to an improvement in the quality of ultrasound unit and probe and to the systematic teaching of this imaging technique to the rheumatology fellows. Applications have broadened from the study of degenerative and mechanical diseases to inflammatory rheumatic diseases. Ultrasound is more sensitive than clinical examination. Power Doppler allows the direct visualisation of inflammation within the tissues. Finally, it is a prognostic tool helping the physician in the management of the disease. This review will focus on the value and applications of ultrasonography in the 2 most frequent rheumatic diseases: rheumatoid arthritis and spondyloarthritis. We will also give some recent data on the usefulness of this imaging technique in the study of musculoskeletal manifestations associated with connective tissue disease. PMID:24439720

  9. Evaluation of gallbladder volume and contraction index with three-dimensional ultrasonography in healthy dogs.

    PubMed

    Rahmani, Vahideh; Molazem, Mohammad; Jamshidi, Shahram; Vali, Yasamin; Hanifeh, Mohsen

    2015-10-01

    Three-dimensional (3D) ultrasonography has been shown to be an accurate and appropriate tool for measurement of gallbladder volume in humans. Therefore, we applied this novel technique for the first time to study fasting and postprandial gallbladder volume in 10 healthy dogs and compared the results with those of 2-dimensional (2D) ultrasonography. Fasting gallbladder volumes determined by 3D ultrasonography were significantly higher than corresponding volumes determined by 2D ultrasonography (P<0.01). Additionally, gallbladder volumes were significantly decreased in the postprandial state compared with the fasting state using 3D ultrasonography (P<0.001), but 2D ultrasonography showed no significant difference (P=0.189). The Gallbladder contraction index was higher in 3D ultrasonography than 2D ultrasonography; however, it did not reach statistical significance (P=0.25). In conclusion, 3D ultrasonography was able to measure gallbladder volume in healthy dogs in this study. It is suggested that 3D ultrasonography can be used to accurately estimate gallbladder volume and contractility. PMID:25903917

  10. Evaluation of gallbladder volume and contraction index with three-dimensional ultrasonography in healthy dogs

    PubMed Central

    RAHMANI, Vahideh; MOLAZEM, Mohammad; JAMSHIDI, Shahram; VALI, Yasamin; HANIFEH, Mohsen

    2015-01-01

    Three-dimensional (3D) ultrasonography has been shown to be an accurate and appropriate tool for measurement of gallbladder volume in humans. Therefore, we applied this novel technique for the first time to study fasting and postprandial gallbladder volume in 10 healthy dogs and compared the results with those of 2-dimensional (2D) ultrasonography. Fasting gallbladder volumes determined by 3D ultrasonography were significantly higher than corresponding volumes determined by 2D ultrasonography (P<0.01). Additionally, gallbladder volumes were significantly decreased in the postprandial state compared with the fasting state using 3D ultrasonography (P<0.001), but 2D ultrasonography showed no significant difference (P=0.189). The Gallbladder contraction index was higher in 3D ultrasonography than 2D ultrasonography; however, it did not reach statistical significance (P=0.25). In conclusion, 3D ultrasonography was able to measure gallbladder volume in healthy dogs in this study. It is suggested that 3D ultrasonography can be used to accurately estimate gallbladder volume and contractility. PMID:25903917

  11. Transcranial Doppler ultrasonography in intensive care.

    PubMed

    Rasulo, F A; De Peri, E; Lavinio, A

    2008-01-01

    Transcranial Doppler is an innovative, flexible, accessible tool for the bedside monitoring of static and dynamic cerebral flow and treatment response. Introduced by Rune Aaslid in 1982, it has become indispensable in clinical practice. The main obstacle to ultrasound penetration of the skull is bone. Low frequencies, 1-2 MHz, reduce the attenuation of the ultrasound wave caused by bone. Transcranial Doppler also provides the advantage of acoustic windows representing specific points of the skull where the bone is thin enough to allow ultrasounds to penetrate. There are four acoustic windows: transtemporal, transorbital, suboccipital and retromandibular. The identification of each intracranial vessel is based on the following elements: (a) velocity and direction; (b) depth of signal capture; (c) possibility of following the vessel its whole length; (d) spatial relationship with other vessels; and (e) response to homolateral and contralateral carotid compression. The main fields of clinical application of transcranial Doppler are assessment of vasospasm, detection of stenosis of the intracranial arteries, evaluation of cerebrovascular autoregulation, non-invasive estimation of intracranial pressure, measure of effective downstream pressure and assessment of brain death. Mean flow velocity is directly proportional to flow and inversely proportional to the section of the vessel. Any circumstance that leads to a variation of one of these factors can thus affect mean velocity. The main pathological condition affecting flow velocity is the vasospasm. Vasospasm is a frequent complication of subarachnoid haemorrhage, it often remains clinically silent and the factors that make it symptomatic are largely unknown. Threshold velocities above which vasospasm comes into place are well defined as regards the median cerebral artery, while there is no consensus for the other vessels. Nevertheless, an increase in velocity alone is not sufficient to arrive at a diagnosis of vasospasm; a condition of hyperaemia also presents with an increase in flow velocity. The Lindegaard Index has therefore been introduced, which is defined by the ratio between the mean flow velocity in the median cerebral artery and the mean flow velocity in the internal carotid artery. Criteria for diagnosis of a stenosis >50% of an intracranial vessel with transcranial Doppler include: (a) segmentary acceleration of flow velocity; (b) drop in velocity below the stenotic segment; (c) asymmetry; and (d) circumscribed flow disturbances (turbulence and musical murmur). The transcranial Doppler enables us to assess both components of self-regulation. The static component is measured by observing changes in flow velocity caused by pharmacologically induced episodes of hypertension and hypotension. The dynamic component of autoregulation can be measured using a method devised by Aaslid known as the 'cuff test'. A very effective and safe device for measuring cerebral autoregulation is the transient hyperaemic response test. This test is based on the compensatory vasodilatation of the arterioles, which occurs after brief compression of the common carotid. Csonyka proposed the following formula based on clinical observation for the calculation of cerebral perfusion pressure: CPP = MAP x FVd/FVm + 14. Brain death is defined as the irreversible cessation of all functions of the whole brain. The clinical criteria are usually considered sufficient to establish a diagnosis of brain death; however, they might not be sufficient in patients who have been on sedatives or when there are ethical or legal controversies. Many authors have demonstrated the existence of a transcranial Doppler pattern, which is typical of brain death. PMID:18289437

  12. [Doppler ultrasonography of carotid atheromatous lesions].

    PubMed

    Tranquart, F; De Bray, J M; Aesch, B; Pourcelot, L

    2000-04-01

    Carotid stenosis is the most frequently factor involved in stroke. The diagnosis of these lesions in routinely based on ultrasonic examination which allows to detect the carotid stenoses which were essentially atheromatous. B-mode evaluates the fine echostructure of plaques and Doppler helps to quantify the degree of stenosis using direct and indirect hemodynamic criteria. Echography with the help of color Doppler imaging identifies the site of stenosis in order to determine the degree of stenosis as a percentage of normal carotid area. Moreover echography is an essential method to appreciate the surface as well as the echostructure of the carotid lesion which have to be taking into account for a well-adapted therapy. The maximal velocities determined at the tight site of the lesion, the spectral changes downstream the stenosis and the hemodynamic changes observed upstream and downsteam of the carotid stenosis allow a precise quantification of this stenosis. The information obtained using sonographic methods (including 2 direct hemodynamic criteria, 2 indirect hemodynamic criteria and, if possible, a B-mode assessment of the area) are essential to appreciate the neurological risk in these patients. PMID:10794998

  13. Sentinel Node Biopsy for the Head and Neck Using Contrast-Enhanced Ultrasonography Combined with Indocyanine Green Fluorescence in Animal Models: A Feasibility Study

    PubMed Central

    Sato, Dai; Ikeda, Tetsuya; Matsumoto, Yoshifumi; Moro, Yorihisa; Kimura, Toru; Hamanoue, Yasuhiro; Nakamura, Takehiro; Yamauchi, Koichi; Saito, Koichiro; Sugasawa, Masashi; Kohno, Naoyuki

    2015-01-01

    Background Sentinel node navigation surgery is gaining popularity in oral cancer. We assessed application of sentinel lymph node navigation surgery to pharyngeal and laryngeal cancers by evaluating the combination of contrast-enhanced ultrasonography and indocyanine green fluorescence in animal models. Methods This was a prospective, nonrandomized, experimental study in rabbit and swine animal models. A mixture of indocyanine green and Sonazoid was used as the tracer. The tracer mixture was injected into the tongue, larynx, or pharynx. The sentinel lymph nodes were identified transcutaneously by infra-red camera and contrast-enhanced ultrasonography. Detection time and extraction time of the sentinel lymph nodes were measured. The safety of the tracer mixture in terms of mucosal reaction was evaluated macroscopically and microscopically. Results Sentinel lymph nodes were detected transcutaneously by contrast-enhanced ultrasonography alone. The number of sentinel lymph nodes detected was one or two. Despite observation of contrast enhancement of Sonazoid for at least 90 minutes, the number of sentinel lymph nodes detected did not change. The average extraction time of sentinel lymph nodes was 4.8 minutes. Indocyanine green fluorescence offered visual information during lymph node biopsy. The safety of the tracer was confirmed by absence of laryngeal edema both macro and microscopically. Conclusions The combination method of indocyanine green fluorescence and contrast-enhanced ultrasonography for detecting sentinel lymph nodes during surgery for head and neck cancer seems promising, especially for pharyngeal and laryngeal cancer. Further clinical studies to confirm this are warranted. PMID:26161800

  14. Age determination using ultrasonography in young football players

    PubMed Central

    Karami, Mehdi; Moshirfatemi, Alireza; Daneshvar, Pooya

    2014-01-01

    Background: Increasing of age cheating in sports makes problems to athletes comparable to taking illegal substances. Current method used by AFC and FIFA is applying MRI of growth plate of distal of radius to determine the bone age. This study was designed to evaluate the diagnostic accuracy of ultrasonography in bone age determination by measuring the width of growth plate in distal of radius, and comparing it with identity documents. Materials and Methods: The study was conducted from September to December 2009 in the Department of Radiology at Al-Zahra University Hospital, Isfahan, Iran. Ultrasonography was done for 82 (15-20 years old) young professional football players and results were compared with identity documents (such as National ID card). Young football players were divided into three age categories: < 16 and > 16 years old, < 17 and > 17 years old, and < 18 and > 18 years old. Receiver Operator Characteristics (ROC) curves for discriminant values and sensitivity and specificity were analyzed. Results: Cut-off point was set for each group, based on the width of the growth plate, and negative test was defined as subjects < cut-off point, showing subjects over the defined age in each group. ROC curve analysis demonstrates consistently acceptable diagnostic sensitivity and specificity values in age determination of each group. Conclusions: The overall predictive accuracy of ultrasonography, as described by the area under the ROC curve, was high for determination of bone age. It has an acceptable sensitivity and specificity to use for determination of age in sport competitions, and has the capability to become the screening test for age determination, especially because it is inexpensive and without any risk of radiation. It seems to be comparable with MRI in age determination. PMID:25250288

  15. Recent advances in endoscopic ultrasonography-guided biliary interventions

    PubMed Central

    Kawakubo, Kazumichi; Kawakami, Hiroshi; Kuwatani, Masaki; Haba, Shin; Kawahata, Shuhei; Abe, Yoko; Kubota, Yoshimasa; Kubo, Kimitoshi; Isayama, Hiroyuki; Sakamoto, Naoya

    2015-01-01

    Interventional endoscopic ultrasonography (EUS) based on EUS-guided fine-needle aspiration has rapidly spread as a minimally invasive procedure. Especially in patients with failed endoscopic retrograde cholangiopancreatography, EUS-guided biliary intervention is reported to be useful as salvage therapy. EUS-guided biliary interventions are carried out using three techniques: EUS-guided bilioenteric anastomosis, EUS-guided rendezvous procedure, and EUS-guided antegrade treatment. Although interventional EUS is not yet a standardized procedure, there have been recent advances in this field that address various biliary diseases. Here, we summarize the indications, techniques, clinical results of previous studies, and future perspectives. PMID:26327757

  16. Trans-vaginal oocyte retrieval and subsequent in vitro production of embryos from a cow involuntarily culled.

    PubMed

    Shaw, D G; Bowles, C M; Raja, K; Lishman, A W

    1999-09-01

    A Holstein cow of high genetic merit, in late lactation (205 days) and diagnosed with salpingitis (after 4 infertile services and veterinary consultation), was subjected to 1 trans-vaginal oocyte collection attempt, prior to slaughter. Of an estimated 10 follicles punctured, a total of 4 cumulus-oocyte complexes were retrieved. These were matured in vitro in a maturation medium for 24 hours. After 24 hours maturation, the oocytes were fertilised in vitro with Percoll-processed frozen/thawed imported semen, of the owner's choice. Fertilisation was achieved in a modified Tyrode's medium. At 18 hours post-insemination, the presumptive zygotes were transferred into culture in vitro in Charles Rosenkran's amino-acid medium and supplemented on Day 4 post-insemination with 10% foetal calf serum. All in vitro procedures were conducted in 50 microl medium droplets, under oil, in a humidified incubator at 38.5 degrees C in 5% CO2 in air. Three of the potential zygotes cleaved and, by Day 7 of culture, these had developed to the morula stage. The embryos were frozen in 1.5 M ethylene glycol and later transferred non-surgically to synchronised Holstein recipient heifers. One morula resulted in the only pregnancy and subsequent birth of a healthy heifer calf. An independent commercial company confirmed parentage through standard blood-typing assays. The genetic salvage of oocytes, for in vitro production of embryos, has potential benefits to the producer. PMID:10852684

  17. Transvaginal cervical length and tobacco use in Appalachian women: association with increased risk for spontaneous preterm birth.

    PubMed

    Findley, Joseph; Seybold, Dara J; Broce, Mike; Yadav, Dolly; Calhoun, Byron C

    2015-01-01

    Currently ACOG recommends that a mid-term screening strategy may be considered to identify short cervix in low risk populations in an effort to prevent preterm birth. Vaginal progesterone is recommended for women with a cervical length ?20 mm. Cerclage is recommended for women with prior spontaneous preterm birth who are already receiving progesterone supplementition and CL is <25 mm. This study examined risk factors for spontaneous preterm birth (SPB) <35 weeks among a general obstetrical population prior to these ACOG recommendations. However, cervical cerclage was a possible intervention. Study population included 1,074 patients from 1 Jan 2007-30 Jun 2008 receiving mid-trimester transvaginal ultrasounds during prenatal care at a tertiary medical center clinic. Receiver operator characteristic (ROC) curve cutoff optimal value was ?34 mm, (n=224), corresponding to 8.9% SPB with shortened cervices compared to 1.4% in patients with normal cervices (>34 mm; n=850; p<0.001 (Area Under the Curve (AUC) 76.6, p<0.001). Cervical lengths <30 mm had 12 times the risk of SPB (p<0.001) while 30-34 mm had 5 times (p=0.005). Tobacco use (?10 cigarettes per day), p=0.030, and low BMI, p=0.034, had additive effect. Shortened cervical length during routine screening independently predicted SPB while heavy smoking with shortened cervix during pregnancy doubled risk compared to shortened cervix alone. PMID:26050294

  18. Transvaginal ovarian trauma, poor responders and improvement of success rates in IVF: anecdotal data and a hypothesis.

    PubMed

    Siristatidis, Charalampos; Vogiatzi, Paraskevi; Bettocchi, Stefano; Basios, George; Mastorakos, George; Vrachnis, Nikos

    2014-08-01

    In this report, we propose an intervention capable of improving IVF outcomes in subfertile women with poor ovarian response. This intervention derives from anecdotal data and observations in our daily practice, but most importantly from trials on experimental models and subfertile women with Polycystic Ovarian Syndrome (PCOS). Our hypothesis suggests that transvaginal induction of trauma to the ovary in the cycle preceding IVF should benefit poor ovarian responders and their lowered pregnancy rates by increasing - at least - the number of retrieved oocytes during oocyte retrieval. Up-to-the minute data show that, via this means, there is a unique response of the ovarian surface epithelium and stroma to the induced trauma. The potential pathways of this beneficial response involve an improvement of the raised gonadotrophins to act either through the mechanical reduction of the size of the ovary or through alterations of the hormonal profile by lowering LH, inhibin and local androgen concentrations through hypothalamic-pituitary axis feedbacks, the induction of increased blood flow to the ovaries, a differentiated local immune reaction and a non-elucidated as yet role of reactive oxygen species. In this report, we also describe the technique and the associated possible negative points while we try to point out the needed research steps to ensure its efficiency before it enters daily clinical practice. PMID:24837687

  19. Design of optimal light delivery system for co-registered transvaginal ultrasound and photoacoustic imaging of ovarian tissue

    PubMed Central

    Salehi, Hassan S.; Kumavor, Patrick D.; Li, Hai; Alqasemi, Umar; Wang, Tianheng; Xu, Chen; Zhu, Quing

    2015-01-01

    A hand-held transvaginal probe suitable for co-registered photoacoustic and ultrasound imaging of ovarian tissue was designed and evaluated. The imaging probe consists of an ultrasound transducer and four 1-mm-core multi-mode optical fibers both housed in a custom-made sheath. The probe was optimized for the highest light delivery output and best beam uniformity on tissue surface, by simulating the light fluence and power output for different design parameters. The laser fluence profiles were experimentally measured through chicken breast tissue and calibrated intralipid solution at various imaging depths. Polyethylene tubing filled with rat blood mimicking a blood vessel was successfully imaged up to ?30 mm depth through porcine vaginal tissue at 750 nm. This imaging depth was achieved with a laser fluence on the tissue surface of 20 mJ/cm2, which is below the maximum permissible exposure (MPE) of 25 mJ/cm2 recommended by the American National Standards Institute (ANSI). Furthermore, the probe imaging capability was verified with ex vivo imaging of benign and malignant human ovaries. The co-registered images clearly showed different vasculature distributions on the surface of the benign cyst and the malignant ovary. These results suggest that our imaging system has the clinical potential for in vivo imaging and characterization of ovarian tissues. PMID:26640774

  20. Transvaginal Cervical Length and Tobacco Use in Appalachian Women: Association with Increased Risk for Spontaneous Preterm Birth

    PubMed Central

    Findley, Joseph; Seybold, Dara J.; Broce, Mike; Yadav, Dolly; Calhoun, Byron C.

    2015-01-01

    Currently ACOG recommends that a mid-term screening strategy may be considered to identify short cervix in low risk populations in an effort to prevent preterm birth. Vaginal progesterone is recommended for women with a cervical length ?20 mm. Cerclage is recommended for women with prior spontaneous preterm birth who are already receiving progesterone supplementation and CL is <25 mm. This study examined risk factors for spontaneous preterm birth (SPB) <35 weeks among a general obstetrical population prior to these ACOG recommendations. However, cervical cerclage was a possible intervention. Study population included 1,074 patients from 1 Jan 2007-30 Jun 2008 receiving mid-trimester transvaginal ultrasounds during prenatal care at a tertiary medical center clinic. Receiver operator characteristic (ROC) curve cutoff optimal value was ?34 mm, (n=224), corresponding to 8.9% SPB with shortened cervices compared to 1.4% in patients with normal cervices (>34 mm; n=850; p<0.001 (Area Under the Curve (AUC) 76.6, p<0.001). Cervical lengths <30 mm had 12 times the risk of SPB (p<0.001) while 30-34 mm had 5 times (p=0.005). Tobacco use (?10 cigarettes per day), p=0.030, and low BMI, p=0.034, had additive effect. Shortened cervical length during routine screening independently predicted SPB while heavy smoking with shortened cervix during pregnancy doubled risk compared to shortened cervix alone. PMID:26050294

  1. Interobserver reliability in musculoskeletal ultrasonography: results from a “Teach the Teachers” rheumatologist course

    PubMed Central

    Naredo, E; Möller, I; Moragues, C; de Agustín, J J; Scheel, A K; Grassi, W; de Miguel, E; Backhaus, M; Balint, P; Bruyn, G A W; D'Agostino, M A; Filippucci, E; Iagnocco, A; Kane, D; Koski, J M; Mayordomo, L; Schmidt, W A; Swen, W A A; Szkudlarek, M; Terslev, L; Torp?Pedersen, S; Uson, J; Wakefield, R J; Werner, C

    2006-01-01

    Objective To assess the interobserver reliability of the main periarticular and intra?articular ultrasonographic pathologies and to establish the principal disagreements on scanning technique and diagnostic criteria between a group of experts in musculoskeletal ultrasonography. Methods The shoulder, wrist/hand, ankle/foot, or knee of 24 patients with rheumatic diseases were evaluated by 23 musculoskeletal ultrasound experts from different European countries randomly assigned to six groups. The participants did not reach consensus on scanning method or diagnostic criteria before the investigation. They were unaware of the patients' clinical and imaging data. The experts from each group undertook a blinded ultrasound examination of the four anatomical regions. The ultrasound investigation included the presence/absence of joint effusion/synovitis, bony cortex abnormalities, tenosynovitis, tendon lesions, bursitis, and power Doppler signal. Afterwards they compared the ultrasound findings and re?examined the patients together while discussing their results. Results Overall agreements were 91% for joint effusion/synovitis and tendon lesions, 87% for cortical abnormalities, 84% for tenosynovitis, 83.5% for bursitis, and 83% for power Doppler signal; ? values were good for the wrist/hand and knee (0.61 and 0.60) and fair for the shoulder and ankle/foot (0.50 and 0.54). The principal differences in scanning method and diagnostic criteria between experts were related to dynamic examination, definition of tendon lesions, and pathological v physiological fluid within joints, tendon sheaths, and bursae. Conclusions Musculoskeletal ultrasound has a moderate to good interobserver reliability. Further consensus on standardisation of scanning technique and diagnostic criteria is necessary to improve musculoskeletal ultrasonography reproducibility. PMID:15941835

  2. Delayed intra-abdominal bleeding following trans-vaginal ultrasonography guided oocyte retrieval for in vitro fertilization in patients at risk for thrombo-embolic events under anticoagulant therapy

    PubMed Central

    Orvieto, Raoul

    2013-01-01

    We report herein, two cases of massive delayed (2 and 4 days) intra abdominal hemorrhage following ovum pick-up (OPU), in patients at risk for thrombo-embolic events, who concomitantly used therapeutic doses of low molecular weight heparin (LMWH). We discuss the possible mechanisms involved in causing the aforementioned delayed bleeding, and call for re-evaluation of the presently accepted anticoagulant co-treatment regimen. These case reports should direct physicians' attention and keep them alert, while conducting IVF treatment to this subgroup of high risk patients. PMID:24555090

  3. Ultrasonography-Assisted Arthroscopic Proximal Iliotibial Band Release and Trochanteric Bursectomy

    PubMed Central

    Weinrauch, Patrick; Kermeci, Sharon

    2013-01-01

    We describe arthroscopic iliotibial band release and trochanteric bursectomy assisted by intraoperative ultrasonography for accurate placement of arthroscopic portals and to ensure adequate decompression of the peritrochanteric space. We have found ultrasonography for endoscopic iliotibial band release a useful tool to assist with localizing the site and length of decompression. PMID:24400195

  4. Quantitative contrast-enhanced ultrasonography of canine spleen.

    PubMed

    Nakamura, Kensuke; Sasaki, Noboru; Yoshikawa, Muneyoshi; Ohta, Hiroshi; Hwang, Shiang-Jyi; Mimura, Takahiro; Yamasaki, Masahiro; Takiguchi, Mitsuyoshi

    2009-01-01

    Contrast-enhanced ultrasonography has an important role in the detection of tumors in humans. The second-generation contrast agent Sonazoid has the ability of real-time contrast imaging along with parenchymal imaging. The purposes of this study were to determine the effect and duration of Sonazoid on the changes in gray-scale enhancement of canine spleen and to establish an appropriate protocol for contrast-enhanced ultrasonography of canine spleen. Six healthy beagles were injected with an intravenous bolus of Sonazoid. In the spleen parenchyma, the enhancement was maintained up to 30 min after injection. Moreover, for 5-22 s after injection, gray-scale enhancement of splenic arteries afforded arterial imaging. Perfusion of the kidney may be investigated from 3.6s to 3.5 min after injection of Sonazoid. These results suggest that Sonazoid is applicable to canine spleen parenchymal imaging and that the optimal time for the parenchymal imaging is 7-30 min after injection. The findings of this quantitative study should prove useful in the evaluation of diffuse or focal splenic and renal diseases in dogs. PMID:19241764

  5. Ultrasonography in predicting and screening liver cirrhosis in children: A preliminary study

    PubMed Central

    Zhu, Jia-An; Hu, Bing

    2003-01-01

    AIM: To evaluate the value of ultrasonography in predicting and screening liver cirrhosis in children. METHODS: Twenty-eight children with liver cirrhosis of various etiologies were examined by routine ultrasonography. A percutaneous liver biopsy guided by ultrasound was also performed on each patient, and the results of liver biopsy and ultrasonography were compared. RESULTS: When compared with the biopsy results, ultrasonography in combination of clinical and laboratory findings gave accurate diagnoses of children liver cirrhosis. Although ultrasound imaging of children with liver cirrhosis revealed abnormal characteristics, these images were not specific to this disease, thus reinforcing the necessity of ultrasound-guided liver biopsy in the diagnosis of children liver cirrhosis. CONCLUSION: Ultrasonography is reliable in the diagnosis of children liver cirrhosis, and its usefulness should be stressed in the screening and follow-up of high-risk pediatric patients. PMID:14562409

  6. A Prospective Study of Aromatase Inhibitor-Associated Musculoskeletal Symptoms and Abnormalities on Serial High-Resolution Wrist Ultrasonography

    PubMed Central

    Henry, N. Lynn; Jacobson, Jon A.; Banerjee, Mousumi; Hayden, Jill; Smerage, Jeffrey B.; Poznak, Catherine Van; Storniolo, Anna Maria; Stearns, Vered; Hayes, Daniel F.

    2010-01-01

    Background Almost half of women treated with aromatase inhibitors (AI) develop AI-associated musculoskeletal symptoms (AIMSS) such as arthralgias, but the etiology is unclear. The upper extremities are frequently affected, especially wrists, hands, and fingers. AI use may also increase the risk of developing carpal tunnel syndrome. Tendon sheath fluid and tenosynovial changes have been demonstrated by imaging symptomatic AI-treated patients. We hypothesized that these abnormalities correlate with AIMSS. Methods Thirty consecutive patients initiating adjuvant therapy with letrozole or exemestane on a prospective clinical trial enrolled in a pilot study evaluating tendon and joint abnormalities at baseline and after 3 months of AI therapy. Patients underwent high resolution ultrasonography of the wrists bilaterally and completed the Health Assessment Questionnaire (HAQ) and pain Visual Analog Scale (VAS). AIMSS were defined as increase in HAQ or VAS score during AI therapy that exceeded a predefined cutoff. Results Twenty-five subjects completed both baseline and 3 month assessments. During the first 12 months of AI therapy, 15 subjects developed AIMSS, and 13 discontinued therapy because of musculoskeletal symptoms. There was a trend toward an association between presence of tendon sheath abnormalities on wrist ultrasound at baseline and development of AIMSS (p=0.06). Conclusions Clinically relevant musculoskeletal symptoms develop in AI-treated women, leading to treatment discontinuation in a substantial percentage. However, patient-reported symptoms were not associated with changes visible on wrist ultrasonography in this pilot study. PMID:20549827

  7. [Acute dyspnea in the emergency room: from pathophysiology to ultrasonography].

    PubMed

    Rosset-Zufferey, Sarah; Ramlawi, Majd

    2015-08-12

    Acute dyspnea is one of the leading clinical symptoms encountered in the emergency room. Its differential diagnosis is wide, ranging from noisy panic attacks to threatening acute heart failure. History taking and physical examination, even when exhaustive are of limited diagnostic value. Patient reported descriptions are fairly correlated to pathophysiology. Vital signs such as the respiratory rate and pulse oximetry carry prognostic significance. Ancillary tests like the chest x-ray lack sensitivity and specificity. The most astonishing adjunct to testing is the chest ultrasound. Its integration into the emergency physician's armamentarium considerably changed clinical management. Fast and accurate, ultrasonography has become the modern era stethoscope. This review discusses acute dyspnea through the main elements useful to diagnosis. PMID:26449099

  8. Diagnostic Dilemma in Cornual Pregnancy- 3D Ultrasonography may Aid!!

    PubMed Central

    Tripathi, Reva; Mala, YM; Batra, Atul

    2015-01-01

    Interstitial or cornual pregnancy is a rare and dangerous type of ectopic gestation. It poses a diagnostic difficulty and differentiating from eccentrically located intrauterine pregnancy may be challenging. We are reporting a case of nulliparous woman diagnosed as having interstitial pregnancy on three-dimensional ultrasonography. We managed the patient successfully with weekly intramuscular doses of methotrexate. The ? HCG levels were high throughout the therapy (89,000 to 1,48,000 IU/ml). The patient was admitted throughout the course of treatment. After three doses of methotrexate, the ?-HCG levels began to fall. Weekly monitoring was done thereafter till normal values of ?-HCG were reported. Early and prompt diagnosis and treatment of interstitial pregnancy is important to prevent catastrophic hemorrhagic complications. Three-dimensional sonography is an important diagnostic tool as it may impart better anatomical orientation and precise location of the gestational sac as compared to other imaging modalities. Methotrexate therapy may be considered in selected cases. PMID:25738045

  9. Diagnosis of Severe Carpal Tunnel Syndrome Using Nerve Conduction Study and Ultrasonography.

    PubMed

    Fujimoto, Kazuhiro; Kanchiku, Tsukasa; Kido, Kenji; Imajo, Yasuaki; Funaba, Masahiro; Taguchi, Toshihiko

    2015-10-01

    This study investigated the correlation between nerve conduction study and ultrasonographic findings for assessment of the usefulness of ultrasonography in determining carpal tunnel syndrome severity. Hands of adults with carpal tunnel syndrome were assessed using ultrasound and nerve conduction studies and grouped according to median nerve cross-sectional area (CSA). There were significant differences (p < 0.01) in mean median nerve CSA between controls, patients with median sensory nerve conduction velocity ?40 m/s and patients with absent sensory nerve action potential and between controls, patients with median nerve distal motor latency ?4.5 ms and patients with absent compound muscle action potentials of the abductor pollicis brevis. This is the first report to define median nerve CSA cutoff values (18 mm(2)) for determining carpal tunnel syndrome severity in patients with absent compound muscle action potentials of the abductor pollicis brevis. Median nerve CSA values below the cutoff values should prompt clinicians to consider other disorders, such as cervical compressive myelopathy. PMID:26111913

  10. Diagnosis of subepithelial tumors in the upper gastrointestinal tract by endoscopic ultrasonography.

    PubMed

    Sakamoto, Hiroki; Kitano, Masayuki; Kudo, Masatoshi

    2010-08-28

    Endoscopic ultrasonography (EUS) is the most accurate procedure for detecting and diagnosing subepithelial tumors, due to its higher sensitivity and specificity than other imaging modalities. EUS can characterize lesions by providing information on echogenic origin, size, borders, homogeneity, and the presence of echogenic or anechoic foci. Linear echoendoscopes, and recently also electronic radial echoendoscopes, can be used with color Doppler or power Doppler to assess the vascular signals from subepithelial masses, and thus permit the differentiation of vascular structures from cysts, as well as the assessment of the tumor blood supply. However, the diagnostic accuracy of EUS imaging alone has been shown to be low in subepithelial lesions with 3rd and 4th layers. It is also difficult to differentiate exactly between benign and malignant tumors and to gain an accurate picture of histology using EUS. On the other hands, EUS guided fine needle aspiration (EUS-FNA) can provide samples for cytologic or histologic analysis. Hypoechoic lesions of the 3rd and the 4th EUS layers, more than in 1 cm diameter are recommended, and histologic confirmation using endoscopic submucosal resection or EUS-FNA should be obtained when possible. Therefore, EUS-FNA plays an important role in the clinical management of subepithelial tumors. Furthermore improvements in endoscopic technology are expected to be more useful modalities in differential diagnosis and discrimination between benign and malignant subepithelial tumors. PMID:21160683

  11. Conventional and color Doppler transvaginal sonography in gynecologic infertility. Current clinical applications.

    PubMed

    Fleischer, A C; Kepple, D M; Vasquez, J

    1992-07-01

    TVS affords accurate follicular monitoring and guidance for follicular aspiration. The role of TVS in assessing the adequacy of the endometrium is still undergoing investigation. Our studies suggest that there is a statistically significant difference in the pregnancy rate when the endometrium has a multilayered appearance. Infertility patients who successfully achieve pregnancy should be monitored with TVS because of a higher incidence of ectopic pregnancy, anembryonic gestation, and spontaneous abortion. TVS has a secondary role in evaluating certain uterine malformations and tubal disorders. With TV-CDS it is also possible to evaluate physiologic parameters such as adnexal and uterine blood flow. The role of TV-CDS in the anatomic and physiologic evaluation of early pregnancy is now being established. PMID:1631278

  12. [The ultrasonography of the capsular ligamentous apparatus of the knee joint in the early stages of rheumatoid arthritis].

    PubMed

    Herasymenko, S I; Huzhevs'ky?, I V; Vovchenko, H Ia; Babko, A N

    1999-07-01

    With the purpose of finding out informative value of the ultrasound investigation designed to study the capsular and ligamentous apparatus of the knee joint in its instability during the early stages of rheumatoid arthritis and correlating clinical symptoms with ultrasonographic findings an examination was done of twenty joints of patients in early stages of rheumatoid arthritis presenting with clinical signs of anterior-medial instability. Sonography confirmed the presence of instability and permitted the qualitative assessment of its degree to be done. The method allows us to disclose relative incompetence of the anterior-medial sector of the knee joint in those patients presenting with early stages of rheumatoid arthritis, which is one of causes of instability, with the cruciate and lateral ligaments remaining uninjured. Ultrasonography makes it possible to perform a quantitative assessment of the degree of instability of the joint irrespective of the clinical test used and experience of the orthopedist. PMID:10822686

  13. Evaluation of transvaginal slings using different materials in the management of female stress urinary incontinence

    PubMed Central

    Teleb, Mohamed; Salem, Emad A.; Naguib, Mohamed; Kamel, Mostafa; Hasan, Usama; Elfayoumi, Abdel Rahman; Kamel, Hussein M.; El Adl, Mahmoud

    2011-01-01

    Purpose To evaluate tailored polypropylene (prolene) mesh, anterior rectus sheath, and vaginal wall slings positioned under the mid-urethra, to treat stress urinary incontinence (SUI) in women, as SUI is a common pathological condition causing considerable distress and compromising social, physical, psychological, and sexual health, and for which surgical treatment remains controversial. Patients and methods This prospective randomised study included 32 patients with SUI, evaluated by SEAPI (Stress, Emptying, Anatomy, Protection, and Instability) symptom score and urodynamics. According to sling material, 12 patients had tailored prolene mesh, 12 had anterior rectus sheath and eight had anterior vaginal wall slings. Operative variables (intraoperative bleeding, duration, complications and hospital stay) were documented, and postoperative complications and continence status were assessed. The follow-up was 12–18 months. Results Patients who received tailored prolene mesh slings had a lower operative duration and hospital stay, and less intraoperative bleeding. Postoperative complications, e.g. urinary retention and urgency, were <12%, with no significant differences. There was no significant difference among the three studied groups in the success rate (75%, 67% and 75%). Conclusions Tailored prolene mesh, anterior rectus sheath and the vaginal wall sling are good alternatives to treat SUI in women, with comparable results in a short-term follow up. The surgeon’s experience and the patient’s clinical circumstances should be considered when choosing a sling material, as success rates are comparable, being slightly better for the prolene sling in operative duration, bleeding and hospital stay.

  14. The value of pre-operative multicompartment pelvic floor ultrasonography: a 1-year prospective study

    PubMed Central

    Lone, F; Stankiewicz, A; Thakar, R

    2014-01-01

    Objective: Comprehensive assessment of the pelvic floor (PF) provides information and diagnoses of coexisting abnormalities that may affect operative decisions. Our aim was to establish if pre-operative PF ultrasonography (PFUS) in patients complaining of PF dysfunction can complement clinical findings and contribute to additional management strategies. Methods: Females were recruited from the urogynaecology/gynaecology clinics between July and October 2009 and underwent pelvic organ prolapse quantification (POPQ) by an independent examiner. PFUS was performed using two-dimensional (2D) transperineal ultrasound (TPUS), high-frequency 2D/three-dimensional (3D) endovaginal ultrasound (EVUS) using a biplane probe with linear and transverse arrays and a 360° rotational 3D-EVUS. The clinician performing PFUS was blinded to POPQ results. POPQ and PFUS were repeated at 1 year. Two clinicians analysed the scans independently. Results: 158 of 160 females had a POPQ and PFUS. 105 females had pelvic organ prolapse and/or incontinence and 53 asymptomatic females were controls. 26 additional ultrasound diagnoses were noted at baseline and 46 at 1 year using 2D-TPUS and EVUS. Only one female with additional diagnoses on PFUS needed surgical intervention for this condition. Conclusion: Multicompartment PFUS identifies additional conditions to that diagnosed on clinical assessment. However, it neither changes the initial surgical management nor the management at 1-year follow-up and therefore clinical assessment should not be substituted by PFUS. Advances in knowledge: PFUS can be helpful in providing additional information; however, it does not change the initial management of the patient and therefore should not replace clinical assessment. PMID:24959953

  15. [Role of ultrasonography in the diagnosis of carcinoma of the breast].

    PubMed

    Amato, C; Cipolla, C; Salanitro, L; Iacoponelli, A; Graceffa, G; Di Lisi, G; Caravello, V; Bajardi, G; Latteri, M

    1990-01-01

    Breast ultrasonography is today a diagnostic technique whose results are either under or overestimated by different Authors. In this paper the Authors report their experience with ultrasound for the diagnosis of breast cancer. In 214 patients with palpable breast nodule ultrasonography employed as the only diagnostic technique allowed the diagnosis of breast cancer in 89.7% (61/68 patients), and in particular in 82.4% of T1 in 96.9% of T2 and in 100% of T3 tumors. From these data it can be resumed that breast ultrasonography reaches a good diagnostic reliability. Unfortunately the limits in defining malignancy of solid appearing mass don't allow its routine use as the gold standard for breast cancer diagnosis. We believe indeed that ultrasonography has an important role as an integrative diagnostic method among those commonly used in this field. PMID:2282279

  16. Early endoscopic ultrasonography in acute biliary pancreatitis: A prospective pilot study

    PubMed Central

    Anderloni, Andrea; Galeazzi, Marianna; Ballarè, Marco; Pagliarulo, Michela; Orsello, Marco; Del Piano, Mario; Repici, Alessandro

    2015-01-01

    AIM: To investigate the clinical usefulness of early endoscopic ultrasonography (EUS) in the management of acute biliary pancreatitis (ABP). METHODS: All consecutive patients entering the emergency department between January 2010 and December 2012 due to acute abdominal pain and showing biochemical and/or radiological findings consistent with possible ABP were prospectively enrolled. Patients were classi?ed as having a low, moderate, or high probability of common bile duct (CBD) stones, according to the established risk strati?cation. Exclusion criteria were: gastrectomy or patient in whom the cause of biliary obstruction was already identified by ultrasonography. All enrolled patients underwent EUS within 48 h of their admission. Endoscopic retrograde cholangiopancreatography was performed immediately after EUS only in those cases with proven CBD stones or sludge. The following parameters were investigated: (1) clinical: age, sex, fever; (2) radiological: dilated CBD; and (3) biochemical: bilirubin, AST, ALT, gGT, ALP, amylase, lipasis, PCR. Association between presence of CBD stone at EUS and the individual predictors were assessed by univariate logistic regression. Predictors significantly associated with CBD stones (P < 0.05) were entered in a multivariate logistic regression model. RESULTS: A total of 181 patients with pancreatitis were admitted to the emergency department between January 2010 and December 2012. After exclusion criteria a total of 71 patients (38 females, 53.5%, mean age 58 ± 20.12 years, range 27-89 years; 33 males, 46.5%, mean age 65 ± 11.86 years, range 41-91 years) were included in the present study. The probability of CBD stones was considered low in 21 cases (29%), moderate in 26 (37%), and high in the remaining 24 (34%). The 71 patients included in the study underwent EUS, which allowed for a complete evaluation of the target sites in all the cases. The procedure was completed in a mean time of 14.7 min (range 9-34 min), without any notable complications.The overall CBD stone frequency was 44% (31 of 71), with a significant increase from the group at low pretest probability to that at moderate (OR = 5.79, P = 0.01) and high (OR = 4.25, P = 0.03) pretest probability. CONCLUSION: Early EUS in ABP allows, if appropriate, immediate endoscopic treatment and significant spare of unnecessary operative procedures thus reducing possible related complications. PMID:26420969

  17. Interobserver reliability of rheumatologists performing musculoskeletal ultrasonography: results from a EULAR "Train the trainers" course

    PubMed Central

    Scheel, A; Schmidt, W; Hermann, K; Bruyn, G; D'Agostino, M; Grassi, W; Iagnocco, A; Koski, J; Machold, K; Naredo, E; Sattler, H; Swen, N; Szkudlarek, M; Wakefield, R; Ziswiler, H; Pasewaldt, D; Werner, C; Backhaus, M

    2005-01-01

    Objective: To evaluate the interobserver reliability among 14 experts in musculoskeletal ultrasonography (US) and to determine the overall agreement about the US results compared with magnetic resonance imaging (MRI), which served as the imaging "gold standard". Methods: The clinically dominant joint regions (shoulder, knee, ankle/toe, wrist/finger) of four patients with inflammatory rheumatic diseases were ultrasonographically examined by 14 experts. US results were compared with MRI. Overall agreements, sensitivities, specificities, and interobserver reliabilities were assessed. Results: Taking an agreement in US examination of 10 out of 14 experts into account, the overall ? for all examined joints was 0.76. Calculations for each joint region showed high ? values for the knee (1), moderate values for the shoulder (0.76) and hand/finger (0.59), and low agreement for ankle/toe joints (0.28). ? Values for bone lesions, bursitis, and tendon tears were high (? = 1). Relatively good agreement for most US findings, compared with MRI, was found for the shoulder (overall agreement 81%, sensitivity 76%, specificity 89%) and knee joint (overall agreement 88%, sensitivity 91%, specificity 88%). Sensitivities were lower for wrist/finger (overall agreement 73%, sensitivity 66%, specificity 88%) and ankle/toe joints (overall agreement 82%, sensitivity 61%, specificity 92%). Conclusion: Interobserver reliabilities, sensitivities, and specificities in comparison with MRI were moderate to good. Further standardisation of US scanning techniques and definitions of different pathological US lesions are necessary to increase the interobserver agreement in musculoskeletal US. PMID:15640263

  18. Advances in quantitative muscle ultrasonography using texture analysis of ultrasound images.

    PubMed

    Molinari, Filippo; Caresio, Cristina; Acharya, U Rajendra; Mookiah, Muthu Rama Krishnan; Minetto, Marco Alessandro

    2015-09-01

    Musculoskeletal ultrasound imaging can be used to investigate the skeletal muscle structure in terms of architecture (thickness, cross-sectional area, fascicle length and fascicle pennation angle) and texture. Gray-scale analysis is commonly used to characterize transverse scans of the muscle. Gray mean value is used to distinguish between normal and pathologic muscles, but it depends on the image acquisition system and its settings. In this study, quantitative ultrasonography was performed on five muscles (biceps brachii, vastus lateralis, rectus femoris, medial gastrocnemius and tibialis anterior) of 20 healthy patients (10 women, 10 men) to assess the characterization performance of higher-order texture descriptors to differentiate genders and muscle types. A total of 53 features (7 first-order descriptors, 24 Haralick features, 20 Galloway features and 2 local binary pattern features) were extracted from each muscle region of interest (ROI) and were used to perform the multivariate linear regression analysis (MANOVA). Our results show that first-order descriptors, Haralick features (energy, entropy and correlation measured along different angles) and local binary pattern (LBP) energy and entropy were highly linked to the gender, whereas Haralick entropy and symmetry, Galloway texture descriptors and LBP entropy helped to distinguish muscle types. Hence, the combination of first-order and higher-order texture descriptors (Haralick, Galloway and LBP) can be used to discriminate gender and muscle types. Therefore, multi-texture analysis may be useful to investigate muscle damage and myopathic disorders. PMID:26026375

  19. Reliability of ultrasonography measurement for the longus colli according to inward probe pressure

    PubMed Central

    Jeong, Byoung-Lock; Ha, Sung-Min; Jeon, In-Cheol; Hong, Ki-Hoon

    2015-01-01

    [Purpose] To investigate the intra- and inter-rater reliability of the cross-sectional area (CSA) and muscle thickness (MT) of the longus colli according to the inward pressure of an ultrasonography (US) probe (0.5 and 1?kg). [Subjects] Thirteen subjects (11 males and 2 females; age, 23.1 ± 2.9?years) were recruited via convenience sampling of university students. [Methods] Real-time US measurements of the CSA and MT of the longus colli were recorded. Repeated US measurements using a standard protocol were performed on the same day 1 hour apart to assess intra- and inter-rater reliability. Intra-class correlation coefficients (ICC; 2, 1) were used to determine the intra- and inter-rater reliability of the CSA and MT measurements. [Results] This study demonstrated that the US measurements (0.5 and 1?kg) of the CSA and MT of the longus colli give reliable and consistent results. [Conclusion] Based on these results, a consistent inward pressure of the probe is needed to ensure precise US measurement of the longus colli muscle. PMID:26696741

  20. Abdominal ultrasonography: improved image quality with the combined use of a diet and laxatives.

    PubMed

    Vogel, H J; Schipper, J; Hermans, J

    1990-10-01

    Intestinal contents (gas and food particles) are well known to cause problems in abdominal ultrasonography by inducing confusing and inconclusive images. We prospectively studied the effect on the combination of a 2-day low-calorie, low gas-forming diet with laxatives on abdominal sonographic image quality. For a total group of 100 consecutive outpatients, 50 patients (diet-laxative or DL group) were randomly assigned to follow the preparation of a diet and laxatives, and 50 patients (control or C group) served as a control group without any special preparation. The sonographic imaging quality of abdominal organs and retroperitoneal structures was assessed without knowledge of which group the patients were assigned to. The DL group patients showed a significant improvement in visibility of the extra-hepatic common bile duct (p = 0.009), head and body of the pancreas (p = 0.015 and 0.004, respectively), para-aortic region (p = 0.001), and the iliac vessels (p = 0.0005). The combined use of a low-calorie, low gas-forming diet and laxatives improves the abdominal sonographic image quality of the above-mentioned structures to such an extent that the sonographer will be able to make more pertinent statements about the presence or absence of pathology. PMID:2172309

  1. A CMUT probe for medical ultrasonography: from microfabrication to system integration.

    PubMed

    Savoia, Alessandro Stuart; Calianov, Giosuè; Pappalardo, Massimo

    2012-06-01

    Medical ultrasonography is a powerful and cost-effective diagnostic technique. To date, high-end medical imaging systems are able to efficiently implement real-time image formation techniques that can dramatically improve the diagnostic capabilities of ultrasound. Highly performing and thermally efficient ultrasound probes are then required to successfully enable the most advanced techniques. In this context, ultrasound transducer technology is the current limiting factor. Capacitive micromachined ultrasonic transducers (CMUTs) are micro-electro-mechanical systems (MEMS)-based devices that have been widely recognized as a valuable alternative to piezoelectric transducer technology in a variety of medical imaging applications. Wideband operation, good thermal efficiency, and low fabrication cost, especially for those applications requiring high-volume production of small-area dice, are strength factors that may justify the adoption of this MEMS technology in the medical ultrasound imaging field. This paper presents the design, development, fabrication, and characterization of a 12-MHz ultrasound probe for medical imaging, based on a CMUT array. The CMUT array is microfabricated and packed using a novel fabrication concept specifically conceived for imaging transducer arrays. The performance of the developed probe is optimized by including analog front-end reception electronics. Characterization and imaging results are used to assess the performance of CMUTs with respect to conventional piezoelectric transducers. PMID:22711408

  2. Development of Scanning Method for Puncture Needle-Type Ultrasonography

    NASA Astrophysics Data System (ADS)

    Yoshizawa, Masasumi; Emoto, Ryuuji; Kawabata, Hirotaka; Irie, Takasuke; Itoh, Kouichi; Moriya, Tadashi

    2009-07-01

    In this paper, we propose a scanning method for determining the acoustic impedance difference for puncture needle-type ultrasonography using a thin rod. The principle of the proposed scanning method is based on the movements of the end point of a lever. A thin rod is placed on the fulcrum, there by forming a lever. When the end point of the thin rod rotates clockwise forming a circle, the other side of the thin rod moves counterclockwise also forming a circle. By sensing the surface of the sample as a function of the angle made by the thin rod and center axis, scanning can be performed. First, we confirmed that the scanning is possible using the lever; moreover, the movement of the end of the rod is related to that of the other end of the lever. Next, we also confirmed that a one-dimensional image of the amplitude of an interference signal shows the difference in impedance between the polyethylene (PE), acrylic (AC), and polypropylene (PP). The experimental results show that the method is useful for scanning.

  3. Diagnostic value of endoscopic ultrasonography for gastrointestinal leiomyoma

    PubMed Central

    Xu, Guo-Qiang; Zhang, Bing-Ling; Li, You-Ming; Chen, Li-Hua; Ji, Feng; Chen, Wei-Xing; Cai, Shu-Ping

    2003-01-01

    AIM: To investigate the clinical pathologic features of gastrointestinal leiomyoma and the diagnostic value of endoscopic ultrasonography (EUS) on gastrointestinal leiomyoma. METHODS: A total of 106 patients with gastrointestinal leiomyoma diagnosed with EUS were studied. The location, size and layer origin of gastric and esophageal leiomyomas were analyzed and compared. The histological diagnosis of the resected specimens by endoscopy or surgery in some patients was compared with their results of EUS. RESULTS: The majority of esophageal leiomyomas were located in the middle and lower part of the esophagus and their size was smaller than 1.0 cm, and 62.1% of esophageal leiomyomas originated from the muscularis mucosae. Most of the gastric leiomyomas were located in the body and fundus of the stomach with a size of 1-2 cm. Almost all gastric leiomyomas (94.2%) originated from the muscularis propria. The postoperative histological results of 54 patients treated by endoscopic resection or surgical excision were completely consistent with the preoperative diagnosis of EUS, and the diagnostic specificity of EUS to gastrointestinal leiomyoma was 94.7%. CONCLUSION: The size and layer origin of esophageal leiomyomas are different from that of gastric leiomyomas. Being safe and accurate, EUS is the best method not only for gastrointestinal leiomyoma diagnosis but also for the follow-up of patients. PMID:12970912

  4. Bedside ultrasonography by emergency physicians for anterior talofibular ligament injury

    PubMed Central

    Gün, Cem; Ünlüer, Erden Erol; Vandenberk, Nergiz; Karagöz, Arif; Sentürk, Güldehen Ozmen; Oyar, Orhan

    2013-01-01

    Objective: Our objective was to study the accuracy of emergency physician (EP) performed bedside ultrasonography (BUS) in patients with suspected anterior talofibular ligament (ATFL) injury. Materials and Methods: After a 6-h training program, from January to December 2011, an EP used BUS to prospectively evaluate patients presenting to the emergency department (ED) with suspected ATFL injury. Then, patients underwent ankle X-ray and Magnetic Resonance (MR) imaging. Outcome was determined by official radiology reports of the MR imaging. BUS and MR imaging results were compared using Chi-square testing. Results: Of the 65 enrolled patients, 30 patients were BUS positive. Of these, MR imaging results agreed with the BUS findings in 30 patients. In 35 cases, BUS was negative, and 33 of these were corroborated by MR imaging. The sensitivity, specificity, positive predictive value, negative predictive value, and negative likelihood ratio for BUS were 93.8%, 100%, 100%, 94.3%, and 0.06%, respectively. The diagnostic accuracy of BUS was not statistically different from MR imaging (K = 0.938, P = 0.001). Conclusion: BUS for the diagnosis of ATFL injury is another application of BUS in the ED. EPs can diagnose ATFL injury using BUS with a high degree of accuracy. PMID:23960377

  5. Ultrasonography in the evaluation of hemoperitoneum in war casualties.

    PubMed

    Mileti?, D; Fuckar, Z; Mraovi?, B; Dimec, D; Mozetic, V

    1999-08-01

    The aim of this study was to evaluate the sensitivity, specificity, accuracy, and positive and negative predictive values of emergent ultrasound examination in the detection of hemoperitoneum among war casualties, and to compare the results of this method in a specific war situation and civil conditions. Ninety-four wounded individuals with suspected blunt or penetrating abdominal trauma were treated at a level I war hospital (group W), and 242 civilians with multiple injuries with suspected blunt abdominal trauma were evaluated at the emergency center of a university hospital (group C). All examinations were performed in less than 5 minutes with a portable ultrasonographic scanner, and typical points were scanned (Morison's pouch, Douglas and perisplenic spaces, paracolic gutter). In group W, hemoperitoneum was identified correctly in 19 patients, with three false-negative and no false-positive findings, whereas group C presented 98 true-positive results, 13 false-negative results, and again no false-positive results. We observed that ultrasonography in specific war conditions showed sensitivity of 86%, specificity of 100%, accuracy as high as 97%, positive predictive value of 100%, and negative predictive value of 96%, whereas in civil conditions the corresponding values were 88%, 100%, 95%, 100%, and 91%, respectively. The sensitivity, specificity, accuracy, and positive and negative predictive values of emergent ultrasound examination in the diagnosis of hemoperitoneum are approximately equal in war and civil conditions. PMID:10459274

  6. [Hepatic psittacosis: a case of liver abnormality diagnosed by ultrasonography].

    PubMed

    Carella, G; Marra, L; Vallot, T

    1996-02-10

    Psittacosis marked by liver and spleen involvement and minimal pericarditis was observed in an 18-year-old patient hospitalized for fever of 1 month duration. At admission, there was no other clinical manifestation and the chest X-ray showed no sign of pulmonary involvement. Liver tests revealed cholestasis. Ultrasonography of the abdomen revealed multiple nodular formations in the liver and spleen, images confirmed on computed tomography. Liver biopsy showed granulomatous with hyperplasia of the Kupffer cells surrounded by healthy tissue. Complement fixation to psittacosis antigen was positive and increased significantly over a 15-day interval. Treatment with tetracycline led to rapid remission of the fever and normalization of the liver tests and hepatic images. Liver involvement in psittacosis is not uncommon, but this is apparently the first case reporting echographic anomalies. The absence of pulmonary involvement has been reported earlier in a few cases. The diagnosis is usually suggested on the basis of epidemiologic criteria and confirmed by complement fixation. PMID:8729379

  7. Does Prebiopsy, Nonsterile Ultrasonography Gel Affect Biopsy-Site Asepsis?

    SciTech Connect

    Gurel, Kamil Karabay, Oguz; Gurel, Safiye; Hildebolt, Charles

    2008-01-15

    Purpose. The purpose of this study was to determine the extent to which the use of nonsterile gel, prior to antiseptic procedures in ultrasonography (US)-guided percutaneous biopsies, results in contamination of the biopsy site. Materials and Methods. Patients referred for US-guided percutaneous biopsies were included in this study. Transmission material used for US evaluation before biopsy-site antiseptic procedures were performed was either nonsterile gel or sterile saline. Patients were randomly assigned to two groups: nonsterile gel (n = 30) and sterile saline (n = 30). Before the transmission material was used and after antiseptic procedures were performed, microbial swabs of a 10-cm{sup 2}-diameter area were obtained at the biopsy site. Swabs were also obtained from the gel, saline, and povidine-iodine. Inoculated specimen plates were incubated at 37{sup o}C under aerobic conditions, and the numbers of colony-forming units recorded. Nominal logistic regression analysis was used to calculate the odds of postantisepsis bacterial growth (after antiseptic procedures were performed) based on group, gender, coincidental disease (diabetes, chronic renal failure, and malignancy), biopsy-site location (head and neck or breast and abdomen), and local factors (skin fold, skin tag, and hair). Results. The following odds ratios (adjusted for the other variables) and their 95% confidence intervals were calculated: (1) group (2.9 [0.8-11.1]; p = 0.10); (2) gender (1.2 [0.3-5.2]; p = 0.78); (3) coincidental disease (7.6 [0.9-166.7]; p = 0.09); (4) biopsy site location (6.2 [1.4-31.3]; p = 0.02); and (5) local factors (7.0 [1.6-36.0]; p = 0.01). No bacterial growth occurred with swabs obtained from gel, povidine-iodine, or saline. Conclusion. We conclude that nonsterile gel used prior to percutaneous biopsy does not affect biopsy-site asepsis.

  8. Harmonic ultrasonography for the detection of microlithiasis in the gallbladder

    PubMed Central

    2014-01-01

    Purpose: To validate the use of harmonic ultrasonography (US) in the detection of gallbladder microlithiasis. Methods: From November 30, 2012, to January 18, 2014, fundamental US (FUS) and harmonic US with a high background noise (HUS-N) were performed for evaluation of gallbladder during the routine abdomen US. During the US, a dot-like stone (or stones) with Brownian motion was regarded as a positive finding of microlithiasis. Fifty-five patients with microlithiasis in the gallbladder detected on US were enrolled as the subjects of a retrospective review. With respect to the obtained images, two abdominal radiologists independently scored the conspicuity of gallbladder microlithiasis on FUS and HUS-N by using a 4-grade scale. The statistical analysis employed a kappa test and a Wilcoxon rank-sum test. Results: For FUS, the conspicuity grades of gallbladder microlithiasis were G1 in 25 and 37, G2 in 21 and 9, G3 in 6 and 6, G4 in 3 and 3 patients, while HUS-N showed G1 in 0 and 0, G2 in 3 and 2, G3 in 12 and 15, and G4 in 40 and 38 patients, respectively, by each of the two radiologists. The kappa value was 0.633 for FUS between the two radiologists and 0.708 for HUS-N. HUS-N showed better conspicuity of gallbladder microlithiasis than FUS with significant P-values of less than 0.001 and 0.001 for the two radiologists, respectively. Conclusion: Compared with FUS, HUS-N enables better detection of microlithiasis in the gallbladder. PMID:25060185

  9. GnRH analogue treatment on LH surge day 0 followed by single transvaginal artificial insemination with frozen semen on day 5 in bitches

    PubMed Central

    OHTAKI, Tadatoshi; KOGA, Yasuna; ONO, Mamiko; WATANABE, Gen; TAYA, Kazuyoshi; TSUMAGARI, Shigehisa

    2014-01-01

    ABSTRACT Reproductive parameters were evaluated in 19 and 14 estrous beagles that received 100 µg of gonadotropin-releasing hormone (GnRH) and saline treatment, respectively, on the day of luteinizing hormone (LH) surge (Day 0; estimated by serial progesterone assay) and balloon catheter-aided single transvaginal artificial insemination of frozen semen on Day 5. Although the conception rate and litter size were similar between the GnRH and saline groups, the concentration of LH peak was significantly higher in GnRH-treated bitches (P<0.01). In addition, the actual LH surge did not occur on the estimated Day 0 in one saline-treated bitch. In clinical practice that daily progesterone assay is difficult, administration of GnRH on estimated Day 0 would be recommended to induce or enhance the LH surge for timely and successful insemination. PMID:25311914

  10. Application of contrast-enhanced ultrasonography in the diagnosis of skeletal muscle crush injury in rabbits

    PubMed Central

    Zhang, C-D; Lv, F-Q; Li, Q-Y; Zhang, Y; Shi, X-Q; Li, X-Y

    2014-01-01

    Objective: To explore the diagnostic value of quantitative contrast-enhanced (CE) ultrasonography for crush injury in the hind limb muscles of rabbits. Methods: A total of 120 New Zealand white rabbits were randomized to receive compression on the left hind limb for either 2?h (n?=?56) or 4?h (n?=?56) to induce muscle crush injury. Another eight animals were not injured and served as normal controls. CE ultrasonography parameters such as peak intensity (PI), ascending slop, descending slop and area under curve (AUC) were measured at 0.5, 2, 6 and 24?h and 3, 7 and 14 days after decompression. Results: Compared with the uninjured muscles, reperfusion of the injured muscles showed early and high enhancement in CE ultrasonography images. The time-intensity curve showed a trend of rapid lift and gradual drop. The PI and AUC values differed significantly among the three groups and were positively correlated with serum and tissue biomarkers. Rabbits of the 4-h compression group showed significantly higher PI and AUC values, and serum and tissue parameters than the 2-h compression group at each time points. Conclusion: CE ultrasonography can effectively detect muscle crush injury and monitor dynamic changes of the injured muscles in rabbits. PI and AUC are promising diagnostic parameters for this disease. Advances in knowledge: CE ultrasonography might play an important role in the pre-hospital and bedside settings for the diagnosis of muscle crush injury. PMID:25026985

  11. Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study

    PubMed Central

    Sovio, Ulla; White, Ian R; Dacey, Alison; Pasupathy, Dharmintra; Smith, Gordon C S

    2015-01-01

    Summary Background Fetal growth restriction is a major determinant of adverse perinatal outcome. Screening procedures for fetal growth restriction need to identify small babies and then differentiate between those that are healthy and those that are pathologically small. We sought to determine the diagnostic effectiveness of universal ultrasonic fetal biometry in the third trimester as a screening test for small-for-gestational-age (SGA) infants, and whether the risk of morbidity associated with being small differed in the presence or absence of ultrasonic markers of fetal growth restriction. Methods The Pregnancy Outcome Prediction (POP) study was a prospective cohort study of nulliparous women with a viable singleton pregnancy at the time of the dating ultrasound scan. Women participating had clinically indicated ultrasonography in the third trimester as per routine clinical care and these results were reported as usual (selective ultrasonography). Additionally, all participants had research ultrasonography, including fetal biometry at 28 and 36 weeks' gestational age. These results were not made available to participants or treating clinicians (universal ultrasonography). We regarded SGA as a birthweight of less than the 10th percentile for gestational age and screen positive for SGA an ultrasonographic estimated fetal weight of less than the 10th percentile for gestational age. Markers of fetal growth restriction included biometric ratios, utero-placental Doppler, and fetal growth velocity. We assessed outcomes for consenting participants who attended research scans and had a livebirth at the Rosie Hospital (Cambridge, UK) after the 28 weeks' research scan. Findings Between Jan 14, 2008, and July 31, 2012, 4512 women provided written informed consent of whom 3977 (88%) were eligible for analysis. Sensitivity for detection of SGA infants was 20% (95% CI 15–24; 69 of 352 fetuses) for selective ultrasonography and 57% (51–62; 199 of 352 fetuses) for universal ultrasonography (relative sensitivity 2·9, 95% CI 2·4–3·5, p<0·0001). Of the 3977 fetuses, 562 (14·1%) were identified by universal ultrasonography with an estimated fetal weight of less than the 10th percentile and were at an increased risk of neonatal morbidity (relative risk [RR] 1·60, 95% CI 1·22–2·09, p=0·0012). However, estimated fetal weight of less than the 10th percentile was only associated with the risk of neonatal morbidity (pinteraction=0·005) if the fetal abdominal circumference growth velocity was in the lowest decile (RR 3·9, 95% CI 1·9–8·1, p=0·0001). 172 (4%) of 3977 pregnancies had both an estimated fetal weight of less than the 10th percentile and abdominal circumference growth velocity in the lowest decile, and had a relative risk of delivering an SGA infant with neonatal morbidity of 17·6 (9·2–34·0, p<0·0001). Interpretation Screening of nulliparous women with universal third trimester fetal biometry roughly tripled detection of SGA infants. Combined analysis of fetal biometry and fetal growth velocity identified a subset of SGA fetuses that were at increased risk of neonatal morbidity. Funding National Institute for Health Research, Medical Research Council, Sands, and GE Healthcare. PMID:26360240

  12. Diagnostic accuracy of endoscopic ultrasonography for rectal neuroendocrine neoplasms

    PubMed Central

    Chen, Hong-Tan; Xu, Guo-Qiang; Teng, Xiao-Dong; Chen, Yi-Peng; Chen, Li-Hua; Li, You-Ming

    2014-01-01

    AIM: To investigate the diagnostic accuracy of endoscopic ultrasonography (EUS) for rectal neuroendocrine neoplasms (NENs) and the differential diagnosis of rectal NENs from other subepithelial lesions (SELs). METHODS: The study group consisted of 36 consecutive patients with rectal NENs histopathologically diagnosed using biopsy and/or resected specimens. The control group consisted of 31 patients with homochronous rectal non-NEN SELs confirmed by pathology. Epithelial lesions such as cancer and adenoma were excluded from this study. One EUS expert blinded to the histological results reviewed the ultrasonic images. The size, original layer, echoic intensity and homogeneity of the lesions and the perifocal structures were investigated. The single EUS diagnosis recorded by the EUS expert was compared with the histological results. RESULTS: All NENs were located at the rectum 2-10 cm from the anus and appeared as nodular (n = 12), round (n = 19) or egg-shaped (n = 5) lesions with a hypoechoic (n = 7) or intermediate (n = 29) echo pattern and a distinct border. Tumors ranged in size from 2.3 to 13.7 mm, with an average size of 6.8 mm. Homogeneous echogenicity was seen in all tumors except three. Apart from three patients (stage T2 in two and stage T3 in one), the tumors were located in the second and/or third wall layer without involvement of the fourth and fifth layers. In the patients with stage T1 disease, the tumors were located in the second wall layer only in seven cases, the third wall layer only in two cases, and both the second and third wall layers in 27 cases. Approximately 94.4% (34/36) of rectal NENs were diagnosed correctly by EUS, and 74.2% (23/31) of other rectal SELs were classified correctly as non-NENs. Eight cases of other SELs were misdiagnosed as NENs, including two cases of inflammatory lesions and one case each of gastrointestinal tumor, endometriosis, metastatic tumor, lymphoma, neurilemmoma, and hemangioma. The positive predictive value of EUS for rectal NENs was 80.9% (34/42), the negative predictive value was 92.0% (23/25), and the diagnostic accuracy was 85.1%. CONCLUSION: EUS has satisfactory diagnostic accuracy for rectal NENs with good sensitivity, but unfavorable specificity, making the differential diagnosis of NENs from other SELs challenging. PMID:25132764

  13. Economic analysis of bedside ultrasonography (US) implementation in an Internal Medicine department.

    PubMed

    Testa, Americo; Francesconi, Andrea; Giannuzzi, Rosangela; Berardi, Silvia; Sbraccia, Paolo

    2015-12-01

    The economic crisis, the growing healthcare demand, and Defensive Medicine wastefulness, strongly recommend the restructuring of the entire medical network. New health technology, such as bedside ultrasonography, might successfully integrate the clinical approach optimizing the use of limited resources, especially in a person-oriented vision of medicine. Bedside ultrasonography is a safe and reliable technique, with worldwide expanding employment in various clinical settings, being considered as "the stethoscope of the 21st century". However, at present, bedside ultrasonography lacks economic analysis. We performed a Cost-Benefit Analysis "ex ante", with a break-even point computing, of bedside ultrasonography implementation in an Internal Medicine department in the mid-term. Number and kind estimation of bedside ultrasonographic studies were obtained by a retrospective study, whose data results were applied to the next 3-year period (foresight study). All 1980 foreseen bedside examinations, with prevailing multiorgan ultrasonographic studies, were considered to calculate direct and indirect costs, while specific and generic revenues were considered only after the first semester. Physician professional training, equipment purchase and working time represented the main fixed and variable cost items. DRG increase/appropriateness, hospitalization stay shortening and reduction of traditional ultrasonography examination requests mainly impacted on calculated revenues. The break-even point, i.e. the volume of activity at which revenues exactly equal total incurred costs, was calculated to be 734 US examinations, corresponding to € 81,998 and the time considered necessary to reach it resulting 406 days. Our economic analysis clearly shows that bedside ultrasonography implementation in clinical daily management of an Internal Medicine department can produce consistent savings, or economic profit according to managerial choices (i.e., considering public or private targets), other than evident medical benefits. PMID:26450846

  14. Ultrasonography and color Doppler of proximal gluteal enthesitis in juvenile idiopathic arthritis: a descriptive study

    PubMed Central

    2011-01-01

    Background The presence of enthesitis (insertional inflammation) in patients with juvenile idiopathic arthritis (JIA) is difficult to establish clinically and may influence classification and treatment of the disease. We used ultrasonography (US) and color Doppler (CD) imaging to detect enthesitis at the small and deep-seated proximal insertion of the gluteus medius fascia on the posterior iliac crest where clinical diagnosis is difficult. The findings in JIA patients were compared with those obtained in healthy controls and with the patients' MRI results. Methods Seventy-six proximal gluteus medius insertions were studied clinically (tenderness to palpation of the posterior iliac crest) and by US and CD (echogenicity, thickness, hyperemia) in 38 patients with JIA and in 38 healthy controls, respectively (median age 13 years, range 7-18 years). In addition, an additional MRI examination of the sacroiliac joints and iliac crests was performed in all patients. Results In patients with focal, palpable tenderness, US detected decreased echogenicity of the entheses in 53% of the iliac crests (bilateral in 37% and unilateral in 32%). US also revealed significantly thicker entheses in JIA patients compared to healthy controls (p < 0.003 left side, p < 0.001 right side). There was no significant difference in thickness between the left and right sides in individual subjects. Hyperemia was detected by CD in 37% (28/76) of the iliac crests and by contrast-enhanced MRI in 12% (6/50). Conclusions According to US, the gluteus medius insertion was thicker in JIA patients than in controls, and it was hypoechoic (enthesitis) in about half of the patients. These findings may represent chronic, inactive disease in some of the patients, because there was only limited Doppler flow and MRI contrast enhancement. The present study indicates that US can be useful as an adjunct to clinical examination for improved assessment of enthesitis in JIA. This may influence disease classification, ambition to treat, and choice of treatment regimen. PMID:21835006

  15. Separation of the Proximal Humeral Epiphysis in the Newborn: Rapid Diagnosis with Ultrasonography

    PubMed Central

    Goldfisher, Rachelle; Amodio, John

    2015-01-01

    Separation of the proximal humeral epiphysis (SPHE) is a well-known occurrence and may occur secondary to trauma, infection, and nonaccidental trauma. Since most newborns do not have the proximal humeral epiphysis ossified at birth, the diagnosis may be difficult to make on routine radiographs. Ultrasonography of the shoulder in the newborn is rapid, noninvasive, and nonionizing imaging techniques which can diagnose SPHE. In this report, we describe and emphasize the diagnostic utility of state-of-the-art ultrasonography for the diagnosis of SPHE. PMID:25694841

  16. The Values of Combined and Sub-Stratified Imaging Scores with Ultrasonography and Mammography in Breast Cancer Subtypes

    PubMed Central

    Chang, Tsun-Hou; Hsu, Hsian-He; Chou, Yu-Ching; Yu, Jyh-Cherng; Hsu, Giu-Cheng; Huang, Guo-Shu; Liao, Guo-Shiou

    2015-01-01

    Background and Objectives The Breast Imaging Reporting and Data System (BI-RADS) of Mammography (MG) and Ultrasonography (US) were equivalent to the “5-point score” and applied for combined and sub-stratified imaging assessments. This study evaluated the value of combined and sub-stratified imaging assessments with MG and US over breast cancer subtypes (BCS). Materials and Methods Medical records of 5,037 cases having imaging-guided core biopsy, performed from 2009 to 2012, were retrospectively reviewed. This study selected 1,995 cases (1,457 benign and 538 invasive cancer) having both MG and US before biopsy. These cases were categorized with the “5-point score” for their MG and US, and applied for combined and sub-stratified imaging assessments. Invasive cancers were classified on the basis of BCS, and correlated with combined and sub-stratified imaging assessments. Results These selected cases were evaluated by the “5-point score.” MG, US, and combined and sub-stratified imaging assessments all revealed statistically significant (P < 0.001) incidence of malignancy. The sensitivity was increased in the combined imaging score (99.8%), and the specificity was increased in the sub-stratified combined score (75.4%). In the sub-stratified combined imaging assessment, all BCS can be classified with higher scores (abnormality hierarchy), and luminal B subtype showed the most salient result (hierarchy: higher, 95%; lower, 5%). Conclusions Combined and sub-stratified imaging assessments can increase sensitivity and specificity of breast cancer diagnosis, respectively, and Luminal B subtype shows the best identification by sub-stratified combined imaging scoring. PMID:26689198

  17. Ultrasonography of the reticulum, rumen, omasum and abomasum before, during and after ingestion of hay and grass silage in 10 calves.

    PubMed

    Braun, U; Gautschi, A; Tschuor, A; Hässig, M

    2012-12-01

    The reticulum, rumen, omasum and abomasum were assessed via ultrasonography in 10 healthy female calves before, during and 2 h after feeding hay and grass silage. The evaluations were made using an ultrasound machine with a 5.0 MHz linear transducer. The reticulum could be visualized before feeding in all the calves. Its appearance and pattern of contractions were similar to those in adult cattle, although the amplitude (5.2±1.06 cm) and velocity (3.5±1.42 cm/s) of the first contraction were markedly less than in adult cattle. The position and size of the entire rumen including the dorsal and ventral sacs and the ruminal contents were assessed. Except for its smaller size, the ultrasonographic appearance of the omasum of calves was similar to that of adult cattle. The abomasum was seen to the left and right of the ventral midline before feeding in all calves; it occupied considerably more space on the left than the right. Compared with its appearance before feeding, the ultrasonographic appearance of the rumen, omasum and abomasum did not change during or after feeding. Ultrasonography is an ideal imaging tool for evaluating the reticulum, rumen, omasum and abomasum before, during and after feeding in calves. PMID:22534583

  18. Ultrasound Obstet Gynecol 2005; 26: 770775 Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/uog.2636

    E-print Network

    zone; ectopic pregnancy; human chorionic gonadotropin; pregnancy of unknown location; transvaginal ultrasonography ABSTRACT Objectives Various serum human chorionic gonadotropin (hCG) discriminatory zones

  19. Validation of screening examinations of the ureteral orifices in dogs: Comparison of ultrasonography with dissection.

    PubMed

    Balogh, O; Degrandi, F; Hässig, M; Reichler, I M

    2015-08-01

    In dogs, ultrasonography is performed to locate the ureteral orifices in the urinary bladder, but reference values for their normal location using this technique are missing. In this study, the ureterovesical-vesicourethral and inter-ureterovesical distances were determined in 20 freshly euthanized medium size dogs by detecting artificially produced ureteral jets in color-flow Doppler ultrasonography at two different bladder volumes, and comparing them to manual measurements in the dissected bladder. All distances determined by ultrasonography were in agreement with values found by dissection (P???0.100). With increasing bladder volume only the left ureterovesical-vesicourethral distance changed (P?=?0.041). The right ureteral opening was more cranial than the left in 16 dogs. The inter-ureterovesical distances differed by gender (P?=?0.016), but spay/neuter status had no influence (P???0.847). In conclusion, ultrasonography is a reliable modality for screening ureteral orifices in medium size dogs and agrees with anatomical findings. PMID:26027729

  20. Temperature influences upon vascular dynamics in cattle measured by doppler ultrasonography

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Two preliminary studies were performed to determine if Doppler-image ultrasonography can be used to document vascular changes of cattle under hot and cold conditions. Three calves per study (320 ± 38 kg) were acclimated to thermoneutrality (17.5oC). Ultrasound measurements were taken of the median...

  1. Undergraduate Student Perceptions of the Use of Ultrasonography in the Study of "Living Anatomy"

    ERIC Educational Resources Information Center

    Ivanusic, Jason; Cowie, Brian; Barrington, Michael

    2010-01-01

    Ultrasonography is a noninvasive imaging modality, and modern ultrasound machines are portable, inexpensive (relative to other imaging modalities), and user friendly. The aim of this study was to explore student perceptions of the use of ultrasound to teach "living anatomy". A module utilizing transthoracic echocardiography was developed and…

  2. Quantitative Lingual, Pharyngeal and Laryngeal Ultrasonography in Swallowing Research: A Technical Review

    ERIC Educational Resources Information Center

    Chi-Fishman, Gloria

    2005-01-01

    Because of its distinct advantage in radiation-free soft tissue imaging, ultrasonography has been widely used to study lingual, pharyngeal, hyoid, laryngeal, and even esophageal action during swallowing in individuals of all ages. Qualitative ultrasonographic observations have made considerable contributions to our understanding of deglutition.…

  3. Preoperative Ultrasonography as a Predictor of Difficult Laparoscopic Cholecystectomy that Requires Conversion to Open Procedure

    PubMed Central

    Chand, Prem; Singh, Rommel; Singh, Bimaljot; Singla, Rachan Lal; Yadav, Manish

    2015-01-01

    Aim: The present study was conducted to see whether preoperative ultrasonography can be used as a predictor of difficult lapariscopic cholecystectomy or not. Methods: 50 patients of cholelithiasis, selected from surgical OPD of Rajindra Hospital Patiala, who fulfilled all inclusion and exclusion criteria for the study underwent elective cholecystectomy. Ultrasonography was done pre-operatively on all cases in the same setup and with same probe and patients underwent laparoscopic cholecystectomy in same setup. Results: A significant prediction was found between ultrasonographic parameters and conversion of the procedure to open cholecystectomy which proved that pre-operative ultrasonography is a good predictor of difficulty in laparoscopic cholecystectomy in majority of the cases and should be used as a screening procedure. Conclusion: Preoperative ultrasonography should be used as a screening procedure as it is a good predictor of difficulty in laparoscopic cholecystectomy in majority of the cases. It can help surgeon to get an idea of potential difficulty that he can face in the particular patient. PMID:26425061

  4. Animated respiratory movement of a spinal intradural arachnoid cyst visualized by intraoperative ultrasonography.

    PubMed

    Miyashita, Tomohiro; Ataka, Hiromi; Tanno, Takaaki

    2015-04-01

    This study aims to describe the animated respiratory movement of a spinal intradural arachnoid cyst visualized by intraoperative ultrasonography. A 69-year-old man with a spinal arachnoid cyst of the thoracic spine presented with gait disturbance. Magnetic resonance images showed a mild anterior displacement and flattening of the spinal cord at T4-T5. We performed ultrasonography before incision of the dura during the operation and observed the movement of the cyst consisting of not only pulsation in accordance with the cardiac cycle but also rhythmic expansion and contraction in accordance with the respiratory cycle. In the inspiratory phase, the cyst gradually expanded and pulsated in accordance with the cardiac cycle. In the expiratory phase, the cyst gradually contracted with the same pulsation. After resection of the cyst, the patient's neurological improvements were excellent. To our knowledge, this is the first report of animated respiratory movement of a spinal arachnoid cyst visualized by intraoperative ultrasonography. Although cine magnetic resonance imaging can detect spinal intradural arachnoid cysts preoperatively, intraoperative ultrasonography is useful for close analysis of their movement and pathology. Considering the dynamic compression mechanism revealed in this study, we think that an early operation should be performed for such cysts. PMID:25530355

  5. Botfly larva masquerading as periorbital cellulitis: identification by point-of-care ultrasonography.

    PubMed

    Minakova, Elena; Doniger, Stephanie J

    2014-06-01

    Myiasis, or the infiltration of the botfly larvae, is a relatively frequent problem encountered by travelers to parts of Latin America. This is a novel case report that documents a Dermatobia hominis infestation of the left facial region with secondary periorbital cellulitis diagnosed by point-of-care ultrasonography. PMID:24892687

  6. Local longitudinal muscle shortening of the human esophagus from high-frequency ultrasonography

    E-print Network

    Brasseur, James G.

    Local longitudinal muscle shortening of the human esophagus from high-frequency ultrasonography. Brasseur, Ji-Bin Liu, and Larry S. Miller. Local longitudinal muscle shortening of the human esophagus from pressure, from which correlations between local contraction of longitudinal and circular muscle

  7. Factorial comparison of two transvaginal surgical approaches and of perioperative behavioral therapy for women with apical vaginal prolapse: The OPTIMAL Randomized Trial

    PubMed Central

    Barber, Matthew D.; Brubaker, Linda; Burgio, Kathryn L.; Richter, Holly E.; Nygaard, Ingrid; Weidner, Alison C.; Menefee, Shawn A.; Lukacz, Emily S.; Norton, Peggy; Schaffer, Joseph; Nguyen, John N.; Borello-France, Diane; Goode, Patricia S.; Jakus-Waldman, Sharon; Spino, Cathie; Klein Warren, Lauren; Gantz, Marie G.; Meikle, Susan F.

    2014-01-01

    IMPORTANCE Over 300,000 surgeries are performed annually in the United States for pelvic organ prolapse. Sacrospinous ligament fixation (SSLF) and uterosacral ligament suspension (ULS) are commonly performed transvaginal surgeries to correct apical prolapse. Little is known about their comparative efficacy and safety, and it is unknown whether perioperative behavioral therapy with pelvic floor muscle training (BPMT) improves outcomes of prolapse surgery. OBJECTIVE To compare outcomes between 1) SSLF and ULS and 2) perioperative BPMT and usual perioperative care in women undergoing surgery for vaginal prolapse and stress urinary incontinence. DESIGN, SETTING AND PARTICIPANTS Multi-center, 2×2 factorial randomized trial of 374 women undergoing surgery to treat both apical vaginal prolapse and stress urinary incontinence was conducted between 2008 and 2013 at 9 U.S. medical centers. Two-year follow-up rate was 84.5%. INTERVENTIONS Surgical intervention: Transvaginal surgery including mid-urethral sling with randomization to SSLF (n = 186) or ULS (n=188); Behavioral intervention: Randomization to perioperative BPMT (n = 186) or usual care (n=188). MAIN OUTCOME MEASURES The primary outcome for the surgical intervention (surgical success) was defined as: 1) no apical descent greater than one-third into vaginal canal or anterior or posterior vaginal wall beyond the hymen (anatomic success); 2) no bothersome vaginal bulge symptoms and 3) no retreatment for prolapse at 2 years. For the behavioral intervention, primary outcome at 6 months was urinary symptom scores (Urinary Distress Inventory; range 0–300, higher scores worse), and primary outcomes at 2 years were prolapse symptom scores (Pelvic Organ Prolapse Distress Inventory; range 0–300, higher scores worse) and anatomic success. RESULTS At 2 years, surgical group was not significantly associated with surgical success rates [ULS 59.2% (93/154) vs. SSLF 60.5% (92/152), OR 0.9 (95% CI 0.6, 1.5)] or serious adverse event rates [ULS 16.5% (31/188) vs. SSLF 16.7% (31/186), OR 0.9 (95% CI 0.5, 1.6)]. BPMT was not associated with greater improvements in urinary scores at 6 months [treatment difference ?6.7 (95% CI ?19.7, 6.2)], prolapse scores at 24 months [treatment difference ?8.0 (95% CI ?22.1, 6.1)] or anatomic success at 24 months. CONCLUSIONS AND RELEVANCE Two years after vaginal surgery for prolapse and stress urinary incontinence, neither ULS nor SSLF was significantly superior to the other for anatomic, functional, and or adverse event outcomes. Perioperative BPMT did not improve urinary symptoms at 6 months or prolapse outcomes at 2 years. PMID:24618964

  8. Characterization of follicle and CL development in beef heifers using high resolution three-dimensional ultrasonography.

    PubMed

    Scully, Stephanie; Evans, Alex C O; Duffy, Patrick; Crowe, Mark A

    2014-02-01

    The aim was to characterize dominant follicle (DF) and CL development through the estrous cycle of cattle using three-dimensional (3D) ultrasonography while making a comparison with conventional two-dimensional (2D) B-mode ultrasound (US) and to relate the measures taken to systemic concentrations of steroid hormones and gonadotropins. After synchronization of estrus, the ovaries of crossbred beef heifers (N = 5) were assessed using daily US with a GE Voluson i US scanner until the end of the first follicle wave, then every other day until emergence of the final (ovulatory) wave, when daily US resumed until ovulation. Follicle and CL growth were recorded and mapped. Measures of diameter (2D) and volume (3D) of the DF from the first and ovulatory waves of the cycles; and CL development were captured and stored for further analysis. Blood flow to the DF and CL were assessed using 3D power Doppler US measuring vascularization index (VI; %), vascularization flow index (0/100) and flow index (0/100). Jugular blood samples were collected every 24 hours for progesterone from the first estrus until the second ovulation. Concentrations of estradiol (E2) and follicle stimulating hormone (FSH) were measured every 8 hours from estrus to second follicle wave emergence; then, E2 only was measured from final follicle wave emergence until ovulation. Data were analyzed using PROC MIXED and PROC REG in SAS. Dominant follicle blood flow tended to decrease during follicle wave emergence and DF VI increased (P < 0.05) 24 hours before ovulation after peak E2. Measures of the DF and CL volume (3D) were highly predictive of 2D diameter measures throughout the cycle (P < 0.0001). Predictive values (r(2)) for day of wave emergence and day from ovulation were similar for 2D and 3D measures; however, 2D measures had higher repeatability when compared with 3D measures. There was no relationship between CL VI and progesterone early in the cycle (r(2) = 0.12; P = 0.1); however, there was a strong positive relationship approaching ovulation (r(2) = 0.77; P < 0.0001). In conclusion, 3D power Doppler measures of blood flow appears to be representative of vascular changes in the DF and CL throughout the estrous cycle. However, the extra time required to acquire and analyze a 3D image and the relatively little additional information obtained over that achievable with 2D imaging in terms of follicle and CL development might preclude its widespread use other than for detailed research purposes. PMID:24220362

  9. Doppler Ultrasonography in Suspected Subclavian Artery Obstruction and in Patient Monitoring after Subclavian Stenting

    SciTech Connect

    Kablak-Ziembicka, Anna Przewlocki, Tadeusz; Pieniazek, Piotr; Musialek, Piotr; Kozanecki, Artur; Stopa, Ireneusz; Zalewski, Jaroslaw; Tracz, Wieslawa

    2007-09-15

    Purpose. Subclavian or innominate artery (SIA) stenosis affects up to 5% of patients referred to coronary bypass grafting; it is symptomatic in less than half of these. This study aimed to assess the Doppler ultrasonography (DU) findings in SIA obstruction and patients' follow-up after percutaneous angioplasty (PTA). Methods. The study enrolled 118 patients (68 men, 50 women), aged 61.3 {+-} 8.7 years, with suspected SIA obstruction, in whom peak systolic velocity (PSV) in the SIA and subclavian steal grade were assessed on DU and verified by quantitative angiography (QA). Serial follow-up DU was performed in patients treated with PTA. Results. Grade I-III of subclavian steal from the vertebral artery (VA) was found in 89.8% of patients. In the remaining 10.2% only a PSV increase in the SIA was observed. QA confirmed the presence of SIA obstruction in all patients (stenosis grade: 80.9 {+-} 17.3%). In patients with one-sided SIA obstruction, the ultrasonographic steal grade correlated with the QA stenosis grade (p < 0.001, r = 0.648). Lack of subclavian steal was noted in the case of distal subclavian stenosis, VA obstruction, VA originating from the aortic arch, and bilateral SIA obstruction. Successful PTA was performed in 77 of 83 patients referred to that procedure. PSV was reduced from 4.4 {+-} 1.2 (2.2-6.5) m/sec to 1.34 {+-} 0.51 (0.5-2.5) m/sec and flow in the VA was normalized. During the mean follow-up time of 24.7 {+-} 15.6 months, there was a gradual increase in the in-stent PSV as well as gradual VA flow alterations, resulting in symptom recurrence. More than a twofold PSV increase, compared with the post-PTA values, was an indicator of restenosis in 11 of 12 patients. Conclusions. Careful DU evaluation enables the recognition of SIA obstruction in all patients. Ninety percent of them have subclavian steal correlating with the stenosis grade. Restenosis can be reliably detected with DU based on in-stent PSV and VA flow alterations.

  10. Long-Term Ultrasonography Follow-Up of Thyroid Colloid Cysts at the Health Center: A Single-Center Study

    PubMed Central

    Rho, Myung Ho; Kim, Dong Wook

    2015-01-01

    Objective. No previous study has employed long-term follow-up ultrasonography (US) examinations for evaluating thyroid colloid cysts (TCCs) in the general population. This study aimed to assess the interval changes of TCCs at the health center by evaluating long-term US follow-up examinations. Methods. For evaluation of the thyroid gland at our health center from 2006 to 2010, 3692 individuals underwent 4 or more thyroid US examinations at an interval of 1 year or 2 years. We assessed the interval changes of TCCs ? 5?mm on US follow-up examinations. Results. Of the 3692 subjects, only 115 (3.1%) showed TCCs ? 5?mm on one or more thyroid US examinations. The interval changes in TCCs, as shown by the thyroid US examinations performed during the study period, were classified as follows: no interval change (n = 60), gradual increase (n = 37), gradual decrease (n = 6), positive fluctuation (n = 10), negative fluctuation (n = 0), and disappearance (n = 2). No subject reported any relevant symptom pertaining to TCCs. Conclusions. Overall, follow-up US examinations showed various interval changes in TCCs, but a majority of TCCs showed no interval change or a gradual increase in size. PMID:26579197

  11. Assessment of coronary thrombolysis

    SciTech Connect

    Geltman, E.M.; Abendschein, D.R.; Devries, S.R.

    1987-02-01

    The efficacy of coronary thrombolysis may be assessed by several invasive and noninvasive means, including coronary angiography, contrast and radionuclide angiography, thallium 201 or /sup 99m/Tc-pyrophosphate scintigraphy, positron emission tomography, cardiac ultrasonography, electrocardiography, and analysis of plasma creatine kinase activity. Each technique has its own strengths and limitations, but when used in concert these methods may provide insight into the physiology of coronary reperfusion and the efficacy of reperfusion in individual patients and populations. 104 references.

  12. Ultrasonography of the healing process during a 3-month follow-up after a splenic injury

    PubMed Central

    Rafailidis, Vasileios; Apostolou, Dimitrios; Kaitartzis, Christodoulos; Rafailidis, Dimitrios

    2015-01-01

    We present a 14-year-old boy with a grade III splenic injury due to a bicycle accident, who was treated conservatively. The boy’s medical history included splenomegaly due to thalassemia. The splenic lesion was initially investigated with computed tomography (CT) and then, was followed by ultrasonography for 3 months. CT revealed a large intraparenchymal hematoma which appeared hyperechoic on ultrasonography. During follow-up, the hematoma developed a more complex echogenicity and became gradually hypoechoic. The hematoma increased in size during the first week but then, started decreasing until it eventually resolved completely. The patient had an uneventful full recovery. In this report, we discuss the ultrasonographic changes of the hematoma throughout the healing process. PMID:25623053

  13. Recurrent juvenile ischemic stroke caused by bow hunter's stroke revealed by carotid duplex ultrasonography.

    PubMed

    Takekawa, Hidehiro; Suzuki, Keisuke; Nishihira, Takahito; Iwasaki, Akio; Hoshiyama, Eisei; Okamura, Madoka; Numao, Ayaka; Suzuki, Shiho; Hirata, Koichi

    2015-07-01

    Bow hunter's stroke (BHS) is a rare cause of vertebrobasilar insufficiency due to rotational vertebral artery (VA) occlusion associated with head turning. We report a juvenile patient presenting with recurrent ischemic stroke caused by BHS, which was revealed by carotid duplex ultrasonography. Carotid duplex ultrasonography performed in the neutral position showed normal findings. However, disappearance of end-diastolic blood flow of contralateral VAs was observed with head rotation. Digital subtraction angiography confirmed occlusion at C1/2 levels in the VA contralateral to the head rotation, bilaterally. Importantly, our patient did not recognize the association of head rotation and previous episodes of stroke. We suggest that BHS should be considered in patients with cryptogenic stroke occurring in the vertebrobasilar artery territory. PMID:26576800

  14. Ultrasonography of adnexal causes of acute pelvic pain in pre-menopausal non-pregnant women

    PubMed Central

    Dupuis, Carolyn S.; Kim, Young H.

    2015-01-01

    Acute-onset pelvic pain is an extremely common symptom in premenopausal women presenting to the emergency department. After excluding pregnancy in reproductive-age women, ultrasonography plays a major role in the prompt and accurate diagnosis of adnexal causes of acute pelvic pain, such as hemorrhagic ovarian cysts, endometriosis, ovarian torsion, and tubo-ovarian abscess. Its availability, relatively low cost, and lack of ionizing radiation make ultrasonography an ideal imaging modality in women of reproductive age. The primary goal of imaging in these patients is to distinguish between adnexal causes of acute pelvic pain that may be managed conservatively or medically, and those requiring emergency/urgent surgical or percutaneous intervention. PMID:26062637

  15. Endoscopic Extraction of Biliary Fascioliasis Diagnosed Using Intraductal Ultrasonography in a Patient with Acute Cholangitis

    PubMed Central

    Ha, Ji Su; Choi, Hyun Jong; Moon, Jong Ho; Lee, Yun Nah; Tae, Jae Woong; Choi, Moon Han; Lee, Tae Hoon; Cha, Sang-Woo

    2015-01-01

    Fasciola hepatica infection may result in biliary obstruction with or without cholangitis in the chronic biliary phase. Because clinical symptoms and signs of F. hepatica are similar to other biliary diseases that cause bile duct obstruction, such as stones or bile duct malignancies, that are, in fact, more common, this condition may not be suspected and diagnosis may be overlooked and delayed. Patients undergoing endoscopic retrograde cholangiopancreatography or endoscopic ultrasonography for the evaluation of bile duct obstruction may be incidentally detected with the worm, and diagnosis can be confirmed by extraction of the leaf-like trematode from the bile duct. Intraductal ultrasonography (IDUS) can provide high-resolution cross-sectional images of the bile duct, and is useful in evaluating indeterminate biliary diseases. We present a case of biliary fascioliasis that was diagnosed using IDUS and managed endoscopically in a patient with acute cholangitis. PMID:26668810

  16. Usefulness and Limitation of Ultrasonography in the Diagnosis of Intestinal Intussusception in Cows

    PubMed Central

    Imran, Sheikh; Tyagi, S. P.; Kumar, Adarsh; Kumar, Amit; Sharma, Arvind; Sharma, Shivali

    2011-01-01

    The present study was conducted on 6 chronically ill Jersey/Red Sindhi cross-bred cows, which were suspected for intestinal obstruction on the basis of history and clinical signs. These cows were ultimately diagnosed with intestinal intussusception based on a combination of clinical, ultrasonographic and surgical examinations. “Bull's eye lesion” was the most prominent ultrasonographic finding, diagnostic for intussusception either trans-abdominally or transrectally. Dilated intestinal loops greater than 3.1?cm (mean ± SE, 4.41 ± 0.25) were imaged in the lower flank and the 12th intercostal space on the right side. Ultrasonography proved to be a useful tool in supplementing and substantiating the transrectal findings in cases of the bovine intestinal intussusception. However, ultrasonography was not significantly helpful where transrectal examination of the cows did not reveal any suspected intestinal mass. PMID:21547218

  17. Duodenal Mucosa-Associated Lymphoid Tissue Lymphomas: Two Cases and the Evaluation of Endoscopic Ultrasonography

    PubMed Central

    Kim, Su Jin; Choi, Choel Woong; Ha, Jong Kun; Hong, Young Mi; Park, Jin Hyun; Park, Soo Bum; Kang, Dae Hwan

    2013-01-01

    Mucosa-associated lymphoid tissue lymphoma mainly arises in the stomach, with fewer than 30% arising in the small intestine. We describe here two cases of primary duodenal mucosa-associated lymphoid tissue lymphoma which were evaluated by endoscopic ultrasonography. A 52-year-old man underwent endoscopy due to abdominal pain, which demonstrated a depressed lesion on duodenal bulb. Endoscopic ultrasonographic finding was hypoechoic lesion invading the submucosa. The other case was a previously healthy 51-year-old man. Endoscopy showed a whitish granular lesion on duodenum third portion. Endoscopic ultrasonography image was similar to the first case, whereas abdominal computed tomography revealed enlargement of multiple lymph nodes. The first case was treated with eradication of Helicobacter pylori, after which the mucosal change and endoscopic ultrasound finding were normalized in 7 months. The second case was treated with cyclophosphamide, vincristine, prednisolone, and rituximab every 3 weeks. After 6 courses of chemotherapy, the patient achieved complete remission. PMID:24143321

  18. Observation of the internal response of the kidney during compressive loading using ultrafast ultrasonography.

    PubMed

    Helfenstein-Didier, C; Tanter, M; Gennisson, J-L; Beillas, P

    2015-07-16

    A protocol based on ultrafast ultrasonography was developed to study the internal response of isolated perfused human (n=3) and porcine (n=11) kidneys subjected to loading at 0.003 m/s and 0.3m/s respectively. Regional uniaxial strains were calculated based on natural target tracking. The effect of loading speed and regional differences could be statistically detected on the porcine specimens. However, despite the inhomogeneity of their anatomical structures, strains' responses appeared relatively homogeneous at 0.3m/s in both porcine and human kidneys. Failure, identified as a sudden change on the ultrasonography movie, also appeared at similar compression levels for both species (38.3% of applied strain in average for human and 35.8% of applied strain in average for porcine). PMID:25980554

  19. Educational courses for physiological function examination at Jichi Medical University: practical trainings in ultrasonography.

    PubMed

    Omoto, Kiyoka; Kawano, Mikihiko; Yamada, Toshiyuki; Taniguchi, Nobuyuki; Konno, Kei; Fujii, Yasutomo; Kotani, Kazuhiko; Koibuchis, Harumi; Matsunaga, Hiroaki

    2011-08-01

    To foster work-ready general physicians, Jichi Medical University has developed various clinical teaching practices since its foundation. The educational courses for clinical laboratory medicine, being one of them, adopt practical trainings in ultrasonography, which is essential in practical medicine today. The aims and the specifics of the trainings adopted in the seminar of ultrasound and the required or the optional subjects of Bedside Learning (BSL) at Jichi Medical University are reported. PMID:21942088

  20. The practice patterns of second trimester fetal ultrasonography: A questionnaire survey and an analysis of checklists

    PubMed Central

    Park, Hyun Soo; Hong, Joon Seok; Seol, Hyun-Joo; Hwang, Han Sung; Kim, Kunwoo; Ko, Hyun Sun; Kwak, Dong-Wook; Oh, Soo-young; Kim, Moon Young; Kim, Sa Jin

    2015-01-01

    Objective To analyze practice patterns and checklists of second trimester ultrasonography, and to investigate management plans when soft markers are detected among Korean Society of Ultrasound in Obstetrics and Gynecology (KSUOG) members. Methods An internet-based self-administered questionnaire survey was designed. KSUOG members were invited to the survey. Checklists of the second trimester ultrasonography were also requested. In the questionnaire survey, general practice patterns of the second trimester ultrasonography and management schemes of soft markers were asked. In the checklists analysis, the number of items were counted and also compared with those recommended by other medical societies. Results A total of 101 members responded. Eighty-seven percent routinely recommended second trimester fetal anatomic surveillance. Most (91.1%) performed it between 20+0 and 23+6 weeks of gestation. Written informed consents were given by 15.8% of respondents. Nearly 60% recommended genetic counseling when multiple soft markers and/or advanced maternal age were found. Similar tendencies were found in the managements of individual soft markers. However, practice patterns were very diverse and sometimes conflicting. Forty-eight checklists were analyzed in context with the number and content of the items. The median item number was 46.5 (range, 17 to 109). Of 49 items of checklists recommended by International Society of Ultrasound in Obstetrics and Gynecology and/or American Congress of Obstetricians and Gynecologists, 14 items (28.6%) were found in less than 50% of the checklists analyzed in this study. Conclusion Although general practice patterns were similar among KSUOG members, some of which were conflicting, and there is a need for standardization of the practice patterns and checklists of second trimester ultrasonography, which also have very wide range of spectrum. PMID:26623407

  1. The Feasibility of Ultrasonography in Defining the Size of Jaw Osseous Lesions

    PubMed Central

    Shahidi, Shoaleh; Shakibafard, Alireza; Zamiri, Barbod; Mokhtare, Mohammad Reza; Houshyar, Maneli; Mahdian, Soroush

    2015-01-01

    Statement of the Problem Jaw bone lesions are common pathologic conditions. The role of ultrasonography in evaluation of the extra-osseous lesions is confirmed, however, this imaging modality is not the diagnostic routine for the intra-osseous jaw lesions. Purpose The purpose of this study was to evaluate the efficiency of ultrasonography in diagnosis of intra-osseous jaw lesions concerning their size and content and also to study its correlation with the histopathological findings. Materials and Method For this study, 15 patients with intra-osseous jaw lesions in the maxilla and mandible were selected from those referred to the Department of Oral Surgery. Panoramic imaging, computed tomography (CT) or cone beam computed tomography (CBCT) and ultrasonography (USG) were performed for all the lesions. The size of the lesions was measured by USG and then compared with CT or CBCT. Moreover, the correlation amongst the echographic patterns and histopathologic results was evaluated. Results In 12 cases, size values were in complete agreement with CT or CBCT. The size of 3 lesions could not be measured by the radiologist due to the thickness of buccal cortical plate. Conclusion Findings of this study suggested that USG might be feasible in estimating the size of intra-osseous jaw lesions with little underestimation. This study also confirmed that ultrasound imaging was a very useful imaging technique which could provide significant diagnostic information regarding the content of jaw bone lesions where the buccal bone thickness was thin enough. PMID:26636122

  2. Comparison of Ultrasonography-Guided Central Venous Catheterization Between Adult and Pediatric Populations

    SciTech Connect

    Tercan, Fahri Oguzkurt, Levent; Ozkan, Ugur; Eker, Hatice Evren

    2008-05-15

    The purpose of this study was to compare the technical success and complication rates of ultrasonography-guided central venous catheterization between adult and pediatric patients which have not been reported previously. In a 4-year period, 859 ultrasonography-guided central vein catheterizations in 688 adult patients and 247 catheterizations in 156 pediatric patients were retrospectively evaluated. Mean age was 56.3 years (range, 18 to 95 years) for adults and 3.3 years (range, 0.1 to 16.3 years) for children. The preferred catheterization site was internal jugular vein in 97% of adults and 85% of children. The technical success rate, mean number of punctures, and rate of single wall puncture were 99.4%, 1.04 (range, 1-3), and 83% for adults and 90.3%, 1.25 (range, 1-5), and 49% for children, respectively. All the differences were statistically significant (p < 0.05). Complication rates were 2.3% and 2.4% for adults and children, respectively (p > 0.05). Major complications such as pneumothorax and hemothorax were not seen in any group. In conclusion, ultrasonography-guided central venous catheterization has a high technical success rate, lower puncture attempt rate, and higher single wall puncture rate in adults compared to children. Complication rates are comparable in the two groups.

  3. [Quantitative bone ultrasonography: state of the art and perspectives].

    PubMed

    Guglielmi, G; de Terlizzi, F; Aucella, F

    2004-01-01

    Quantitative Ultrasound (QUS) is a relatively new method of bone assessment that measures the velocity of sound and the broadband ultrasound attenuation at different skeletal sites: heel and phalanges. This is a mobile, inexpensive, easy to perform and radiation-free technique, capable of assessing not only bone density, commonly measured by means of Single Energy X-ray Absorptiometry, SXA, Dual Energy X-ray Absorptiometry, DXA and Quantitative Computed Tomography, QCT, but also its elasticity and structure. QUS has been validated for diagnosis of osteoporosis and prevention of hip fractures. Very recently, QUS was also been applied to the study of uremic osteodistrophy, of female premenopausal osteoporosis, male osteoporosis and in paediatric population. Moreover, many studies in the dialysis population has also shown the effectiveness of QUS at the phalanges site in evaluating bone turn-over and bone osteopenia. QUS may be an useful tool for the nephrologist in the day by day monitoring of uremic osteodistrophy and secondary hyperparathyroidism. PMID:15470660

  4. Diagnosis of varicocele and postoperative evaluation using inguinal ultrasonography.

    PubMed Central

    Orda, R; Sayfan, J; Manor, H; Witz, E; Sofer, Y

    1987-01-01

    Ultrasonographic real-time imaging and measurements of spermatic veins in the inguinal canal were evaluated in two groups of patients: 20 young men with varicocele and 18 controls. Examinations were performed with the patient in an upright relaxed position, and performing the Valsalva maneuver. The increase in diameter of the main vein during Valsalva maneuver was considered to quantitatively represent venous reflux. The data obtained were correlated with pre- and postoperative clinical findings. This method of evaluation proved to be a useful noninvasive diagnostic modality for detecting varicocele and for assessing treatment results. On the basis of venous diameters and reflux values, a classification of varicocele is proposed. Such an objective method of grading would eliminate the subjective impression and interpretation factors of the examiner. Images Fig. 1. PMID:3300579

  5. Automatic detection and measurement of femur length from fetal ultrasonography

    NASA Astrophysics Data System (ADS)

    Mukherjee, Prateep; Swamy, Gokul; Gupta, Madhumita; Patil, Uday; Krishnan, Kajoli Banerjee

    2010-03-01

    Femur bone length is used in the assessment of fetal development and in the prediction of gestational age (GA). In this paper, we present a completely automated two-step method for identifying fetal femur and measuring its length from 2D ultrasound images. The detection algorithm uses a normalized score premised on the distribution of anatomical shape, size and presentation of the femur bone in clinically acceptable scans. The measurement process utilizes a polynomial curve fitting technique to determine the end-points of the bone from a 1D profile that is most distal from the transducer surface. The method has been tested with manual measurements made on 90 third trimester femur images by two radiologists. The measurements made by the experts are strongly correlated (Pearson's coefficient = 0.95). Likewise, the algorithm estimate is strongly correlated with expert measurements (Pearson's coefficient = 0.92 and 0.94). Based on GA estimates and their bounds specified in Standard Obstetric Tables, the GA predictions from automated measurements are found to be within +/-2SD of GA estimates from both manual measurements in 89/90 cases and within +/-3SD in all 90 cases. The method presented in this paper can be adapted to perform automatic measurement of other fetal limbs.

  6. Muscle ultrasonography for detecting fasciculations in frontotemporal dementia.

    PubMed

    Tremolizzo, Lucio; Susani, Emanuela; Aliprandi, Angelo; Salmaggi, Andrea; Ferrarese, Carlo; Appollonio, Ildebrando

    2014-12-01

    Ultrasound detection of muscle fasciculations was recently proposed for assessing lower motor neuron (LMN) dysfunction in ALS patients. Given the continuum between ALS and frontotemporal degeneration (FTD), the aim of the present study was to evaluate muscle ultrasound (MUS) in FTD both for feasibility and prevalence of fasciculations. Twenty-two FTD patients were examined (five muscles bilaterally: biceps brachii, first dorsalis interosseous, T10 paraspinalis, vastus lateralis, tibialis anterior) with a 7-MHz linear array transducer and a fasciculation score (FS) computed. Twenty-two matched cognitively-intact control subjects and six ALS patients were also included. Results showed that MUS was feasible, reliable and well tolerated in all subjects. Two FTD/MND patients displayed very high FS values, similar to those in ALS patients. The remaining 20 FTD patients displayed a mean FS value significantly higher than the control group with six patients (30%) having FS values out of the range of controls. Disease progression rate correlated with the FS. In conclusion, MUS can be easily applied to FTD patients and represents a non-invasive technique for defining LMN involvement in these patients. LMN dysfunction is a frequent condition in FTD and might identify a subset of patients with a different clinical course. PMID:24863345

  7. Ultrasonography and MR Imaging in Progressive Supranuclear Palsy.

    PubMed

    Liboni, W; Pignatta, P; Salzedo, E; Giordano, S; Molinari, F

    2011-05-15

    Progressive supranuclear palsy (PSP) also known as Steele, Richardson and Olszewski disorder (1-4) is a neurodegenerative brain disease that has no known cause, treatment or cure. PSP has no known geographical, occupational or racial preference and affects brain cells that control walking, balance, mobility, vision, speech and swallowing. Symptoms begin on average in the early 60s, but may start as early as in the 40s: a good history and physical examination support the clinical diagnosis and latency of each feature makes us suspect a probable PSP, an atypical Parkinsonism. The diagnosis of a large number of cases of PSP is missed or delayed: 75% of the patients are never clinically diagnosed by neurologist and in most cases the median interval between onset and diagnosis is three years. Notwithstanding such differences in clinical presentation, there remains an overlap in symptoms making the differential diagnosis between such neurodegenerative disorders challenging. A few imaging techniques developed to evaluate brain anatomy and function are used extensively to improve the diagnostic accuracy of different forms of Parkinsonism. Non-invasive and safe methods can now document brain structures. Transcranial sonography (TCS) is a very low cost tool to assess the basal ganglia and mesencephalic echogenicity (5,6). Conventional magnetic resonance imaging (MRI) is a valuable tool to exclude secondary Parkinsonism. Our purpose is to define characteristic objectively measured imaging markers that point out normal biological processes, and pathogenic processes in PSP. Such markers should be sufficiently sensitive and specific to show the underlying biological disease and the pharmacological responses to therapy. PMID:24059611

  8. Automatic detection and estimation of biparietal diameter from fetal ultrasonography

    NASA Astrophysics Data System (ADS)

    Annangi, Pavan; Banerjee Krishnan, Kajoli; Banerjee, Jyotirmoy; Gupta, Madhumita; Patil, Uday

    2011-03-01

    Fetal bi-parietal diameter (BPD) is known to provide a reliable estimate of gestational age (GA) of a fetus in the first half of pregnancy. In this paper, we present an automated method to identify and measure BPD from B-mode ultrasound images of fetal head. The method (a) automatically detects and places a region-of-interest on the head based on a prior work in our group (b) utilizes the concept of phase congruency for edge detection and (c) employs a cost function to identify the third ventricle inside the head (d) measures the BPD along the perpendicular bisector of occipital frontal diameter (OFD) from the outer rim of the cranium closer to the transducer to the inner rim of the cranium away from the transducer. The cost function is premised on the distribution of anatomical shape, size and presentation of the third ventricle in images that adhere to clinical guidelines describing the scan plane for BPD measurement. The OFD is assumed to lie along the third ventricle. The algorithm has been tested on 137 images acquired from four different scanners. Based on GA estimates and their bounds specified in Standard Obstetric Tables, the GA predictions from automated measurements are found to be within +/-2SD of GA estimates from manual measurements by the operator and a second expert radiologist in 98% of the cases. The method described in this paper can also be adapted to assess the accuracy of the scan plane based on the presence/absence of the third ventricle.

  9. Artifacts in Musculoskeletal Ultrasonography Mihra S. Taljanovic, MD, PhD, FACR1 David M. Melville, MD1 Luke R. Scalcione, MD1

    E-print Network

    Witte, Russell S.

    the electrical signal to the transducer, which results in the production of sound waves. Ultrasound gel (coupling ultrasonography ultrasound artifact anisotropy posterior acoustic shadowing posterior acoustic enhancement

  10. Ultrasonography in the diagnosis of hemorrhagic cystitis – a complication of bone marrow transplantation in pediatric oncology patients

    PubMed Central

    Biel, Anna; Soko?owska-D?bek, D?brówka; Olchowy, Cyprian; ?asecki, Mateusz

    2014-01-01

    Objective The aim of this study was to evaluate the usefulness of ultrasonography in the diagnosis of hemorrhagic cystitis following bone marrow transplantation in children. Material and methods The study involved an analysis of clinical material and the results of imaging tests performed in 334 patients who underwent hematopoietic cell transplantation. Ultrasonographic findings in 42 patients with hemorrhagic cystitis were analyzed in detail. The ultrasound images served to assess the severity of hemorrhagic cystitis and the results were compared with the clinical assessment of the disease on the Droller scale, as well as the laboratory and endoscopic tests. Results In the studied group of patients hemorrhagic cystitis following allogeneic transplantation was diagnosed in 12.5% cases. 73.8% patients received transplants from unrelated donors, 26.2% – from compatible siblings. The study revealed a higher incidence of hemorrhagic cystitis in children above 10 years of age. Grade 3 according to the Droller was diagnosed in 42.9%, grade 2 – in 30.9%, grade 4 – in 14.3%, and grade 1 – in 11.9% patients. The number of ultrasound examinations depended on the clinical symptoms, severity, duration and co-occurrence of other complications following the transplantation and was within the 1–15 range (average: 4.6). Grades 3 and 4 were related to the poor clinical condition of the patients and to their longer hospitalization. During this period there was an increased risk of renal malfunction and acute renal failure, post-inflammatory narrowing of the ureters, hydronephrosis, and in grade 4 the fibrosis of the bladder with reduced bladder capacity. Analyses demonstrated a significant correlation between the ultrasound image of the bladder wall and the clinical severity. Conclusions Ultrasound with Doppler options remains the primary diagnostic tool in the evaluation of hemorrhagic cystitis, and is useful in terms of its diagnosis, determination of the severity, and monitoring of the treatment.

  11. The usefulness of contrast-enhanced ultrasonography in the early detection of hepatocellular carcinoma viability after transarterial chemoembolization: pilot study

    PubMed Central

    Cho, Youn Zoo; Park, So Yeon; Choi, Eun Hee; Baik, Soon Koo; Kwon, Sang Ok; Kim, Young Ju

    2015-01-01

    Background/Aims The therapeutic effect of transarterial chemoembolization (TACE) against hepatocellular carcinoma (HCC) is usually assessed using multidetector computed tomography (MDCT). However, dense lipiodol depositions can mask the enhancement of viable HCC tissue in MDCT. Contrast-enhanced ultrasonography (CEUS) could be effective in detecting small areas of viability and patency in vessels. We investigated whether arterial enhancement in CEUS after treatment with TACE can be used to detect HCC viability earlier than when using MDCT. Methods Twelve patients received CEUS, MDCT, and gadoxetic-acid-enhanced dynamic magnetic resonance imaging (MRI) at baseline and 4 and 12 weeks after TACE. The definition of viable HCC was defined as MRI positivity after 4 or 12 weeks. Results Eight of the 12 patients showed MRI positivity at 4 or 12 weeks. All patients with positive CEUS findings at 4 weeks (n=8) showed MRI positivity and residual viable HCC at 4 or 12 weeks. Five of the eight patients with positive CEUS findings at 4 weeks had negative results on the 4-week MDCT scan. Four (50%) of these eight patients did not have MRI positivity at 4 weeks and were ultimately confirmed as having residual HCC tissue at the 12-week MRI. Kappa statistics revealed near-perfect agreement between CEUS and MRI (?=1.00) and substantial agreement between MDCT and MRI (?=0.67). Conclusions In the assessment of the response to TACE, CEUS at 4 weeks showed excellent results for detecting residual viable HCC, which suggests that CEUS can be used as an early additive diagnosis tool when deciding early additional treatment with TACE. PMID:26157754

  12. The accuracy of endorectal ultrasonography in rectal cancer staging

    PubMed Central

    COTE, ADRIAN; GRAUR, FLORIN; LEBOVICI, ANDREI; MOIS, EMIL; AL HAJJAR, NADIM; MARE, CODRUTA; BADEA, RADU; IANCU, CORNEL

    2015-01-01

    Background and aims The incidence of rectal cancer in the European Union is about 35% of the total colorectal cancer incidence. Staging rectal cancer is important for planning treatment. It is essential for the management of rectal cancer to have adequate preoperative imaging, because accurate staging can influence the therapeutic strategy, type of resection, and candidacy for neoadjuvant therapy. The aim of this work is to evaluate the accuracy of endorectal ultrasound (ERUS) in rectal cancer staging. Methods A retrospective study was performed to assess the accuracy of ERUS by analyzing patients discharged from Regional Institute of Gastroenterology and Hepatology (IRGH) Cluj-Napoca, Romania, diagnosed with rectal cancer between 01 January 2011 and 31 December 2013. Patients who were preoperatively staged by other imaging methods and those who had ERUS performed in another service were excluded from the analysis. As inclusion criteria remained ERUS performed for patients with rectal cancer in IRGH Cluj-Napoca where they were also operated. We analyzed preoperative T stage obtained by ERUS and it was compared with the histopathology findings. Results The number of patients discharged with a diagnosis of rectal cancer were 200 (operated – 157) in 2011, 193 (operated – 151) in 2012, and 198 (operated – 142) in 2013. We analyzed a total of 51 cases diagnosed with rectal cancer who performed ERUS in IRGH Cluj-Napoca. The results according to the T stage obtained by ERUS and histopathology test were: Under-stage T2= 25.0%, T3=7.9% of cases; Over-stage T2=25.0%, T3=31.6% and T4=60.0% of cases. Less than 20% of patients underwent preoperative radio-chemotherapy. Conclusions ERUS is a method of staging rectal cancer which is human dependent. ERUS is less accurate for T staging of stenotic tumours, but the accuracy may still be within acceptable limits. Surgeons use ERUS to adopt a treatment protocol, knowing the risk of under-staging and over-staging of this method. The accuracy of ERUS is higher in diagnosing rectal cancer in stages T1, T2 and even in stage T3 with malignant tumor which is not occlusive. ERUS is less accurate for T staging of locally advanced and stenotic tumours. PMID:26609269

  13. [Ultrasonography methods in the diagnosis of renal osteodystrophy].

    PubMed

    Tomi?-Brzac, Hrvojka; Pavlovi?, Drasko

    2004-01-01

    Bone disease, i.e. renal osteodystrophy, is commonly seen in patients with chronic renal failure. It encompasses all the disorders of mineral and bone metabolism associated with chronic renal insufficiency, i.e. secondary hyperparathyroidism, retention and accumulation of beta 2 microglobulin and aluminum. The most frequent cause of renal osteodystrophy is secondary hyperthyroidism, with a consequence of high turnover bone disease. Secondary hyperparathyroidism, i.e. increased parathyroid hormone (PTH) secretion and parathyroid gland hyperplasia, develops early in the course of chronic renal insufficiency. Hypocalcemia, phosphate retention and deficiency of calcitriol stimulate PTH synthesis and secretion and parathyroid cell proliferation, i.e. hyperplasia. Parathyroid cell proliferation is initially polyclonal (diffuse hyperplasia), and later it is monoclonal or multiclonal (nodular hyperplasia). Calcitriol receptors as well as calcium-sensing receptors are significantly reduced in parathyroid glands in nodular hyperplasia. Patients with such parathyroid gland hyperplasia are often resistant to vitamin D therapy. A specific form of bone disease is beta 2 amyloidosis. Destructive arthropathy, cystic changes and carpal tunnel syndrome are clinical manifestations of dialysis-related amyloidosis, which is one of the major complications in patients on longterm hemodialysis. Aluminum intoxication leads to the low turnover bone disease and consequential osteomalacia or aplastic bone lesions, the cause of which has not yet been fully clarified. Ultrasound can be a useful, economical and noninvasive method in the evaluation of renal osteodystrophy. Ultrasound waves are very important for noninvasive imaging of soft tissue, especially parathyroid glands, pathologic changes of the joints, and for detection of metastatic calcifications. They are also useful in the evaluation of skeletal status in dialysis patients. Ultrasound waves of a frequency above the limit of human hearing are used in the morphological diagnosis of parathyroid gland. Today, because of its simplicity and non-invasiveness, it is a generally accepted method for the detection of enlarged parathyroid gland in patients with secondary hyperparathyroidism, for the monitoring of pathologic changes, and for making decisions on the method of treatment based on the size and number of parathyroid glands. Ultrasound can distinguish nodal from diffuse parathyroid hyperplasia. Under ultrasound guidance it is possible to perform fine needle aspiration biopsy, to confirm ultrasound findings, and percutaneous inactivation of parathyroid gland (PEI) with alcohol. Ultrasound is useful in the diagnosis of pathologic changes of the musculoskeletal system in patients with beta 2 amyloidosis, to assess the process of its spread, especially in the shoulder joint where the changes are most pronounced (rotator cuff thickness, amyloid deposits as hyperechogenic pads, and detection of fluid in the joint), but it can also be used to examine other joints as well as soft tissue in which metastatic calcifications may occur. Standard ultrasound equipment (pulse-echo) and linear probe of 5-13 MHz are used, also serving for ultrasound examination of the neck, joints and soft tissue. Quantitative bone ultrasonometry is based on different physical characteristics of the ultrasound including: transmission, Speed Of Sound (SOS) in meters/sec and Broad Band Attenuation (BUA) in dB/MHz, and different concepts of the apparatus. These parameters depend on the strength and architecture of the bones and describe better the changes in bone structure in dialysis patients by calculation of the Stiffness Index (QUI), better than the standard bone densitometry by dual-energy x-ray absorptiometry, which only measures bone density. Combined ultrasound measurement of the bone in several locations may be successful in monitoring dialysis patients. PMID:15125393

  14. Blood flow in intracranial aneurysms treated with Pipeline embolization devices: computational simulation and verification with Doppler ultrasonography on phantom models

    PubMed Central

    2015-01-01

    Purpose: The aim of this study was to validate a computational fluid dynamics (CFD) simulation of flow-diverter treatment through Doppler ultrasonography measurements in patient-specific models of intracranial bifurcation and side-wall aneurysms. Methods: Computational and physical models of patient-specific bifurcation and sidewall aneurysms were constructed from computed tomography angiography with use of stereolithography, a three-dimensional printing technology. Flow dynamics parameters before and after flow-diverter treatment were measured with pulse-wave and color Doppler ultrasonography, and then compared with CFD simulations. Results: CFD simulations showed drastic flow reduction after flow-diverter treatment in both aneurysms. The mean volume flow rate decreased by 90% and 85% for the bifurcation aneurysm and the side-wall aneurysm, respectively. Velocity contour plots from computer simulations before and after flow diversion closely resembled the patterns obtained by color Doppler ultrasonography. Conclusion: The CFD estimation of flow reduction in aneurysms treated with a flow-diverting stent was verified by Doppler ultrasonography in patient-specific phantom models of bifurcation and side-wall aneurysms. The combination of CFD and ultrasonography may constitute a feasible and reliable technique in studying the treatment of intracranial aneurysms with flow-diverting stents. PMID:25754367

  15. Clients' reasons for prenatal ultrasonography in Ibadan, South West of Nigeria

    PubMed Central

    Enakpene, Christopher A; Morhason-Bello, Imran O; Marinho, Anthony O; Adedokun, Babatunde O; Kalejaiye, Adegoke O; Sogo, Kayode; Gbadamosi, Sikiru A; Awoyinka, Babatunde S; Enabor, Obehi O

    2009-01-01

    Background Prenatal ultrasonography has remained a universal tool but little is known especially from developing countries on clients' reasons for desiring it. Then aim was to determine the reasons why pregnant women will desire a prenatal ultrasound. Methods It was a cross-sectional survey of consecutive 222 women at 2 different ultrasonography facilities in Ibadan, South-west Nigeria. Results The mean age of the respondents was 30.1 ± 4.5 years. The commonest reason for requesting for prenatal ultrasound scans was to check for fetal viability in 144 women (64.7%) of the respondents, followed by fetal gender determination in 50 women (22.6%. Other reasons were to check for number of fetuses, fetal age and placental location. Factors such as younger age, artisans profession and low level of education significantly influenced the decision to check for fetal viability on bivariate analysis but all were not significant on multivariate analysis. Concerning fetal gender determination, older age, Christianity, occupation and gravidity were significant on bivariate analysis, however, only gravidity and occupation remained significant independent predictor on logistic regression model. Women with less than 3 previous pregnancies were about 4 times more likely to request for fetal sex determination than women with more than 3 previous pregnancies, (OR 3.8 95%CI 1.52 – 9.44). The professionals were 7 times more likely than the artisans to request to find out about their fetal sex, (OR 7.0 95%CI 1.47 – 333.20). Conclusion This study shows that Nigerian pregnant women desired prenatal ultrasonography mostly for fetal viability, followed by fetal gender determination. These preferences were influenced by their biosocial variables. PMID:19426518

  16. Serial transrectal ultrasonography for monitoring the reproductive activity of the Asiatic black bear (Ursus thibetanus ussuricus).

    PubMed

    Kang, H G; Jeong, D H; Yang, J J; Lee, B K; Kong, J K; Lee, J W; Kim, I H

    2015-02-01

    This study evaluated the structural changes in the reproductive tract of Asiatic black bears using serial transrectal ultrasonography. In addition, the ultrasonographic observations were compared with the results of vaginal cytology and hormonal analyses. The collection of blood for hormonal analysis, vaginal cytology and transrectal ultrasonography was performed in two bears (Bears 1 and 2) from June 2011 to August 2013 without mating and in a third bear (Bear 3) from April to December 2012, allowing natural mating. Serial ultrasonographic observations showed cyclic changes in ovarian structures (e.g. emergence of small follicles, growth and ovulation of dominant follicles and corpus luteum (CL) formation) during the reproductive cycles of the three bears. The diameter of the uterine horns remained similar throughout the reproductive cycle in Bears 1 and 2, and it remained similar from April until October, but an enlargement containing foetuses was observed in Bear 3 in December. The ultrasonographic observations were consistent with the data obtained through vaginal cytology and progesterone analysis during the reproductive cycle. An average of 4.0 (±0.4) dominant follicles was observed during the oestrous stage (May-August), during which the superficial cells accounted for >90% of the total vaginal cells. In addition, the detection of an average of 2.6 (±0.2) CL was associated with increased plasma progesterone concentrations (3.0 ± 0.4 ng/ml) between June and December (near hibernation). In conclusion, serial transrectal ultrasonography demonstrated yearly oestrous (ovulation) cycles via follicular dynamics and CL formation on ovaries, accordingly with vaginal cytology and hormonal level in the Asiatic black bear. PMID:25522189

  17. Reliability of Rehabilitative Ultrasonography to Measure Transverse Abdominis and Multifidus Muscle Dimensions

    PubMed Central

    Nabavi, Narjes; Mosallanezhad, Zahra; Haghighatkhah, Hamid Reza; Mohseni Bandpeid, Mohammad Ali

    2014-01-01

    Background: Lumbar paraspinal muscles play an important role in providing both mobility and stability during dynamic tasks. Among paraspinal muscles, transverse abdominis and lumbar multifidus have been of particular interest as active stabilizers of the lumbar spine. These muscles may become dysfunctional in chronic low back pain (CLBP). Low back injury can result in muscle inhibition and control loss that cannot recover spontaneously, and specific exercises are required to stimulate their recovery. Objectives: The purpose of this study was to test the reliability of ultrasonography to measure muscle dimensions and to present a reliable method for measuring transverse abdominis and lumbar multifidus as stabilizing muscles of the lumbar spine. Subjects and Methods: Fifteen healthy participants (18-55 year olds) were evaluated by a radiologist using ultrasonography (ES500) with two probes (50mm linear 7.5 MHZ and 70 mm curvilinear 3.5 MHz). The muscle thickness of transverse abdominis and the anterior-posterior diameter and cross sectional area of the LMF were measured. To determine within and between days reliabilities, second and third measurements were repeated with half an hour and one week intervals, respectively. Results: Intraclass correlation coefficient for left and right showed good to high reliability for the cross sectional area of lumbar multifidi (0.74 and 0.88, respectively) as well as the anterior-posterior dimensions of lumbar multifidi (0.89 and 0.91, respectively) and transverse abdomini thickness (0.73 and 0.85, respectively). Conclusions: Rehabilitative ultrasonography is a reliable and non-invasive instrument to measure muscle thickness. The method used in this study is a reliable way to measure lumbar stabilizing muscles. PMID:25763078

  18. Usefulness of pelvic ultrasonography for the diagnosis of central precocious puberty in girls

    PubMed Central

    Yu, Jung; Shin, Ha Young; Lee, Sun Hee; Kim, You Sung

    2015-01-01

    Purpose It is difficult to differentiate between central precocious puberty (CPP) and premature thelarche (PT) in girls. The aim of this study was to investigate the diagnostic usefulness of pelvic ultrasonography to distinguish between CPP and PT in girls with early breast development. Methods This study included girls with early breast development who visited the clinic between January 2012 and December 2013. Clinical, laboratory, and pelvic ultrasonographic data were evaluated. CPP and PT were confirmed using the gonadotropin-releasing hormone stimulation test. Results A total of 248 girls aged 7-8 years were included, among whom 186 (75.0%) had CPP and 62 (25.0%) had PT. The uterine length, transverse diameter, fundus, volume, and cross-sectional area were significantly larger in the CPP group (uterine length, 2.45±0.50 cm vs. 2.63±0.49 cm, P=0.015; uterine volume, 0.95±0.62 cm3 vs. 1.35±0.76 cm3, P<0.001). However, there were no differences in the fundus/cervix ratio and ovarian measurements. In receiver operating characteristic analysis, a uterine volume of at least 1.07 cm3 was the most predictive parameter for CPP with an area under the curve of 0.670 (95% confidence interval, 0.593-0.747). Conclusion Uterine measurements by pelvic ultrasonography in girls with early pubertal development were significantly larger in the CPP group. However, the diagnostic value of ultrasonographic parameters was not high because of a considerable overlap of values between the two groups. Therefore, pelvic ultrasonography in combination with clinical and laboratory tests may be useful to distinguish between CPP and PT in girls. PMID:26388894

  19. Ultrasonography and the ultrasound-based management of thyroid nodules: consensus statement and recommendations.

    PubMed

    Moon, Won-Jin; Baek, Jung Hwan; Jung, So Lyung; Kim, Dong Wook; Kim, Eun Kyung; Kim, Ji Young; Kwak, Jin Young; Lee, Jeong Hyun; Lee, Joon Hyung; Lee, Young Hen; Na, Dong Gyu; Park, Jeong Seon; Park, Sun Won

    2011-01-01

    The detection of thyroid nodules has become more common with the widespread use of ultrasonography (US). US is the mainstay for detecting and making the differential diagnosis of thyroid nodules as well as for providing guidance for a biopsy. The Task Force on Thyroid Nodules of the Korean Society of Thyroid Radiology has developed recommendations for the US diagnosis and US-based management of thyroid nodules. The review and recommendations in this report have been based on a comprehensive analysis of the current literature, the results of multicenter studies and from the consensus of experts. PMID:21228935

  20. Relationship of Elongated Styloid Process in Digital Panoramic Radiography with Carotid Intima Thickness and Carotid Atheroma in Doppler Ultrasonography in Osteoporotic Females

    PubMed Central

    Hamedani, Shahram; Dabbaghmanesh, Mohammad Hossein; Zare, Zahra; Hasani, Mahvash; Torabi Ardakani, Mahshid; Hasani, Mahsa; Shahidi, Shoaleh

    2015-01-01

    Statement of the Problem Cardiovascular disease and osteoporosis are major health dilemmas. Osteoporotic patients frequently display vascular calcification that consequently increases the cardiovascular morbidity and mortality. Purpose This study aimed to investigate the relation of osteoporosis, vascular calcification (atheroma, intima-media thickness (IMT)) and elongated styloid process (ESP) in a sample of osteoporotic and normal female individuals. Materials and Method This study recruited 78 women who were assessed for bone mass density (BMD). Sample included individuals with normal BMD (n=13, 17 %), osteopenia (n=36, 46 %), and osteoporosis (n=29, 37%). The presence of atheroma and IMT was examined using color Doppler ultrasonography (CD-US). In addition, digital panoramic radiographs (PRs) were obtained to assess ESP. Results In this study, 55 subjects (70%) with low BMD exhibited at least one side ESP. Femoral BMD decreased significantly in subjects with ESP (p= 0.03). Bilateral ESP was correlated with the presence of atheroma (p= 0.029). The CIMT was greater in patients with ESP, although the relation was not significant. Conclusion The obtained data suggest referring the aged individuals with ESP for BMD assessment and individuals with low bone mass and ESP for more cardiovascular risk assessment. PMID:26046104

  1. Diagnosis of luteal and follicular ovarian cysts by palpation per rectum and linear-array ultrasonography in dairy cows.

    PubMed

    Farin, P W; Youngquist, R S; Parfet, J R; Garverick, H A

    1992-04-15

    The purpose of this study was to determine and compare the accuracy of palpation per rectum and linear-array ultrasonography for diagnosing follicular vs luteal ovarian cysts in cows. Forty-seven examinations of ovarian cysts from 28 cows were diagnosed by palpation per rectum as either a firm, thick-walled structure (luteal cyst) or a soft, thin-walled structure (follicular cyst) during weekly herd examinations. The ovaries of each cow were then examined by ultrasonography. Ultrasonograms of cysts greater than 25 mm in diameter were diagnosed as luteal or follicular cysts and were recorded on videotape for evaluation by a second clinician. Serum progesterone concentrations at the time of examination were determined by radioimmunoassay and used to classify luteal (greater than 0.5 ng/ml) or follicular (less than or equal to 0.5 ng/ml) cysts. Selection of this discriminatory level was based on response of a proportion of cows with luteal cysts that were given 25 mg of prostaglandin F2 alpha at the time of diagnosis by ultrasonography. Sensitivity and specificity of palpation per rectum for diagnosis of type of ovarian cyst were low (43.3 and 64.7%, respectively). In contrast, sensitivity and specificity of ultrasonography were considerably higher (86.7 and 82.3%, respectively). Agreement between the 2 methods of diagnosis was 57.4%. Overall agreement between the 2 clinicians' diagnoses by ultrasonography was 85.1%. On the basis of our findings, we confirm that luteal and follicular cysts cannot be accurately differentiated by palpation per rectum alone. These data suggest that linear-array ultrasonography is more effective than palpation per rectum for diagnosing type of ovarian cyst in cows. PMID:1607312

  2. Current prevalence of goiter determined by ultrasonography and associated risk factors in a formerly iodine-deficient area of Turkey.

    PubMed

    Kocak, Mustafa; Erem, Cihangir; Deger, Orhan; Topbas, Murat; Ersoz, Halil Onder; Can, Emine

    2014-09-01

    The aim of this study was to determine the prevalence of goiter and related risk factors in an adult population in a formerly iodine-deficient area of Turkey. In this cross-sectional study, we enrolled 2,500 subjects (1,270 women and 1,230 men, aged over 20 years) by multistage sampling. Blood and urine specimens were collected for the assessment of thyroid function. Thyroid ultrasonography (USG) was performed to measure thyroid volume and evaluate nodules. The overall goiter prevalence was 26.5 % (28.4 % in women, 24.5 % in men, P < 0.05). Median thyroid volume was 15.59 mL (13.65 mL in women, 17.96 mL in men, P < 0.0001). Median urinary iodine was 122.79 ?g/L. USG revealed thyroid nodules in 35.2 % of the subjects (38.4 % in women, 31.8 % in men, P < 0.005). Age group analysis revealed the lowest rate in the 20-29-year age group (12.5 %), which increased with age, reaching the highest level (38.4 %) in the 70+ years age group. The prevalence of goiter was negatively correlated with education level and positively correlated with body mass index (BMI) and positive family history. According to occupation, goiter prevalence was highest in farmers (35.3 %) and housewives (32.2 %). Despite a normal range of current urinary iodine excretion levels, prevalence of goiter in this adult population in a formerly iodine-deficient province of Turkey remained high, even about 10 years after salt iodine supplementation program introduction. In addition, the goiter prevalence was higher for female gender, advanced age, positive family history of goiter, low education level, and high BMI. PMID:24415172

  3. Quantitative analysis of contrast-enhanced ultrasonography in acute radiation-induced liver injury: An animal model

    PubMed Central

    FENG, JUN; CHEN, SHU-BO; WU, SHU-JUN; SUN, PING; XIN, TIAN-YOU; CHEN, YING-ZHEN

    2015-01-01

    The aim of the present study was to examine and assess contrast-enhanced ultrasound in the early diagnosis of acute radiation-induced liver injury in a rat model. Sixty female rats were used, with 50 rats being utilized to produce an animal model of liver injury with a single dose of stereotactic X-ray irradiation of 20 Gy. Ten rats from the injury group and 2 rats from the control group were randomly selected on days 3, 7, 14, 21 and 28, and examined by contrast-enhanced ultrasound and histopathology of liver specimens. The rats were divided into four groups: the normal control group, mild, moderate, and severe radioactive liver injury groups based on the histopathological examination results. Hepatic artery arriving time (HAAT) and hepatic vein arriving time (HVAT) were recorded, and hepatic artery to vein transit time (HA-HVTT) was calculated. The time-intensity curve of liver parenchyma, the time to peak (TTP) and peak intensity (PI) were also obtained. Significant differences were observed between liver injury and control groups for PI and HA-HVTT (P<0.05). PI and HA-HVTT were shorter in the severe liver injury group compared to the mild and moderate liver injury groups (P<0.05). Compared to the control group, higher TTP was recorded in all the liver injury groups (P<0.05), and the highest TTP level was observed in the severe liver injury group compared to the mild or moderate group (P<0.05). However, no significant difference was observed between the mild and moderate groups for PI, HA-HVTT and TTP. In conclusion, the results showed that contrast-enhanced ultrasonography is useful for an earlier diagnosis in a rat model of acute radiation-induced liver injury.

  4. Should Complete and Incomplete Spinal Cord Injury Patients Receive the Same Attention in Urodynamic Evaluations and Ultrasonography Examinations of the Upper Urinary Tract?

    ERIC Educational Resources Information Center

    Akkoc, Yesim; Cinar, Yasemin; Kismali, Erkan

    2012-01-01

    The aim of the study was to compare urodynamic findings and upper urinary tract (UUT) abnormalities detected by ultrasonography in complete and incomplete suprasacral spinal cord injury (SCI) patients with neurogenic detrusor overactivity. Thirty-eight suprasacral SCI patients who underwent ultrasonography evaluation of the UUT and urodynamic…

  5. The Use of Contrast-enhanced Ultrasonography for Imaging of Carotid Atherosclerotic Plaques: Current Evidence, Future Directions.

    PubMed

    Saha, Sandeep A; Gourineni, Venu; Feinstein, Steven B

    2016-02-01

    Contrast-enhanced ultrasonography (CEUS) is a rapidly evolving modality for imaging carotid artery disease and systemic atherosclerosis. CEUS coupled with diagnostic ultrasonography predicts the degree of carotid artery stenosis and is comparable with computed tomography and magnetic resonance angiography. This article reviews the literature on the evolving role of CEUS for the identification and characterization of carotid plaques with an emphasis on detection of intra-plaque neovascularization and related high-risk morphologic features notably present in symptomatic patients. CEUS carotid imaging may play a prominent additive role in risk stratifying patients and serve as a powerful tool for monitoring therapeutic interventions. PMID:26610662

  6. Application of high-frequency ultrasonography in closing small blood vessels

    PubMed Central

    Malinowska, Sylwia

    2014-01-01

    One of the most common treatments performed in phlebological and aesthetic medicine clinics is closing small blood vessels in the lower extremities, so-called telangiectasias and reticular vessels. Currently, there are several methods that allow for closing the dilated vessels and obtaining desirable effects, both therapeutic and aesthetic. Unfortunately, despite applying various methods and instruments, the effects of treatments are frequently not satisfactory. The factor that largely contributes to decreasing the efficacy of such procedures is complicated anatomy of the venous system and the lack of a method to precisely specify the vessel's course, its diameter, location in the skin etc. High-frequency ultrasonography is a method enabling accurate determination of the vessels’ course as well as the measurement of their basic parameters, such as diameter, depth in the skin and presence or absence of perfusion. Thanks to ultrasound imaging with the use of high-frequency transducers, an adequate treatment method and procedure parameters may be selected, which entails enhancing the efficacy of the procedure itself. Ultrasonography may be also used for monitoring the performed procedures. PMID:26674921

  7. Case-control study of prenatal ultrasonography exposure in children with delayed speech.

    PubMed Central

    Campbell, J D; Elford, R W; Brant, R F

    1993-01-01

    OBJECTIVE: To determine whether there is an association between prenatal ultrasound exposure and delayed speech in children. DESIGN: Case-control study. SETTING: Network of community physicians affiliated with the Primary Care Research Unit, University of Calgary. SUBJECTS: Thirty-four practitioners identified 72 children aged 24 to 100 months who had undergone a formal speech-language evaluation and were found to have delayed speech of unknown cause by a speech-language pathologist. For each case subject the practitioners found two control subjects matched for sex, date of birth, sibling birth order and associated health problems. MAIN OUTCOME MEASURES: Rates of prenatal ultrasound exposure and delayed speech. RESULTS: The children with delayed speech had a higher rate of ultrasound exposure than the control subjects. The findings suggest that a child with delayed speech is about twice as likely as a child without delayed speech to have been exposed to prenatal ultrasound waves (odds ratio 2.8, 95% confidence limit 1.5 to 5.3; p = 0.001). CONCLUSION: An association between prenatal ultrasonography exposure and delayed speech was found. If there is no obvious clinical indication for diagnostic in-utero ultrasonography, physicians might be wise to caution their patients about the vulnerability of the fetus to noxious agents. PMID:8221427

  8. Contrast-enhanced ultrasonography evaluation after autologous fat grafting in scar revision

    PubMed Central

    BOLLERO, D.; POZZA, S.; GANGEMI, E.N.; DE MARCHI, A.; GANEM, J.; EL KHATIB, A.M.; FALETTI, C.; STELLA, M.

    2014-01-01

    Aim Fat transfer is commonly used to fill loss of volume in depressed scars caused by trauma, deep burns or surgery. The aim of the study is to investigate the degree of fat graft take through evaluation of the microcirculation of grafted autologous adipose tissue using contrast-enhanced ultrasonography. Patients and method From 2010 to 2012 at the Department of Plastic and Reconstructive Surgery of the Traumatological Center in Turin, a study population was selected from patients with surgical indications for autologous fat transfer for scar correction. For each surgical procedure patients underwent a clinical and sonographic evaluation before and after intervention (at 1 month and 3 months). Results Out of a total of 28 interventions, 24 showed a good result; defined as improvement of the scar, and confirmed by the presence of vascularization in the transplanted tissue. In 4 cases, there was a lack of blood supply at the first evaluation but an initial good clinical scar correction. The absence of blood vessels was confirmed at 3 months accompanied by complete resorption of the transferred fat with a failure of good clinical outcome. Conclusion Contrast-enhanced ultrasonography was able to evaluate the microvasculature of adipose tissue after fat transfer. Due to this characteristic, it allows to monitor and predict the take of adipose tissue and provide realistic and early information on the clinical outcome of fat transfer. PMID:25644727

  9. Transvaginal sonography of adnexal masses.

    PubMed

    Coleman, B G

    1992-07-01

    In conclusion, the clinical utility of TVS has expanded since its inception so that numerous gynecologic applications now exist. TVS has most certainly had a major impact upon the diagnosis of adnexal disease. The addition of duplex and color Doppler capability to vaginal probes has expanded further the scope of TVS. In our laboratory, TVS is used as an adjunctive tool to complement TAS in cases of inadequate bladder distention, incomplete evaluation of the pelvis, and equivocal findings that require improved visualization for diagnosis. TVS is now recognized as the procedure of choice in the evaluation of patients who have a suspected ectopic pregnancy. It also can be used as the initial procedure in the follow-up of a known adnexal process. This article has emphasized how TVS can contribute to the diagnosis of cystic, complex, and solid adnexal masses. With continued technologic advancements, additional applications for TVS are likely to emerge. PMID:1631277

  10. Use of Audible and Chart-recorded Ultrasonography to Monitor Fetal Heart Rate and Uterine Blood Flow Parameters in Cattle

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of the present study was to evaluate the use of audible chart-recorded doppler ultrasonography (DUS) to monitor both uterine blood flow and fetal heart rate (FHR) during pregnancy in dairy cattle. Possible applications of DUS include the monitoring of fetal distress when a pregnancy be...

  11. Do Human Fetuses Anticipate Self-Oriented Actions? A Study by Four-Dimensional (4D) Ultrasonography

    ERIC Educational Resources Information Center

    Myowa-Yamakoshi, Masako; Takeshita, Hideko

    2006-01-01

    Using four-dimensional (4D) ultrasonography, arm and hand movements toward the face were examined in 27 human fetuses at 19 to 35 weeks of gestation, thereby enabling the continuous monitoring of their faces and other surface features such as the extremities. More than half of the observed arm movements resulted in the hand touching the mouth…

  12. Ultrasonography-Based Thyroidal and Perithyroidal Anatomy and Its Clinical Significance

    PubMed Central

    Ha, Eun Ju; Lee, Jeong Hyun

    2015-01-01

    Ultrasonography (US)-guided procedures such as ethanol ablation, radiofrequency ablation, laser ablation, selective nerve block, and core needle biopsy have been widely applied in the diagnosis and management of thyroid and neck lesions. For a safe and effective US-guided procedure, knowledge of neck anatomy, particularly that of the nerves, vessels, and other critical structures, is essential. However, most previous reports evaluated neck anatomy based on cadavers, computed tomography, or magnetic resonance imaging rather than US. Therefore, the aim of this article was to elucidate US-based thyroidal and perithyroidal anatomy, as well as its clinical significance in the use of prevention techniques for complications during the US-guided procedures. Knowledge of these areas may be helpful for maximizing the efficacy and minimizing the complications of US-guided procedures for the thyroid and other neck lesions. PMID:26175574

  13. Finding of Biliary Fascioliasis by Endoscopic Ultrasonography in a Patient with Eosinophilic Liver Abscess

    PubMed Central

    Behzad, Catherine; Lahmi, Farhad; Iranshahi, Majid; Alizadeh, Amir Houshang Mohammad

    2014-01-01

    Fascioliasis is an endemic zoonotic disease in Iran. It occurs mainly in sheep-rearing areas of temperate climates, but sporadic cases have been reported from many other parts of the world. The usual definitive host is the sheep. Humans are accidental hosts in the life cycle of Fasciola. Typical symptoms may be associated with fascioliasis, but in some cases diagnosis and treatment may be preceded by a long period of abdominal pain and vague gastrointestinal symptoms. We report a case with epigastric and upper quadrant abdominal pain for the last 6 months, with imaging suggesting liver abscess and normal biliary ducts. The patient had no eosinophilia with negative stool examinations, so she was initially treated with antibiotics for liver abscess. Her clinical condition as well as follow-up imagings showed appropriate response after antibiotic therapy. Finally, endoscopic ultrasonography revealed Fasciola hepatica, which was then extracted with endoscopic retrograde cholangiopancreatography. PMID:25473389

  14. Our experience in transrectal ultrasonography and biopsy in carcinoma of the prostate.

    PubMed

    Solivetti, F M; Bacaro, D; De Majo, A; Coscarella, G; Cecconi, P

    2003-09-01

    The Authors present a short review of the literature comparing transrectal ultrasound of the prostate (TRUS) and ultrasound guided biopsy and the results of 694 consecutive prostatic biopsies from their cohort. All the biopsies were US guided with an endorectal biplanar 5 MHz probe and transperineal samples were carried out with an 18 G needle (cutting length 22 mm) over the last 4 years. The histological exam showed 187 prostates affected by cancer while 112 had only inflammation. The operator's opinion, based on ultrasonography and integrated with a digital rectal exam (DRE) and a prostate specific antigen (PSA) blood test, was correct in 80% of the cases, with 90% sensitivity and 70% specificity. The positive prediction rate was 74% and the negative prediction rate was 89%. PMID:14582696

  15. Dual thyroid ectopia-role of thyroid scintigraphy and neck ultrasonography.

    PubMed

    Jain, Tarun Kumar; Meena, Ram Singh; Bhatia, Anmol; Sood, Ashwani; Bhattacharya, Anish; Mittal, Bhagwant Rai

    2015-01-01

    Ectopic thyroid tissue (ETT) is a rare developmental anomaly of the thyroid tissue where the thyroid gland is not located in its usual position. Dual thyroid ectopia is far rarer. This case of a 5-year-old euthyroid girl with thyroglossal cyst was planned for surgery. Presurgical ultrasonography (USG) of the neck followed by thyroid scintigraphy was performed. There was absent normal thyroid gland with single ETT in neck swelling on USG. However, thyroid scintigraphy revealed two ectopic foci of thyroid tissue; one was corresponding to neck swelling, and other was superior to it at the base of the tongue along with absent eutopic thyroid gland. The repeat neck USG could demonstrate the same. The present case emphasizes that, if the thyroid gland is not visible by USG; ETT should be evaluated with thyroid scintigraphy in case of thyroid dysgenesis. PMID:26430320

  16. Transient gallbladder distention in sick premature infants: the value of ultrasonography and radionuclide scintigraphy.

    PubMed

    el-Shafie, M; Mah, C L

    1986-01-01

    Transient gallbladder distention in sick premature infants has been reported with increasing frequency over the last few years. It is important to be aware of this entity of gallbladder disease which resolves spontaneously and to be able to differentiate it from other problems that require surgical correction. We believe that ultrasonography is most helpful in confirming the diagnosis, excluding stone formation, and documenting any changes in size or appearance. However, there are no reliable ultrasonic criteria for distinguishing inflamed or pathologically distended gallbladders from noninflamed or temporarily enlarged gallbladders. Radioisotope imaging, though useful in demonstrating malfunction of the hepatobiliary system, should be interpreted with caution. In the final analysis, the dilemma as to whether gallbladder distention is a transient or persistent malfunction can be settled best by thoughtful clinical judgement. PMID:3534774

  17. Recurrent pyogenic cholangitis in Asian immigrants: use of ultrasonography, computed tomography, and cholangiography

    SciTech Connect

    Federle, M.P.; Cello J.P.; Laing, F.C.; Jeffery, R.B. Jr.

    1982-04-01

    Five cases of recurrent pyogenic cholangitis (RPC) were studied by ultrasonography, computed tomography (CT), and cholangiography. All patients were recent immigrants from the Orient or Indonesia and had had recurrent attacks of cholangitis for many years. The bile was infected by E. coli and the biliary ducts were dilated; in addition, extrahepatic bile-pigment calculi we represent in all 5 and intrahepatic calculi in 4. Abdominal ultrasound usually failed to demonstrate duct calculi and extrahepatic dilatation due to the soft, mud-like consistency of the stones. CT was successful in showing the calculi and the full extent of dilatation. The authors conclude that preoperative diagnosis of RPC is best achieved by awareness of the characteristic clinical presentation and the findings on abdominal CT. Preoperative cholangiography provides excellent detail, but poses the danger of biliary sepsis requiring antibiotics.

  18. Ultrasonography-Based Thyroidal and Perithyroidal Anatomy and Its Clinical Significance.

    PubMed

    Ha, Eun Ju; Baek, Jung Hwan; Lee, Jeong Hyun

    2015-01-01

    Ultrasonography (US)-guided procedures such as ethanol ablation, radiofrequency ablation, laser ablation, selective nerve block, and core needle biopsy have been widely applied in the diagnosis and management of thyroid and neck lesions. For a safe and effective US-guided procedure, knowledge of neck anatomy, particularly that of the nerves, vessels, and other critical structures, is essential. However, most previous reports evaluated neck anatomy based on cadavers, computed tomography, or magnetic resonance imaging rather than US. Therefore, the aim of this article was to elucidate US-based thyroidal and perithyroidal anatomy, as well as its clinical significance in the use of prevention techniques for complications during the US-guided procedures. Knowledge of these areas may be helpful for maximizing the efficacy and minimizing the complications of US-guided procedures for the thyroid and other neck lesions. PMID:26175574

  19. Endoscopic ultrasonography in the diagnosis and treatment of a gastric wall abscess.

    PubMed

    Mandai, Koichiro; Amamiya, Kana; Uno, Koji; Yasuda, Kenjiro

    2016-01-01

    A gastric wall abscess is rare and it can reportedly appear similar to a submucosal tumor on endoscopy. Few reports have described endoscopic ultrasonographic findings for a gastric wall abscess. An 84-year-old man was admitted to our hospital for tarry stools. Esophagogastroduodenoscopy showed an elevated lesion similar to a submucosal tumor at the posterior wall of the stomach. Erosion and a white coat were observed on top of the lesion. Endoscopic ultrasonography showed an anechoic lesion connected to the proper muscular layer with a hyperechoic area in the center of the lesion. The lesion was diagnosed as a gastric wall abscess using endoscopic ultrasound-guided fine-needle aspiration and was treated with endoscopic ultrasound-guided drainage. The final diagnosis was a gastric wall abscess presenting as gastrointestinal hemorrhage. The patient was discharged with internal drainage stents. Computed tomography performed 3 months after discharge did not show recurrence of the abscess. PMID:26703177

  20. Effect of increase in birth weight in a newborn on hip ultrasonography.

    PubMed

    Orak, Mehmet M; Karaman, Ozgur; Gursoy, Tugba; Cagirmaz, Talat; Oltulu, Ismail; Muratli, Hasan H

    2015-11-01

    Exposure to the pressure experienced by higher birth weight babies during the intrauterine period might cause hip dysplasia. The aim of this study is to determine the effect of birth weight in newborns on hip ultrasonography when the paternal and maternal risk factors are excluded. A total of 701 babies born at 38-42 gestational weeks were included in the study. Hip ultrasonography was performed within 7 days following birth using the Graf technique in the babies without risk factors for developmental dysplasia of the hip. Images obtained were controlled with respect to conformity to the Graf method and angular measurements were performed. According to the ? and ? angle values obtained, type 1A and 1B hips were categorized as mature; type 2A hips were categorized as immature; and type 2C, D, 3A, 3B, and 4 hips were categorized as pathological hips. The results obtained were analyzed for the effect of birth weight on the angular values and hip typing. The birth weight of the babies was 338?488±48?241?g (2030-6124?g). It was determined that the birth weight had no effect on the values of ? and ? angles in the male babies (P=0.21, 0.76). It was determined that increasing birth weight decreased the ? angle value (P=0.001) and caused no difference in the ? angle value (P=0.057) in the female babies. It was found that birth weight had no effect on hip typing in both female and male babies (P=0.060, 0.22). Increases in birth weights caused decreases in ultrasonographic ? angles only in female babies. PMID:26196367

  1. The role of preoperative ultrasonography, computed tomography, and sestamibi scintigraphy localization in secondary hyperparathyroidism

    PubMed Central

    Lee, Jae Bok; Kim, Woo Young

    2015-01-01

    Purpose The role of preoperative localization studies is controversial in surgery of secondary hyperparathyroidism (sHPT). The aim of study was to evaluate the accuracy of preoperative ultrasonography (USG), CT, and 99mTc sestamibi scintigraphy (MIBI) in localizing enlarged parathyroid glands and to find the impact of correct localization in successful parathyroidectomy. Methods We compared operative findings with the preoperative localization of ultrasonography, computerized tomography and sestamibi scintigraphy in 109 patients with sHPT and identified well-visualized locations of abnormal parathyroid glands by evaluating the sensitivity of each imaging study with regard to typical locations of glands. We investigated the effect of preoperative imaging localization on the surgical outcomes by measuring the intraoperative parathyroid hormone (ioPTH) decrement for positive or negative imaging localization. Results USG (91.5%) had the highest sensitivity and MIBI (56.1%) had the lowest among 3 modalities. The sensitivity of combined USG and CT (95.0%) was the highest among combined 2 modalities. The combination of all 3 modalities (95.4%) had the highest sensitivity among the combinations of modalities. The reduction of ioPTH in patients with positive imaging localization (86.6%) was greater than negative imaging localization (84.2%), with no significant difference (P = 0.586). The recurrence or persistence of sHPT was not correlated with preoperative imaging localization (19 patients in negative, 16 in positive; P = 0.14). Conclusion Preoperative imaging localization contributed to surgical success but not to surgical outcomes. The combination of ioPTH measurement with imaging localization might be valuable for better surgical results in sHPT. PMID:26665124

  2. Evaluation of the Effusion within Biceps Long Head Tendon Sheath Using Ultrasonography

    PubMed Central

    Park, In; Lee, Hyo-Jin; Kim, Sung-Eun; Bae, Sung-Ho; Lee, Kwang-Yeol; Park, Kwang-Sun

    2015-01-01

    Background Many shoulder diseases are related to glenohumeral joint synovitis and effusion. The purpose of the present study is to detect effusion within the biceps long head tendon sheath as the sign of glenohumeral joint synovitis using ultrasonography, and to evaluate the clinical meaning of effusion within the biceps long head tendon sheath. Methods A consecutive series of 569 patients who underwent ultrasonography for shoulder pain were reviewed retrospectively and ultimately, 303 patients were included. The authors evaluated the incidence and amount of the effusion within the biceps long head tendon sheath on the ultrasonographic short axis view. Furthermore, the authors evaluated the correlation between the amount of effusion within the biceps long head tendon sheath and the range of motion and the functional score. Results The effusion within the biceps long head tendon sheath was detected in 58.42% of the patients studied: 69.23% in adhesive capsulitis, 56.69% in rotator cuff tear, 41.03% in calcific tendinitis, and 33.33% in biceps tendinitis. The average amount of the effusion within the biceps long head tendon sheath was 1.7 ± 1.6 mm, and it was measured to be the largest in adhesive capsulitis. The amount of effusion within biceps long head tendon sheath showed a moderate to high degree of correlation with the range of motion, and a low degree of correlation with the functional score and visual analogue scale for pain in each type of shoulder disease. Conclusions The effusion within the biceps long head tendon sheath is closely related to the range of motion and clinical scores in patients with painful shoulders. Ultrasonographic detection of the effusion within the biceps long head tendon sheath might be a simple and easy method to evaluate shoulder function. PMID:26330958

  3. Bayesian estimation of the accuracy of the calf respiratory scoring chart and ultrasonography for the diagnosis of bovine respiratory disease in pre-weaned dairy calves.

    PubMed

    Buczinski, Sébastien; L Ollivett, Terri; Dendukuri, Nandini

    2015-05-01

    There is currently no gold standard method for the diagnosis of bovine respiratory disease (BRD) complex in Holstein pre-weaned dairy calves. Systematic thoracic ultrasonography (TUS) has been used as a proxy for BRD, but cannot be directly used by producers. The Wisconsin calf respiratory scoring chart (CRSC) is a simpler alternative, but with unknown accuracy. Our objective was to estimate the accuracy of CRSC, while adjusting for the lack of a gold standard. Two cross sectional study populations with a high BRD prevalence (n=106 pre-weaned Holstein calves) and an average BRD prevalence (n=85 pre-weaned Holstein calves) from North America were studied. All calves were simultaneously assessed using CRSC (cutoff used ? 5) and TUS (cutoff used ? 1cm of lung consolidation). Bayesian latent class models allowing for conditional dependence were used with informative priors for BRD prevalence and TUS accuracy (sensitivity (Se) and specificity (Sp)) and non-informative priors for CRSC accuracies. Robustness of the model was tested by relaxing priors for prevalence or TUS accuracy. The SeCRSC (95% credible interval (CI)) and SpCRSC were 62.4% (47.9-75.8) and 74.1% (64.9-82.8) respectively. The SeTUS was 79.4% (66.4-90.9) and SpTUS was 93.9% (88.0-97.6). The imperfect accuracy of CRSC and TUS should be taken into account when using those tools to assess BRD status. PMID:25794838

  4. Accuracy of axial length measurements from immersion B-scan ultrasonography in highly myopic eyes

    PubMed Central

    Yang, Qing-Hua; Chen, Bing; Peng, Guang-Hua; Li, Zhao-Hui; Huang, Yi-Fei

    2014-01-01

    AIM To evaluate the accuracy of axial length (AL) measurements obtained from immersion B-scan ultrasonography (immersion B-scan) for intraocular lens (IOL) power calculation in patients with high myopia and cataracts. METHODS Immersion B-scan, contact A-scan ultrasonography (contact A-scan), and the IOLMaster were used to preoperatively measure the AL in 102 eyes from 102 patients who underwent phacoemulsification and IOL implantation. Patients were divided into two groups according to the AL: one containing patients with 22 mm?AL<26 mm(group A) and the other containing patients with AL?26 mm (group B). The mean error (ME) was calculated from the difference between the AL measurement methods predicted refractive error and the actual postoperative refractive error. RESULTS In group A, ALs measured by immersion B-scan (23.48±1.15) didn't differ significantly from those measured by the IOLMaster (23.52±1.17) or from those by contact A-scan (23.38±1.20). In the same group, the standard deviation (SD) of the mean error (ME) of immersion B-scan (-0.090±0.397 D) didn't differ significantly from those of IOLMaster (-0.095±0.411 D) and contact A-scan (-0.099±0.425 D). In group B, ALs measured by immersion B-scan (27.97±2.21 mm) didn't differ significantly from those of the IOLMaster (27.86±2.18 mm), but longer than those measured by Contact A-scan (27.75±2.23 mm, P=0.009). In the same group, the standard deviation (SD) of the mean error (ME) of immersion B-scan (-0.635±0.157 D) didn't differ significantly from those of the IOLMaster (-0.679±0.359 D), but differed significantly from those of contact A-scan (-0.953±1.713 D, P=0.028). CONCLUSION Immersion B-scan exhibits measurement accuracy comparable to that of the IOLMaster, and is thus a good alternative in measuring AL in eyes with high myopia when the IOLMaster can't be used, and it is more accurate than the contact A-scan. PMID:24967188

  5. Evaluation of immersion 20 MHz B-scan ultrasonography in observing lens in the alkali burn eyes

    PubMed Central

    Yang, Qing-Hua; Chen, Bing; Wang, Li-Qiang; Peng, Guang-Hua; Li, Zhao-Hui; Huang, Yi-Fei

    2014-01-01

    AIM To evaluate the accuracy of 20 MHz immersion B-scan ultrasonography in observing lens and to investigate the value of this noninvasive preoperative diagnosis method in alkali burn eyes. METHODS It was a comparative study. Fifty-six cases (56 eyes) of alkali burn eyes were examined by ultrasound biomicroscopy (UBM) and immersion 20 MHz B-scan ultrasonography from June 2011 to April 2013, the images were analyzed, and the ultrasonographic diagnosis compared with the operation results. RESULTS In 56 alkali burn eyes examined by UBM, the lens were not detected in 16 eyes; the IOL could be detected in 2 eyes; the anterior lens capsule surface or/and the front lens could be detected in 18 eyes, and lens opacification in 3 eyes of them; suspected abnormal lens were detected in the other 20 eyes. In all the same eyes examined by immersion 20 MHz B-scan ultrasonography, the lens were not detected in 16 eyes; the IOL could be detected in 2 eyes; 24 abnormal lens (opacity, lens expansion, shrinkage) and 14 normal lens were found. Compared with the intraoperative findings, the diagnostic accordance rate of the immersion 20 MHz B-scan appearance of lens was 100% (56/56), which was significantly higher than examined by UBM 57.14% (32/56) (?2=30.55, P=0.0000). CONCLUSION Immersion 20 MHz B-scan ultrasonography can observe the lens accurately in alkali burn eyes. It has important clinical value to combine with UBM in eyes of alkali burn. PMID:25161933

  6. Intraoperative Ultrasonography during Drainage for Chronic Subdural Hematomas: A Technique to Release Isolated Deep-seated Hematomas-Technical Note.

    PubMed

    Shimizu, Satoru; Mochizuki, Takahiro; Osawa, Shigeyuki; Kumabe, Toshihiro

    2015-09-15

    After the drainage of chronic subdural hematomas (CSDHs), residual isolated deep-seated hematomas (IDHs) may recur. We introduce intraoperative ultrasonography to detect and remove such IDHs. Intraoperative ultrasonography is performed with fine transducers introduced via burr holes. Images obtained before dural opening show the CSDHs, hyper- and/or hypoechoic content, and mono- or multilayers. Images are also acquired after irrigation of the hematoma under the dura. Floating hyperechoic spots (cavitations) on the brain cortex created by irrigation confirm the release of all hematoma layers; areas without spots represent IDHs. Their overlying thin membranes are fenestrated with a dural hook for irrigation. Ultrasonographs were evaluated in 43 CSDHs (37 patients); 9 (21%) required IDH fenestration. On computed tomography scans, 17 were homogeneous-, 6 were laminar-, 16 were separated-, and 4 were trabecular type lesions. Of these, 2 (11.8%), 3 (50%), 4 (25%), and 0, respectively, manifested IDHs requiring fenestration. There were no technique-related complications. Patients subjected to IDH fenestration had lower recurrence rates (11.1% vs. 50%, p = 0.095) and required significantly less time for brain re-expansion (mean 3.78 ± 1.62 vs. 18 ± 5.54 weeks, p = 0.0009) than did 6 patients whose IDHs remained after 48 conventional irrigation and drainage procedures. Intraoperative ultrasonography in patients with CSDHs facilitates the safe release of hidden IDHs. It can be expected to reduce the risk of postoperative hematoma recurrence and to shorten the brain re-expansion time. PMID:26345671

  7. A comparative study on the diagnostic utility of ultrasonography with conventional radiography and computed tomography scan in detection of zygomatic arch and mandibular fractures

    PubMed Central

    Singh, Koijam Sashikumar; Jayachandran, S.

    2014-01-01

    Objectives: The objective of the following study is to evaluate the usefulness of ultrasonography (USG) in comparison with conventional radiography and computed tomography (CT) scan in the diagnosis of zygomatic arch and mandibular fractures. Materials and Methods: A total of 40 patients with suspected fracture of the zygomatic arch and/or mandibular fractures were included in the study. Two groups (one for zygomatic arch fractures and the other for mandibular fractures) of 20 patients each were designed for the study. Ultrasonographic examinations were performed using small linear probe (LA435, Siemens Acuson Antares) with 10 MHz frequency. Data from CT and conventional radiography were compared with that of USG. Results: Sensitivity and specificity of USG in assessing zygomatic arch fractures were 100% and 100%, respectively; and that of mandibular fractures were 94.74% and 100%, respectively. Overall sensitivity, specificity, positive predictive value, and negative predictive value of USG against CT in diagnosing zygomatic arch and mandibular fractures were found out to be 97.4%, 100%, 100%, and 66.7%, respectively. Conclusion: USG is a very reliable tool in detection of fractures involving zygomatic arch and mandible. It can be used for screening of suspected fractures of zygomatic arch and mandible to avoid unnecessary radiation exposure from conventional radiography and CT scans. PMID:24963239

  8. Role of Balloon-Sheathed Intraductal Ultrasonography for Patients with Extensive Pneumobilia

    PubMed Central

    Kim, Ha-Na; Park, Chang-Hwan; Cho, Eun-Ae; Rew, Soo-Jung; Park, In-Hyung; Lim, Sung-Uk; Jun, Chung-Hwan; Park, Seon-Young; Kim, Hyun-Soo; Choi, Sung-Kyu

    2015-01-01

    Intraductal ultrasonography (IDUS) is one of the most useful diagnostic tools for various extrahepatic biliary diseases. However, conventional IDUS has some limitations in providing accurate cross-sectional imaging of the bile duct in patients with extensive pneumobilia. Using a balloon-sheathed catheter, the US system (balloon-sheathed IDUS) can overcome these limitations. Sixteen patients underwent balloon-sheathed IDUS during endoscopic retrograde cholangiography. The balloon-sheathed IDUS was inserted via a transpapillary route when visualization of the bile duct with conventional IDUS was distorted by extensive pneumobilia. The patient group had a mean age of 65.5 years, and 56.3% (9/16) were male. The balloon-sheathed IDUS permitted successful visualization of the bile duct in all patients, regardless of the extent of pneumobilia. Using this system, remnant common bile duct stones were detected in five patients (31.3%), and cholangiocarcinoma was detected in one patient (6.3%). The balloon-sheath IDUS aided in stone sweeping. No significant complications, including bleeding, perforation, or pancreatitis, occurred in any of the patients. The balloon-sheathed catheter US system was useful and safe for biliary IDUS in patients with extensive pneumobilia. PMID:26033684

  9. Intraoperative ultrasonography and surgical strategy in hepatic resection: What difference does it make?

    PubMed Central

    Jrearz, Ricky; Hart, Richard; Jayaraman, Shiva

    2015-01-01

    Background With modern advancements in preoperative imaging for liver surgery, intraoperative ultrasonography (IOUS) may be perceived as superfluous. Our aim was to determine if IOUS provides new information that changes surgical strategy in hepatic resection. Methods We retrospectively analyzed 121 consecutive liver resections performed at a single institution. Preoperative computed tomography and/or magnetic resonance imaging determined the initial surgical strategy. The size, location and number of lesions were compared between IOUS and preoperative imaging. Reviewing the operative report helped determine if new IOUS findings led to changes in surgical strategy. Pathology reports were analyzed for margins. Results Of 121 procedures analyzed, IOUS was used in 88. It changed the surgical plan in 15 (17%) cases. Additional tumours were detected in 10 (11%) patients. A change in tumour size and location were detected in 2 (2%) and 3 (4%) patients, respectively. Surgical plans were altered in 7 (8%) cases for reasons not related to IOUS. There was no significant difference (p = 0.74) in average margin length between the IOUS and non-IOUS groups (1.09 ± 1.18 cm v. 1.18 ± 1.05 cm). Conclusion Surgical strategy was altered owing to IOUS results in a substantial number of cases, and IOUS-guided resection planes resulted in R0 resections in nearly all procedures. The best operative plan in hepatic resection includes IOUS. PMID:26384146

  10. Extraesophageal saline enhances endoscopic ultrasonography to differentiate esophagus and adjacent organs

    PubMed Central

    Li, Jian-Jun; Shan, Hong-Bo; He, Long-Jun; Wang, Thomas D; Xiong, Huan; Chen, Li-Ming; Li, Xiao-Hai; Huang, Xin-Xin; Luo, Guang-Yu; Li, Yin; Xu, Guo-Liang

    2014-01-01

    AIM: To distinguish between the esophagus and adjacent organs using extraesophageal saline injection (ESI) in a canine model. METHODS: ESI was performed through the esophagus under the guidance of linear-array endoscopic ultrasonography (EUS). Approximately 15 mL of methylene blue saline (0.5%) was then injected through each of the extraesophageal puncture points using a 22 G needle. Radial EUS examinations were conducted before and after ESI. EUS images of the trachea, tracheal bifurcation, arcus aortae and thoracic aorta were recorded. Vital signs were monitored during the ESI procedure and EUS examination. The dogs were then sacrificed for exploratory thoracotomy. RESULTS: No obvious fluctuation in vital signs or serious adverse events occurred during the ESI procedure. On EUS imaging, an apparent hypoechoic area outside the esophagus, which separated the esophagus and adjacent organs, was visualized. The adventitious of the esophagus and adjacent organs were easily distinguished. The findings of subsequent exploratory thoracotomy confirmed the EUS findings: obvious accumulation of a blue liquid in the extraesophageal tissues, as well as in the esophageal-thoracic aorta space, esophageal-arcus aortae space and esophageal-tracheal space. CONCLUSION: The esophagus and adjacent organs were successfully separated by ESI, and extraesophageal saline acted as an effective ultrasonic contrast agent. PMID:25253957

  11. Idiopathic Carpal Tunnel Syndrome: Evaluation of the Depth of the Carpal Tunnel by Ultrasonography.

    PubMed

    Elsaman, Ahmed Mohammed Mahrous Yousif; Thabit, Mohamed Nasreldin; Radwan, Ahmed Roshdy Al-Agamy; Ohrndorf, Sarah

    2015-11-01

    The objective of the work described here was to evaluate the depth of the carpal tunnel (DCT) in patients with idiopathic carpal tunnel syndrome (CTS) and healthy volunteers by ultrasonography (US), through measurement of the distance from the flexor retinaculum to the surface of the capitate bone at the carpal tunnel outlet, and compare it with other ultrasonographic and electrophysiologic parameters in CTS. The study was conducted in 60 non-diabetic patients with idiopathic carpal tunnel syndrome (unilateral n = 37, bilateral n = 23) evidenced by electrophysiologic diagnosis according to the criteria of the American Association of Electrodiagnostic Medicine (AAEM). Furthermore, 40 hands from 20 healthy volunteers were examined. Median nerve cross-sectional area (CSA); flattening ratio (FR), the ratio of the length to the width of the median nerve; and DCT at the canal outlet were measured for all participants. The mean age was 35.6 ± 9.48 y. The female-to-male ratio was 47:13 in the CTS patients. The sensitivity and specificity were 82% and 95% for CSA, 75% and 60% for FR and 75% and 87.5% for DCT, respectively. Differences between patients and healthy controls were significant for all three parameters, greatest for DCT, followed by CSA and then FR. We conclude that DCT increased in CTS and this new parameter is comparable in sensitivity and specificity to CSA and FR. DCT increased independently of the cause of the CTS (decrease in size of canal or increase in contents). PMID:26272109

  12. Use of B-mode ultrasonography for fetal sex determination in dogs.

    PubMed

    Gil, E M U; Garcia, D A A; Giannico, A T; Froes, T R

    2015-10-01

    Ultrasonographic determination of fetal sex in dogs has not previously been reported. The aim of this study was to describe a method for determination of intrauterine fetal sex using ultrasound. A cohort study was conducted in pregnant bitches to perform ultrasound examination of the fetal genitalia between the eighth and ninth week of gestation. Fetal sex was determined in utero by consensus agreement of two sonographers. Eighteen pregnant bitches were included in this study, and a total of 39 fetuses were evaluated. The accuracy of ultrasonography to determine the sex with a 95% confidence interval was 62.24% to female fetuses and 65.48% to male fetuses. The sonographic accuracy in determining fetal sex can be achieved at 100% when there are up to two fetuses in the litter; however, the accuracy of the technique reduces (66.7%) when more than three fetuses are present. This study describes the sonographic appearance of the external genitalia in canine fetuses in utero associated with a specific position of the fetus and reports that sex determination is possible between 55 and 58 days of gestation. PMID:26116058

  13. Contrast-enhanced ultrasonography: advance and current status in abdominal imaging

    PubMed Central

    2015-01-01

    In the field of contrast-enhanced ultrasonography (US), contrast agents are classified as either first- or second-generation agents depending on the gas within the microbubbles. In the case of first-generation contrast agents, a high-mechanical-index technique is used and only intermittent scanning is possible due to the early destruction of the microbubbles during the scanning. The use of second-generation contrast agents in a low-mechanical-index technique enables continuous scanning. Besides the detection and characterization of focal liver lesions, contrastenhanced US is helpful in the monitoring of radiofrequency ablation therapy and in the targeting step of an US-guided biopsy. Recently, there has been a demand for new criteria to evaluate the treatment response obtained using anti-angiogenic agents because morphologic criteria alone may not reflect the treatment response of the tumor and contrast-enhanced US can provide quantitative markers of tissue perfusion. In spite of the concerns related to its cost-effectiveness, contrast-enhanced US has the potential to be more widely used as a complimentary tool or to substitute the current imaging modalities in some occasions. PMID:25342120

  14. Evaluation of the use of ultrasonography in the study of liquid gastric emptying

    SciTech Connect

    Marzio, L.; Giacobbe, A.; Conoscitore, P.; Facciorusso, D.; Frusciante, V.; Modoni, S.

    1989-05-01

    Gastric emptying of two different test liquid meals (500 ml isotonic saline and 500 ml skimmed milk, 1.8% fat) has been measured in 10 (saline) and in 19 (milk) normal volunteers by means of real-time ultrasonography (RUS) and scintigraphy, employed simultaneously. In each subject, saline and milk contained 37 MBq of diethylenetriaminopentacetic acid (DPTA) marked with 99mTc. Determinations were made thereafter every 5 min up to 45 min with saline and every 30 min up to a maximum of 220 min with milk. The determination of gastric emptying by RUS was obtained indirectly through the measurement of gastric dimensions, with a single scan performed at the epigastrium, while the subject was kept in a standing position. At each observation, the percent decrease of gastric measurements and the decay in radioactivity over the gastric region were calculated, blind, by two independent examiners. Linear regression and correlation coefficient were subsequently computed for gastric measurements and decay in radioactivity. The results show that the values obtained with RUS do not differ grossly from the ones obtained with scintigraphy. This suggests that the ultrasonographic determination of gastric dimensions with a single section of the stomach may be a valuable method for use in the evaluation of gastric emptying of liquids.

  15. Contrast ultrasonography--a necessary procedure for a better characterization of digestive tract pathology.

    PubMed

    Badea, Radu; Ciobanu, Lidia; Gomotirceanu, Adriana; Hagiu, Claudia; Socaciu, Mihai

    2010-03-01

    The pathology of the digestive tract, extremely popular, with equal sex distribution, can have a clinical history of chronic illness or emergency. Diagnosis is based on endoscopy (identifies the lesion, permits histological sample under visual control, and minimally invasive treatment for polypoid benign tumors). Ultrasonography, being non-invasive and very accessible, is often used as the initial imaging procedure to detect or exclude digestive pathology with similar symptoms. Understanding digestive ultrasound is conditioned by the image quality which can be achieved by removing air and food debris. Even so, the characteristics of the inflammatory diseases and the detection of tumors, particularly those with endoluminal development, can be difficult. In recent years transabdominal ultrasound examination of the digestive tract was supplemented with more precise methods of investigation of the lumen and circulation of the intestinal wall. These methods are represented by the administration of oral or ano-rectal homogenous substances (hydrosonography) and the by intravenous administration of agents containing stabilized microbubbles (CEUS). With these methods useful information are being obtained, high in sensitivity and specificity of lesions characterization. Judicious selection of the cases and of the examination technique remains the key to a successful diagnosis in all situations. PMID:21165458

  16. Sensitivity of hepatobiliary imaging and real-time ultrasonography in the detection of acute cholecystitis

    SciTech Connect

    Fink-Bennett, D.; Freitas, J.E.; Ripley, S.D.; Bree, R.L.

    1985-08-01

    To determine the sensitivity of hepatobiliary imaging (HBI) and strict- and liberal-criteria real-time ultrasonography (RTUS), the authors retrospectively analyzed 100 cases of pathologically proved acute cholecystitis (AC). A positive HBI was one in which there was nonvisualization of the gallbladder up to four hours after the administration of technetium 99m-disofenin. In the absence of hypoalbuminemia, cirrhosis, or ascites, pathognomonic RTUS findings (strict criteria) for AC were wall edema and/or pericholecystic fluid. Findings indicative of AC (liberal criteria) included the demonstration of stones, a thick gallbladder wall, nonshadowing echoes, or the ultrasonographic Murphy's sign. Of the 100 cases of AC, 91 were calculous, and nine were acalculous. Four of 100 patients had associated choledocholithiasis. The sensitivities in detecting calculous AC were as follows: HBI, 97%; liberal-criteria RTUS, 86%; and strict-criteria RTUS, 24%. The sensitivities in detecting acalculous AC were as follows: HBI, 100%; liberal-criteria RTUS, 89%; and strict-criteria RTUS, 44%.

  17. Submandibular Lateral Ectopic Thyroid Tissue: Ultrasonography, Computed Tomography, and Scintigraphic Findings

    PubMed Central

    Çeliker, Metin; Beyazal Çeliker, Fatma; Turan, Arzu; Beyazal, Mehmet; Beyazal Polat, Hatice

    2015-01-01

    Ectopic thyroid can be encountered anywhere between the base of tongue and pretracheal region. The most common form is euthyroid neck mass. Herein, we aimed to present the findings of a female case with ectopic thyroid tissue localized in the left submandibular region. A 44-year-old female patient, who underwent bilateral subtotal thyroidectomy four years ago with the diagnosis of multinodular goiter, was admitted to our hospital due to a mass localized in the left submandibular area that gradually increased in the last six months. Neck ultrasonography, contrast-enhanced computed tomography, and scintigraphic examination were performed on the patient. On thyroid scintigraphy with Tc-99m pertechnetate, thyroid tissue activity uptake showing massive radioactivity was observed in the normal localization of the thyroid gland and in the submandibular localization. The focus in the submandibular region was excised. Pathological examination of the specimen showed normal thyroid follicle cells with no signs of malignancy. The submandibular mass is a rarely encountered lateral ectopic thyroid tissue. Accordingly, ectopic thyroid tissue should also be considered in the differential diagnosis of masses in the submandibular region. PMID:26634164

  18. Colon adenocarcinoma with dome-like phenotype: characteristic endoscopic ultrasonography (EUS) findings.

    PubMed

    Takagi, Wataru; Yamamoto, Katsumi; Amano, Takahiro; Sakamoto, Aisa; Otake, Yuriko; Saiki, Hirotsugu; Kondo, Hisashi; Urabe, Makiko; Takahashi, Kei; Yamamoto, Masashi; Hayashi, Shiro; Nakajima, Sachiko; Nishida, Tsutomu; Komori, Takamichi; Morita, Shunji; Adachi, Shiro; Inada, Masami

    2015-08-01

    An 80-year-old man underwent colonoscopy for proctorrhagia. Conventional white-light imaging showed a superficially flat and elevated lesion that appeared to be a submucosal tumor of the sigmoid colon. Chromoendoscopy with Indigo Carmine showed that the margin of the tumor was covered with normal epithelium but that there was a slight depression on its surface. Magnification endoscopy with Crystal Violet staining revealed the amorphous surface structure of the depressed lesion, but the surrounding mucosa showed a normal pit pattern. Endoscopic ultrasonography demonstrated that a hypoechoic mass was located in the submucosal layer, and a biopsy specimen obtained from the surface of the lesion showed evidence of adenocarcinoma. We then performed sigmoidectomy on the patient. Immunohistochemically, the tumor cells were positive for two mismatch repair proteins (MLH1 and MSH2), but in situ hybridization revealed that the specimen was negative for the Epstein?-?Barr virus. We finally diagnosed the lesion as adenocarcinoma with a dome-like phenotype of the sigmoid colon. PMID:26355327

  19. Efficacy of Ultrasonography at the Ankle Level for Estimation of Pedal Microcirculation.

    PubMed

    Sekiya, Naomi; Ichioka, Shigeru

    2015-01-01

    Chronic wounds due to diabetes mellitus (DM) and/or peripheral arterial disease (PAD) often occur in the pedal region peripheral to the ankle. To predict wound healing potential of limb ulcers, skin perfusion pressure (SPP) and transcutaneous oxygen tension (TcPO2) have recently become popular as the parameters that reflect skin microcirculation. On the other hand, ultrasonography for the macrocirculatory vessels has already prevailed widely as the standard vascular investigation. The skin microcirculation peripheral to the ankle probably depends on the macrocirculatory blood flow at the ankle level. Thus, this study aims to estimate whether the blood flow of the anterior tibial artery (ATA) and the posterior tibial artery, at the ankle level, reflect the values of SPP and TcPO2 on the foot. The protocol enrolled 88 patients (122 limbs) with foot ulcers due to DM and/or PAD. The statistical analysis revealed that the sum of blood flow of the ATA and the PTA (posterior tibial artery), at the ankle level, significantly correlated with SPP on the foot. The findings support the availability of conventional ultrasonographic investigation to estimate microcirculation of the foot crucial for wound healing. (This article is a translation of J Jpn Coll Angiol 2014; 54: 45-50.). PMID:26421067

  20. Comparison of renal ultrasonography and dimercaptosuccinic acid renal scintigraphy in febrile urinary tract infection.

    PubMed

    Ayazi, Parviz; Mahyar, Abolfazl; Noroozian, Elham; Esmailzadehha, Neda; Barikani, Ameneh

    2015-12-01

    Accurate and early diagnosis and appropriate treatment of patient with urinary tract infection (UTI) are essential for the prevention or restriction of permanent damage to the kidneys in children. The aim of this study was to compare renal ultrasonography (US) and dimercaptosuccinic acid (DMSA) renal scan in the diagnosis of patients with febrile urinary tract infection. This study involved the medical records of children with febrile urinary tract infection who were admitted to the children's hospital in Qazvin, Iran. Pyelonephritis was diagnosed on the basis of clinical symptoms, laboratory tests and abnormal DMSA renal scans. The criteria for abnormality of renal US were an increase or a decrease in diffuse or focal parenchymal echogenicity, loss of corticomedullary differentiation, kidney position irregularities, parenchymal reduction and increased kidney size. Of the 100 study patients, 23% had an abnormal US and 46% had an abnormal DMSA renal scan. Of the latter patients, 15 had concurrent abnormal US (P value ? 0.03, concordance rate: 18%). Renal US had a sensitivity of 32%, specificity of 85%, positive predictive value of 65% and negative predictive value of 60%. Of the 77 patients with normal US, 31 (40.2%) had an abnormal DMSA renal scan. Despite the benefits and accessibility of renal US, its value in the diagnosis of pyelonephritis is limited. PMID:26700082

  1. Use of Animated Cartoons with Children's Songs to Increase Compliance with Ultrasonography in Young Children

    PubMed Central

    Lim, Sok Hwan; Kim, Myung-Joon

    2013-01-01

    Purpose To evaluate the effect of animated cartoons with children's songs to increase compliance with ultrasonography (US) examination in young children. Materials and Methods Animated cartoons with children's songs viewed on a cell phone were played just before the start of US examination when pediatric patients were agitated or irritable. The effect of this method was evaluated for initial responses and sustained responses (grade 0, no response; 1, partial response; and 2, good response). Site of US examination, scan duration, and the helpfulness of this method (0, useless; 1, partially helpful; and 2, very helpful) were also recorded. Results Among 464 pediatric patients who underwent US during the study period, 88 children (19%) needed to be calmed (67 abdominal and 21 other parts of the body). All subjects were less than five years of age (mean 1.5 years), except for four patients with mental retardation. Scan duration was less than 5 minutes in almost all examinations. Five children refused to watch the cartoon. Initial responses were good in 75 and partial in eight children. Sustained responses were good in 70 and partial in 12 children. The cartoons were very helpful in 73 (83%) and partially helpful in nine (10%) children. The effect of watching the cartoon did not change with sex, age (less or more than one year), or site of examination. Conclusion Animated cartoons with children's songs viewed on a cell phone were helpful (93%) in increasing compliance with US examination in young children of both the abdomen and other parts. PMID:24142662

  2. Efficacy of Ultrasonography at the Ankle Level for Estimation of Pedal Microcirculation

    PubMed Central

    Ichioka, Shigeru

    2015-01-01

    Chronic wounds due to diabetes mellitus (DM) and/or peripheral arterial disease (PAD) often occur in the pedal region peripheral to the ankle. To predict wound healing potential of limb ulcers, skin perfusion pressure (SPP) and transcutaneous oxygen tension (TcPO2) have recently become popular as the parameters that reflect skin microcirculation. On the other hand, ultrasonography for the macrocirculatory vessels has already prevailed widely as the standard vascular investigation. The skin microcirculation peripheral to the ankle probably depends on the macrocirculatory blood flow at the ankle level. Thus, this study aims to estimate whether the blood flow of the anterior tibial artery (ATA) and the posterior tibial artery, at the ankle level, reflect the values of SPP and TcPO2 on the foot. The protocol enrolled 88 patients (122 limbs) with foot ulcers due to DM and/or PAD. The statistical analysis revealed that the sum of blood flow of the ATA and the PTA (posterior tibial artery), at the ankle level, significantly correlated with SPP on the foot. The findings support the availability of conventional ultrasonographic investigation to estimate microcirculation of the foot crucial for wound healing. (This article is a translation of J Jpn Coll Angiol 2014; 54: 45–50.) PMID:26421067

  3. Evaluation of clinical outcomes of patients with post-stroke wrist and finger spasticity after ultrasonography-guided BTX-A injection and rehabilitation training

    PubMed Central

    Jiang, Li; Dou, Zu-Lin; Wang, Qing; Wang, Qiao-Yuan; Dai, Meng; Wang, Zhen; Wei, Xiao-Mei; Chen, Ying-Bei

    2015-01-01

    Objective: Using ultrasonography (US) to guide botulinum toxin type A (BTX-A) injection in patients with post-stroke wrist and finger flexor muscle spasticity and assessing clinical outcomes after the injection and rehabilitation intervention. Methods: Twenty-three patients with wrist and finger spasticity after stroke were recruited in this study from May 2012 to May 2013. Under US guidance, the proper dose (250 U) of BTX-A was injected into each spastic muscle at two injection sites. Then, conventional rehabilitation training started next day after BTX-A injection. The degree of spasticity was assessed by modified Ashworth scale (MAS) and wrist and finger motor function by active rang of movement (AROM), and Fugl-Meyer assessment (FMA) at the baseline, 1, 2, 4 and 12 weeks after BTX-A injection. Results: Significant decreases (p < 0.02) in the MAS scores of both the finger flexor muscle tone and wrist flexor muscle tone measured at 1, 2, 4, and 12 weeks after the BTX-A injection were found in comparison with the baseline scores. Compared with the baseline, the AROM values of the wrist and finger extensions and the FMA scores of the wrist and hand significantly increased (p < 0.02) at 2, 4 and 12 weeks after the BTX-A injection. Conclusions: US-guided BTX-A injection combined with rehabilitation exercise decrease spasticity of the wrist and finger flexor muscles and improve their motor function in stroke patients up to 12 weeks following BTX-A injection. PMID:26388761

  4. Severity assessment in trauma patient.

    PubMed

    Raux, M; Vivien, B; Tourtier, J-P; Langeron, O

    2013-01-01

    Severity assessment in trauma patients is mandatory. It started during initial phone call that alerts emergency services when a trauma occurred. On-call physician assesses severity based on witness-provided information, to adapt emergency response (paramedics, emergency physicians). Initial severity assessment is subsequently improved based on first-responder provided informations. Whenever information comes, it helps providing adequate therapeutics and orientating the patient to the appropriate hospital. Severity assessment is based upon pre-trauma medical conditions, mechanism of injury, anatomical lesions and their consequences on physiology. Severity information can be summarized using scores, yet those are not used in France, except for post-hoc scientific purposes. Triage is usually performed using algorithms. Whatever the way triage is performed, triage tools are based on mortality as main judgement criterion. Other criteria should be considered, such as therapeutics requirements. The benefit of biomarkers of ultrasonography at prehospital setting remains to be assessed. PMID:23906735

  5. Contrast-Enhanced Ultrasonography of Hepatocellular Carcinoma After Chemoembolisation Using Drug-Eluting Beads: A Pilot Study Focused on Sustained Tumor Necrosis

    SciTech Connect

    Moschouris, Hippocrates; Malagari, Katerina; Papadaki, Marina Georgiou; Kornezos, Ioannis Matsaidonis, Dimitrios

    2010-10-15

    The purpose of this study was to assess the use of contrast-enhanced ultrasonography (CEUS) and the sustained antitumor effect of drug-eluting beads used for transarterial chemoembolisation (TACE) of unresectable hepatocellular carcinoma (HCC). Ten patients with solitary, unresectable HCC underwent CEUS before, 2 days after, and 35 to 40 days after TACE using a standard dose (4 ml) of drug-eluting beads (DC Beads; Biocompatibles, Surrey, UK) preloaded with doxorubicin (25 mg doxorubicin/ml hydrated beads). For CEUS, a second-generation contrast agent (SonoVue, Bracco, Milan, Italy) and a low mechanical-index technique were used. A part of the tumor was characterized as necrotic if it showed complete lack of enhancement. The percentage of necrosis was calculated at the sonographic section that depicted the largest diameter of the tumor. Differences in the extent of early (2 days after TACE) and delayed (35 to 40 days after TACE) necrosis were quantitatively and subjectively assessed. Early post-TACE tumor necrosis ranged from 21% to 70% (mean 43.5% {+-} 19%). There was a statistically significant (p = 0.0012, paired Student t test) higher percentage of delayed tumor necrosis, which ranged from 24% to 88% (mean 52.3% {+-} 20.3%). Subjective evaluation showed a delayed obvious increase of the necrotic areas in 5 patients. In 2 patients, tumor vessels that initially remained patent disappeared on the delayed follow-up. A part of tumor necrosis after chemoembolisation of HCC with DEB seems to take place later than 2 days after TACE. CEUS may provide evidence for the sustained antitumor effect of DEB-TACE. Nevertheless, the ideal time for the imaging evaluation of tumor response remains to be defined.

  6. Antiangiogenic effects of pazopanib in xenograft hepatocellular carcinoma models: evaluation by quantitative contrast-enhanced ultrasonography

    PubMed Central

    2011-01-01

    Background Antiangiogenesis is a promising therapy for advanced hepatocellular carcinoma (HCC), but the effects are difficult to be evaluated. Pazopanib (GW786034B) is a pan-vascular endothelial growth factor receptor inhibitor, the antitumor effects or antiangiogenic effects haven't been investigated in HCC. Methods In vitro direct effects of pazopanib on human HCC cell lines and endothelial cells were evaluated. In vivo antitumor effects were evaluated in three xenograft nude mice models. In the subcutaneous HCCLM3 model, intratumoral blood perfusion was detected by contrast-enhanced ultrasonography (CEUS), and serial quantitative parameters were profiled from the time-intensity curves of ultrasonograms. Results In vitro proliferation of various HCC cell lines were not inhibited by pazopanib. Pazopanib inhibited migration and invasion and induced apoptosis significantly in two HCC cell lines, HCCLM3 and PLC/PRF/5. Proliferation, migration, and tubule formation of human umbilical vein endothelial cells were inhibited by pazopanib in a dose-dependent manner. In vivo tumor growth was significantly inhibited by pazopanib in HCCLM3, HepG2, and PLC/PRF/5 xenograft models. Various intratumoral perfusion parameters changed over time, and the signal intensity was significantly impaired in the treated tumors before the treatment efficacy on tumor size could be observed. Mean transit time of the contrast media in hotspot areas of the tumors was reversely correlated with intratumoral microvessel density. Conclusions Antitumor effects of pazopanib in HCC xenografts may owe to its antiangiogenic effects, and the in vivo antiangiogenic effects could be evaluated by quantitative CEUS. PMID:21251271

  7. Evaluation of calcified carotid atheroma on panoramic radiographs and Doppler ultrasonography in an older population

    PubMed Central

    Atalay, Yusuf; Asutay, Fatih; Agacayak, Kamil Serkan; Koparal, Mahmut; Adali, Fahri; Gulsun, Belgin

    2015-01-01

    Aim The aim of this study is to determine the reliability of panoramic radiograph (PR) as a screening tool for the detection of calcified carotid atheroma (CCA) by comparing it with Doppler ultrasonography (DU) examination. A second aim was to evaluate the relationship among CCA, systemic diseases, smoking, and body mass index in an older population. Materials and methods A total of 1,650 PRs of patients aged over 45 years (736 males and 914 females) were randomly selected. All the patients had been referred to the Faculty of Dentistry, Afyon Kocatepe University, Afyonkarahisar, Turkey, during 2013–2014 for routine PR screening. Medical data were collected from the archival records of the dental school. The patients were divided into two groups: Group A (study group), CCA findings were confirmed by DU (n=59); and Group B (control group), CCA findings were not confirmed by DU (n=34). Results Of the 1,650 individuals, 93 (5.63%) were detected to have CCA on PR. The population consisted of 43 males and 50 females with mean age of 59.84±10.92 years. No difference was determined in respect of CCA between the sexes (P=0.745). There was a significant difference between Group A and Group B in respect of hypertension (P=0.004). But there was no difference between Group A and Group B in respect of age (P=0.495), BMI (P=0.756), diabetes (P=0.168), and smoking (P=0.482) distribution. Conclusion Although PR cannot be used as an initial diagnostic method when searching for CCA, dentists should be aware of CCA on a routine PR, particularly in older patients who may also have the risk factors of obesity, diabetes mellitus, hypertension, and smoking. Recognizing of CCA especially in hypertensive patients could potentially increase the length and quality of life for individuals. PMID:26185431

  8. Correlation of dental pulp stones, carotid artery and renal calcifications using digital panoramic radiography and ultrasonography

    PubMed Central

    Yeluri, Garima; Kumar, C. Anand; Raghav, Namita

    2015-01-01

    Background: The human tissues continuously undergo modification as deposition of calcium (CA) salts either in an organized or disorganized pattern. The latter pattern usually occurs in the soft tissues such as in arteries, brain, kidneys, lungs, and dental pulp. The purpose of this study is to evaluate the presence of pulp calcification and carotid artery calcification (CDC) as a marker for renal calcification and altered serum biomarkers such as serum CA, phosphorus (P), and alkaline phosphatase (ALP). Materials and Methods: Digital panoramic radiographs of 50 patients with the presence of pulp stones and suspected CAC were subjected to carotid artery and renal ultrasonography (USG) examination for the presence of vascular calcification and also to evaluate the alterations in serum CA, P, and ALP levels. Data were analyzed statistically using Chi-square test. Results: Panoramic radiographs of 50 patients showed 88.28% of teeth with the presence of pulp stones stones and 91% carotid arteries with calcification. The sensitivity of panoramic radiograph was greater than that of USG (93.67%), but the specificity of USG was more than the panoramic radiograph (44.44%) in detecting CAC. The prevalence rate of renal calcification on USG was 92%. The statistical difference between the patients with or without alteration in serum Ca levels was not significant (?2 = 0.581 and P = 0.446). On comparison of serum P and ALP, the difference was found to be statistically significant. Conclusion: Presence of pulp stones and CAC's on panoramic radiograph have remarkably proved to establish the chances of renal artery calcification associated with alterations in serum CA levels. PMID:26604565

  9. Abdominal Subcutaneous Fat Thickness Measured by Ultrasonography Correlates with Hyperlipidemia and Steatohepatitis in Obese Children

    PubMed Central

    Lee, Sung Hyun; Kim, Dongwan; Baek, Min Young; Kim, Yeon Sun; Ryoo, Eell; Kim, Yun Mi

    2015-01-01

    Purpose The aim of this study is to evaluate the relationship between abdominal subcutaneous fat thickness measured by ultrasonography (US) and serum lipid profile and liver transaminases in obese children. Methods One hundred and sixty-six children diagnosed with obesity from May 2001 to December 2013 were included in this study. Data on serum lipid profile and liver transaminases were collected from clinical records. Abdominal subcutaneous fat thickness and grade of hepatic steatosis were evaluated by US. Results Of the 166 children, 107 were diagnosed with hepatic steatosis by US, 46 with grade I, 56 with grade II, and five children with grade III. According to the grade of hepatic steasosis, the average values of midline abdominal subcutaneous fat thickness and right flank abdominal subcutaneous fat thickness measured 2.9±0.8 cm and 1.9±0.7 cm in the normal group, 3.3±0.8 cm and 2.0±0.7 cm in grade I, 3.8±0.8 cm and 2.3±0.8 cm in grade II, and 4.1±0.8 cm and 2.8±1.4 cm in grade III, respectively. Abdominal subcutaneous fat thickness correlated with grade of hepatic steatosis (p<0.01). In addition, abdominal subcutaneous fat thickness correlated with concentration of serum lipids and liver transaminases in the age group of 12-14 years (p<0.01). Conclusion Abdominal subcutaneous fat thickness measured by US can be used as a reliable predictor of possible hyperlipidemia and steatohepatitis in children, especially during the adolescent stage. PMID:26157696

  10. Prostate Biopsy Using Transrectal Ultrasonography; The Optimal Number of Cores Regarding Cancer Detection Rate and Complications

    PubMed Central

    Ghafoori, Mahyar; Velayati, Meysam; Aliyari Ghasabeh, Mounes; Shakiba, Madjid; Alavi, Manijeh

    2015-01-01

    Background: Transrectal ultrasound guided biopsy of the prostate is the most common modality used to diagnose prostate cancer. Objectives: The aim of this study was to evaluate the optimal number of cores at prostate biopsy, which have the most diagnostic value with least adverse effects. Patients and Materials: Transrectal ultrasonography (TRUS) guided biopsy was performed in 180 patients suspicious for prostate cancer due to either abnormal rectal examination or elevated PSA. The patients were divided randomly into three groups of six-core, twelve-core and eighteen-core biopsies. The detection rate of prostate cancer in each group with the rate of post biopsy urinary infection and prostatitis were compared. Results: Prostate cancer was diagnosed in 8 (13.3%), 21 (35%) and 24 (40%) patients in six, twelve and eighteen core biopsy groups, respectively. Urinary tract infection and prostatitis occurred in 17 (28.3%), 23 (38.3%) and 35 (58.3%) patients in six, twelve and eighteen core biopsy groups, respectively. Considering the detection rate of prostate cancer, there was a significant difference between 6 and 12 core biopsy groups (P = 0.006) and 12-core biopsies detected more cases of prostate cancer, but there was no significant difference between 12 and 18 core biopsy groups (P = 0.572). Considering the infection rate, there was no significant difference between 6 and 12 core biopsy groups (P = 0.254), but there was a significant difference between 12 and 18 core biopsy groups (P = 0.028) and infectious complications occurred more frequently in 18-core biopsy group. Conclusions: The best balance between detection rate of prostate cancer and infectious complications of biopsies achieved in twelve-core biopsy protocol. Twelve-core biopsy enhances the rate of prostate cancer detection with minimum adverse effects. PMID:26060552

  11. Can one blood draw replace transrectal ultrasonography-estimated prostate volume to predict prostate cancer risk?

    PubMed Central

    Carlsson, Sigrid; Peltola, Mari; Sjoberg, Daniel; Schröder, Fritz; Hugosson, Jonas; Pettersson, Kim; Scardino, Peter; Vickers, Andrew; Lilja, Hans; Roobol, Monique

    2012-01-01

    OBJECTIVE To explore whether a panel of kallikrein markers in blood: total, free and intact prostate-specific antigen (PSA) and kallikrein-related peptidase 2, could be used as a non-invasive alternative for predicting prostate cancer on biopsy in a screening setting. SUBJECTS AND METHODS The study cohort comprised previously unscreened men who underwent sextant biopsy owing to elevated PSA (? 3ng/mL) in two different centres of the European Randomized Study of Screening for Prostate Cancer, Rotterdam (n=2914) and Göteborg (n=740). A statistical model, based on kallikrein markers, was compared with one based on established clinical factors for the prediction of biopsy outcome. RESULTS The clinical tests were found to be no better than blood markers, with an area under the curve in favour of the blood measurements of 0.766 vs. 0.763 in Rotterdam and 0.809 vs. 0.774 in Göteborg. Adding digital rectal examination (DRE) or DRE plus transrectal ultrasonography (TRUS) volume to the markers improved discrimination, although the increases were small. Results were similar for predicting high grade cancer. There was a strong correlation between the blood measurements and TRUS-estimated prostate volume (Spearman’s correlation 0.60 in Rotterdam and 0.57 in Göteborg). CONCLUSIONS In previously unscreened men, each with indication for biopsy, a statistical model based on kallikrein levels was similar to a clinical model in predicting prostate cancer in a screening setting, outside the day-to-day clinical practice. Whether a clinical approach can be replaced by laboratory analyses or used in combination with decision models (nomograms) is a clinical judgment that may vary from clinician to clinician depending on how they weigh the different advantages and disadvantages (harms, costs, time, invasiveness) of both approaches. PMID:23448270

  12. Asymmetric Nerve Enlargement: A Characteristic of Leprosy Neuropathy Demonstrated by Ultrasonography

    PubMed Central

    Marques Jr., Wilson; Foss, Norma Tiraboschi

    2015-01-01

    Background Neurological involvement occurs throughout the leprosy clinical spectrum and is responsible for the most feared consequences of the disease. Ultrasonography (US) provides objective measurements of nerve thickening and asymmetry. We examined leprosy patients before beginning multi-drug therapy aiming to describe differences in US measurements between classification groups and between patients with and without reactions. Methodology/Principal Findings Eleven paucibacillary (PB) and 85 multibacillary (MB) patients underwent nerve US. Twenty-seven patients had leprosy reactions (type 1, type 2 and/or acute neuritis) prior to US. The ulnar (at the cubital tunnel–Ut–and proximal to the tunnel–Upt), median (M) and common fibular (CF) nerves were scanned to measure cross-sectional areas (CSAs) in mm2 and to calculate the asymmetry indexes ?CSA (absolute difference between right and left CSAs) and ?Utpt (absolute difference between Upt and Ut CSAs). MB patients showed greater (p<0.05) CSAs than PB at Ut (13.88±11.4/9.53±6.14) and M (10.41±5.4/6.36±0.84). ?CSAs and ?Utpt were similar between PB and MB. The CSAs, ?CSAs and ?Utpt were similar between PB patients with reactions compared to PB patients without reactions. MB patients with reactions showed significantly greater CSAs (Upt, Ut and M), ?CSAs (Upt and Ut) and ?Utpt compared to MB patients without reactions. PB and MB showed similar frequencies of abnormal US measurements. Patients with reactions had higher frequency of nerve thickening and similar frequency of asymmetry to those without reactions. Conclusions/Significance This is the first study to investigate differences in nerve involvement among leprosy classification groups using US before treatment. The magnitude of thickening was greater in MB and in patients with reactions. Asymmetry indexes were greater in patients with reactions and did not significantly differ between PB and MB, demonstrating that asymmetry is a characteristic of leprosy neuropathy regardless of its classification. PMID:26646143

  13. Detection of bone erosions in early rheumatoid arthritis: 3D ultrasonography versus computed tomography.

    PubMed

    Peluso, G; Bosello, S L; Gremese, E; Mirone, L; Di Gregorio, F; Di Molfetta, V; Pirronti, T; Ferraccioli, G

    2015-07-01

    Three-dimensional (3D) volumetric ultrasonography (US) is an interesting tool that could improve the traditional approach to musculoskeletal US in rheumatology, due to its virtual operator independence and reduced examination time. The aim of this study was to investigate the performance of 3DUS in the detection of bone erosions in hand and wrist joints of early rheumatoid arthritis (ERA) patients, with computed tomography (CT) as the reference method. Twenty ERA patients without erosions on standard radiography of hands and wrists underwent 3DUS and CT evaluation of eleven joints: radiocarpal, intercarpal, ulnocarpal, second to fifth metacarpo-phalangeal (MCP), and second to fifth proximal interphalangeal (PIP) joints of dominant hand. Eleven (55.0%) patients were erosive with CT and ten of them were erosive also at 3DUS evaluation. In five patients, 3DUS identified cortical breaks that were not erosions at CT evaluation. Considering CT as the gold standard to identify erosive patients, the 3DUS sensitivity, specificity, PPV, and NPV were 0.9, 0.55, 0.71, and 0.83, respectively. A total of 32 erosions were detected with CT, 15 of them were also observed at the same sites with 3DUS, whereas 17 were not seen on 3DUS evaluation. The majority of these 3DUS false-negative erosions were in the wrist joints. Furthermore, 18 erosions recorded by 3DUS were false positive. The majority of these 3DUS false-positive erosions were located at PIP joints. This study underlines the limits of 3DUS in detecting individual bone erosion, mostly at the wrist, despite the good sensitivity in identifying erosive patients. PMID:26091903

  14. Clinical evaluation during the acute exacerbation of knee osteoarthritis: the impact of diagnostic ultrasonography.

    PubMed

    E?en, Selma; Akar?rmak, Ulkü; Ayd?n, Filiz Y?ld?z; Unalan, Halil

    2013-03-01

    We aimed to investigate (1) the probable correlation between clinical and ultrasonographic findings in chronic painful primary knee OA patients referred with acute flare-ups and (2) the impact of diagnostic ultrasonography (US) to determine the real source of pain in these patients. We included 100 patients consecutively who were admitted to our outpatient unit with a pain complaint on a single knee with the diagnosis of primary knee OA according to the ACR criteria. The control group consisted of the patients with pain-free knees at least during the last month, who were already included in the study group. The sonographic evaluation of the knee was performed by a physician who was blinded to the clinical evaluation and/or the physical and radiological evaluations. In the present study, sonographic findings were significantly more observed on the painful knees (p < 0.001). The most commonly encountered findings on the symptomatic knees were the suprapatellar effusion (55 %), the baker cyst (25 %), and the pes anserine bursitis. The distribution of the findings on the asymptomatic knees was as follows: 22 %, the suprapatellar effusion and 5 %, the Baker cyst. Effusion was detected in 55 % of the painful knees of our patients with knee OA. This finding was statistically significant compared to the painless knees of the subjects included. The results of our study also showed that there was a significant relation between the Kellgren-Lawrence grading and the frequency of suprapatellar effusion on US examination (p = 0.026). It was concluded that in chronic, primary, painful knee osteoarthritis, US is a valuable diagnostic method in the confirmation of synovitis and/or the inflammatory episode in spite of the absence of obvious clinical parameters. In advanced osteoarthritis, when we consider that the inflammatory episodes are expected findings, the early confirmation of the inflammation on US may be particularly valuable in the clinical setting. PMID:22562715

  15. Digital image analysis of endoscopic ultrasonography is helpful in diagnosing gastric mesenchymal tumors

    PubMed Central

    2014-01-01

    Background Endoscopic ultrasonography (EUS) is a valuable imaging tool for evaluating subepithelial lesions in the stomach. However, there are few studies on differentiation between gastrointestinal stromal tumors (GISTs) and benign mesenchymal tumors, such as leiomyoma or schwannoma, with the use of EUS. In addition, there are limitations in the analysis of the characteristic features of such tumors due to poor interobserver agreement as a result of subjective interpretation of EUS images. Therefore, the aim of this study was to evaluate the role of digital image analysis in distinguishing the features of GISTs from those of benign mesenchymal tumors on EUS. Methods We enrolled 65 patients with histopathologically proven gastric GIST, leiomyoma or schwannoma on surgically resected specimens who underwent EUS examination at our endoscopic unit from January 2007 to September 2010. After standardization of the EUS images, brightness values including the mean (Tmean), indicative of echogenicity, and the standard deviation (TSD), indicative of heterogeneity, in the tumors were analyzed. Results The Tmean and TSD were significantly higher in GIST than in leiomyoma and schwannoma (p?

  16. Comparison of Endoscopic Ultrasonography, Computed Tomography, and Magnetic Resonance Imaging for Pancreas Cystic Lesions

    PubMed Central

    Lee, Yoon Suk; Paik, Kyu-hyun; Kim, Hyung Woo; Lee, Jong-Chan; Kim, Jaihwan; Hwang, Jin-Hyeok

    2015-01-01

    Abstract Consensus regarding which modality is optimal for the measurement of pancreas cystic lesions (PCLs) was not achieved although cyst size is important for clinical decisions. This study aimed to evaluate the properties of endoscopic ultrasonography (EUS) compared with computed tomography (CT) and magnetic resonance imaging (MRI) in measuring the size of PCL. A total of 34 patients who underwent all 3 imaging modalities within 3 months before surgery were evaluated retrospectively. The size measured by each modality was compared with the pathologic size as a reference standard using Bland–Altman analysis and intraclass correlation coefficients (ICCs). The mean size difference was 1.76?mm (ICC 0.86), 7.35?mm (ICC 0.95), and 8.65?mm (ICC 0.93) in EUS, CT, and MRI. EUS had the widest range of 95% limits of agreement (LOA) (?17.54 to +21.07), compared with CT (?6.21 to +20.91), and MRI (?6.82 to +24.12). The size by EUS tended to be read smaller in tail portion, while those by CT and MRI did not. When the size was more than 4?cm, the size on EUS was estimated to be smaller than on pathology (r?=?0.492; P?=?0.003). Although 3 modalities showed very good reliability for the size measurement on PCL compared with corresponding pathologic size, EUS had the lowest level of agreement, while CT showed the highest level among the 3 modalities. Therefore, the size estimated by EUS has to be interpreted with caution, especially when it is located in tail and relevantly large. PMID:26469901

  17. Evaluation of Thyroid Disorders During Head-and-Neck Radiotherapy by Using Functional Analysis and Ultrasonography

    SciTech Connect

    Bakhshandeh, Mohsen; Hashemi, Bijan; Mahdavi, Seyed Rabie; Nikoofar, Alireza; Edraki, Hamid Reza; Kazemnejad, Anoshirvan

    2012-05-01

    Purpose: To evaluate thyroid function and vascular changes during radiotherapy for patients with head and neck cancer. Methods and Materials: Fifty patients treated with primary or postoperative radiotherapy for various cancers in the head and neck region were prospectively evaluated. The serum samples (triiodothyronine [T3], thyroxine [T4], thyroid-stimulating hormone [TSH], free triiodothyronine [FT3], and free thyroxine [FT4]), the echo level of the thyroid gland, and color Doppler ultrasonography (CDU) parameters of the right inferior thyroid artery (RITA) of the patients were measured before and at regular intervals during radiotherapy. The thyroid gland dose-volume histograms of the patients were derived from their computed tomography-based treatment plans. Results: There was a significant fall in TSH level (p < 0.0001) but an increase in FT4 (p < 0.0001) and T4 (p < 0.022) levels during the radiotherapy course. The threshold dose required to produce significant changes was 12 Gy (Biologically Effective Dose in 2-Gy fractions, BED{sub 2}). There were significant rises in the patients' pulsatility index, resistive index, peak systolic velocity, blood volume flow levels, and RITA diameter (p < 0.0001), as detected by CDU during radiotherapy, compared to those parameters measured before the treatment. Hypoechogenicity and irregular echo patterns (p < 0.0001) were seen during radiotherapy compared to those before treatment. There was significant Pearson's correlation between the CDU parameters and T4, FT4, and TSH levels. Conclusions: Radiation-induced thyroiditis is regarded as primary damage to the thyroid gland. Thyroiditis can subsequently result in hypothyroidism or hyperthyroidism. Our results demonstrated that changes in thyroid vessels occur during radiotherapy delivered to patients. Vessel changes also can be attributed to the late effect of radiation on the thyroid gland. The hypoechogenicity and irregular echo patterns observed in patients may result from the increase in intrathyroidal flow.

  18. Standard procedures of endovascular treatment for vascular access stenosis in our facility - clinical usefulness of ultrasonography.

    PubMed

    Sato, Takashi; Tsuboi, Masato; Onogi, Takeshi; Miwa, Naofumi; Sakurai, Hiroshi; Ookubo, Kentarou; Matsubara, Chieko; Kasuga, Hirotake

    2015-11-10

    In Japan, the number of patients receiving dialysis is 314,180 at the end of 2013 and 97% are treated with hemodialysis. And the mean age of patients and the percentage of diabetes have been increasing. For this reason, preparations of a new vascular access (VA) and its long-term maintenance have become difficult. In the guidelines by the Japanese Society for Dialysis Therapy (JSDT), endovascular treatment (ET) is positioned as the first line for VA stenosis. The procedure of ET itself is very simple. The revision of Japanese health insurance set an expensive technical fee for ET in 2012. It also added a restriction by which the claims for both technical and material fees would be denied, if the treatment was performed within 3 months after a previous treatment. This makes determination of best treatment timing more important. The functional evaluation using ultrasonography (US) is a useful monitoring index for determination of the ET timing for patients with stenosis. We investigated the cumulative relative frequency of flow volume (FV) and resistant index (RI) of brachial artery in arteriovenous graft (AVG) and arteriovenous fistula (AVF) cases with access failures. As a result, the cut-off values of FV and RI in AVG were 480 mL/min and 0.57, and in AVF were 354 mL/min and 0.61, respectively. Therefore we determine the treatment timing based on these results. Since 2012, active monitoring using US could have decreased the number of treatment patients by 100 per year. This meant that objective evaluation by US enabled treatments at a more suitable time to promote the proper use of medical expenses for EV treatment. PMID:26349878

  19. Prospective evaluation of healthy Ragdoll cats for chronic kidney disease by routine laboratory parameters and ultrasonography.

    PubMed

    Paepe, Dominique; Bavegems, Valérie; Combes, Anaïs; Saunders, Jimmy H; Daminet, Sylvie

    2013-10-01

    Ragdoll breeder organisations often forewarn Ragdoll cat owners that renal problems may develop as a result of polycystic kidney disease (PKD), chronic interstitial nephritis, familial renal dysplasia or nephrocalcinosis. Healthy Ragdoll and non-Ragdoll cats were prospectively evaluated by measuring serum creatinine and urea concentrations, routine urinalysis and abdominal ultrasonography. All Ragdoll cats also underwent genetic PKD testing. One hundred and thirty-three Ragdoll and 62 control cats were included. Ragdoll cats had significantly lower serum urea concentrations and higher urinary specific gravity. However, median creatinine concentration, median urinary protein-to-creatinine ratio, and the proportion of cats with serum creatinine or urea concentration exceeding the reference interval did not differ. One or more renal ultrasonographical changes were detected in 66/133 (49.6%) Ragdoll and in 25/62 (40%) control cats. Ragdoll cats showed significantly more frequent segmental cortical lesions (7.5% versus 0%), abnormal renal capsule (19.5% versus 8%) and echogenic urine (51.9% versus 25.8%). Chronic kidney disease (CKD) was ultrasonographically suspected in 7/133 (5.3%) Ragdoll and in none of the control cats, which approached significance. Laboratory parameters confirmed kidney dysfunction only in 1/7 of these Ragdoll cats. All Ragdoll cats were PKD negative. In conclusion, first, breed-specific serum creatinine reference intervals are not likely required for Ragdoll cats. Second, renal ultrasonographical abnormalities are common, both in Ragdoll and non-Ragdoll cats. Third, healthy young Ragdoll cats are uncommonly affected by PKD and CKD, but an increased susceptibility of Ragdoll cats to develop CKD cannot be excluded. Finally, Ragdoll cats are predisposed to segmental cortical lesions, which may indicate renal infarction or cortical scarring. PMID:23413268

  20. Detection of gastric cancer using transabdominal ultrasonography is associated with tumor diameter and depth of invasion

    PubMed Central

    TOMIZAWA, MINORU; SHINOZAKI, FUMINOBU; FUGO, KAZUNORI; HASEGAWA, RUMIKO; SHIRAI, YOSHINORI; MOTOYOSHI, YASUFUMI; SUGIYAMA, TAKAO; YAMAMOTO, SHIGENORI; KISHIMOTO, TAKASHI; ISHIGE, NAOKI

    2015-01-01

    Gastric cancer is occasionally diagnosed using transabdominal ultrasonography (US) during screening or investigation of patients with abdominal symptoms. Therefore, the present study analyzed the association of the tumor diameter, pathological T (pT) staging and depth of invasion with the detection of gastric cancer using US. Patient records were analyzed retrospectively and 13 patients were enrolled, who underwent US screening prior to endoscopic mucosal resection, endoscopic submucosal dissection or surgery. In total, 5 patients were diagnosed with gastric cancer using US (positive detection group), while US was unable to detect the gastric cancer in 8 patients (negative detection group). The tumor diameter and depth of invasion were determined by pathologists. One-way analysis of variance or the ?2 test was performed. Wall thickness in gastric cancer cases ranged between 7 and 20 mm (mean, 12.2±5.9 mm), as measured using abdominal US. The hemoglobin level was significantly lower in the positive detection patients compared with the negative detection patients (P=0.0455). In addition, the diameters of the gastric wall in the negative and positive detection patients were 24.5±16.4 and 54.4±26.2 mm, respectively (P=0.0266). These results indicate that gastric cancer in the positive detection patients were at a more advanced-stage compared with that in the negative detection patients. Furthermore, gastric cancer with a stage over pT2 was diagnosed using abdominal US (P=0.0242), whereas stage pT1a gastric cancer was not detected by abdominal US. Gastric tumors invading deeper than the submucosa were diagnosed using US (P=0.0242). However, the gastric cancer cases limited to the mucosa remained undetected. In conclusion, the detection of gastric cancer correlated well with the tumor diameter, pT staging and depth of invasion. PMID:26640558

  1. Identifying the variables associated with pain during transrectal ultrasonography of the prostate

    PubMed Central

    Hou, Chen-Pang; Lin, Yu-Hsiang; Hsieh, Meng-Chiao; Chen, Chien-Lun; Chang, Phei-Lang; Huang, Ying-Chen; Tsui, Ke-Hung

    2015-01-01

    Objective The purpose of this study was to prospectively investigate the degree of pain experienced by the patients receiving transrectal ultrasonography (TRUS) of the prostate by applying a visual analog scale. We also identified the clinical parameters influencing pain during the TRUS examination. Materials and methods Records were obtained from a prospective database for male patients who received TRUS of prostate in the outpatient department of Chang Gung Memorial Hospital, Taiwan, from January 2014 to June 2014. The patients underwent a detailed physical examination and medical history review. Immediately after the TRUS examination, the patients completed questionnaires based on a ten-point visual analog pain scale. The variables of interest were age, body mass index, prostate volume, prostate sagittal length, prostate-specific antigen, previous TRUS experience, external hemorrhoids, anal surgical history, prostate calcification, and image artifact caused by stool in the rectum. All variables were correlated to the visual analog scale by applying multivariate regression analysis. Results By using linear regression analysis, we identified the independent factors that affected the pain score during the TRUS examination. The patients who received the examination for the first time or had longer prostate sagittal lengths, external hemorrhoids, anal surgical history, or stool stored in the rectum experienced more pain during the TRUS examination. Furthermore, the pain was reduced when we provided the patients with a detailed explanation before the procedure and allowed them to observe the real-time images during the examination. Conclusion Although a TRUS examination is uncomfortable for patients, after having identified the factors affecting pain, physicians can assist patients in reducing pain during the procedure, thus providing higher quality examinations. PMID:26347225

  2. Definition and Implications of Novel Pharyngo-Glottal Reflex in Human Infants Using Concurrent Manometry Ultrasonography

    PubMed Central

    Jadcherla, Sudarshan R.; FRCPI; Gupta, Alankar; Wang, Mansen; Coley, Brian D.; Fernandez, Soledad; Shaker, Reza

    2013-01-01

    OBJECTIVES: Glottal relationships during swallowing dominate the etiology of dysphagia. We investigated the pharyngo-glottal relationships during basal and adaptive swallowing. METHODS: Temporal changes in glottal closure kinetics (frequency, response latency, and duration) with spontaneous and adaptive pharyngeal swallows were defined in 12 infants using concurrent pharyngoesophageal manometry and ultrasonography of the glottis. RESULTS: Frequency, response latency, and duration of glottal closure with spontaneous swallows (n = 53) were 100%, 0.27±0.1 s, and 1±0.22 s, respectively. The glottis adducted earlier (P < 0.0001 vs. upper esophageal sphincter relaxation) within the same respiratory phase as swallow (P = 0.03). With pharyngeal provocations (n = 41), glottal adduction (pharyngo-glottal closure reflex (PGCR)) was noted first and then again with pharyngeal reflexive swallow (PRS). The frequency, response latency, and duration of glottal closure with PGCR were 100%, 0.56±0.13 s, and 0.52±0.1 s, respectively. Response latency to PRS was 3.24±0.33 s; the glottis adducted 97% within 0.36±0.08 s in the same respiratory phase (P = 0.03), and remained adducted for 3.08±0.71 s. Glottal adduction was the quickest with spontaneous swallow (P = 0.04 vs. PGCR), and the duration was the longest during PRS (P < 0.005 vs. PGCR or spontaneous swallow). CONCLUSIONS: Glottal adduction during basal or adaptive swallowing reflexes occurs in either respiratory phase, thus ensuring airway protection against pre-deglutitive or deglutitive aspiration. The independent existence and magnitude (duration of adduction) of PGCR suggests a hypervigilant state of the glottis in preventing aspiration during swallowing or during high gastroesophageal reflux events. Investigation of pharyngeal–glottal relationships with the use of noninvasive methods may be more acceptable across the age spectrum. PMID:19603008

  3. Ultrasonography of the distal limbs in Nellore and Girolando calves 8 to 12 months of age

    PubMed Central

    2014-01-01

    Background Ultrasonography can be used anywhere and allows rapid, noninvasive differentiation of soft tissue structures of the musculoskeletal system. The objectives of this study were to describe the ultrasonographic appearance of the structures of the metacarpo-/metatarsophalangeal and the interphalangeal joints, the appearance of the growth plates of the distal metacarpus/metatarsus and of the proximal phalanx and to measure the cross-sectional dimensions of the DDFT and SDFT in Nellore and Girolando calves eight to 12 months of age. Results In the longitudinal dorsal view the common digital extensor tendon and the digital extensor tendon were depicted as echogenic parallel fiber bundles located directly under the skin. The joint spaces appeared as anechoic interruptions of the hyperechogenic bone surfaces. The normal amount of synovial fluid could not be depicted. The growth plates were seen as anechoic interruptions of the bone surface proximal and distal to the fetlock joint space. In transverse sonograms of the distal palmar/plantar regions, the flexor tendons and branchs of the suspensory ligament were imaged as echogenic structures. The lumen of the digital flexor tendon sheath could not be imaged in these normal cattle. The thin digital distal annular ligament and the reversal of positions of the DDFT and SDFT could be appreciated. No significant differences were found between the cross-sectional measurements of the DDFT and the SDFT from Nellore and Girolando in any age, thoracic/pelvic limbs, right/left sides and lateral/medial digits. Conclusions The results of this study establish important ultrasonographic reference data of the normal structures of the distal limbs and the normal dimensions of the flexor tendons in Nellore and Girolando calves for use in clinical practice. PMID:24774582

  4. Ultrasonography-guided central venous catheterisation in haematological patients with severe thrombocytopenia

    PubMed Central

    Napolitano, Mariasanta; Malato, Alessandra; Raffaele, Francesco; Palazzolo, Manuela; Iacono, Giorgio Lo; Pinna, Roberto; Geraci, Girolamo; Modica, Giuseppe; Saccullo, Giorgia; Siragusa, Sergio; Cajozzo, Massimo

    2013-01-01

    Background Cannulation of the internal jugular vein (CVC) is a blind surface landmark-guided technique that could be potentially dangerous in patients with very low platelet counts. In such patients, ultrasonography (US)-guided CVC may be a valid approach. There is a lack of published data on the efficacy and safety of urgent US-guided CVC performed in haematological patients with severe thrombocytopenia. Materials and methods We retrospectively studied the safety of urgent CVC procedures in haematological patients including those with severe thrombocytopenia (platelet count <30×109/L). From January 1999 to June 2009, 431 CVC insertional procedures in 431 consecutive patients were evaluated. Patients were included in the study if they had a haematological disorder and required urgent CVC insertion. Patients were placed in Trendelenburg's position, an 18-gauge needle and guide-wire were advanced under real-time US guidance into the last part of the internal jugular vein; central venous cannulation of the internal jugular vein was performed using the Seldinger technique in all the procedures. Major and minor procedure-related complications were recorded. Results All 431 patients studied had haematological disorders: 39 had severe thrombocytopenia, refractory to platelet transfusion (group 1), while 392 did not have severe thrombocytopenia (group 2). The general characteristics of the patients in the two groups differed only for platelet count. The average time taken to perform the procedure was 4 minutes. Success rates were 97.4% and 97.9% in group 1 and group 2, respectively. No major complications occurred in either group. Discussion US-guided CVC is a safe and effective approach in haematological patients with severe thrombocytopenia requiring urgent cannulation for life support, plasma-exchange, chemotherapy and transfusion. PMID:23399356

  5. Field Use of Ultrasonography to Characterize the Reproductive Tract and Early Pregnancy in a Phocid, the Weddell Seal (Leptonychotes weddellii).

    PubMed

    Shero, Michelle R; Adams, Gregg P; Burns, Jennifer M

    2015-12-01

    The utility of transrectal ultrasonography was tested in a field setting to characterize the reproductive tract and detect early pregnancy (embryonic vesicles?ultrasonography was attempted in January/February 2014 to examine the entire reproductive tract (uterine horns and body, ovaries with follicles and corpora lutea) using a 5-10 MHz linear-array probe with a 70 cm-long extension. A single pregnancy was detected in 14 of 17 seals (82.4%) as a circular or guitar-pick shaped nonechogenic (black) vesicle with a clearly visible echogenic border within the lumen of the uterus. The stage of embryonic development (ostensibly the gestational age) varied markedly among individuals, ranging from a vesicle with no embryo proper to a large fetus with an ocular orbit, nose/mouth, limb buds, spinal column, umbilical cord, and prominent vasculature. Two of the pregnant seals were re-examined 3-6 days after the initial examination to obtain longitudinal growth rates. Images of one or both ovaries were obtained in nine and seven of the 19 examinations, respectively. Numerous ovarian follicles (3 to 12 mm diameter) were detected and animals typically had a single well-perfused corpus luteum (determined by Doppler color-flow) ipsilateral to the uterine horn containing the pregnancy. We conclude that real-time transrectal ultrasonography is an effective tool for characterizing reproductive events in phocids including ovarian dynamics, and for elucidating the nature of embryonic diapause. Anat Rec, 298:1970-1977, 2015. © 2015 Wiley Periodicals, Inc. PMID:26340607

  6. Endoscopic ultrasonography-guided endoscopic treatment of pancreatic pseudocysts and walled-off necrosis: New technical developments

    PubMed Central

    Braden, Barbara; Dietrich, Christoph F

    2014-01-01

    In the last decades, the treatment of pancreatic pseudocysts and necrosis occurring in the clinical context of acute and chronic pancreatitis has shifted towards minimally invasive endoscopic interventions. Surgical procedures can be avoided in many cases by using endoscopically placed, Endoscopic ultrasonography-guided techniques and drainages. Endoscopic ultrasound enables the placement of transmural plastic and metal stents or nasocystic tubes for the drainage of peripancreatic fluid collections. The development of self-expanding metal stents and exchange free delivering systems have simplified the drainage of pancreatic fluid collections. This review will discuss available therapeutic techniques and new developments. PMID:25473173

  7. Use of Intra-Arterial Carbon-Dioxide-Enhanced Ultrasonography for Guidance of Radiofrequency Ablation and Transcatheter Arterial Chemoembolization in Hepatocellular Carcinoma

    SciTech Connect

    Ohmoto, Kenji Yoshioka, Naoko; Tomiyama, Yasuyuki; Shibata, Norikuni; Kawase, Tomoya; Yoshida, Koji; Kuboki, Makoto; Yamamoto, Shinichiro

    2006-12-15

    A 73-year-old man with hepatitis-C-related cirrhosis and an elevated alpha-fetoprotein level and tumor in segment 3 of his liver was referred for interventional radiologic treatment. He was not a candidate for surgical resection due to impaired liver function and his personal preferences. On conventional ultrasonography no lesion could be detected, but the tumor was clearly depicted by intra-arterial carbon-dioxide-enhanced ultrasonography. Radiofrequency ablation was performed safely and accurately under the guidance of carbon-dioxide-enhanced ultrasonography. By concomitant performance of transcatheter arterial chemoembolization with radiofrequency ablation, extensive necrosis was obtained and adequate tumor volume reduction achieved with only one treatment session.

  8. Efficacy of endoscopic ultrasonography-guided fine needle aspiration for pancreatic neuroendocrine tumor grading

    PubMed Central

    Sugimoto, Mitsuru; Takagi, Tadayuki; Hikichi, Takuto; Suzuki, Rei; Watanabe, Ko; Nakamura, Jun; Kikuchi, Hitomi; Konno, Naoki; Waragai, Yuichi; Asama, Hiroyuki; Takasumi, Mika; Watanabe, Hiroshi; Obara, Katsutoshi; Ohira, Hiromasa

    2015-01-01

    AIM: To evaluate the efficacy of endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) for grading pancreatic neuroendocrine tumors (PNETs). METHODS: A total of 22 patients were diagnosed with PNET by EUS-FNA between October 2001 and December 2013 at Fukushima Medical University Hospital. Among these cases, we targeted 10 PNET patients who were evaluated according to the World Health Organization (WHO) 2010 classification. Surgery was performed in eight patients, and chemotherapy was performed in two patients due to multiple liver metastases?Specimens obtained by EUS-FNA were first stained with hematoxylin and eosin and then stained with chromogranin, synaptophysin, CD56, and Ki-67. The specimens were graded by the Ki-67 index according to the WHO 2010 classification. Specimens obtained by surgery were graded by the Ki-67 index and mitotic count (WHO 2010 classification). For the eight specimens obtained by EUS-FNA, the Ki-67 index results were compared with those obtained by surgery. In the two cases treated with chemotherapy, the effects and prognoses were evaluated. RESULTS: The sampling rate for histological diagnosis by EUS-FNA was 100%. No adverse effects were observed. The concordance rate between specimens obtained by EUS-FNA and surgery was 87.5% (7/8). For the two cases treated with chemotherapy, case 1 received somatostatin analog therapy and transcatheter arterial infusion (TAI) targeting multiple liver metastases. Subsequent treatment consisted of everolimus. During chemotherapy, the primary tumor remained unconfirmed, although the multiple liver metastases diminished dramatically. Case 2 was classified as neuroendocrine carcinoma (NEC) according to the Ki-67 index of a specimen obtained by EUS-FNA; therefore, cisplatin and irinotecan therapy was started. However, severe adverse effects, including renal failure and diarrhea, were observed, and the therapy regimen was changed to cisplatin and etoposide. TAI targeting multiple liver metastases was performed. Although the liver metastases diminished, the primary tumor remained unconfirmed. These chemotherapy regimens had immediate effects for both unresectable neuroendocrine tumor (NET) and NEC cases. These two subjects are still alive. CONCLUSION: EUS-FNA was effective for PNET diagnosis and Ki-67 index grading for WHO 2010 classification, enabling informed decisions on unresectable PNET treatment by identifying NET or NEC. PMID:26185384

  9. Endoscopic ultrasonography-guided drainage for patients with symptomatic obstruction and enlargement of the pancreatic duct

    PubMed Central

    Will, Uwe; Reichel, Andreas; Fueldner, Frank; Meyer, Frank

    2015-01-01

    AIM: To evaluate the use of translumenal pancreatography with placement of endoscopic ultrasonography (EUS)-guided drainage of the pancreatic duct. METHODS: This study enrolled all consecutive patients between June 2002 and April 2014 who underwent EUS-guided pancreatography and subsequent placement of a drain and had symptomatic retention of fluid in the pancreatic duct after one or more previous unsuccessful attempts at endoscopic retrograde cannulation of the pancreatic duct. In all, 94 patients underwent 111 interventions with one of three different approaches: (1) EUS-endoscopic retrograde drainage with a rendezvous technique; (2) EUS-guided drainage of the pancreatic duct; and (3) EUS-guided, internal, antegrade drainage of the pancreatic duct. RESULTS: The mean duration of the interventions was 21 min (range, 15-69 min). Mean patient age was 54 years (range, 28-87 years); the M:F sex ratio was 60:34. The technical success rate was 100%, achieving puncture of the pancreatic duct including pancreatography in 94/94 patients. In patients requiring drainage, initial placement of a drain was successful in 47/83 patients (56.6%). Of these, 26 patients underwent transgastric/transbulbar positioning of a stent for retrograde drainage; plastic prostheses were used in 11 and metal stents in 12. A ring drain (antegrade internal drainage) was placed in three of these 26 patients because of anastomotic stenosis after a previous surgical intervention. The remaining 21 patients with successful drain placement had transpapillary drains using the rendezvous technique; the majority (n = 19) received plastic prostheses, and only two received metal stents (covered self-expanding metal stents). The median follow-up time in the 21 patients with transpapillary drainage was 28 mo (range, 1-79 mo), while that of the 26 patients with successful transgastric/transduodenal drainage was 9.5 mo (range, 1-82 mo). Clinical success, as indicated by reduced or absence of further pain after the EUS-guided intervention was achieved in 68/83 patients (81.9%), including several who improved without drainage, but with manipulation of the access route. CONCLUSION: EUS-guided drainage of the pancreatic duct is a safe, feasible alternative to endoscopic retrograde drainage when the papilla cannot be reached endoscopically or catheterized. PMID:26674313

  10. Correlation between computerised findings and Newman's scaling on vascularity using power Doppler ultrasonography imaging and its predictive value in patients with plantar fasciitis

    PubMed Central

    Chen, H; Ho, H M; Ying, M; Fu, S N

    2012-01-01

    Objectives The purpose of this study was to correlate findings on small vessel vascularity between computerised findings and Newman's scaling using power Doppler ultrasonography (PDU) imaging and its predictive value in patients with plantar fasciitis. Methods PDU was performed on 44 patients (age range 30–66 years; mean age 48 years) with plantar fasciitis and 46 healthy subjects (age range 18–61 years; mean age 36 years). The vascularity was quantified using ultrasound images by a customised software program and graded by Newman's grading scale. Vascular index (VI) was calculated from the software program as the ratio of the number of colour pixels to the total number of pixels within a standardised selected area of proximal plantar fascia. The 46 healthy subjects were examined on 2 occasions 7–10 days apart, and 18 of them were assessed by 2 examiners. Statistical analyses were performed using intraclass correlation coefficient and linear regression analysis. Results Good correlation was found between the averaged VI ratios and Newman's qualitative scale (? = 0.70; p<0.001). Intratester and intertester reliability were 0.89 and 0.61, respectively. Furthermore, higher VI was correlated with less reduction in pain after physiotherapeutic intervention. Conclusions The computerised VI not only has a high level of concordance with the Newman grading scale but is also reliable in reflecting the vascularity of proximal plantar fascia, and can predict pain reduction after intervention. This index can be used to characterise the changes in vascularity of patients with plantar fasciitis, and it may also be helpful for evaluating treatment and monitoring the progress after intervention in future studies. PMID:22167513

  11. Immediate versus delayed integrated point-of-care-ultrasonography to manage acute dyspnea in the emergency department

    PubMed Central

    2014-01-01

    Background Dyspnea is one of the most frequent complaints in the Emergency Department. Thoracic ultrasound should help to differentiate cardiogenic from non-cardiogenic causes of dyspnea. We evaluated whether the diagnostic accuracy can be improved by adding a point-of-care-ultrasonography (POC-US) to routine exams and if an early use of this technique produces any advantage. Methods One hundred sixty-eight patients were enrolled and randomized in two groups: Group 1 received an immediate POC-US in addition to routine laboratory and instrumental tests; group 2 received an ultrasound scan within 1 h from the admission to the Emergency Department. The concordance between initial and final diagnosis and the percentage of wrong diagnosis in the two groups were evaluated. Mortality, days of hospitalization in Emergency Medicine department and transfers to other wards were compared. Sensitivity and specificity of the routine protocol and the one including ultrasonography for the diagnosis of the causes of dyspnea were also analyzed. Results Eighty-eight patients were randomized in group 1 and 80 in group 2. The concordance rate between initial and final diagnoses was significantly different (0.94 in group 1 vs. 0.22 in group 2, p?

  12. Determination of Testicular Blood Flow in Camelids Using Vascular Casting and Color Pulsed-Wave Doppler Ultrasonography

    PubMed Central

    Kutzler, Michelle; Tyson, Reid; Grimes, Monica; Timm, Karen

    2011-01-01

    We describe the vasculature of the camelid testis using plastic casting. We also use color pulsed-wave Doppler ultrasonography to measure testicular blood flow and compare the differences between testicular blood flow in fertile and infertile camelids. The testicular artery originates from the ventral surface of the aorta, gives rise to an epididymal branch, and becomes very tortuous as it approaches the testis. Within the supratesticular arteries, peak systolic velocity (PSV) was higher in fertile males compared to infertile males (P = 0.0004). In addition, end diastolic velocity (EDV) within the supratesticular arteries was higher for fertile males when compared to infertile males (P = 0.0325). Within the marginal arteries, PSV was also higher in fertile males compared to infertile males (P = 0.0104). However, EDV within the marginal arteries was not significantly different between fertile and infertile males (P = 0.121). In addition, the resistance index was not significantly different between fertile and infertile males within the supratesticular (P = 0.486) and marginal arteries (P = 0.144). The significance of this research is that in addition to information obtained from a complete reproductive evaluation, a male camelid's fertility can be determined using testicular blood flow measured by Doppler ultrasonography. PMID:21941690

  13. Cognitive Load Imposed by Knobology May Adversely Affect Learners' Perception of Utility in Using Ultrasonography to Learn Physical Examination Skills, but Not Anatomy

    ERIC Educational Resources Information Center

    Jamniczky, Heather A.; McLaughlin, Kevin; Kaminska, Malgorzata E.; Raman, Maitreyi; Somayaji, Ranjani; Wright, Bruce; Ma, Irene W. Y.

    2015-01-01

    Ultrasonography is increasingly used for teaching anatomy and physical examination skills but its effect on cognitive load is unknown. This study aimed to determine ultrasound's perceived utility for learning, and to investigate the effect of cognitive load on its perceived utility. Consenting first-year medical students (n?=?137) completed…

  14. Comparative evaluation of the liver in dogs with a splenic mass by using ultrasonography and contrast-enhanced computed tomography.

    PubMed

    Irausquin, Roelof A; Scavelli, Thomas D; Corti, Lisa; Stefanacci, Joseph D; DeMarco, Joann; Flood, Shannon; Rohrbach, Barton W

    2008-01-01

    Evaluation of dogs with splenic masses to better educate owners as to the extent of the disease is a goal of many research studies. We compared the use of ultrasonography (US) and contrast-enhanced computed tomography (CT) to evaluate the accuracy of detecting hepatic neoplasia in dogs with splenic masses, independently, in series, or in parallel. No significant difference was found between US and CT. If the presence or absence of ascites, as detected with US, was used as a pretest probability of disease in our population, the positive predictive value increased to 94% if the tests were run in series, and the negative predictive value increased to 95% if the tests were run in parallel. The study showed that CT combined with US could be a valuable tool in evaluation of dogs with splenic masses. PMID:18320977

  15. Foreign body-induced changes in the reticular contraction pattern of sheep observed with M-mode ultrasonography

    PubMed Central

    Morgado, A.A.; Sucupira, M.C.A.; Nunes, G.R.; Hagen, S.C.F.

    2015-01-01

    In the pre-experimental period of a clinical trial, an apparently clinically healthy sheep fitted with ruminal and abomasal cannulas showed changes in the reticular contraction pattern visualized in M-mode ultrasonogram. Radiographic examination revealed a blunt metal screw in its reticulum. By the time change in the reticular motility through the ultrasound examination was detected, the animal had still not expressed any behavioral changes. A description of the clinical case, follow-up of the findings and laboratory data, like white blood cell count, serum pepsinogen and fibrinogen concentrations, were presented. The foreign body was removed through the ruminal cannula and reticular contraction tended to normal. An association of the contraction pattern with measured clinical data was possible, leading to the conclusion that use of M-mode ultrasonography has a potential application in similar clinical situations.

  16. Application of Endobronchial Ultrasonography for the Preoperative Detecting Recurrent Laryngeal Nerve Lymph Node Metastasis of Esophageal Cancer

    PubMed Central

    Shan, Hong-Bo; Zhang, Rong; Li, Yin; Gao, Xiao-Yan; Lin, Shi-Yong; Luo, Guang-Yu; Li, Jian-Jun; Xu, Guo-Liang

    2015-01-01

    Background The preoperative detection of recurrent laryngeal nerve lymph node (RLN LN) metastasis provides important information for the treatment of esophageal cancer. We investigated the possibility of applying endobronchial ultrasonography (EBUS) with conventional preoperative endoscopic ultrasonography (EUS) and computerized tomography (CT) examination to evaluate RLN LN metastasis in patients with esophageal cancer. Methods A total of 115 patients with advanced thoracic esophageal cancer underwent EBUS examinations. Patients also underwent EUS and CT imaging as reference diagnostic methods. Positron emission tomography /computed tomography (PET/CT) was also introduced in partial patients as reference method. The preoperative evaluation of RLN LN metastasis was compared with the surgical and pathological staging in 94 patients who underwent radical surgery. Results The sensitivities of the preoperative evaluations of RLN LN metastasis by EBUS, EUS and CT were 67.6%, 32.4% and 29.4%, respectively. The sensitivity of EBUS was significantly different from that of EUS or CT, especially in the detection of right RLN LNs. In addition, according to the extra data from reference method, PET/CT was not superior to EBUS or EUS in detecting RLN LN metastasis. Among all 115 patients, 21 patients who were diagnosed with tracheal invasions by EUS or EBUS avoided radical surgery. Another 94 patients who were diagnosed as negative for tracheobronchial tree invasion by EUS and EBUS had no positive findings in radical surgery. Conclusions EBUS can enhance the preoperative sensitivity of the detection of RLN LN metastasis in cases of thoracic esophageal cancer and is a useful complementary examination to conventional preoperative EUS and CT, which can alert thoracic surgeons to the possibility of a greater range of preoperative lymph node dissection. EBUS may also indicate tracheal invasion in cases of esophageal stricture. PMID:26372339

  17. Unenhanced and Contrast-Enhanced Ultrasonography During Hepatic Transarterial Embolization and Chemoembolization With Drug-Eluting Beads

    SciTech Connect

    Moschouris, Hippocrates; Malagari, Katerina; Kornezos, Ioannis; Papadaki, Marina Georgiou; Gkoutzios, Panagiotis; Matsaidonis, Dimitrios

    2010-12-15

    The purpose of this study was to describe and evaluate the findings of unenhanced ultrasonography (US) and contrast-enhanced ultrasonography (CEUS) when these modalities are applied during transarterial embolization (TAE) or transarterial chemoembolization (TACE) of liver tumors. Sixteen tumors (9 hepatocellular carcinomas, 5 metastases from colorectal cancer, and 2 hemangiomas) were treated with TAE with microspheres and/or TACE with drug-eluting beads. All of these lesions were studied with intraprocedural unenhanced US and 12 were studied with intraprocedural CEUS. For the latter, a second-generation echo-enhancer (SonoVue; Bracco, Milan, Italy) and a low mechanical index technique were used. Intraprocedural findings were classified according to an arbitrary scale and were compared with pretreatment imaging (CEUS and computed tomography or CEUS and magnetic resonance imaging), with postembolization angiography, and with follow-up results. On unenhanced intraprocedural US, 13 of 16 tumors demonstrated intralesional high-level echoes of varying extent. These feature correlated poorly (r = 0.33, p = 0.097) with and generally underestimated the actual extent of necrosis. Exceptionally, high-level echoes that occupied the largest part of the treated lesions were associated with >50% tumor necrosis. Intraprocedural CEUS clearly depicted immediate partial or complete disappearance of tumor enhancement as a result of TAE/TACE. Three of 6 tumors with complete devascularization on postembolization angiogram showed residual enhancement on intraprocedural CEUS. Intraprocedural CEUS findings correlated closely (r = 0.91, p = 0.002) with follow-up findings. Intraprocedural sonography, particularly with echo-enhancers, could be used for intraprocedural monitoring in selected cases of liver tumors that undergo TAE or TACE.

  18. A prospective comparative study to evaluate the utility of lung ultrasonography to improve the accuracy of traditional clinical methods to confirm position of left sided double lumen tube in elective thoracic surgeries

    PubMed Central

    Parab, Swapnil Y; Divatia, Jigishu V; Chogle, Apurva

    2015-01-01

    Background and Aims: Traditional clinical methods like auscultation or inspection have been found to be inaccurate in confirmation of double-lumen tube (DLT) position. Lung ultrasonography (USG) reliably identifies the tidal movement (lung sliding) and the collapse of the lung (lung pulse). We intended to check whether the accuracy of clinical methods can be improved by the addition of USG in confirmation of left DLT (LDLT) position. Methods: A single centred, prospective, comparative study was conducted involving 70 patients undergoing thoracic surgeries requiring the use of LDLT. The patients were assigned to Group A - where LDLT position was assessed by using clinical methods alone, and Group B - where LDLT position was assessed by USG and clinical methods. The correct position was predicted when USG demonstrated the absence of lung sliding and the presence of lung pulse on the operative side, the presence of lung sliding on non-operative side, along with normal airway pressures and oxygenation. The final verification of LDLT position was done by direct observation of lung isolation by one surgeon who was blinded to the method of confirmation. Contingency tables were drawn to calculate sensitivity, specificity, positive predictive value, negative predictive value and accuracy of each method. Results: Compared to clinical methods alone, addition of lung USG improved sensitivity (75% vs. 88%), specificity (18% vs. 75%) and accuracy (57% vs. 85%) for correct prediction of LDLT position. Conclusion: USG is a useful addition to the armamentarium of anaesthesiologist for the confirmation of LDLT position. PMID:26379290

  19. Clinical assessment of vascular calcification.

    PubMed

    Raggi, Paolo; Bellasi, Antonio

    2007-01-01

    Cardiovascular calcification poses an increased risk for cardiovascular events in advanced phases of chronic kidney disease. This evidence has brought many investigators to focus their attention on the importance of detection of calcification and avoidance of further development of it with appropriate therapeutic choices. Physicians can use a variety of noninvasive imaging tools to identify cardiovascular calcification, some with merely qualitative and others with both qualitative and quantitative capabilities. Plain x-rays and ultrasonography can be used to identify macroscopic calcification of aorta and peripheral arteries, echocardiography is helpful for assessment of valvular calcification, and computed tomography technologies constitute the gold standard for quantification of cardiovascular calcification. The latter is also useful to monitor calcification progression and to assess the effect of different therapeutic strategies directed at modifying calcification progression. In this article, we review the clinical significance of vascular calcification and some of the evidence surrounding the most commonly employed noninvasive imaging techniques. PMID:17200042

  20. Blood flow velocity in monocular retinoblastoma assessed by color doppler

    PubMed Central

    Bonanomi, Maria Teresa B C; Saito, Osmar C; de Lima, Patricia Picciarelli; Bonanomi, Roberta Chizzotti; Chammas, Maria Cristina

    2015-01-01

    OBJECTIVE: To analyze the flow of retrobulbar vessels in retinoblastoma by color Doppler imaging. METHODS: A prospective study of monocular retinoblastoma treated by enucleation between 2010 and 2014. The examination comprised fundoscopy, magnetic resonance imaging, ultrasonography and color Doppler imaging. The peak blood velocities in the central retinal artery and central retinal vein of tumor-containing eyes (tuCRAv and tuCRVv, respectively) were assessed. The velocities were compared with those for normal eyes (nlCRAv and nlCRVv) and correlated with clinical and pathological findings. Tumor dimensions in the pathological sections were compared with those in magnetic resonance imaging and ultrasonography and were correlated with tuCRAv and tuCRVv. In tumor-containing eyes, the resistivity index in the central retinal artery and the pulse index in the central retinal vein were studied in relation to all variables. RESULTS: Eighteen patients were included. Comparisons between tuCRAv and nlCRAv and between tuCRVv and nlCRVv revealed higher velocities in tumor-containing eyes (p<0.001 for both), with a greater effect in the central retinal artery than in the central retinal vein (p=0.024). Magnetic resonance imaging and ultrasonography measurements were as reliable as pathology assessments (p=0.675 and p=0.375, respectively). A positive relationship was found between tuCRAv and the tumor volume (p=0.027). The pulse index in the central retinal vein was lower in male patients (p=0.017) and in eyes with optic nerve invasion (p=0.0088). CONCLUSIONS: TuCRAv and tuCRVv are higher in tumor-containing eyes than in normal eyes. Magnetic resonance imaging and ultrasonography measurements are reliable. The tumor volume is correlated with a higher tuCRAv and a reduced pulse in the central retinal vein is correlated with male sex and optic nerve invasion.

  1. Predictive value of excretory urography, ultrasonography, computerized tomography, and liver and bone scan in the staging of bilharzial bladder cancer in Saudi Arabia

    SciTech Connect

    Hanash, K.A.; Bissada, N.K.; Abla, A.; Esmail, D.; Dowling, A.

    1984-07-01

    The role of ultrasonography, computed tomography (CT), and radioisotopic scanning in the staging of bilharzial bladder cancer has not been reported previously. Forty patients with invasive bladder cancer seen at the King Faisal Specialist Hospital and Research Centre between January 1978 and June 1981 underwent complete preoperative workup for staging of their tumors prior to radical cystectomy. The preoperative radiologic investigations included excretory urography (IVP), ultrasonography (US), CT of the pelvis, and liver and bone scans. The results of these investigations were compared with the operative and pathologic staging. Ninety-three percent of the patients with bilharzial cancer had evidence of ureteric obstruction on IVP compared with 22% of the nonbilharzial cancer patients. The presence of ureteric obstruction in these patients did not correlate with the stage of the disease with 83% of the patients with superficial tumors (T1 and T2) having hydroureteronephrosis. Ultrasonography and CT had an 83% accuracy in the staging of superficial tumors. Stage T3 tumors were understaged in 14% of the cases. Ultrasonography did not differentiate Stages T3 and T4 tumors while CT scan differentiated these two stages in 57% of the cases. Bone scan failed to reveal evidence of metastatic disease in any of the bilharzial cancer patients. Liver scan was suspicious for liver metastases in two patients with bilharzial cancers in whom open liver biopsy revealed only hepatic bilharziasis. Of all the radiographic studies, US or preferably CT scan seem to be of some value in the staging of bilharzial tumors localized to the bladder. Bone and liver scans are probably of no cost effective benefit.

  2. SU-E-I-30: Image Analysis in Ultrasonography for Diagnosis of Sjoegren's Syndrome Using Dual-Tree Complex Wavelet Transform

    SciTech Connect

    Matsui, T; Ohki, M; Nakamura, T; Takagi, Y

    2014-06-01

    Purpose: Sjoegren's syndrome (SS) is an autoimmune disease invading mainly salivary and lacrimal glands. Ultrasonography is used for an initial and non-invasive examination of this disease. However, the ultrasonography diagnosis tends to lack in objectivity and depends on the operator's skills. The purpose of this study is to propose a computer-aided diagnosis (CAD) system for SS based on a dual-tree complex wavelet transform (DT-CWT) and machine learning. Methods: The subjects of this study were 174 patients suspected of having SS at Nagasaki University Hospital and examined with ultrasonography of the parotid glands. Out of these patients, 77 patients were diagnosed with SS by sialography. A region of interest (ROI) of 128 × 128 pixels was set within the parotid gland that was indicated by a dental radiologist. The DT-CWT was applied to the images in the ROI and every image was decomposed into 72 sub-images of the real and imaginary components in six different resolution levels and six orientations. The statistical features of the sub-image were calculated and used as data input for the support vector machine (SVM) classifier for the detection of SS. A ten-fold cross-validation was employed to verify the Resultof SVM. The accuracy of diagnosis was compared by a CAD system with a human observer performance. Results: The sensitivity, specificity, and accuracy in the detection of SS were 95%, 86%, and 91% through our CAD system respectively, while those by a human observer were 84%, 81%, and 83% respectively. Conclusion: The proposed computer-aided diagnosis system for Sjoegren's syndrome in ultrasonography based on dual-tree complex wavelet transform had a better performance than a human observer.

  3. Diagnostic Thyroidectomy May Be Preferable in Patients With Suspicious Ultrasonography Features After Cytopathology Diagnosis of AUS/FLUS in the Bethesda System

    PubMed Central

    Lee, Yong Sang; Kim, Hyeung Kyoo; Chang, Hojin; Kim, Seok Mo; Kim, Bup-Woo; Chang, Hang-Seok; Park, Cheong Soo

    2015-01-01

    Abstract Atypia/follicular lesion of undetermined significance (AUS/FLUS) is a new category in the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) for which repeat fine-needle aspiration cytology (FNAC) is recommended. The aim of this study was to identify specific ultrasonography and clinical predictors of malignancy in a subset of thyroid nodules associated with cytology diagnoses of AUS/FLUS. Between January 2011 and December 2102, 5440 patients underwent thyroid surgery at our institution. Of these, 213 patients were diagnosed AUS/FLUS at the preoperative cytopathology diagnosis. The frequency of FNAC and ultrasonography images was compared between patients with cancerous and benign tumors based on their final pathology. Of the 213 patients, 158 (74.2%) were diagnosed with thyroid carcinoma in their final pathology reports. In univariate and multivariate analyses, the frequency of FNAC was not significantly correlated with the cancer diagnosis. Hypoechogenicity (odds ratio 2.521, P?=?0.007) and microcalcification (odds ratio 3.247, P?=?0.005) were statistically correlated with cancer risk. Although AUS/FLUS in cytopathology is recommended for repeating FNAC in BSRTC, we proposed that thyroid nodules with ultrasonography findings that suggest the possibility of cancer should undergo thyroidectomy with diagnostic intent. PMID:26705204

  4. Pre-operative trans-thoracic doppler ultrasonography evaluation and intraoperative manual evaluation of the left internal thoracic artery in patients with type 2 diabetes with coronary artery disease.

    PubMed

    Cihan, H B; Erbas, F; Erdil, N; Sigirci, A; Battaloglu, B; Yologlu, S

    2011-01-01

    Patients with coronary artery disease, with (n = 25) and without (n = 59) type 2 diabetes, who were scheduled to undergo coronary artery bypass grafting were enrolled in this prospective study. The left internal thoracic artery (LITA) was assessed for graft suitability before surgery by trans-thoracic Doppler ultra sonography and during surgery by manual measurement. Significant differences were seen between preoperative and intra-operative LITA blood flow rates and LITA diameters, and the values of each at the two time points showed significant correlation, suggesting that pre-operative measurements largely related to intra-operative conditions. The pre-operative and intra-operative LITA blood flow rates and LITA diameters were not significantly different between patients with and without type 2 diabetes. Pre-operative LITA blood flow was monophasic in three patients without diabetes and the LITA grafts of these patients were deemed unsuitable for implantation during surgery. It is concluded that type 2 diabetes does not seem to have a negative effect on the suitability of LITA grafts. In addition, trans-thoracic Doppler ultrasonography is an easy, cost-effective, reproducible and non-invasive examination method, which may help in the evaluation of LIMA function and contribute to graft selection. PMID:21672331

  5. Hydrogen peroxide mediated transvaginal drug delivery.

    PubMed

    Fatakdawala, Hussain; Uhland, Scott A

    2011-05-16

    Simple, safe and effective permeability enhancers are crucial for successful non-invasive drug delivery methods. We seek local permeability augmentation mechanisms for integration into passive or active architectures in order to enable novel therapeutic delivery routes of the target drug while minimizing drug formulation challenges. This study explores the efficacy of hydrogen peroxide (HP) as a permeability enhancer for transmucosal delivery of macromolecules. HP at low concentrations (2–8 mM) is an effective permeability enhancer that is locally metabolized and safe. HP improves drug permeation through mucosa by altering tight junctions (TJ) between cells and oxidizing enzymes that function to degrade the foreign species. Results from trans-epithelial electrical resistance measurements and cell viability assay show reversible disassembly of TJ with minimal cell damage demonstrating the feasibility of HP as a safe permeability enhancer for drug delivery. Permeation studies show that HP treatment of cell cultured vaginal mucosa significantly enhances the permeability to insulin by more than an order of magnitude. This work lays foundation for the development of a drug delivery platform that administers drug doses by enhancing the permeability of local epithelial tissue via a separate HP treatment step. PMID:21498011

  6. Case Report of Multimodality Imaging in Omental Cake: Plain Radiograph, Computed Tomography, and Ultrasonography: A Care-Compliant Article.

    PubMed

    Juan, Yu-Hsiang; Cheung, Yun-Chung; Ng, Koon-Kwan; Ng, Shu-Hang; Huang, Jen-Seng; Chang, Liang-Che; Lin, Yu-Ching

    2015-11-01

    The imaging finding of omental cake has been demonstrated in other modalities, such as computed tomography, magnetic resonance imaging, and ultrasonography. However, to the best of our knowledge, the image presentation of omental cake on a routine kidney-ureter-bladder film has not been reported before in the literature.We presented a unique case of a 61-year-old woman, with known advanced cecal colon mucinous adenocarcinoma, presented to our institution with abdominal fullness, poor appetite, and decreased stool passage for 20 days. Physical examination was unremarkable, except distended abdomen. Subsequent study revealed massive post-pigtail catheter drainage ascites with a prominent soft-tissue mass-causing centralization and tethering of focally distended small bowel gas, suggestive of omental cake on plain radiograph. The imaging finding in plain radiograph corresponds to the findings in other imaging modalities, including abdominal sonography and computed tomography. The patient underwent subtotal colectomy and ileostomy during later courses of chemotherapy due to adhesion ileus and possible intraabdominal abscess, and pathologic study confirmed the diagnosis of cecal mucinous adenocarcinoma and peritoneal carcinomatosis.Although the image finding of omental cake on plain radiograph has never been described, this image finding is unique and should be recognized, as it may suggest the presence of omental cake when first identified in the emergency department from patients with abdominal distension and warrant further evaluation to evaluate the underlying cause. PMID:26559303

  7. Diagnostic accuracy of gray-scale ultrasonography for the detection of hepatic and splenic lymphoma in dogs.

    PubMed

    Crabtree, Amanda C; Spangler, Elizabeth; Beard, Debra; Smith, Annette

    2010-01-01

    Gray-scale ultrasonography is often used to screen for involvement of the liver and spleen in canine lymphoma patients but the utility of sonography for staging lymphoma has not been evaluated quantitatively. We performed abdominal sonography in 28 dogs with a confirmed diagnosis of lymphoma. Needle aspirates were obtained for cytology from three separate sites in the liver and three sites in the spleen and the sonographic appearance was noted at each site. Our hypothesis was that in dogs newly diagnosed with lymphoma, abnormal appearance of the liver or spleen on ultrasound examination is an indication that lymphoma is present in that organ. Cytologic evaluation was used as the gold standard. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of hepatic and splenic abnormalities seen on ultrasound for diagnosis of lymphoma were 72.7%, 80.6%, 77.4%, 76.3%, and 76.8% for the liver, respectively, and 100%, 23.3%, 64.6%, 100%, and 68.1% for the spleen, respectively. Based on these results, we recommend that aspirates be performed for detection of lymphoma in the spleen of dogs only when the spleen appears abnormal ultrasonographically and that cytology of the liver be performed, regardless of ultrasonographic appearance, to determine the presence or absence of lymphoma. PMID:21158242

  8. Diffusion-weighted MR imaging and Doppler ultrasonography in the evaluation of renal parenchyma in acute ureteral obstruction

    PubMed Central

    Soylu Boy, Fatma Nur; Kayhan, Arda; Karakas, Hakki Muammer; Alp, Turgut; Verit, Ayhan

    2015-01-01

    Objective: To compare the efficacy of diffusion-weighted (DW) magnetic resonance (MR) imaging and Doppler ultrasonography (US) by using quantitative markers in acute unilateral obstruction due to renal stones. Methods: This prospective study included 28 patients with unilateral ureteral obstruction and 18 healthy control subjects. In Doppler US and DW MR imaging, resistive index (RI) and apparent diffusion coefficient (ADC) values were measured respectively. The results were compared in patients and in control subjects. Paired samples test, two-tailed unpaired Student’s t test and Spearman analysis were performed for statistical analysis. Results: The mean RI in the 28 obstructed kidneys was significantly higher than the mean RI in unobstructed kidneys and in control subjects (P < 0.05). The ADC of obstructed kidneys in the cortex was significantly lower than the ADC of the contralateral unobstructed kidneys (P < 0.05). The ADC of unobstructed kidneys was significantly higher than the ADC of control subjects in the cortex (P < 0.05). RI and ADC values yielded no significant correlation. Conclusion: Doppler US and DW MR imaging provide accurate and noninvasive diagnosis, Doppler US may be preferred as it is a more practical technique compared to DW MR imaging in the evaluation of acute ureteral obstruction due to renal stones. PMID:25932225

  9. Change of Muscle Architecture following Body Weight Support Treadmill Training for Persons after Subacute Stroke: Evidence from Ultrasonography

    PubMed Central

    Liu, Peng; Wang, Yanjun; Hu, Huijing; Mao, Yurong; Huang, Dongfeng; Li, Le

    2014-01-01

    Although the body weight support treadmill training (BWSTT) in rehabilitation therapy has been appreciated for a long time, the biomechanical effects of this training on muscular system remain unclear. Ultrasonography has been suggested to be a feasible method to measure muscle morphological changes after neurological diseases such as stroke, which may help to enhance the understanding of the mechanism underlying the impaired motor function. This study investigated the muscle architectural changes of tibialis anterior and medial gastrocnemius in patients after subacute stroke by ultrasound. As expected, we found the effect of BWSTT on the muscular system. Specifically, the results showed larger pennation angle and muscle thickness of tibialis anterior and longer fascicle length of medial gastrocnemius after the training. The findings of this study suggest that the early rehabilitation training of BWSTT in subacute stage of stroke provides positive changes of the muscle architecture, leading to the potential improvement of the force generation of the muscle. This may not only help us understand changes of subacute stroke in muscular system but also have clinical implications in the evaluation of rehabilitation training after neurological insults. PMID:24783198

  10. Primary Non-Hodgkin Lymphoma of the Breast: Ultrasonography, Elastography, Digital Mammography, Contrast-Enhanced Digital Mammography, and Pathology Findings.

    PubMed

    Gkali, Christina An; Chalazonitis, Athanasios N; Feida, Eleni; Giannos, Aris; Sotiropoulou, Maria; Dimitrakakis, Constantine; Loutradis, Dimitrios

    2015-12-01

    Lymphomas constitute approximately 0.15% of malignant mammary neoplasms. Less than 0.5% of all malignant lymphomas involve the breast primarily. Primary non-Hodgkin breast lymphoma is usually right sided. The combined therapy approach, with chemotherapy and radiotherapy, is the most successful treatment. Mastectomy offers no benefit in the treatment of primary non-Hodgkin breast lymphoma. To the author's knowledge, this is the first published case of primary non-Hodgkin breast lymphoma reported with conventional ultrasonography, elastography (both freehand and acoustic radiation force impulse imaging), digital mammography, contrast-enhanced digital mammography, and pathology findings. A 45-year-old woman presented with a lump in the right breast for 2 months. There was no evidence of systemic lymphoma or leukemia when the breast lesion was detected. Imaging findings were negative for lymphoma. Ipsilateral lymph nodes were not palpable. The mass was resected, and histopathology findings were diagnostic of non-Hodgkin lymphoma. Immunohistochemistry was confirmatory of non-Hodgkin lymphoma, diffuse large cell type of B-cell lineage. Although primary and secondary lymphomas of the breast are rare entities, they should be considered in the differential diagnosis of breast malignancies. PMID:25831151

  11. Role of endometrial blood flow assessment with color Doppler energy in predicting pregnancy outcome of IVF-ET cycles.

    PubMed

    Wang, Lina; Qiao, Jie; Li, Rong; Zhen, Xiumei; Liu, Zhaohui

    2010-01-01

    This is a prospective study of 182 women (38 yrs or younger) undergoing IVF-ET. Endometrial thickness, echo pattern and blood flow on transvaginal ultrasonography were recorded eight hours prior to hCG administration. The patients were divided into three groups: A (n = 10) with undetectable endometrial blood flow; B (n = 82) with sub-endometrial blood flow; C (n = 90) with both endometrial and sub-endometrial blood flow. According to IVF-ET outcomes, all patients were re-divided into three groups: 1 non-pregnancy (n = 92); 2 intrauterine pregnancy with live fetus (n = 70); 3 others (n = 20 including biochemical pregnancy, embryonic diapause, ectopic pregnancy and miscarriage). Intrauterine pregnancy with live fetus in Group C (62.2%) was much higher than that in Group A and B (0% and 17.1%, p less than or equal to 0.001). The implantation rate (33.2%) was much higher than that in Group A and B (0% and 19.90%, p less than or equal to 0.001). The pulsatility index, resistance index, and S/D of endometrial spiral arteries were 0.1 +/- 0.2, 0.6 +/- 0.1 and 2.5 +/- 0.4 in Group 2, which were much lower than those in Group 1 and Group 3 (p1-2 less than 0.001, p2-3 less than 0.05). The patients with detectable endometrial blood flow had higher clinical pregnancy rates and implantation rates. PMID:20955593

  12. Layer measurement in high frequency ultra-sonography images for skin

    NASA Astrophysics Data System (ADS)

    Wawrzyniak, Zbigniew M.; Szyszka, Micha?

    2015-09-01

    In this paper, the problem of automatic determination of the position and measuring the thickness of the human skin layers in high-frequency ultrasound images (HFUS) is solved. Location and the process of position determination of the skin layers are not an obvious process due to the phenomenological nature of the images received in HFUS, the so-called speckle noise and the lack of the objective measures. In order to determine the positions of the boundaries of the skin layers, the image analysis methods were used, based on the specific features of the HFUS images, such as layered structure and echogenicity features. Only the fusion of the results of the analysis algorithms based on global (histogram of intensity levels) and local image features (cross-sectional and topological characteristics) improves discriminative features applicable to complete the information about the properties of the HFUS images with layered structure and to develop a method assessing the thickness of the skin layers. The knowledge gathered from such layers checks can improve understanding of the nature of the human skin and provide a more objective conditions for HFUS diagnostic imaging with speeding up the diagnostic process for dermatologists. We proposed a new method for automatic segmentation on HFUS images using fusion of discriminative information based on nonlinear segmentation with a reasonable threshold setting, boundary selecting and linking, and false boundary point removing strategies for intensity distributions.

  13. Accuracy of ultrasonography in the diagnosis of acute appendicitis in adult patients: review of the literature

    PubMed Central

    2013-01-01

    Background Ultrasound is a widely used technique in the diagnosis of acute appendicitis; nevertheless, its utilization still remains controversial. Methods The accuracy of the Ultrasound technique in the diagnosis of acute appendicitis in the adult patient, as shown in the literature, was searched for. Results The gold standard for the diagnosis of appendicitis still remains pathologic confirmation after appendectomy. In the published literature, graded-compression Ultrasound has shown an extremely variable diagnostic accuracy in the diagnosis of acute appendicitis (sensitivity range from 44% to 100%; specificity range from 47% to 99% ). This is due to many reasons, including lack of operator skill, increased bowel gas content, obesity, anatomic variants, and limitations to explore patients with previuos laparotomies. Conclusions Graded-compression Ultrasound still remains our first-line method in patients referred with clinically suspected acute appendicitis: nevertheless, due to variable diagnostic accuracy, individual skill is requested not only to perform a successful exam, but also in order to triage those equivocal cases that, subsequently, will have to undergo assessment by means of Computed Tomography. PMID:23902717

  14. Effect of Cortical Bone Thickness on Detection of Intraosseous Lesions by Ultrasonography

    PubMed Central

    Adibi, Sadaf; Shakibafard, Alireza; Karimi Sarvestani, Zohreh; Saadat, Najmeh; Khojastepour, Leila

    2015-01-01

    Background. Usefulness of ultrasound (US) in detection of intrabony lesions has been showed. A cortical bone perforation or a very thin and intact cortical bone is prerequisite for this purpose. Objective. The current in vitro study was aimed at measuring the cut-off thickness of the overlying cortical bone which allows ultrasonic assessment of bony defects. Materials and Methods. 20 bovine scapula blocks were obtained. Samples were numbered from 1 to 20. In each sample, 5 artificial lesions were made. The lesions were made in order to increase the overlying bone thickness, from 0.1?mm in the first sample to 2?mm in the last one (with 0.1?mm interval). After that, the samples underwent ultrasound examinations by two practicing radiologists. Results. All five lesions in samples numbered 1 to 11 were detected as hypoechoic area. Cortical bone thickness more than 1.1 mm resulted in a failure in the detection of central lesions. Conclusion. We can conclude that neither bony perforation nor very thin cortical bones are needed to consider US to be an effective imaging technique in the evaluation of bony lesion. PMID:26366296

  15. DXA, bioelectrical impedance, ultrasonography and biometry for the estimation of fat and lean mass in cats during weight loss

    PubMed Central

    2012-01-01

    Background Few equations have been developed in veterinary medicine compared to human medicine to predict body composition. The present study was done to evaluate the influence of weight loss on biometry (BIO), bioimpedance analysis (BIA) and ultrasonography (US) in cats, proposing equations to estimate fat (FM) and lean (LM) body mass, as compared to dual energy x-ray absorptiometry (DXA) as the referenced method. For this were used 16 gonadectomized obese cats (8 males and 8 females) in a weight loss program. DXA, BIO, BIA and US were performed in the obese state (T0; obese animals), after 10% of weight loss (T1) and after 20% of weight loss (T2). Stepwise regression was used to analyze the relationship between the dependent variables (FM, LM) determined by DXA and the independent variables obtained by BIO, BIA and US. The better models chosen were evaluated by a simple regression analysis and means predicted vs. determined by DXA were compared to verify the accuracy of the equations. Results The independent variables determined by BIO, BIA and US that best correlated (p?

  16. Evaluation of ultrasonography as a diagnostic tool in the management of head and neck facial space infections: A clinical study

    PubMed Central

    Shah, Ajaz; Ahmed, Irshad; Hassan, Shahid; Samoon, Amina; Ali, Babar

    2015-01-01

    Introduction: Superficial facial space infections represent a significant amount of the dental problems that present to hospital. Determining whether an odontogenic swelling is a cellulitis or abscess is difficult, but important as both may require different treatments. The use of an ultrasound may aid in differentiating cellulitis and abscess. This study was done to compare the accuracy of clinical examination alone versus ultrasonography (USG) in the diagnosis of cellulitis and abscess in symptomatic patients with a diagnosis of superficial facial space infection. Materials and Methods: Twenty patients (1870 years) diagnosed as superficial facial space infections by clinical and radiographic examinations were included in the study and patients with significant medical conditions were excluded. The provisional clinical diagnosis was made after a thorough history was taken and clinical examination was performed to determine if the swelling was a cellulitis or abscess. Swelling was then evaluated using the ultrasonic transducer which was placed over the swelling to aid the diagnosis which was again recorded. An incision and drainage procedure was performed after the administration of local anesthesia. The success of the ultrasound intervention versus clinical examination was based on whether frank exudation was detected during incision and drainage of such swellings. Results: The statistical analysis found that USG is a valuable diagnostic aid for detection of abscess or cellulitis in head and neck facial space infections. Interpretation and Conclusion: The findings of this prospective analysis indicate that there was statistical difference between clinical examination alone and USG in making the correct diagnosis. The sensitivity, specificity, positive predictive, negative predictive, and accuracy were not similar for all methods tested. From the results of this study, ultrasound is recommended as an adjunct to clinical examination in differentiating between cellulitis and abscess. PMID:26668454

  17. SU-D-17A-07: Development and Evaluation of a Prototype Ultrasonography Respiratory Monitoring System for 4DCT Reconstruction

    SciTech Connect

    Yan, P; Cheng, S; Chao, C; Jain, A

    2014-06-01

    Purpose: Respiratory motion artifacts are commonly seen in the abdominal and thoracic CT images. A Real-time Position Management (RPM) system is integrated with CT simulator using abdominal surface as a surrogate for tracking the patient respiratory motion. The respiratory-correlated four-dimensional computed tomography (4DCT) is then reconstructed by GE advantage software. However, there are still artifacts due to inaccurate respiratory motion detecting and sorting methods. We developed an Ultrasonography Respiration Monitoring (URM) system which can directly monitor diaphragm motion to detect respiratory cycles. We also developed a new 4DCT sorting and motion estimation method to reduce the respiratory motion artifacts. The new 4DCT system was compared with RPM and the GE 4DCT system. Methods: Imaging from a GE CT scanner was simultaneously correlated with both the RPM and URM to detect respiratory motion. A radiation detector, Blackcat GM-10, recorded the X-ray on/off and synchronized with URM. The diaphragm images were acquired with Ultrasonix RP system. The respiratory wave was derived from diaphragm images and synchronized with CT scanner. A more precise peaks and valleys detection tool was developed and compared with RPM. The motion is estimated for the slices which are not in the predefined respiratory phases by using block matching and optical flow method. The CT slices were then sorted into different phases and reconstructed, compared with the images reconstructed from GE Advantage software using respiratory wave produced from RPM system. Results: The 4DCT images were reconstructed for eight patients. The discontinuity at the diaphragm level due to an inaccurate identification of phases by the RPM was significantly improved by URM system. Conclusion: Our URM 4DCT system was evaluated and compared with RPM and GE 4DCT system. The new system is user friendly and able to reduce motion artifacts. It also has the potential to monitor organ motion during therapy.

  18. Esophago-Glottal Closure Reflex in Human Infants: A Novel Reflex Elicited With Concurrent Manometry and Ultrasonography

    PubMed Central

    Jadcherla, Sudarshan R.; Gupta, Alankar; Coley, Brian D.; Fernandez, Soledad; Shaker, Reza

    2014-01-01

    BACKGROUND AND AIMS Our aims were to identify and characterize the glottal response to esophageal mechanostimulation in human infants. We tested the hypotheses that glottal response is related to the type of esophageal peristaltic response, stimulus volume, and respiratory phase. METHODS Ten infants (2.8 kg, SD 0.5) were studied at 39.2 wk (SD 2.4). Esophageal manometry concurrent with ultrasonography of the glottis (USG) was performed. The sensory-motor characteristics of mechanostimulation-induced esophago-glottal closure reflex (EGCR, adduction of glottal folds upon esophageal provocation) were identified. Mid-esophageal infusions of air (N 41) were given and the temporal relationships of glottal response with deglutition, secondary peristalsis (SP), and the respiratory phase were analyzed using multinomial logistic regression models. RESULTS The frequency occurrence of EGCR (83%) was compared (P < 0.001) with deglutition (44%), SP (34%), and no esophageal responses (22%). The odds ratios (OR, 95% CI) for the coexistence of EGCR with SP (0.4, 0.06–2.2), deglutition (1.9, 0.1–26), and no response (1.9, 0.4–9.0) were similar. The response time for esophageal reflexes was 3.8 (SD 1.8) s, and for EGCR was 0.4 (SD 0.3) s (P < 0.001). Volume-response relationship was noted (1 mL vs 2 mL, P < 0.05). EGCR was noted in both respiratory phases; however, EGCR response time was faster during expiration (P < 0.05). CONCLUSION The occurrence of EGCR is independent of the peristaltic reflexes or the respiratory phase of infusion. The independent existence of EGCR suggests a hypervigilant state of the glottis to prevent retrograde aspiration during GER events. PMID:17617206

  19. Significance of ultrasonography in selecting methods for the treatment of acute cholecystitis

    PubMed Central

    Wyro?lak-Najs, Justyna; Skoczylas, Tomasz; Wallner, Grzegorz

    2013-01-01

    Surgical removal of the gallbladder is indicated in nearly all cases of complicated acute cholecystitis. In the 1990s, laparoscopic cholecystectomy became the method of choice in the treatment of cholecystolithiasis. Due to a large inflammatory reaction in the course of acute inflammation, a laparoscopic procedure is conducted in technically difficult conditions and entails the risk of complications. The aim of this paper The aim of this paper was: 1) to analyze ultrasound images in acute cholecystitis; 2) to specify the most common causes of conversion from the laparoscopic method to open laparotomy; 3) to determine the degree to which the necessity for such a conversion may be predicted with the help of ultrasound examinations. Material and methods In 1993–2011, in the Second Department and Clinic of General, Gastroenterological and Oncological Surgery of the Medical University in Lublin, 5,596 cholecystectomies were performed including 4,105 laparoscopic procedures that constituted 73.4% of all cholecystectomies. Five hundred and forty-two patients (13.2%) were qualified for laparoscopic procedure despite manifesting typical symptoms of acute cholecystitis in ultrasound examination, which comprise: thickening of the gallbladder wall of > 3 mm, inflammatory infiltration in the Calot's triangle region, gallbladder filled with stagnated or purulent contents and mural or intramural effusion. Results In the group of operated patients, the conversion was necessary in 130 patients, i.e. in 24% of cases in comparison with 3.8% of patients with uncomplicated cholecystolithiasis (without the signs of inflammation). The conversion most frequently occurred when the assessment of the anatomical structures of the Calot's triangle was rendered more difficult due to local inflammatory process, mural effusion and thickening of the gallbladder wall of >5 mm. The remaining changes occurred more rarely. Conclusions Based on imaging scans, the most common causes of conversion included inflammatory infiltration in the Calot's triangle region, mural effusion and wall thickening to > 5 mm. The classical cholecystectomy in acute cholecystitis should be performed in patients with three major local complications detected on ultrasound examination and in those, who manifest acute clinical symptoms.

  20. First experience using 4-dimensional hysterosalpingo-contrast sonography with SonoVue for assessing fallopian tube patency.

    PubMed

    He, Yanni; Geng, Qiang; Liu, Hongmei; Han, Xiaohua

    2013-07-01

    This study was conducted to describe our first experience using transvaginal 4-dimensional (4D) hysterosalpingo-contrast sonography with SonoVue (Bracco International BV, Amsterdam, the Netherlands) for diagnosis of fallopian tube patency. The study was prospective and conducted in a university hospital setting. The sonographic procedures included 2-dimensional transvaginal sonography for evaluating uterine and ovarian mobility, observing intubation, and determining the initial plane and 4D hysterosalpingo-contrast sonography for observing periovarian and pelvic diffusion. Ninety-six outpatients visiting infertility clinics underwent 4D hysterosalpingo-contrast sonography. All patients finished the examination successfully. A total of 192 fallopian tubes were assessed, of which 95 (49.5%) were classified as type A (the tube was patent, and the contrast agent flowed smoothly through it), 72 (37.5%) as type B (the tube was patent, but the contrast agent did not flow smoothly inside it), and 25 (13.0%) as type C (blocked). Sixteen patients underwent laparoscopy or laparoscopy combined with hysteroscopy; 28 tubes (87.5%) were concordant with laparoscopy. The sensitivity, specificity, positive predictive value, negative predictive value, and Youden index for 4D hysterosalpingo-contrast sonography versus laparoscopy were 81.8%, 90.5%, 81.8%, 90.5%, and 0.72 respectively. In total, 92.7% of patients did not require a hospital stay after 4D hysterosalpingo-contrast sonography, and none need resuscitation. The others stayed in the hospital for clinical observation because of a severe vasovagal reaction or severe pain but received only bed rest without any medical treatment. Forty patients (41.7%) felt slight pain; 39 (40.6%) felt moderate pain; and 15 (15.6%) had a vasovagal reaction. No procedure or postprocedure complications occurred in any patient. In conclusion, 4D hysterosalpingo-contrast sonography with SonoVue is an available screening method for assessment of tubal patency and is tolerable for most patients. PMID:23804346

  1. Affects of Anxiety and Depression on Health-Related Quality of Life among Patients with Benign Breast Lumps Diagnosed via Ultrasonography in China

    PubMed Central

    Lou, Zhe; Li, Yinyan; Yang, Yilong; Wang, Lie; Yang, Jun

    2015-01-01

    There is a high incidence of benign breast lumps among women, and these lumps may lead to physical and psychological problems. This study aims to evaluate anxiety and depressive symptoms among patients with benign breast lumps diagnosed via ultrasonography and investigate their impacts on health-related quality of life (HRQOL). A cross-sectional survey was conducted in Shenyang, China, from January to November 2013. Data were collected with self-administered questionnaires, including the Zung Self-Rating Anxiety Scale (SAS), the Center for Epidemiologic Studies Depression Scale (CES-D), and the 36-item Short-Form Health Survey (SF-36), together with demographic characteristics, from patients of the Department of Breast Surgery of the First Affiliated Hospital of China Medical University. Hierarchical multiple regression analysis (HMR) was performed to explore the effects of anxiety and depression on HRQOL. The overall prevalences of anxiety (SAS score ? 40) and depression (CES-D scores ? 16) were 40.2% and 62.0%, respectively, and 37.5% of the participants had both of these psychological symptoms. The means and standard deviations of PCS and MCS were 75.42 (15.22) and 68.70 (17.71), respectively. Anxiety and depressive symptoms were significantly negatively associated with the HRQOL of patients with benign breast lumps diagnosed via ultrasonography. Women with benign breast lumps diagnosed via ultrasonography in China experienced relatively high levels of anxiety and depressive symptoms. Anxiety and depressive symptoms had significant negative impacts on both the mental and physical quality of life (QOL) of women with benign breast lumps. Beyond the necessary clinical treatment procedures, psychological guidance and detailed explanations of the disease should be offered to alleviate the anxiety and depressive symptoms and enhance the HRQOL of patients with benign breast lumps. PMID:26343700

  2. Evaluation of normal findings using a detailed and focused technique for transcutaneous abdominal ultrasonography in the horse

    PubMed Central

    2014-01-01

    Background Ultrasonography is an important diagnostic tool in the investigation of abdominal disease in the horse. Several factors may affect the ability to image different structures within the abdomen. The aim of the study was to describe the repeatability of identification of abdominal structures in normal horses using a detailed ultrasonographic examination technique and using a focused, limited preparation technique. Methods A detailed abdominal ultrasound examination was performed in five normal horses, repeated on five occasions (total of 25 examinations). The abdomen was divided into ten different imaging sites, and structures identified in each site were recorded. Five imaging sites were then selected for a single focused ultrasound examination in 20 normal horses. Limited patient preparation was performed. Structures were recorded as ‘identified’ if ultrasonographic features could be distinguished. The location of organs and their frequency of identification were recorded. Data from both phases were analysed to determine repeatability of identification of structures in each examination (irrespective of imaging site), and for each imaging site. Results Caecum, colon, spleen, liver and right kidney were repeatably identified using the detailed technique, and had defined locations. Large colon and right kidney were identified in 100% of examinations with both techniques. Liver, spleen, caecum, duodenum and other small intestine were identified more frequently with the detailed examination. Small intestine was most frequently identified in the ventral abdomen, its identification varied markedly within and between horses, and required repeated examinations in some horses. Left kidney could not be identified in every horse using either technique. Sacculated colon was identified in all ventral sites, and was infrequently identified in dorsal sites. Conclusions Caecum, sacculated large intestine, spleen, liver and right kidney were consistently identified with both techniques. There were some normal variations which should be considered when interpreting ultrasonographic findings in clinical cases: left kidney was not always identified, sacculated colon was occasionally identified in dorsal flank sites. Multiple imaging sites and repeated examinations may be required to identify small intestine. A focused examination identified most key structures, but has some limitations compared to a detailed examination. PMID:25238559

  3. Monitoring of embryonic and fetal losses in different breeds of goats using real-time B-mode ultrasonography.

    PubMed

    Samir, Haney; Karen, Aly; Ashmawy, Tarek; Abo-Ahmed, Mostafa; El-Sayed, Mohamed; Watanabe, Gen

    2016-01-15

    Compared to cattle and sheep, few studies had been undertaken to evaluate the incidence of embryonic and fetal losses (EFL) in goats. The objectives of the present study were to characterize the timing of EFL and to identify the factors that are associated with EFL in goats such as breed, age, parity, method of estrous synchronization, and breeding. Moreover, this study aimed to ensure whether a relationship existed between serum progesterone (P4) and EFL. Goats (n = 151) of different breeds (70 Zaraiebi, 42 Damascus, and 39 Cross goats [Baladi × Damascus]) were evaluated by ultrasonography to monitor EFL during different stages of gestation (D20-23, D26-29, D33-36, D40-45, and D47-54 after breeding). Blood samples were collected at D7, D20, and at each ultrasonographic scanning to clarify changes of serum P4 levels concurrently with EFL. Results revealed that 45 of 109 goats (41.28%) were exposed to EFL. A higher EFL % was observed between D20 to 23 and D47 to 54 (19.61%) compared with D47 to 54 to birth (11.76%). Moreover, a higher EFL % was observed in Zaraiebi goats compared with others. Age and goat parity had no significant effect on the EFL % in all goats. A high EFL % were observed in goats synchronized by P4 sponge, as well as artificially inseminated goats compared with goats with spontaneous estrus, and bred by natural mating, respectively. Serum P4 at D7 or D20 after breeding showed nonsignificant difference between normal pregnant goats and goats that experienced EFL. Unlike goats that experienced partial EFL, goats that experienced total EFL between D20 to 23 and D26 to 29 showed an abrupt P4 reduction (85.06%; P < 0.01) suggesting the probability of endocrine disruption of the CL. However, goats that were exposed to total EFL between D26 and 29 to D33 to 36 showed a low P4 reduction (24.90%; P < 0.05), which might be considered as an effect rather than a cause of EFL. In conclusion, different factors such as breed, estrous synchronization, breeding, and stage of pregnancy may be involved in EFL in goats. Therefore, improvement of the goat management in the early stage of pregnancy is important to decrease EFL % in goats. Although the P4 did not show any significant difference between normal pregnancy goats and goats that experienced EFL, CL disruption should be taken into the consideration, at least, in goats exposed to total embryonic losses. PMID:26489907

  4. Ultrasonography in testicular torsion.

    PubMed

    Bird, K; Rosenfield, A T; Taylor, K J

    1983-05-01

    Testicular torsion was evaluated by B-scan ultrasound in one experimental animal and in 12 patients. The clinical findings were categorized as acute, subacute, or chronic depending on the amount of time that had elapsed since the onset of pain (less than 24 hours, 1 to 10 days, and more than 10 days, respectively). A consistent pattern of sonographic parenchymal changes for each of these stages is described. The ultrasound textural changes were found to be diagnostically useful when correlated with the clinical findings. Scrotal ultrasound also complements radioisotope studies, locating the testicle when it cannot be found by palpation, and may detect testicular torsion that is not suspected clinically. When physiologic blood flow studies are normal in the clinical setting of possible torsion, ultrasound is more accurate than other imaging modalities in demonstrating pathology. PMID:6836134

  5. Musculoskeletal ultrasonography in gout.

    PubMed

    Scirocco, Chiara; Rutigliano, Iolanda Maria; Finucci, Annacarla; Iagnocco, Annamaria

    2015-12-01

    Gout is a frequent inflammatory disease induced by the deposition of monosodium urate crystals in joints and extra-articular tissues. The natural history of the disease includes four different phases: asymptomatic hyperuricemia, acute attacks, intercritical phase, and chronic tophaceous gout. Imaging techniques have several applications in the diagnosis, clinical monitoring and management of the disease but particularly, musculoskeletal ultrasound is able to detect a wide set of abnormalities in gout. This review reports the most relevant findings detectable by ultrasound and the current available data in the literature regarding the role of musculoskeletal ultrasound in gout.. PMID:26649351

  6. New techniques in the diagnosis of ectopic pregnancy.

    PubMed

    Taylor, K J; Meyer, W R

    1991-03-01

    Pulse and color Doppler studies have provided a potent method for the investigation of functional changes and pathologic conditions in the female pelvis, both in the gravid and nongravid state. Combined with transvaginal sonography, which optimizes the imaging capability, the transvaginal color Doppler ultrasonography provides a new major modality for reproductive flow studies that have hitherto been possible only in animal models because of the invasiveness of the technique. Apart from these potential applications of the technique for research purposes, however, transvaginal imaging and the Doppler technique have become major modalities in all patients suspected of ectopic pregnancy at our institution. PMID:1923256

  7. Efficacy of a combined protocol for re-insemination of open cows after early pregnancy diagnosis using ultrasonography and its effect on fertility

    PubMed Central

    Gaja, A.O.; Al-Dahash, S.Y.A.; Kubota, C.; Kojima, T.; Hatazoe, I.

    2013-01-01

    The objective of the present field study was to establish the beneficial effects of re-insemination of non-pregnant cows using ultrasonography 20 to 23 days after the artificial insemination. A total of 245 Japanese Black cows were artificially inseminated and early pregnancy diagnosis (EPD) was performed on 92 cows 20 days after insemination, using ultrasonography. The remaining 153 cows were considered as negative controls in which routine rectal palpation was performed for pregnancy diagnosis 45-50 days post-insemination. EPD revealed that eleven of the 92 cows (12%) were infertile due to ovarian abnormalities and were thus excluded from the rest of the study. Forty-eight (59%) of the remaining 81 cows were diagnosed as pregnant, while the other 33 (41%) were diagnosed as non-pregnant. Of these non-pregnant cows, 17 of them received a dose of an analogue of the gonadotropin-releasing hormone (GnRH analogue) and were then timed-inseminated, while the other 16 were observed for estrus signs, and 13 of them (81%) were artificially inseminated. Rates of conception were 35% and 38% in the GnRH and the artificially inseminated groups, respectively (P>0.05). Total pregnancy rate for the EPD group increased significantly (74%) (P<0.01) when compared to the control cows (54%) within the same period. In conclusion, our field study demonstrated that re-insemination of non-pregnant cows following EPD is highly efficacious not only in improving the rate of fertility via reducing inter-insemination and inter-calving intervals, but also aids in the early detection of ovarian disorders.

  8. [Ultrasound assessment in renal infections].

    PubMed

    Granata, Antonio; Floccari, Fulvio; Insalaco, Monica; Clementi, Anna; Di Lullo, Luca; D'Amelio, Alessandro; Zamboli, Pasquale; Logias, Francesco; Romano, Marcello; Fiorini, Fulvio

    2012-01-01

    Urinary tract infections (UTIs) are a common clinical problem, especially among women. Ultrasound assessment is indicated in case of complicated UTIs, in particular in children, pregnant women and patients with chronic kidney disease. Even though B-mode imaging alone is rarely diagnostic in case of particular kidney infections such as focal and multifocal acute pyelonephritis, Doppler and power-Doppler (PD) techniques are able to increase its sensitivity. Contrast-enhanced ultrasound (CEUS) further improves the signal-to-noise ratio, thus increasing the diagnostic accuracy of ultrasound in case of renal infectious disease. Recent studies performed on kidney transplant recipients have indeed demonstrated the high sensitivity and specificity of CEUS in diagnosing acute pyelonephritis. Moreover, ultrasonography is a useful diagnostic tool in case of kidney abscesses, emphysematous pyelonephritis, early phases of pyonephrosis, and in the evaluation and monitoring of echinococcal cysts. Ultrasound imaging is less specific in diagnosing xanthogranulomatous pyelonephritis, malacoplakia and renal tuberculosis. Finally, several authors recommend routine ultrasound assessment in HIV patients, given the high incidence of renal complications in this population of patients. PMID:23229529

  9. Assessment of reproductive status in male echidnas.

    PubMed

    Johnston, S D; Nicolson, V; Madden, C; Logie, S; Pyne, M; Roser, A; Lisle, A T; D'Occhio, M

    2007-01-01

    This study reports the development and application of techniques to assess the reproductive status of male echidnas. The pattern of testosterone secretion over a 24-h period in five echidnas was documented. Testosterone secretion after injection i.m. of either 1000 IU hCG (n=4) or 4 microg GnRH agonist (n=6) was determined to establish whether this could be used as a practical index of the prevailing steroidogenic capacity of the testes. hCG (1000 IU) was also used to assess seasonal changes in testosterone secretion in six echidnas over a 13-month period. Seasonal changes in testicular volume were examined by transabdominal ultrasonography. Electroejaculation was attempted to monitor seasonal changes in sperm production, which was also determined by spermatorrhea. There was no apparent diurnal pattern of testosterone secretion in echidnas and circulating concentrations of testosterone remained relatively low (maximum 1.2 ng/mL) and stable over 24h. Injection of hCG resulted in an increase (P<0.01; n=4) in testosterone concentration with a peak (2.9+/-0.3 ng/mL) approximately 4h after injection. GnRH also induced an increase (P<0.01; n=6) in circulating testosterone that was apparent after 1h (2.6+/-0.3 ng/mL) and concentrations remained elevated (3.4+/-0.3 ng/mL) for up to 8h after injection. Seasonal changes in testosterone secretion determined after injection of hCG, increased (P=0.03; n=6) from late-autumn, peaked in late-winter, and decreased by early-spring. Testicular volume followed a similar seasonal pattern (P<0.01; n=6) with an increase from late-autumn, peak in winter and a decline in mid-spring. There was no seasonal change in live weight. Electroejaculation was attempted throughout two breeding seasons but no semen was obtained. Spermatorrhoea in the echidna was described for the first time and was subsequently used to assess seasonal sperm production. Spermatozoa were found in the urine from June to September. This study has demonstrated that exogenous hormones can be used to obtain an index of the prevailing steroidogenic capacity of the testes in echidnas, which is not apparent with repetitive non-stimulated samples over 24 h. The assessment of testosterone secretion after injection of trophic hormones provides a valuable and practical procedure for the assessment of reproductive status. Testicular ultrasonography and spermatorrhea are useful in assessing reproductive status and in this study were successfully used to determine seasonal reproduction in captive echidnas. PMID:16476529

  10. [Ultrasound assessment of reconstructed rotator cuffs].

    PubMed

    Cammerer, U; Habermeyer, P; Plenk, A; Huber, R

    1992-12-01

    The evaluation of recurrent shoulder symptoms in patients who have had rotator cuff repair is a diagnostic challenge. Pain and limitation of motion may be caused by a recurrence of the rotator cuff tear. Arthrography is not considered to be helpful in postoperative cases, since it is false-positive in most of them. Pre-operative ultrasonography of the shoulder is regarded as a highly accurate diagnostic tool for rotator cuff tears. The diagnostic criteria used are: the continuity of the rotator cuff, its contour, its thickness and its echogenicity. Our study was aimed at determining which ultrasonographic criteria were significant for a retear. In addition, the "normal" postoperative sonographic appearance of the rotator cuff was established. Of 133 patients with a full thickness rotator cuff tear, 110 were evaluated 4-48 months (mean in 21 months) after surgery. A total of 85 cuffs were reconstructed, in 46 cases by direct suture, in 33 cases by suture to the major tubercle and in 6 cases by tendon transfer (Cofield technique). In 25 cases cuffs the could not be reconstructed. Subacromial decompression was performed routinely. The patients were evaluated clinically by range of movement, force and isometric and impingement tests. The subjective outcome was assessed by the algo-functional index of Patte. Ultrasonography was performed using a 7.5-MHz linear scanner. Each sonographic criterion was referred to the clinical and subjective findings. Ultrasonographic evaluation of the rotator cuffs that could not be reconstructed revealed non-visualization of the tendons. In 13 of the 85 patients in whom reconstruction of the cuff was possible a normal sonographic pattern was seen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1287844

  11. Intraductal tubulopapillary neoplasm with expansile invasive carcinoma of the pancreas diagnosed by endoscopic ultrasonography-guided fine needle aspiration: a case report.

    PubMed

    Furuhata, Ayako; Minamiguchi, Sachiko; Mikami, Yoshiki; Kodama, Yuzo; Sumiyoshi, Shinji; Adachi, Souichi; Haga, Hironori

    2014-04-01

    Intraductal tubulopapillary neoplasm (ITPN) of the pancreas, a novel entity included in the World Health Organization 2010 classification, accounts for <1% of all pancreatic exocrine neoplasms and the number of reported cases is limited in the English literature. Herein we describe the cytologic features of ITPN with invasive carcinoma showing expansile growth on endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) cytology. A 74-year-old male patient is presented with a 6.2 cm irregular mass in the head of the pancreas. Microscopic examination of EUS-FNA material showed abundant branching clusters of cells, with some scattered discohesive cells. High power magnification revealed tubular and cribriform patterns with central lumina, containing mucinous or proteinaceous secretions. The constituent cells were relatively uniform and showed mild to intermediate nuclear atypia. Intracytoplasmic mucin was not identified. On cell-block preparation, luminal spaces of clusters contained wispy luminal mucin. Immunohistochemically, constituent cells were positive for MUC1 and MUC6, and were negative for MUC5AC. The large cribriform and tubular clusters with luminal spaces containing wispy mucin were considered to be diagnostic clues for the cytologic diagnosis of ITPN by EUS-FNA. MUC1, MUC6, and MUC5AC immunohistochemistry for cell-block preparation appears to be a useful adjunctive tool to confirm the diagnosis. On EUS-FNA, ITPN should be included in the differential diagnosis of a pancreatic mass lesion showing good circumscription. PMID:24339429

  12. Evaluation of the efficacy of a combination of diltiazem and periprostatic nerve block in pain control during transrectal ultrasonography-guided biopsy of the prostate

    PubMed Central

    Mandal, SN; Biswas, G; Karmakar, D

    2013-01-01

    Introduction The choice of analgesia during prostate biopsy remains controversial. The pain has dual origin: from the insertion of the probe as well as the biopsy itself. Periprostatic nerve block (PPNB) is currently the gold standard modality for decreasing pain of prostate biopsy but it does not alleviate the pain of probe insertion. A randomised controlled trial was performed to test the efficacy and safety of the combination of topical application of diltiazem gel and PPNB for pain control during transrectal ultrasonography guided prostate biopsy. Methods A total of 73 patients who were to undergo their first prostate biopsy were randomised to receive either 2ml of 2% topical diltiazem gel or a placebo 15 minutes before the biopsy. All the patients then had a PPNB using 1% lignocaine. A ten-point visual analogue scale was used to record the pain immediately after the insertion of the probe and during the biopsy. Any adverse effects were also recorded. Results There was no significant difference in the mean age and prostate volumes between the groups. There was a significantly lower mean pain score due to probe insertion in those patients who received topical diltiazem than in the placebo group (p<0.0001). There was no significant difference between the pain scores during the biopsy itself between the two groups. Conclusions Topical diltiazem significantly reduces the pain of probe insertion during prostate biopsy and can be used effectively as an adjuvant to PPNB. PMID:23838501

  13. Histological diagnosis of gastric submucosal tumors: A pilot study of endoscopic ultrasonography-guided fine-needle aspiration biopsy vs mucosal cutting biopsy

    PubMed Central

    Ikehara, Hisatomo; Li, Zhaoliang; Watari, Jiro; Taki, Masato; Ogawa, Tomohiro; Yamasaki, Takahisa; Kondo, Takashi; Toyoshima, Fumihiko; Kono, Tomoaki; Tozawa, Katsuyuki; Ohda, Yoshio; Tomita, Toshihiko; Oshima, Tadayuki; Fukui, Hirokazu; Matsuda, Ikuo; Hirota, Seiichi; Miwa, Hiroto

    2015-01-01

    AIM: To compare the usefulness of endoscopic ultrasonography-guided fine-needle aspiration biopsy (EUS-FNAB) without cytology and mucosal cutting biopsy (MCB) in the histological diagnosis of gastric submucosal tumor (SMT). METHODS: We prospectively compared the diagnostic yield, feasibility, and safety of EUS-FNAB and those of MCB based on endoscopic submucosal dissection. The cases of 20 consecutive patients with gastric SMT ? 1 cm in diameter. who underwent both EUS-FNAB and MCB were investigated. RESULTS: The histological diagnoses were gastrointestinal stromal tumors (n = 7), leiomyoma (n = 6), schwannoma (n = 2), aberrant pancreas (n = 2), and one case each of glomus tumor, metastatic hepatocellular carcinoma, and no-diagnosis. The tumors’ mean size was 23.6 mm. Histological diagnosis was made in 65.0% of the EUS-FNABs and 60.0% of the MCBs, a nonsignificant difference. There were no significant differences in the diagnostic yield concerning the tumor location or tumor size between the two methods. However, diagnostic specimens were significantly more frequently obtained in lesions with intraluminal growth than in those with extraluminal growth by the MCB method (P = 0.01). All four SMTs with extraluminal growth were diagnosed only by EUS-FNAB (P = 0.03). No complications were found in either method. CONCLUSION: MCB may be chosen as an alternative diagnostic modality in tumors showing the intraluminal growth pattern regardless of tumor size, whereas EUS-FNAB should be performed for SMTs with extraluminal growth. PMID:26468338

  14. The effect of anesthesia with propofol and sedation with butorphanol on quantitative contrast-enhanced ultrasonography of the healthy feline kidney.

    PubMed

    Stock, Emmelie; Vanderperren, Katrien; Van der Vekens, Elke; Haers, Hendrik; Duchateau, Luc; Polis, Ingeborgh; Hesta, Myriam; Saunders, Jimmy H

    2014-12-01

    Contrast-enhanced ultrasonography of the left kidney was performed using a commercial contrast agent in six healthy adult purpose-bred cats. A cross-over design was used to compare three protocols: (1) awake, (2) butorphanol (0.4?mg/kg IM), and (3) propofol (3.5-7.7?mg/kg IV boluses to effect). Time-intensity curves were created from two regions-of-interest drawn in the renal cortex. The curves were analyzed for blood flow parameters representing blood volume (base intensity, peak intensity, area-under-curve) and blood velocity (arrival time, time-to-peak, wash-in/out). There was no difference in the subjective enhancement pattern between the three protocols. No significant effect of butorphanol was observed in any of the perfusion parameters (P?>?0.05). Propofol did not influence the most important perfusion parameter, area-under-the-curve, and is adequate for use in contrast-enhanced ultrasound studies. PMID:25458879

  15. Assessing Classroom Assessment Techniques

    ERIC Educational Resources Information Center

    Simpson-Beck, Victoria

    2011-01-01

    Classroom assessment techniques (CATs) are teaching strategies that provide formative assessments of student learning. It has been argued that the use of CATs enhances and improves student learning. Although the various types of CATs have been extensively documented and qualitatively studied, there appears to be little quantitative research…

  16. Assessments Introduction to Assessments

    E-print Network

    Ishida, Yuko

    Assessments are required only for income generated from external clients (i.e., does not have a Kuali account to the recharge rate. The NUD is the UC Davis mechanism for recovering the indirect (or overhead) costs negotiated rate Campus Assessment: A 3% campus charge is applied to all revenue with the following exemptions

  17. Sonohysterography: Principles, technique and role in diagnosis of endometrial pathology

    PubMed Central

    Yang, Thomas; Pandya, Amit; Marcal, Leonardo; Bude, Ronald O; Platt, Joel F; Bedi, Deepak G; Elsayes, Khaled M

    2013-01-01

    Sonohysterography (SHG), which provides enhanced endometrial visualization during standard transvaginal ultrasonography, is a relatively safe procedure for the evaluation of endometrial pathology. It can be used to evaluate patients with abnormal vaginal bleeding or infertility. This modality offers real time imaging of the endometrium without exposure to ionizing radiation. SHG is typically used in patients for whom standard transvaginal ultrasonography does not show the endometrium well, show a potential abnormality for which further imaging is required, or in patients without endometrial pathology defined on routine transvaginal imaging but in whom there is a strong clinical suspicion of an abnormality. This article will discuss the utility of the sonohysterogram in evaluation of various endometrial pathologies. Imaging examples of these pathological entities will be illustrated as well. PMID:23671744

  18. Diagnostic value of color doppler ultrasonography in detecting stenosis and occlusion of central veins in patients with chronic kidney disease.

    PubMed

    Rad, Masoud Pezeshki; Kazemzadeh, Gholam Hosain; Ziaee, Masood; Azarkar, Ghodsieh

    2015-03-01

    Venography is an invasive diagnostic test that uses contrast material that provides a picture of the condition of the veins. But, complications, including adverse effects on the kidney, do occur. On the other hand, with the current technological development, application of ultrasound in the diagnosis of obstructive diseases of the veins is gaining popularity, being non-invasive, easy to perform and cost-effective. The aim of this study was to evaluate the diagnostic value of Doppler sonography in the diagnosis of central vein stenosis. In this descriptive-analytical study, 41 hemodialysis patients who had been referred for 50 upper limb venographies to the radiology department of Imam Reza (AS) were included. Patients with chronic kidney disease with a history of catheterization of the vein, jugular or subclavian, and who had established fistulas or synthetic vascular grafts were targeted. Central venous ultrasound was performed on both sides to evaluate stenosis or occlusion. Venography was performed by the radiologist the next day or the day before hemodialysis. Data on demographic characteristics, findings of clinical examination and findings of ultrasound as well as venography were recorded by using the SPSS software, Chi-square test and Spearman correlation, and Kappa agreement was calculated for sensitivity, specificity and predictive values. Twenty-three (56%) patients were male subjects and 18 patients (44%) were female. Twenty-three (56%) patients of the study population were aged <60 years and 18 (43/9%) patients were aged >60 years. The overall sensitivity, specificity and positive predictive value and negative predictive value of Doppler sonography in the proximal veins in hemodialysis patients compared with venography were, respectively, 80.9%, 79.3%, 73.9% and 85.1%. Color Doppler sonography, as a non-invasive method, could be a good alternative for venography in the assessment of the upper limb with central vein stenosis and occlusion. PMID:25758875

  19. Diagnostic Testing for Female Infertility

    MedlinePLUS

    ... out their ends if they are open. Transvaginal Ultrasonography: An ultrasound probe placed in the vagina allows the clinician to check the uterus and ovaries for abnormalities such as fibroids and ovarian cysts. Ovarian Reserve Testing: When attempting to test for a woman’s ovarian ...

  20. Physician Knowledge and Awareness of CA-125 As a Screen for Ovarian Cancer in the Asymptomatic, Average-Risk Population

    ERIC Educational Resources Information Center

    Stewart, Sherri L.; Rim, Sun Hee; Gelb, Cynthia A.

    2012-01-01

    Effective early detection strategies for ovarian cancer do not exist. Current screening guidelines recommend against routine screening using CA-125 alone or in combination with transvaginal ultrasonography (TVS). In this study, the authors used the 2008 "DocStyles" survey to measure clinician beliefs about the effectiveness of CA-125 and TVS in…

  1. Ultrasonography-Guided Core Biopsy of Supraclavicular Lymph Nodes for Diagnosis of Metastasis and Identification of Epidermal Growth Factor Receptor (EGFR) Mutation in Advanced Lung Cancer

    PubMed Central

    Choe, Jooae; Kim, Mi Young; Baek, Jung Hwan; Choi, Chang-Min; Kim, Hwa Jung

    2015-01-01

    Abstract The aim of this study was to evaluate the diagnostic performance of ultrasonography (US)-guided core biopsy of a supraclavicular lymph node (SCN) for detecting metastasis and epidermal growth factor receptor (EGFR) mutations. We included 229 patients who underwent US-guided core biopsy of SCN with lung cancer from January 2011 to December 2013. We evaluated the morphologic characteristics and measured the sizes of SCNs on US and chest computed tomography (CT). The clinical stage, maximum standardized uptake value (SUVmax) on 18F-fluorodeoxyglucose positron emission tomography, and the morphology on US and CT in the positive metastasis were compared with those in the negative metastasis. The prevalence of EGFR mutations of the adenocarcinoma and procedure-related complication was investigated. The accuracy of US-guided core biopsy of SCN diagnosing metastasis was 97.8% (224/229). The cutoff values (sensitivity; specificity; area under the receiver operating characteristic curve, 95% confidence interval [CI]) of the short-axis dimension of SCN on CT were 0.85?cm (72.3%; 80.6%; 0.808, 95% CI: 0.740–0.875), on US 0.75?cm (73.5%; 84.8%; 0.843, 95% CI: 0.788–0.897), and that of SUVmax 4.05 (79.1%; 81.8%; 0.853, 95% CI: 0.780–0.925). The mutations were positive in 35.8% with adenocarcinoma. There were no procedure-related complications of US-guided SCN core biopsy. US-guided SCN core biopsy is a reliable and safe method for detecting metastasis, histologic subtyping, and identifying the EGFR mutation in the advanced lung cancers. It may be a substitute for more invasive lung biopsy as an initial tissue confirmation in the advanced disease. PMID:26200642

  2. Comparison of gray-scale contrast-enhanced ultrasonography with contrast-enhanced computed tomography in different grading of blunt hepatic and splenic trauma: an animal experiment.

    PubMed

    Tang, Jie; Li, Wenxiu; Lv, Faqin; Zhang, Huiqin; Zhang, Lihai; Wang, Yuexiang; Li, Junlai; Yang, Li

    2009-04-01

    To compare the diagnostic value of contrast-enhanced ultrasonography (CEUS) with contrast-enhanced computed tomography (CECT) for the detection of different grading of solid organ injuries in blunt abdominal trauma in animals. A self-made miniature tools were used as models to simulate a blunt hepatic or splenic trauma in 16 and 14 anesthetized dogs, respectively. Baseline ultrasound, CEUS and CECT were used to detect traumatic injuries of livers and spleens. The degree of injuries was determined by CEUS according to the American Association for the Surgery of Trauma (AAST) scale and the results compared with injury scale based on CECT evaluation. CEUS showed 22 hepatic injury sites in 16 animals and 17 splenic injury sites in other 14 animals. According to AAST scale, 2 grade I, 4 grade II, 3 grade III, 5 grade IV and 2 grade V hepatic lesions were present in 16 animals; 2 grade I, 4 grade II, 6 grade III and 2 grade IV splenic lesions in 14 animals. On CECT scan, 21 hepatic and 17 splenic injuries were demonstrated. According to Becker CT scaling for hepatic injury, 1 grade I, 2 grade II, 4 grade III, 5 grade IV and 2 grade V hepatic injuries were present. On the basis of Buntain spleen scaling, 2 grade I, 5 grade II, 5 grade III, 2 grade IV splenic injuries were showed. After Spearman rank correlation analysis, the agreement of CEUS with CECT on the degree of hepatic and splenic injury is 93.3% and 92.9%, respectively. CT is currently considered as the reference method for grading blunt abdominal trauma, according to experiment results, CEUS grading showed high levels of concordance with CECT. CEUS can accurately determine the degree of injury and will play an important role in clinical application. PMID:19097681

  3. Ten-core versus 16-core transrectal ultrasonography guided prostate biopsy for detection of prostatic carcinoma: a prospective comparative study in Indian population

    PubMed Central

    Prakash, V. Surya; Mohan, G. Chandra; Krishnaiah, S. Venkata; Vijaykumar, V.; Babu, G. Ramesh; Reddy, G. Vijaya Bhaskar; Mahaboob, V. S.

    2013-01-01

    Purpose: To compare the cancer detection rate in patients with raised serum prostate-specific antigen (PSA) or abnormal digital rectal examination (DRE) results between the 10-core and the 16-core biopsy techniques in an Indian population. Methods: Between November 2010 and November 2012, 95 men aged >50 years who presented to the Urology Department with lower urinary tract symptoms, elevated serum PSA, and/or abnormal DRE findings underwent transrectal ultrasonography (TRUS)-guided prostate biopsy. A total of 53 patients underwent 10-core biopsy and 42 patients underwent 16-core biopsy. Results: Of the 53 men in the 10-core group, 8 had cancer, whereas in the 16-core biopsy group, 23 of 42 men had cancer. Detection of prostate cancer was significantly higher in patients who underwent 16-core biopsy than in those who underwent 10-core biopsy (P<0.001). Among the 95 men, 44 men had abnormal DRE findings (46.3%), of whom 23 showed cancer (52.27%). Of 51 men with normal DRE findings and elevated PSA, 8 men had malignancy with a cancer detection rate of 15.68%. Among 20 men with PSA between 4.1 and 10 ng/mL, 2 (10%) had cancer. In 31 men with PSA between 10.1 and 20 ng/mL, 3 cancers (9.67%) were detected, and in 44 men with PSA >20 ng/mL, 26 cancers were detected (59.09%). Conclusions: The cancer detection rate with 16-core TRUS-guided biopsy is significantly higher than that with 10-core biopsy (54.76% vs. 15.09%, P<0.001). In patients with both normal and abnormal DRE findings, 16-core biopsy has a better detection rate than the 10-core biopsy protocol. With increasing PSA, there is a high rate of detection of prostate cancer in both 10-core and 16-core biopsy patients. PMID:24392441

  4. 3D-Ultrasonography for evaluation of facial muscles in patients with chronic facial palsy or defective healing: a pilot study

    PubMed Central

    2014-01-01

    Background While standardized methods are established to examine the pathway from motorcortex to the peripheral nerve in patients with facial palsy, a reliable method to evaluate the facial muscles in patients with long-term palsy for therapy planning is lacking. Methods A 3D ultrasonographic (US) acquisition system driven by a motorized linear mover combined with conventional US probe was used to acquire 3D data sets of several facial muscles on both sides of the face in a healthy subject and seven patients with different types of unilateral degenerative facial nerve lesions. Results The US results were correlated to the duration of palsy and the electromyography results. Consistent 3D US based volumetry through bilateral comparison was feasible for parts of the frontalis muscle, orbicularis oculi muscle, depressor anguli oris muscle, depressor labii inferioris muscle, and mentalis muscle. With the exception of the frontal muscle, the facial muscles volumes were much smaller on the palsy side (minimum: 3% for the depressor labii inferior muscle) than on the healthy side in patients with severe facial nerve lesion. In contrast, the frontal muscles did not show a side difference. In the two patients with defective healing after spontaneous regeneration a decrease in muscle volume was not seen. Synkinesis and hyperkinesis was even more correlated to muscle hypertrophy on the palsy compared with the healthy side. Conclusion 3D ultrasonography seems to be a promising tool for regional and quantitative evaluation of facial muscles in patients with facial palsy receiving a facial reconstructive surgery or conservative treatment. PMID:24782657

  5. Technology Assessment TECHNOLOGY ASSESSMENT

    E-print Network

    Rock, Chris

    -in strategies. · Utilize the most effective and reliable information sources. · Utilize technical writers of reliable and concise information sources. Strategies: · Through trial and error, determine the optimum. VISION STATEMENT Texas Tech University Technology Assessment will be recognized as the reliable

  6. Investigative techniques in the assessment of oral-pharyngeal dysphagia.

    PubMed

    Cook, I J

    1998-01-01

    Oral-pharyngeal dysphagia is a common problem with a high morbidity and mortality. In general, it is not managed as well as esophageal dysphagia by gastroenterologists. A number of techniques are now available for the assessment of oral-pharyngeal dysphagia. However, a careful clinical assessment followed by a video barium swallow is all that is required for the diagnosis and management in the majority of patients. Pharyngeal manometry is likely to play an increasingly important role in the assessment of difficult or atypical cases in whom it can provide functional information not achievable with videoradiography alone. Videolaryngoscopy is a quick and simple way of detecting structural lesions and of assessing deglutitive airway protection. Videolaryngoscopy is non-invasive and easily performed in an office setting. Ultrasonography is a convenient way of assessing lingual function, but provides no more information than the video barium swallow. Pharyngeal scintigraphy is likely to assume a greater clinical relevance as a means of quantifying swallow efficiency and response to therapy. PMID:9618131

  7. Feasibility and Diagnostic Yield of Endoscopic Ultrasonography-Guided Fine Needle Biopsy With a New Core Biopsy Needle Device in Patients With Gastric Subepithelial Tumors

    PubMed Central

    Lee, Minju; Min, Byung-Hoon; Lee, Hyuk; Ahn, Sangjeong; Lee, Jun Haeng; Rhee, Poong-Lyul; Kim, Jae J.; Sohn, Tae Sung; Kim, Sung; Kim, Kyoung-Mee

    2015-01-01

    Abstract As treatment decisions for patients with gastric subepithelial tumors (SETs) largely depend on the histopathologic diagnosis, noninvasive and effective tissue acquisition methods are definitely required for proper management of gastric SETs. Recently, a new endoscopic ultrasonography-guided fine needle biopsy (EUS-FNB) device with ProCore reverse bevel technology was developed. We aimed to elucidate the feasibility and diagnostic yield of EUS-FNB with this new core biopsy needle device in patients with gastric SETs. A prospectively maintained database was retrospectively reviewed to identify consecutive patients who underwent EUS-FNB with a 22-gauge ProCore needle for gastric SETs 2?cm or larger. The main outcome measurement was the diagnostic yield of EUS-FNB. Procedure results were categorized into diagnostic, suggestive, or nondiagnostic. Of the 43 patients, needle punctures were successful in all cases irrespective of tumor location. EUS-FNB procedure results were diagnostic in 86.0%, suggestive in 4.7%, and nondiagnostic in 9.3% of cases, respectively. The diagnostic yield was the highest in fundus (100.0%), followed by body (89.5%), cardia (83.3%), and antrum (50.0%). All 18 patients with cardiac SET were finally diagnosed to have leiomyoma, and 16 patients with diagnostic or suggestive results avoided surgery. A heterogeneous echo pattern on EUS was found in 33.3% of cases with nondiagnostic or suggestive results and in 5.4% with diagnostic results. In multivariate analysis, no independent predictor of unsuccessful EUS-FNB with nondiagnostic or suggestive results was identified. Agreement between EUS-FNB and surgical pathology was 100% with respect to the diagnosis of gastrointestinal stromal tumor. However, there was a significant discrepancy in mitotic counts observed between the EUS-FNB and surgical specimens in patients with gastrointestinal stromal tumor. There were no significant procedure-related adverse events during and after the procedures. EUS-FNB with a 22G ProCore needle is a technically feasible, safe, and effective procedure for pathologic diagnosis of gastric SETs. This procedure can help refine surgical indications and facilitate a proper treatment decisions for gastric SETs, especially in the cardia. PMID:26448008

  8. Transvaginal fluoroscopic recanalization of a proximally occluded oviduct

    SciTech Connect

    Platia, M.P.; Krudy, A.G.

    1985-11-01

    A hysterosalpingogram performed on a patient with infertility showed bilateral interstitial obstruction with partial intramural patency of the right tube and complete intramural obstruction of the left. Recanalization of the tube under fluoroscopy resulted in unilateral tubal patency and an intrauterine pregnancy followed. 7 references, 3 figures.

  9. Transvaginal retropubic sling systems: efficacy and patient acceptability

    PubMed Central

    Moldovan, Christina P; Marinone, Michelle E; Staack, Andrea

    2015-01-01

    Stress urinary incontinence is a common, disabling, and costly medical problem that affects approximately 50% of women with urinary incontinence. Suburethral retropubic slings have been developed as a minimally invasive and effective surgical option, and they have been used as a first-line treatment for stress urinary incontinence since 1995. However, complications including vaginal extrusion, erosion, pain, bleeding, infections, lower urinary tract symptoms, urinary retention, and incontinence have been reported with use of the slings. Several companies manufacture sling kits, and the sling kits vary with regard to the composition of the mesh and introducer needle. The aim of this review was to determine which sling kit was most effective for patients, had minimal reported side effects, and was best accepted by patients and surgeons. In a review of the literature, it was found that a total of 38 studies were published between 1995 and 2014 that reported on eight tension-free retropubic sling kits: SPARC, RetroArc, Align, Advantage, Lynx, Desara, Supris, and Gynecare TVT. The Gynecare TVT was the most cited sling kit; the second most cited was the SPARC. This review provides a summary of the studies that have examined positive and negative outcomes of the retropubic tension-free suburethral sling procedure using various sling kits. Overall, the results of the literature review indicated that data from comparisons of the available sling kits are insufficient to make an evidenced-based recommendation. Therefore, the decision regarding which sling kit is appropriate to use in surgery is determined by the medical provider’s preference, training, and past experience, and not by the patient. PMID:25733928

  10. Transvaginal retropubic sling systems: efficacy and patient acceptability.

    PubMed

    Moldovan, Christina P; Marinone, Michelle E; Staack, Andrea

    2015-01-01

    Stress urinary incontinence is a common, disabling, and costly medical problem that affects approximately 50% of women with urinary incontinence. Suburethral retropubic slings have been developed as a minimally invasive and effective surgical option, and they have been used as a first-line treatment for stress urinary incontinence since 1995. However, complications including vaginal extrusion, erosion, pain, bleeding, infections, lower urinary tract symptoms, urinary retention, and incontinence have been reported with use of the slings. Several companies manufacture sling kits, and the sling kits vary with regard to the composition of the mesh and introducer needle. The aim of this review was to determine which sling kit was most effective for patients, had minimal reported side effects, and was best accepted by patients and surgeons. In a review of the literature, it was found that a total of 38 studies were published between 1995 and 2014 that reported on eight tension-free retropubic sling kits: SPARC, RetroArc, Align, Advantage, Lynx, Desara, Supris, and Gynecare TVT. The Gynecare TVT was the most cited sling kit; the second most cited was the SPARC. This review provides a summary of the studies that have examined positive and negative outcomes of the retropubic tension-free suburethral sling procedure using various sling kits. Overall, the results of the literature review indicated that data from comparisons of the available sling kits are insufficient to make an evidenced-based recommendation. Therefore, the decision regarding which sling kit is appropriate to use in surgery is determined by the medical provider's preference, training, and past experience, and not by the patient. PMID:25733928

  11. Liver and spleen stiffness and other noninvasive methods to assess portal hypertension in cirrhotic patients: a review of the literature.

    PubMed

    Colecchia, Antonio; Marasco, Giovanni; Taddia, Martina; Montrone, Lucia; Eusebi, Leonardo H; Mandolesi, Daniele; Schiumerini, Ramona; Di Biase, Anna R; Festi, Davide

    2015-09-01

    Portal hypertension (PH) is one of the most important causes of morbidity and mortality in patients with chronic liver disease. PH measurement is crucial to stage and predict the clinical outcome of liver cirrhosis. Measurement of hepatic vein pressure gradient is considered the gold standard for assessment of the degree of PH; however, it is an invasive method and has not been used widely. Thus, noninvasive methods have been proposed recently. We critically evaluated serum markers, abdominal ultrasonography, and particularly liver and spleen stiffness measurement, which represent the more promising methods to stage PH degree and to assess the presence/absence of esophageal varices (EV). A literature search was carried out on MEDLINE, EMBASE, Web of Science, and Scopus for articles and abstracts. The search terms used included 'liver cirrhosis', 'portal hypertension', 'liver stiffness', 'spleen stiffness', 'ultrasonography', and 'portal hypertension serum biomarker'. The articles cited were selected on the basis of their relevance to the objective of the review. The results of available studies indicate that individually, these methods have a mild accuracy in predicting the presence of EV, and thus they cannot substitute endoscopy to predict EV. When these tests were used in combination, their accuracy increased. In addition to the PH staging, several serum markers and spleen stiffness measurement can predict the clinical outcome of liver cirrhosis with a good accuracy, comparable to that of hepatic vein pressure gradient. In the future, noninvasive methods could be used to select patients requiring further investigations to identify the best tailored clinical management. PMID:26020376

  12. Management of symptomatic ureteral calculi during pregnancy: Experience of 23 cases

    PubMed Central

    Abdel-Kader, Mohammad S.; Tamam, Abdel-Aziz; Elderwy, Ahmad A.; Gad, Mohammad; El-Gamal, Mohammad A.; Kurkar, Adel; Safwat, Ahmed S.

    2013-01-01

    Purpose: To present our experience in the management of symptomatic ureteral calculi during pregnancy. Materials and Methods: Twenty-three pregnant women, aged between 19 and 28 years presented to the obstetric and urology departments with renal colic (17 cases, 73.9%) and fever and renal pain (6 cases, 26.1%); suggesting ureteric stones. The diagnosis was established by ultrasonography (abdominal and transvaginal). Outpatient follow-up consisted of clinical assessment and abdominal ultrasonography. Follow-up by X-ray of the kidneys, ureter, and bladder (KUB), or intravenous urography (IVU) was done in the postpartum period. Results: Double J (DJ) stent was inserted in six women (26%) with persistent fever followed by extracorporeal shock wave lithotripsy (ESWL) one month post-partum. Ureteroscopic procedure and pneumatic lithotripsy were performed for 17 women (distal ureteric stone in 10, middle ureter in 5, and upper ureteric stone in 2). Stone-free rate was 100%. No urologic, anesthetic, or obstetric complications were encountered. Conclusions: Ureteroscopy, pneumatic lithotripsy, and DJ insertion could be a definitive and safe option for the treatment of obstructive ureteric stones during pregnancy. PMID:24311902

  13. Transformative Assessment

    ERIC Educational Resources Information Center

    Popham, W. James

    2008-01-01

    If you're at all skeptical that "formative assessment" is just another buzzword, then here's a book that will change the way you think about the role that formative assessment can play in transforming education into a more powerful and positive process. Renowned expert W. James Popham clarifies what formative assessment really is, why it's right…

  14. Dynamic Assessment.

    ERIC Educational Resources Information Center

    Schoel, Jim

    1998-01-01

    Adventure therapists are often asked to assess clients in a manner that differs from their therapeutic approach, resulting in assessment being perceived as burdensome. Project Adventure's Decision Tree combines assessment with activity selection to create a dynamic tool that is responsive to group, individual, and leader needs. Example focuses on…

  15. Caregiver Assessment

    ERIC Educational Resources Information Center

    Feinberg, Lynn

    2008-01-01

    Assessment is a critical step in determining appropriate support services. This article discusses "caregiver assessment," a systematic process of gathering information to describe a caregiving situation. Caregiver assessment identifies the particular problems, needs, resources, and strengths of the family caregiver and approaches issues from the…

  16. Peer Assessment

    ERIC Educational Resources Information Center

    Topping, Keith J.

    2009-01-01

    Peer assessment is an arrangement for learners to consider and specify the level, value, or quality of a product or performance of other equal-status learners. Products to be assessed can include writing, oral presentations, portfolios, test performance, or other skilled behaviors. Peer assessment can be summative or formative. A formative view is…

  17. Multicentre external validation of IOTA prediction models and RMI by operators with varied training

    PubMed Central

    Sayasneh, A; Wynants, L; Preisler, J; Kaijser, J; Johnson, S; Stalder, C; Husicka, R; Abdallah, Y; Raslan, F; Drought, A; Smith, A A; Ghaem-Maghami, S; Epstein, E; Van Calster, B; Timmerman, D; Bourne, T

    2013-01-01

    Background: Correct characterisation of ovarian tumours is critical to optimise patient care. The purpose of this study is to evaluate the diagnostic performance of the International Ovarian Tumour Analysis (IOTA) logistic regression model (LR2), ultrasound Simple Rules (SR), the Risk of Malignancy Index (RMI) and subjective assessment (SA) for preoperative characterisation of adnexal masses, when ultrasonography is performed by examiners with different background training and experience. Methods: A 2-year prospective multicentre cross-sectional study. Thirty-five level II ultrasound examiners contributed in three UK hospitals. Transvaginal ultrasonography was performed using a standardised approach. The final outcome was the surgical findings and histological diagnosis. To characterise the adnexal masses, the six-variable prediction model (LR2) with a cutoff of 0.1, the RMI with cutoff of 200, ten SR (five rules for malignancy and five rules for benignity) and SA were applied. The area under the curves (AUCs) for performance of LR2 and RMI were calculated. Diagnostic performance measures for all models assessed were sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR?), and the diagnostic odds ratio (DOR). Results: Nine-hundred and sixty-two women with adnexal masses underwent transvaginal ultrasonography, whereas 255 had surgery. Prevalence of malignancy was 29% (49 primary invasive epithelial ovarian cancers, 18 borderline ovarian tumours, and 7 metastatic tumours). The AUCs for LR2 and RMI for all masses were 0.94 (95% confidence interval (CI): 0.89–0.97) and 0.90 (95% CI: 0.83–0.94), respectively. In premenopausal women, LR2?RMI difference was 0.09 (95% CI: 0.03–0.15) compared with ?0.02 (95% CI: ?0.08 to 0.04) in postmenopausal women. For all masses, the DORs for LR2, RMI, SR+SA (using SA when SR inapplicable), SR+MA (assuming malignancy when SR inapplicable), and SA were 62 (95% CI: 27–142), 43 (95% CI: 19–97), 109 (95% CI: 44–274), 66 (95% CI: 27–158), and 70 (95% CI: 30–163), respectively. Conclusion: Overall, the test performance of IOTA prediction models and rules as well as the RMI was maintained in examiners with varying levels of training and experience. PMID:23674083

  18. Effect of a single injection of gonadotropin-releasing hormone (GnRH) and human chorionic gonadotropin (hCG) on testicular blood flow measured by color doppler ultrasonography in male Shiba goats

    PubMed Central

    SAMIR, Haney; SASAKI, Kazuaki; AHMED, Eman; KAREN, Aly; NAGAOKA, Kentaro; EL SAYED, Mohamed; TAYA, Kazuyoshi; WATANABE, Gen

    2015-01-01

    Although color Doppler ultrasonography has been used to evaluate testicular blood flow in many species, very little has been done in goat. Eight male Shiba goats were exposed to a single intramuscular injection of either gonadotropin-releasing hormone (GnRH group; 1 µg/kg BW) or human chorionic gonadotropin (hCG group; 25 IU/kg BW). Plasma testosterone (T), estradiol (E2) and inhibin (INH) were measured just before (0 hr) and at different intervals post injection by radioimmunoassay. Testis volume (TV) and Doppler indices, such as resistive index (RI) and pulsatility index (PI) of the supratesticular artery, were measured by B-mode and color Doppler ultrasonography, respectively. The results indicated an increase in testicular blood flow in both groups, as RI and PI decreased significantly (P<0.05), but this increase was significant higher and earlier in hCG group (1 hr) than in the GnRH group (2 hr). A high correlation was found for RI and PI with both T (RI, r= ?0.862; PI, r= ?0.707) and INH in the GnRH group (RI, r=0.661; PI, r=0.701). However, a significant (P<0.05) correlation was found between E2 and both RI (r= ?0.610) and PI (r= ?0.763) in hCG group. In addition, TV significantly increased and was highly correlated with RI in both groups (GnRH, r= ?0.718; hCG, r= ?0.779). In conclusion, hCG and GnRH may improve testicular blood flow and TV in Shiba goats. PMID:25715956

  19. Clinical and Biochemical Profiles according to Homeostasis Model Assessment-insulin Resistance (HOMA-IR) in Korean Women with Polycystic Ovary Syndrome

    PubMed Central

    Lee, Da Eun; Park, Soo Yeon; Park, So Yun; Lee, Sa Ra; Chung, Hye Won

    2014-01-01

    Objectives The aim of this study was to investigate the clinical and biochemical profiles according to homeostasis model assessment of insulin resistance (HOMA-IR) in Korean polycystic ovary syndrome (PCOS) patients. Methods In 458 PCOS patients diagnosed by the Rotterdam European Society for Human Reproduction and Embryology (ESHRE) criteria, measurements of somatometry, blood test of hormones, glucose metabolic and lipid profiles, and transvaginal or transrectal ultrasonogram were carried out. HOMA-IR was then calculated and compared with the clinical and biochemical profiles related to PCOS. The patients were divided into 4 groups by quartiles of HOMA-IR. Results The mean level of HOMA-IR was 2.18 ± 1.73. Among the four groups separated according to HOMA-IR, body weight, body mass index (BMI), waist-to-hip ratio (WHR), triglyceride (TG), total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, lipid accumulation product (LAP) index, high-sensitivity C-reactive protein (hs-CRP), Apoprotein B, free testosterone, and sex hormone binding globulin (SHBG) were found to be significantly different. TG, LAP index, glucose metabolic profiles, and hs-CRP were positively correlated with HOMA-IR after adjustment for BMI. Conclusion Our results suggest that the clinical and biochemical profiles which are applicable as cardiovascular risk factors are highly correlated with HOMA-IR in Korean women with PCOS. PMID:25580421

  20. Why Now? Assessing Assessment. Commentary

    ERIC Educational Resources Information Center

    Stage, Frances; Vaisman, Jody Clark

    2010-01-01

    Jaschik's January 2009 article, "Assessing Assessment," describes initiatives designed to extend and broaden nascent assessment of college students learning. In the post-Spellings era of No Child Left Behind, many responded to the continuing discussion, "Why now?" He reports on two organizations, the National Institute for Learning Outcomes…

  1. Peer Assessment without Assessment Criteria

    ERIC Educational Resources Information Center

    Jones, Ian; Alcock, Lara

    2014-01-01

    Peer assessment typically requires students to judge peers' work against assessment criteria. We tested an alternative approach in which students judged pairs of scripts against one another in the absence of assessment criteria. First year mathematics undergraduates (N?=?194) sat a written test on conceptual understanding of multivariable…

  2. Central retinal artery resistive index and optical coherence tomography in assessment of glaucoma progression

    PubMed Central

    Ghany, Ahmed F. Abdel; Botros, Samer M.; El-Raggal, Tamer M.

    2015-01-01

    AIM To assess the relation between central retinal artery (CRA) resistive index (RI) and retinal nerve fiber thickness measured by optical coherence tomography (OCT) in assessment of disease progress in cases of open angle glaucoma. METHODS Twenty-three patients with diagnosed open angle glaucoma were included in this study. They were examined by colored duplex ultrasonography of CRA with estimation of RI of CRA and ophthalmic artery (OA) with estimation of CRA/OA RI ratio as well as OCT measurement of the average retinal nerve fiber layer (RNFL) thickness in order to assess the disease progress. RESULTS There was strong inverse relation between the increased RI in CRA as well as the increased CRA/OA RI ratio and the decrease in average RNFL thickness in cases of open angle glaucoma. CONCLUSION Assessment of CRA RI can indirectly assess the vascular changes associated with glaucoma and can assess the degree of retinal atrophy helping in evaluating prognosis thus guiding the choice of treatment. PMID:25938045

  3. Translabial ultrasound in the assessment of pelvic floor and anorectal function in women with defecatory disorders.

    PubMed

    Dietz, H P

    2014-05-01

    This article shows how modern ultrasound imaging can contribute to the investigation of patients with posterior vaginal wall prolapse, obstructed defecation, fecal incontinence and rectal intussusception/prolapse, conditions that should be similarly relevant and of interest to colorectal surgeons, gastroenterologists and gynecologists. Translabial/perineal ultrasound, a simple, universally available technique, may serve as a first-line diagnostic tool in women with posterior compartment prolapse and/or symptoms of obstructed defecation, largely replacing defecation proctography and magnetic resonance proctography. This has advantages for healthcare systems, since sonographic imaging is less expensive, non-invasive, less time-consuming and does not involve radiation exposure. However, there is a substantial need for teaching that remains unmet to date. This article illustrates in details the technique of translabial ultrasonography adopted by our unit and reviews the literature supporting this method of assessing pelvic floor and anorectal function in women with defecatory disorders. PMID:24515287

  4. Needs Assessment.

    ERIC Educational Resources Information Center

    Berrie, Phillip J.

    The only essential criterion for a needs assessment at the school district level is that it be focused on the students. This criterion is integrated into the seven factors that compose a successful needs assessment: (1) prediction of skills needed in the future (what the schools should provide students five or ten years from the present); (2)…

  5. Educational Assessment

    ERIC Educational Resources Information Center

    Hogan, Thomas P.

    2005-01-01

    Following a practical approach, this book focuses on educational assessment as it is practiced today, in the actual world of classrooms, school systems, state departments, and national organizations. It first covers the basic concepts applicable to all types of assessment: statistical concepts, reliability, validity, and interpretive frameworks.…

  6. Symposium: Assessment

    ERIC Educational Resources Information Center

    Anson, Chris M.; Perelman, Les; Poe, Mya; Sommers, Nancy

    2008-01-01

    This article presents four symposium papers on assessment. It includes: (1) "Closed Systems and Standardized Writing Tests" (Chris M. Anson); (2) "Information Illiteracy and Mass Market Writing Assessments" (Les Perelman); (3) "Genre, Testing, and the Constructed Realities of Student Achievement" (Mya Poe); and (4) "The Call of Research: A…

  7. [Developmental Assessment.

    ERIC Educational Resources Information Center

    Fenichel, Emily, Ed.

    1994-01-01

    This newsletter theme issue contains contributions by parents, practitioners, researchers, administrators, and providers of technical assistance, which explore aspects of the complex process of developmental assessment of infants and young children. They describe what is helpful and what can be harmful in current assessment practice. They offer…

  8. Existential Assessment

    ERIC Educational Resources Information Center

    Dana, Richard H.; Leech, Shirley

    1974-01-01

    Present psychological assessment stems from a philosophy of science that values objectivity but fails to comprehend the existence of the person being evaluated. A humanistic-existential model shifts the focus from omnipotence to encounter and encourages client responsibility. Some pertinent assessment issues are formulated and specific instruments…

  9. Colour Doppler ultrasonography for evaluation of anterior chest blood supply: the possible role of arterial blood supply to the costosternal junction in the aetiology of idiopathic scoliosis in female adolescents.

    PubMed

    Korovessis, Panagiotis; Iliopoulos, Panagiotis; Misiris, Alexandros; Koureas, Georgios

    2004-02-01

    This prospective comparative study was carried out to investigate the blood supply to the anterior chest wall by measurement of several anatomical and haemodynamic flow parameters of the internal mammary artery, with the use of colour Doppler ultrasonography, in female scoliotics with idiopathic right convex scoliosis in adolescence. Previous investigations have postulated that asymmetry of the breasts in female adolescents may be linked with the development of right convex thoracic scoliosis. This breast asymmetry is supposed to be linked with anatomical and functional asymmetry of the internal mammary artery that is the main supplier to the mammary gland. However, no measurements of anatomical and haemodynamic parameters of the internal mammary artery have been made to justify or reject the hypothesis of asymmetric blood flow volume to the breasts and costosternal junction in female adolescent scoliotics. Twenty female adolescents with right convex thoracic scoliosis and 16 comparable female individuals without spine deformity were examined with roentgenograms (scoliotics only) to measure scoliosis curve, vertebral rotation and concave and convex rib-vertebra angle at three vertebrae (the apical, one level above and one below the apical vertebra). Doppler ultrasonography was used to measure, at the origin of the internal mammary artery, its lumen diameter, cross-sectional area, time average mean flow and flow volume per minute in scoliotics and controls, which were compared with each other. The roentgenographic parameters were compared with the ultrasonographic parameters in the scoliotics to disclose any relationship. The reliability of colour Doppler ultrasonography was high and the intra-observer variability low (ANOVA, P=0.92-0.94). There was no statistically significant difference in the ultrasonographic parameters of the internal mammary artery between right and left side in each individual as well as between scoliotics and controls. In scoliotics the right mammary artery time average mean velocity increases with the convex ( P<0.05) and concave ( P<0.01) rib-vertebra angle one level above the apical vertebrae and with the apical convex rib-vertebra angle ( P<0.05). The right internal mammary artery flow volume per minute increases with convex ( P<0.01) and concave ( P<0.01) rib-vertebra angle one level above the apical vertebrae and with the apical convex rib-vertebra angle ( P<0.05). Left internal mammary artery cross-sectional area increases with convex apical rib-vertebra angle ( P<0.01) and concave rib-vertebra angle one level above the apical vertebra ( P<0.01). Conclusively, this investigation showed that haemodynamic flow parameters of the right internal mammary artery and anatomical parameters of the left internal mammary artery are significantly correlated with the magnitude of rib-vertebra angles close to the apex of right thoracic scoliosis in female adolescents. This study did not find any evidence for side-difference in vascularity of the anterior thorax wall and, thus, it could not clearly justify previous theories for development of right thoracic scoliosis in female adolescents. PMID:14648305

  10. Dietary Assessment

    Cancer.gov

    The Epidemiology and Genomics Research Program's goals in Dietary Assessment are to increase the precision of dietary intake estimates by improving self-report of dietary intake and the analytic procedures for processing reported information.

  11. NUTRITIONAL ASSESSMENT

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Nutritional assessment is an essential component of the history and physical examination of children with gastrointestinal disorders. Protein-energy malnutrition, linear growth failure, overweight, and iron deficiency anemia frequently complicate the clinical course of common gastrointestinal proble...

  12. Pain Assessment

    MedlinePLUS

    ... clarify its impact, and evaluate other medical and psychosocial problems. The assessment determines whether additional evaluation is ... pain Describe the negative effects on physical and psychosocial functioning caused by the pain Understand the medical ...

  13. US in the assessment of acute scrotum

    PubMed Central

    2013-01-01

    Background The acute scrotum is a medical emergency . The acute scrotum is defined as scrotal pain, swelling, and redness of acute onset. Scrotal abnormalities can be divided into three groups , which are extra-testicular lesion, intra-testicular lesion and trauma. This is a retrospective analysis of 164 ultrasound examination performed in patient arriving in the emergency room for scrotal pain. The objective of this article is to familiarize the reader with the US features of the most common and some of the least common scrotal lesions. Methods Between January 2008 and January 2010, 164 patients aged few month and older with scrotal symptoms, who underwent scrotal ultrasonography (US), were retrospectively reviewed. The clinical presentation, outcome, and US results were analyzed. The presentation symptoms including scrotal pain, painless scrotal mass or swelling, and trauma. Results Of 164 patients, 125 (76%) presented with scrotal pain, 31 (19%) had painless scrotal mass or swelling and 8 (5%) had trauma. Of the 125 patients with scrotal pain, 72 had infection,10 had testicular torsion, 8 had testicular trauma, 18 had varicocele, 20 had hydrocele, 5 had cryptorchidism, 5 had scrotal sac and groin metastases, and 2 had unremarkable results. In the 8 patients who had history of scrotal trauma, US detected testicular rupture in 1 patients, scrotal haematomas in 2 patients . Of the 19 patients who presented with painless scrotal mass or swelling, 1 6 had extra-testicular lesions and 3 had intra-testicular lesions. All the extra-testicular lesions were benign. Of the 3 intra-testicular lesions, one was due to tuberculosis epididymo-orchitis, one was non-Hodgkin’s lymphoma, and one was metastasis from liposarcoma Conclusions US provides excellent anatomic detail; when color Doppler and Power Doppler imaging are added, testicular perfusion can be assessed PMID:23902859

  14. Lateral Calcaneal Artery Flaps in Atherosclerosis: Cadaveric Study, Vascular Assessment and Clinical Applications

    PubMed Central

    Tanthanatip, Pattaya; Kuhaphensaeng, Paiboon; Ruamthanthong, Anuchit; Pitiseree, Anont; Suwantemee, Chaichoompol

    2015-01-01

    Background: Soft tissue defects of the lateral malleolus (LM) and Achilles tendon pose difficult reconstructive problems due to the bony prominence and limited local tissue available. The objectives were to study the anatomical landmarks of the lateral calcaneal artery (LCA) and patency of LCA in atherosclerotic patients. Methods: Part I: Thirty-four cadaveric feet were dissected to identify the LCA. The distance between the LCA and the most prominent point of the LM was measured horizontally (LCAa-LM), obliquely (LCAb-LM), and vertically (LCAc-LM). Part II: Thirty-two patients were divided in 2 groups as nonatherosclerotic and atherosclerotic groups. The LCA was assessed by both Doppler ultrasonography and computed tomographic angiography (CTA). Part III: Clinical applications were demonstrated. Results: Part I: Mean distances of LCAa-LM, LCAb-LM, and LCAc-LM were 24.76, 33.68, and 35.03 mm, respectively. The LCA originated 94.12% from the peroneal artery. Part II: Doppler ultrasonography detected the LCA at 90.62% and 87.50% in nonatherosclerotic and atherosclerotic groups, respectively, whereas 100.00% and 93.75%, respectively, were detected by CTA. No statistically significant difference was found in the patency of the LCA between nonatherosclerotic and atherosclerotic patients. Part III: Clinical applications were performed in atherosclerotic patients. Conclusions: The LM is a reliable point to identify the LCA, and the LCA flap can be raised safely in atherosclerotic patients. Preoperative CTA should be performed in severely atherosclerotic patients or cases of major lower extremity vascular injuries. PMID:26495230

  15. BASELINE ASSESSMENT

    EPA Science Inventory

    Resource Purpose:The Baseline Assessment is a project to collect data on environmental conditions in Indian country from existing data sources using a geographic enabling system called the Oracle Spatial Data Cartridge.
    Legislation/Enabling Authority:None
    S...

  16. Assessment models

    NASA Technical Reports Server (NTRS)

    Pyle, J. A.; Butler, D. M.; Cariolle, D.; Garcia, R. R.; Grose, W. L.; Guthrie, P. D.; Ko, M.; Owens, A. J.; Plumb, R. A.; Prather, M. J.

    1985-01-01

    The types of models used in assessment of possible chemical perturbations to the stratosphere are reviewed. The statue of one and two dimensional models are discussed. The problem of model validation is covered before the status of photochemical modeling efforts is discussed. A hierarchy of tests for photochemical models is presented.

  17. Reference Assessment

    ERIC Educational Resources Information Center

    Bivens-Tatum, Wayne

    2006-01-01

    This article presents interesting articles that explore several different areas of reference assessment, including practical case studies and theoretical articles that address a range of issues such as librarian behavior, patron satisfaction, virtual reference, or evaluation design. They include: (1) "Evaluating the Quality of a Chat Service"…

  18. Cervical pregnancy: assessment with three-dimensional power Doppler imaging and successful management with selective uterine artery embolization.

    PubMed

    Su, Y N; Shih, J C; Chiu, W H; Lee, C N; Cheng, W F; Hsieh, F J

    1999-10-01

    Cervical pregnancy is frequently associated with extensive hemorrhage which, in severe cases, may be stopped only by hysterectomy. We report a case of an anembryonic cervical pregnancy diagnosed at 10 weeks, and associated with a large arteriovenous malformation. The patient was conservatively managed with simple selective uterine artery embolization. After embolization, her vaginal bleeding ceased and the level of serum beta-human chorionic gonadotropin decreased rapidly. No additional treatment was given. The patient's postoperative course was uneventful and the cervical mass had disappeared at the follow-up 4 months later. To the best of our knowledge, this is the first report of conservative management of cervical pregnancy simply by uterine artery embolization. The role of three-dimensional power Doppler ultrasonography in the assessment of cervical pregnancy and in monitoring the therapeutic response is discussed. PMID:10586481

  19. Quantification of Hepatorenal Index for Computer-Aided Fatty Liver Classification with Self-Organizing Map and Fuzzy Stretching from Ultrasonography

    PubMed Central

    Kim, Kwang Baek; Kim, Chang Won

    2015-01-01

    Accurate measures of liver fat content are essential for investigating hepatic steatosis. For a noninvasive inexpensive ultrasonographic analysis, it is necessary to validate the quantitative assessment of liver fat content so that fully automated reliable computer-aided software can assist medical practitioners without any operator subjectivity. In this study, we attempt to quantify the hepatorenal index difference between the liver and the kidney with respect to the multiple severity status of hepatic steatosis. In order to do this, a series of carefully designed image processing techniques, including fuzzy stretching and edge tracking, are applied to extract regions of interest. Then, an unsupervised neural learning algorithm, the self-organizing map, is designed to establish characteristic clusters from the image, and the distribution of the hepatorenal index values with respect to the different levels of the fatty liver status is experimentally verified to estimate the differences in the distribution of the hepatorenal index. Such findings will be useful in building reliable computer-aided diagnostic software if combined with a good set of other characteristic feature sets and powerful machine learning classifiers in the future. PMID:26247023

  20. Quantification of Hepatorenal Index for Computer-Aided Fatty Liver Classification with Self-Organizing Map and Fuzzy Stretching from Ultrasonography.

    PubMed

    Kim, Kwang Baek; Kim, Chang Won

    2015-01-01

    Accurate measures of liver fat content are essential for investigating hepatic steatosis. For a noninvasive inexpensive ultrasonographic analysis, it is necessary to validate the quantitative assessment of liver fat content so that fully automated reliable computer-aided software can assist medical practitioners without any operator subjectivity. In this study, we attempt to quantify the hepatorenal index difference between the liver and the kidney with respect to the multiple severity status of hepatic steatosis. In order to do this, a series of carefully designed image processing techniques, including fuzzy stretching and edge tracking, are applied to extract regions of interest. Then, an unsupervised neural learning algorithm, the self-organizing map, is designed to establish characteristic clusters from the image, and the distribution of the hepatorenal index values with respect to the different levels of the fatty liver status is experimentally verified to estimate the differences in the distribution of the hepatorenal index. Such findings will be useful in building reliable computer-aided diagnostic software if combined with a good set of other characteristic feature sets and powerful machine learning classifiers in the future. PMID:26247023

  1. The Utility of Carotid Ultrasonography in Identifying Severe Coronary Artery Disease in Asymptomatic Type 2 Diabetic Patients Without History of Coronary Artery Disease

    PubMed Central

    Irie, Yoko; Katakami, Naoto; Kaneto, Hideaki; Nishio, Mayu; Kasami, Ryuichi; Sakamoto, Ken’ya; Umayahara, Yutaka; Sumitsuji, Satoru; Ueda, Yasunori; Kosugi, Keisuke; Shimomura, Iichiro

    2013-01-01

    OBJECTIVE Although many studies have shown that carotid intima-media thickness (IMT) is associated with coronary artery disease (CAD), it remains inconclusive whether assessment of carotid IMT is useful as a screening test for asymptomatic but severe CAD in diabetic patients. RESEARCH DESIGN AND METHODS A total of 333 asymptomatic type 2 diabetic patients without history of CAD underwent exercise electrocardiogram or myocardial perfusion scintigraphy for detection of silent myocardial ischemia, and those whose test results were positive were subjected to coronary computed tomography angiography or coronary angiography. The ability of carotid IMT to identify severe CAD corresponding to treatment with revascularization was examined by receiver-operating characteristic (ROC) curve analyses. RESULTS Among the 333 subjects, 17 were treated with revascularization. A multiple logistic regression analysis showed that maximum IMT was an independent predictor of severe CAD even after adjustment for conventional risk factors. ROC curve analyses revealed that the addition of maximum IMT to conventional risk factors significantly improved the prediction ability for severe CAD (from area under the curve, 0.67 to 0.79; P = 0.039). The greatest sensitivity and specificity were obtained when the cut-off value of maximum IMT was set at 2.45 mm (pretest probability, 5%; posttest probability, 11%; sensitivity, 71%). When we applied age-specific cut-off values, the sensitivity of screening further increased in both the nonelderly (pretest probability, 6%; posttest probability, 10%; sensitivity, 100%) and the elderly subjects (pretest probability, 5%; posttest probability, 15%; sensitivity, 100%). CONCLUSIONS Our study suggests that carotid maximum IMT is useful for screening asymptomatic type 2 diabetic patients with severe CAD equivalent to revascularization. PMID:23404302

  2. Ambulatory Assessment

    PubMed Central

    Trull, Timothy J.; Ebner-Priemer, Ulrich

    2014-01-01

    Ambulatory assessment (AA) covers a wide range of assessment methods to study people in their natural environment, including self-report, observational, and biological/physiological/behavioral. AA methods minimize retrospective biases while gathering ecologically valid data from patients’ everyday life in real time or near real time. Here, we report on the major characteristics of AA, and we provide examples of applications of AA in clinical psychology (a) to investigate mechanisms and dynamics of symptoms, (b) to predict the future recurrence or onset of symptoms, (c) to monitor treatment effects, (d) to predict treatment success, (e) to prevent relapse, and (f) as interventions. In addition, we present and discuss the most pressing and compelling future AA applications: technological developments (the smartphone), improved ecological validity of laboratory results by combined lab-field studies, and investigating gene-environment interactions. We conclude with a discussion of acceptability, compliance, privacy, and ethical issues. PMID:23157450

  3. Neurological Assessment.

    PubMed

    Fritz, Deborah; Musial, Maryann K

    2016-01-01

    Reasons for completing a neurological exam include: detecting life-threatening conditions, identifying nervous system dysfunction and the effects of this dysfunction on activities of daily living, comparing current data to previous exams to determine trends, and to provide a database upon which to base collaborative care across disciplines. In this third article of a four-part series, subjective and objective assessment of the neurological exam is reviewed. PMID:26645839

  4. Low-field magnetic resonance imaging or combined ultrasonography and anti-cyclic citrullinated peptide antibody improve correct classification of individuals as established rheumatoid arthritis: results of a population-based, cross-sectional study

    PubMed Central

    2014-01-01

    Background The aim of the present study was to evaluate the accuracy of two approaches using magnetic resonance imaging (MRI) or combined ultrasonography (US) and anti-cyclic citrullinated peptide antibody (ACPA) for diagnosis and classification of individuals with established rheumatoid arthritis (RA). Methods In 53 individuals from a population-based, cross-sectional study, historic fulfilment of the American College of Rheumatology (ACR) 1987 criteria (“classification”) or RA diagnosed by a rheumatologist (“diagnosis”) were used as standard references. The sensitivity, specificity and Area under Curve for Receiver Operating Characteristics curves (ROC-area: (sensitivity?+?specificity)/2) were calculated for “current fulfilment of the ACR 1987 criteria” (list format), “adapted ACR 1987 criteria” (list format, substituting IgM rheumatoid factor with ACPA and clinical joint swelling and erosions on radiography with synovitis and erosions detected by US on a semi-quantitative scale), and RA MRI scoring System (RAMRIS) scores on low-field MRI in the unilateral hand. Results For the ACR 1987 criteria the ROC-area was 75% (sensitivity/specificity?=?50%/100%) (with “classification” as standard reference) and 69% (44%/94%) (with “diagnosis” as standard reference), while for the adapted ACR 1987 criteria it was 86% (75%/97%) (classification) and 82% (72%/91%) (diagnosis). For RAMRIS synovitis score in metacarpophalangeal (MCP) joints only (cut-off ?5), the ROC-area (sensitivity/specificity) was 78% (62%/94%) (classification) and 85% (69%/100%) (diagnosis), while for the total synovitis score of MCP joints plus wrist (cut-off ?10) it was 78% (62%/94%) (both classification and diagnosis). Conclusions Compared with the ACR 1987 criteria, low-field MRI alone or adapted criteria incorporating US and ACPA increased the correct classification and diagnosis of RA. PMID:25103610

  5. Tools for Alternative Assessment.

    ERIC Educational Resources Information Center

    Brewer, Mark

    1996-01-01

    Presents alternative assessment tools, including concept maps, initial and summary assessments, Vee diagrams, and three types of alternative learning activities that assess different levels of understanding. (MKR)

  6. Serum vitamin D3 level inversely correlates with uterine fibroid volume in different ethnic groups: a cross-sectional observational study

    PubMed Central

    Sabry, Mohamed; Halder, Sunil K; Allah, Abdou S Ait; Roshdy, Eman; Rajaratnam, Veera; Al-Hendy, Ayman

    2013-01-01

    Purpose Currently there is no effective medicinal treatment for uterine fibroids (UFs), a common health disorder that affects women of reproductive age. Identification of modifiable risk factors such as vitamin D (Vit D) deficiency could help develop novel strategies for the prevention and/or treatment of UFs. The purpose of this study was to identify whether low serum Vit D3 levels correlate with increased risk of UFs. Methods A total of 154 premenopausal women were recruited for this cross-sectional study. The control group comprised 50 subjects with a normal, fibroid-free uterine structure, confirmed by transvaginal ultrasonography. The 104 case subjects had at least one fibroid lesion that was 2 cm3 in volume or larger, confirmed by transvaginal ultrasonography. For each case subject, total uterine volume and total volume of all existing fibroids were measured in three perpendicular planes, with volume determined according to the prolate ellipse formula (a × b × c × 0.523), where a is height, b is width, and c is depth. Serum Vit D [25(OH) D3] levels were measured by radioimmunoassay. The independent t-test was used to compare serum Vit D levels across groups. Correlations were assessed by Spearman’s rank correlation test. Results Lower serum 25-(OH) Vit D levels were significantly associated with the occurrence of UFs (P = 0.01). A statistically significant inverse correlation was also observed between serum 25-(OH) Vit D levels and total UF volume (r = ?0.31; P = 0.002) within the case cohort. Subjects with larger fibroid volumes had lower serum Vit D levels and vice versa. Data stratified for ethnicity showed a statistically significant inverse correlation between serum 25-(OH) Vit D levels and total fibroid volume in black subjects (r = ?0.42; P = 0.001). An inverse correlation was also evident in white subjects (r = ?0.86; P = 0.58) but this did not reach statistical significance. Conclusion Lower serum Vit D levels are inversely correlated with UF burden in different ethnic groups. Vit D deficiency is a possible risk factor for the occurrence of UFs. PMID:23467803

  7. Flibe assessments.

    SciTech Connect

    Sze, D. K.; McCarthy, K.; Sawan, M.; Tillack, M.; Ying, A.; Zinkle, S.

    2000-11-15

    An assessment of the issues on using flibe for fusion applications has been made. It is concluded that sufficient tritium breeding can be achieved for a flibe blanket, especially if a few cm of Be is include in the blanket design. A key issue is the control of the transmutation products such as TF and F{sub 2}. A REDOX (Reducing-Oxidation) reaction has to be demonstrated which is compatible to the blanket design. Also, MHD may have strong impact on heat transfer if the flow is perpendicular to the magnetic field. The issues associated with the REDOX reaction and the MHD issues have to be resolved by both experimental program and numerical solutions.

  8. The intervention effects of different treatments for chronic low back pain as assessed by the thickness of the musculus transversus abdominis.

    PubMed

    Huang, Qiuchen; Li, Desheng; Zhang, Yuying; Rui, Gu; Huo, Ming; Maruyama, Hitoshi

    2014-09-01

    [Purpose] The purpose of this study was to examine the immediate effects of an intervention comprising proprioceptive neuromuscular facilitation (PNF) or neuromuscular joint facilitation (NJF) on chronic low back pain as assessed by the thickness of musculus transversus abdominis [Subjects] The subjects were 12 young people (five males, seven females) who had chronic low back pain on one side for more than 6 months. [Methods] Subjects were asked to lie their sides with the painful side facing up. The subjects received PNF or NJF exercise treatments. The changes in the musculus transversus abdominis thickness were measured using ultrasonography. [Result] The thickness of the musculus transversus abdominis in the NJF group increased significantly and was higher than that in the PNF group and at rest. [Conclusion] The results showed that significantly better improvement can be obtained for chronic low back pain by applying NJF patterns to the musculus transversus abdominis. PMID:25276020

  9. Automatic Nuchal Translucency Measurement from Ultrasonography

    E-print Network

    Translucency (NT) refers to the fluid-filled region under the skin of pos- terior neck of a fetus. Increased NT behind fetus neck. The NT detection is constrained by automatically found anchoring structure, fetal head

  10. Ultrasonography findings of vulvar liposarcoma. Case report.

    PubMed

    Yanik, Bahar; Inceboz, Umit; Bulbul, Erdogan; Demirpolat, Gulen; Uzgoren, Ismail Engin

    2015-09-01

    Liposarcoma (LPS) of vulva is a rare entity. We present the ultrasonographic (US) and color Doppler ultrasonographic (CDUS) findings of a vulvar myxoid LPS. Although LPS cases have been reported in the extremities and trunk, the US or CDUS findings of LPS in vulva have not been described previously. On US the mass appeared as a well-defined, homogeneous hypoechoic structure and on CDUS it was quite hypervascular. PMID:26343091

  11. Ultrasonography of the bovine female genital tract.

    PubMed

    DesCôteaux, Luc; Gnemmi, Giovanni; Colloton, Jill

    2009-11-01

    The objective of this article is to help interested readers learn to use ultrasound for female bovine reproductive tract examinations. The first section discusses practical issues for using ultrasound in the field, such as animal restraint and preparation, type of ultrasound units available, and scanning technique. The second section reviews ultrasound diagnosis of various ovarian structures. The third section explores uterine changes during the estrous cycle, in addition to uterine pathologic conditions. The fourth section covers early pregnancy, twinning, embryonic and fetal viability, and fetal anomalies. The final section considers the use of ultrasound with advanced techniques, such as embryo transfer, in vitro fertilization, and color Doppler technology, and as a complement tool in reproduction synchronization protocols for dairy cattle. PMID:19825441

  12. Is pneumoperitoneum the terra ignota in ultrasonography?

    PubMed Central

    Ko?aczyk, Katarzyna

    2015-01-01

    In most cases, pneumoperitoneum is caused by gastrointestinal perforation, which usually requires surgical treatment. Many authors believe that ultrasound imaging of pneumoperitoneum is at least as effective as conventional radiography, or even that its efficacy is superior. In such a situation, it is imperative to make this modality one of the main tools in the diagnostic arsenal of emergency medicine. This is the main aim of this paper. First, ultrasound anatomy of so-called thoracic-abdominal border is discussed. The equipment requirements emphasize that the diagnostic process can be conducted with the simplest portable US scanner, even without the Doppler mode. The technique of a US examination, the aim of which is to detect, free air in the peritoneal cavity is also simple and conducted with the patients lying down, either in the supine or lateral position. A convex transducer with the frequency of 3.5–5 MHz is applied above the lower intercostal spaces on the right and left side, to the epigastric region below the xiphoid process and in various sites of the abdominal wall. The most effective examination, however, is conducted in the left lateral position via the right intercostal spaces. The differential diagnosis on the right side under the diaphragm should include the presence of a subdiaphragmatic abscess with gas and a hepatic abscess with a similar content as well as transposition of the colon in between the diaphragm and the liver (Chilaiditi syndrome). It seems that the inclusion of a US examination to the E-FAST method in order to detect free gas in the peritoneal cavity is justified since it is a sign of gastrointestinal perforation in numerous cases, and is clinically as relevant as the presence of free fluid. PMID:26672969

  13. Diagnostic Value of Preoperative Needle Biopsy for Tumor Grading Assessment in Hepatocellular Carcinoma

    PubMed Central

    Zhang, Xuanyu; Li, Jie; Wei, Xuyong; Cheng, Jun; Ling, Qi; Xie, Haiyang; Zhou, Lin; Xu, Xiao; Zheng, Shusen

    2015-01-01

    Background Needle core biopsy (NCB) is one of the most widely used and accepted methods for the diagnosis of focal hepatic lesions. Although many studies have assessed the diagnostic accuracy of NCB in predicting the tumor grade, it is still under debate. Objective To identify the influence of number of biopsies on NCB diagnostic accuracy. Methods 153 patients with HCC were selected from patients who received preoperative NCB under the guidance of ultrasonography in our hospital. The diagnostic reference standard was the surgical pathologic diagnosis. Results Using a 3-tier grading scheme (well, moderate and poor), the accuracy of NCB has no significant differences among different number of passes in HCC ?5cm. For HCC >5?8cm, the increasing number of passes could increase the diagnostic accuracy (63.3%, 81.8%, and 84.8% for passes one, two, and three, respectively). While in HCC>8cm, the diagnostic accuracy of passes one, two, and three were 62.1%, 69%, and 75.8%, respectively. Conclusions The accuracy of NCB in assessing tumor grading associated with tumor size and number of passes. Meanwhile, a minimum of two passes should be performed to get better accuracy in patients with HCC >5cm. PMID:26658912

  14. High-frequency ultrasound in carpal tunnel syndrome: assessment of patient eligibility for surgical treatment

    PubMed Central

    Urbanik, Andrzej

    2015-01-01

    Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy and a frequent cause of sick leaves because of work-related hand overload. That is why an early diagnosis and adequate treatment (conservative or surgical) are essential for optimal patient management. Aim The aim of the study is to assess the usefulness of high-frequency ultrasound in CTS for the assessment of patient eligibility for surgical treatment. Material and methods The study involved 62 patients (50 women and 12 men, aged 28–70, mean age 55.2) with scheduled surgeries of CTS on the basis of clinical symptoms, physical examination performed by a neurosurgeon and a positive result of EMG testing. The ultrasound examinations of the wrist were performed in all these patients. On the basis of the collected data, the author has performed multiple analyses to confirm the usefulness of ultrasound imaging in assessing patient eligibility for surgical treatment of CTS. Results US examinations showed evidence of median nerve compression at the level of the carpal tunnel in all of the examined patients. This was further confirmed during surgical procedures. The mean value of the cross-sectional area at the proximal part of the pisiform bone was 17.45 mm2 (min. 12 mm2, max. 31 mm2). Nerve hypoechogenicity proximal to the nerve compression site was visible in all 62 patients (100%). Increased nerve vascularity on the transverse section was present in 50 patients (80.65%). Conclusions Ultrasonography with the use of high-frequency transducers is a valuable diagnostic tool both for assessing patient eligibility for surgical treatment of CTS, and in postoperative assessment of the treatment efficacy. PMID:26673415

  15. Uterine Artery Embolization Combined with Local Methotrexate and Systemic Methotrexate for Treatment of Cesarean Scar Pregnancy with Different Ultrasonographic Pattern

    SciTech Connect

    Lian Fan; Wang Yu Chen Wei; Li Jiaping; Zhan Zhongping; Ye Yujin; Zhu, Yunxiao; Huang Jia; Xu Hanshi; Yang Xiuyan; Liang Liuqin; Yang Jianyong

    2012-04-15

    Purpose: This study was designed to compare the effectiveness of systemic methotrexate (MTX) with uterine artery embolization (UAE) combined with local MTX for the treatment of cesarean scar pregnancy (CSP) with different ultrasonographic pattern, and to indicate the preferable therapy in CSP patients. Methods: The results of 21 CSP cases were reviewed. All subjects were initially administrated with systemic MTX (50 mg/m{sup 2} body surface area). UAE combined with local MTX was added to the patients who had failed systemic MTX. The transvaginal ultrasonography data were retrospectively assessed, and two different ultrasonographic patterns were found: surface implantation and deep implantation of amniotic sac. The management and its effectiveness for patients with the two ultrasonographic patterns were studied retrospectively. Ultrasound scan and serum {beta}-hCG were monitored during follow-up. Data were analyzed with the Student's t test. Results: Nine patients were successfully treated with systemic MTX. The remaining 12 cases were successfully treated with additional UAE combined with local MTX. According to the classification by Vial et al. of CSP on ultrasonography, most surface implanted CSPs (8/11, 72.7%) could be successfully treated with systemic MTX, whereas most deeply implanted CSPs (9/10, 90%) had failed systemic MTX but still could be successfully treated with additional UAE combined with local MTX. All patients recovered without severe side effects. Most patients with a future desire for reproduction achieved subsequent pregnancy. Conclusions: For CSP patients suitable for nonsurgical treatment, UAE combined with local MTX would be the superior option compared with systemic MTX in the cases with deep implantation of amniotic sac.

  16. Diet Assessment Primer Roadmap | Dietary Assessment Primer

    Cancer.gov

    Skip to Main Content at the National Institutes of Health | www.cancer.gov Search the Primer: Dietary Assessment Primer Menu Home Roadmap Citation Contact Us Print Home  »  Diet Assessment Primer Roadmap Instrument Profiles Key Concepts Choosing

  17. Assessing Endothelial Vasodilator Function with the Endo-PAT 2000

    PubMed Central

    Axtell, Andrea L.; Gomari, Fatemeh A.; Cooke, John P.

    2010-01-01

    The endothelium is a delicate monolayer of cells that lines all blood vessels, and which comprises the systemic and lymphatic capillaries. By virtue of the panoply of paracrine factors that it secretes, the endothelium regulates the contractile and proliferative state of the underlying vascular smooth muscle, as well as the interaction of the vessel wall with circulating blood elements. Because of its central role in mediating vessel tone and growth, its position as gateway to circulating immune cells, and its local regulation of hemostasis and coagulation, the the properly functioning endothelium is the key to cardiovascular health. Conversely, the earliest disorder in most vascular diseases is endothelial dysfunction. In the arterial circulation, the healthy endothelium generally exerts a vasodilator influence on the vascular smooth muscle. There are a number of methods to assess endothelial vasodilator function. The Endo-PAT 2000 is a new device that is used to assess endothelial vasodilator function in a rapid and non-invasive fashion. Unlike the commonly used technique of duplex ultra-sonography to assess flow-mediated vasodilation, it is totally non-operator-dependent, and the equipment is an order of magnitude less expensive. The device records endothelium-mediated changes in the digital pulse waveform known as the PAT ( peripheral Arterial Tone) signal, measured with a pair of novel modified plethysmographic probes situated on the finger index of each hand. Endothelium-mediated changes in the PAT signal are elicited by creating a downstream hyperemic response. Hyperemia is induced by occluding blood flow through the brachial artery for 5 minutes using an inflatable cuff on one hand. The response to reactive hyperemia is calculated automatically by the system. A PAT ratio is created using the post and pre occlusion values. These values are normalized to measurements from the contra-lateral arm, which serves as control for non-endothelial dependent systemic effects. Most notably, this normalization controls for fluctuations in sympathetic nerve outflow that may induce changes in peripheral arterial tone that are superimposed on the hyperemic response. In this video we demonstrate how to use the Endo-PAT 2000 to perform a clinically relevant assessment of endothelial vasodilator function. PMID:20972417

  18. WORLD WATER ASSESSMENT PROGRAMME

    EPA Science Inventory

    The overall objective of the World Water Assessment Programme is to support the building of global security - food, environment, economic, social and political security -- through an integrated comprehensive freshwater assessment.The specific objectives within the assessment pr...

  19. Methods for assessing pre-induction cervical ripening

    PubMed Central

    Ezebialu, Ifeanyichukwu U; Eke, Ahizechukwu C; Eleje, George U; Nwachukwu, Chukwuemeka E

    2015-01-01

    Background Induction of labour is the artificial initiation of labour in a pregnant woman after the age of fetal viability but without any objective evidence of active phase labour and with intact fetal membranes. The need for induction of labour may arise due to a problem in the mother, her fetus or both, and the procedure may be carried out at or before term. Obstetricians have long known that for this to be successful, it is important that the uterine cervix (the neck of the womb) has favourable characteristics in terms of readiness to go into the labour state. Objectives To compare Bishop score with any other method for assessing pre-induction cervical ripening in women admitted for induction of labour. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 March 2015) and reference lists of retrieved studies to identify randomised controlled trials (RCTs). Selection criteria All RCTs comparing Bishop score with any other methods of pre-induction cervical assessment in women admitted for induction of labour. Cluster-RCTs were eligible for inclusion but none were identified. Quasi-RCTs and studies using a cross-over design were not eligible for inclusion. Studies published in abstract form were eligible for inclusion if they provided sufficient information. Comparisons could include the following. Bishop score versus transvaginal ultrasound (TVUS). Bishop score versus Insulin-like growth factor binding protein-1 (IGFBP-1). Bishop score versus vaginal fetal fibronectin (fFN). However, we only identified data for a comparison of Bishop score versus TVUS. Data collection and analysis Two review authors independently assessed the trials for inclusion, extracted the data and assessed trial quality. Data were checked for accuracy. Main results We included two trials that recruited a total of 234 women. The overall risk of bias was low for the two studies. Both studies compared Bishop score withTVUS. The two included studies did not show any clear difference between the Bishop score and TVUS groups for the following main outcomes: vaginal birth (RR 1.07, 95% CI 0.92 to 1.25, moderate quality evidence), caesarean delivery (RR 0.81, 95% CI 0.49 to 1.34, moderate quality evidence), neonatal admission into neonatal intensive care unit (RR 1.67, 95% CI 0.41 to 6.71, moderate quality evidence). Both studies only provided median data in relation to induction-delivery interval and reported no clear difference between the Bishop and TVUS groups. Perinatal mortality was not reported in the included studies. For the review's secondary outcomes, the need for misoprostol for cervical ripening was more frequent in the TVUS group compared to the Bishop score group (RR 0.52, 95% CI 0.41 to 0.66, two studies, 234 women, moderate quality evidence). In contrast, there were no clear differences between the Bishop scope and TVUS groups in terms of meconium staining of the amniotic fluid, fetal heart rate abnormality in labour, and Apgar score less than seven. Only one trial reported median data on the induction-delivery interval and induction to active phase interval, the trialist reported no difference between the Bishop group and the TVUS group for this outcome. Neither of the included studies reported on uterine rupture. Authors' conclusions Moderate quality evidence from two small RCTs involving 234 women that compared two different methods for assessing pre-induction cervical ripening (Bishop score and TVUS) did not demonstrate superiority of one method over the other in terms of the main outcomes assessed in this review. We did not identify any data relating to perinatal mortality. Whilst use of TVUS was associated with an increased need for misoprostol for cervical ripening, both methods could be complementary. The choice of a particular method of assessing pre-induction cervical ripening may differ depending on the environment and need where one is practicing since some methods (i.e. TVUS) may not be readily available and affordable in resource-poor settings where the sequelae of labour and its manag

  20. Solar radiation resource assessment

    SciTech Connect

    Not Available

    1990-11-01

    The bulletin discusses the following: introduction; Why is solar radiation resource assessment important Understanding the basics; the solar radiation resource assessment project; and future activities.

  1. Assessment of vascular function in Mexican women exposed to polycyclic aromatic hydrocarbons from wood smoke.

    PubMed

    Ruiz-Vera, Tania; Pruneda-Álvarez, Lucia G; Ochoa-Martínez, Ángeles C; Ramírez-GarcíaLuna, José L; Pierdant-Pérez, Mauricio; Gordillo-Moscoso, Antonio A; Pérez-Vázquez, Francisco J; Pérez-Maldonado, Iván N

    2015-09-01

    The use of solid fuels for cooking and heating is likely to be the largest source of indoor air pollution on a global scale; these fuels emit substantial amounts of toxic pollutants such as polycyclic aromatic hydrocarbons (PAHs) when used in simple cooking stoves (such as open "three-stone" fires). Moreover, indoor air pollution from biomass fuels is considered an important risk factor for human health. The aim of this study was to evaluate the relationship between exposure to PAHs from wood smoke and vascular dysfunction; in a group of Mexican women that use biomass combustion as their main energy source inside their homes. We used 1-hydroxypyrene (1-OHP) as an exposure biomarker to PAHs and it was assessed using high performance liquid chromatography. The endothelium-dependent vasodilation was assessed through a vascular reactivity compression test performed with a pneumatic cuff under visualization of the brachial artery using high resolution ultrasonography (HRU). Assessment of the carotid intima-media thickness (CIMT) was used as an atherosclerosis biomarker (also assessed using HRU); and clinical parameters such as anthropometry, blood pressure, glucose, triglycerides, total cholesterol, HDL cholesterol, LDL cholesterol, among others were also evaluated. The mean concentration of urinary 1-OHP found in exposed women was 0.46±0.32?mol/mol Cr (range: 0.086-1.23?mol/mol Cr). Moreover, vascular dysfunction (diminished endothelium dependent vasodilation) was found in 45% of the women participating in the study. Association between vascular function and 1-OHP levels was found to be significant through a logistic regression analysis (p=0.034; r(2)=0.1329). Furthermore, no association between CIMT and clinical parameters, urinary 1-OHP levels or vascular dysfunction was found. Therefore, with the information obtained in this study, we advocate for the need to implement programs to reduce the risk of exposure to PAHs in communities that use biomass fuels as a main energy source. PMID:26276550

  2. What Is Authentic Assessment?

    ERIC Educational Resources Information Center

    Bracey, Gerald W.

    1993-01-01

    Describes four criteria that can be used to evaluate methods of assessment: (1) "What are the consequences of using the test?" (2) "Is this assessment fair?" (3) "Do the skills and knowledge of this assessment transfer or generalize?" and (4) "Does this assessment cover cognitively complex task?" (KDP)

  3. Personal Training & Fitness Assessment

    E-print Network

    Hill, Wendell T.

    Personal Training & Fitness Assessment Renewal Form UM RecWell Fitness Programs 301.405.PLAY www.25/$141.75/ na $163.75/$204.75/na $264.50/$330.75/na*** $294/$367.50/na*** $24.60/$33 $13/$16.50 Fitness Assessment and Body Composition Fees Full Fitness Assessment UMD Students/ RecWell Members Fitness Assessment

  4. Assessment of Cardiovascular Parameters in Obese Children and Adolescents with Non-Alcoholic Fatty Liver Disease

    PubMed Central

    Eklio?lu, Beray Selver; Atabek, Mehmet Emre; Akyürek, Nesibe; Alp, Hayrullah

    2015-01-01

    Objective: The aim of this study was to evaluate the periaortic fat thickness (PAFT) using conventional echocardiography in obese children and adolescents with non-alcoholic fatty liver disease (NAFLD). Methods: Two hundred and ninety-seven obese children and adolescents were included in the study. Anthropometric measurements were made in all subjects, and fasting venous blood samples were taken for determination of glucose, insulin, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Ultrasonography of the liver was used for assessment of NAFLD and the subjects were grouped as NAFLD and non-NAFLD. Echocardiography was performed in all subjects. Results: PAFT was higher in patients with NAFLD compared with the non-NAFLD group. In patients with NAFLD, PAFT was positively correlated with waist circumference and with total cholesterol levels. In multiple regression analysis, waist circumference (?=0.28, p=<0.001) was found to be the best predictor of PAFT. Conclusion: Conventional echocardiography may be used to determine increased PAFT at an early stage in obese children and adolescents with NAFLD for careful monitoring of cardiovascular risk.

  5. Modified sonoelastographic scale score for lymph node assessment in lymphoma – a preliminary report

    PubMed Central

    ?asecki, Mateusz; Olchowy, Cyprian; Soko?owska-D?bek, D?brówka; Biel, Anna; Chaber, Rados?aw

    2015-01-01

    Elastography is a new method of assessment of lymph node consistency. The majority of papers focus on metastases detection of head and neck or breast tumors. The typical desmoplastic reaction in connective tissue stroma in cancer, which is responsible for tissue's hardening, is seen in lymphoma less frequently. Material and methods Study of 15 patients with active Hodgkin and non-Hodgkin lymphomas and 16 previously treated patients with no evidence of recurrence. A total of 60 patients suffering from reactive lymphadenopathy was the control group. The size, appearance, vascularity and elastogram of lymph node was analyzed. Results Type C elastogram correlated strongly with lymph nodes which presented at least three pathologic features in 2D image. Large lymph nodes with long axis diameter over 3 cm may have ‘cheese with holes’ appearance rather than common type C elastogram. Conclusion According to our simplified sonoelastography scoring system, type C elastogram was present mainly in patients with active lymphoma affecting lymph nodes, which showed all four features that we analyzed using conventional ultrasonography. This elastogram was also present in reactive lymphadenopathies. Distinctive for large lymph nodes in patients with active forms of lymphoma “cheese with holes” appearance, can be considered as equal with type C image, although it is corresponding to type B sonoelastographic map. PMID:26675578

  6. Distributed road assessment system

    DOEpatents

    Beer, N. Reginald; Paglieroni, David W

    2014-03-25

    A system that detects damage on or below the surface of a paved structure or pavement is provided. A distributed road assessment system includes road assessment pods and a road assessment server. Each road assessment pod includes a ground-penetrating radar antenna array and a detection system that detects road damage from the return signals as the vehicle on which the pod is mounted travels down a road. Each road assessment pod transmits to the road assessment server occurrence information describing each occurrence of road damage that is newly detected on a current scan of a road. The road assessment server maintains a road damage database of occurrence information describing the previously detected occurrences of road damage. After the road assessment server receives occurrence information for newly detected occurrences of road damage for a portion of a road, the road assessment server determines which newly detected occurrences correspond to which previously detected occurrences of road damage.

  7. EXPOSURE ASSESSMENT: INPUT INTO RISK ASSESSMENT

    EPA Science Inventory

    The validity of a risk assessment can be no better than that of the exposure assessment upon which it is based. he general paucity of relevant exposure data, combined with the limited appreciation by most risk assessors of the critical dimensions and metrics of exposure, often le...

  8. Comparing Dietary Assessment Instruments | Dietary Assessment Primer

    Cancer.gov

    This table provides an at-a-glance comparison of the major features of self-report instruments for assessing diet. Further details on each instrument can be found in the Instrument Profiles. Considerations for the use of different instruments or combinations of instruments in different types of studies can be found in Choosing an Approach for Dietary Assessment.

  9. Assessment of the reproductive status of female veiled chameleons (Chamaeleo calyptratus) using hormonal, behavioural and physical traits.

    PubMed

    Pimm, Robyn H; Dutton, Christopher; O'Handley, Stacey; Mastromonaco, Gabriela F

    2015-01-01

    Egg binding is a common reproductive disorder in captive female reptiles leading to premature loss of breeding potential, or in severe cases death. It can result from failure to ovulate (and reabsorb) follicles; follicular stasis, or failure to lay eggs; dystocia. Reproductive status of female veiled chameleons (Chamaeleo calyptratus) in a research colony was assessed using enzyme immunoassay (EIA) of fecal reproductive hormones (estradiol; E2, progesterone; P, and testosterone; T) and their metabolites, ultrasound imaging of the reproductive tract, and receptivity to conspecific males. Periods of follicular growth (vitellogenesis) corresponded with increasing levels of E2, and following ovulation, a distinct change in morphology from round (follicles) to oval (eggs) structures, which was accompanied by a surge in P (>20-fold above baseline). P levels remained elevated throughout the gravid phase until just prior to oviposition. Length/width ratios of follicles and eggs were statistically different, but distinguishing a follicle from an egg based on the ratio was unreliable due to a large overlap in values. In animals that failed to ovulate on their first cycle, follicles began to recede but were not fully reabsorbed and could be distinguished from a second batch of follicles based on their echogenicity. Female receptivity to conspecific males was not related to cycle stage (i.e., previtellogenesis, vitellogenesis, or gravid) or reproductive hormone levels. This study demonstrates the use of ultrasonography and reproductive hormone analysis to assess phase of the reproductive cycle (pre- or post-ovulatory), or confirm ongoing follicular stasis. PMID:25393418

  10. Role of US Contrast Agents in the Assessment of Indeterminate Solid and Cystic Lesions in Native and Transplant Kidneys.

    PubMed

    Harvey, Chris J; Alsafi, Ali; Kuzmich, Siarhei; Ngo, An; Papadopoulou, Ioanna; Lakhani, Amish; Berkowitz, Yaron; Moser, Steven; Sidhu, Paul S; Cosgrove, David O

    2015-01-01

    Ultrasonography (US) is often the initial imaging modality employed in the evaluation of renal diseases. Despite improvements in B-mode and Doppler imaging, US still faces limitations in the assessment of focal renal masses and complex cysts as well as the microcirculation. The applications of contrast-enhanced US (CEUS) in the kidneys have dramatically increased to overcome these shortcomings with guidelines underlining their importance. This article describes microbubble contrast agents and their role in renal imaging. Microbubble contrast agents consist of a low solubility complex gas surrounded by a phospholipid shell. Microbubbles are extremely safe and well-tolerated pure intravascular agents that can be used in renal failure and obstruction, where computed tomographic (CT) and magnetic resonance (MR) imaging contrast agents may have deleterious effects. Their intravascular distribution allows for quantitative perfusion analysis of the microcirculation, diagnosis of vascular problems, and qualitative assessment of tumor vascularity and enhancement patterns. Low acoustic power real-time prolonged imaging can be performed without exposure to ionizing radiation and at lower cost than CT or MR imaging. CEUS can accurately distinguish pseudotumors from true tumors. CEUS has been shown to be more accurate than unenhanced US and rivals contrast material-enhanced CT in the diagnosis of malignancy in complex cystic renal lesions and can upstage the Bosniak category. CEUS can demonstrate specific enhancement patterns allowing the differentiation of benign and malignant solid tumors as well as focal inflammatory lesions. In conclusion, CEUS is useful in the characterization of indeterminate renal masses and cysts. PMID:26273994

  11. [Current status of vaginal ultrasound. Part II: Obstetrical diagnosis, new aspects and future perspectives].

    PubMed

    Merz, E

    1994-04-01

    In obstetrics the main advantage of transvaginal sonography is in the first trimester. It is possible to diagnose normal or abnormal pregnancy or ectopic pregnancy earlier and more exactly than with transabdominal ultrasound. Furthermore different foetal malformations can be detected within the first trimester. Applications in the second and third trimesters are the evaluation of the cervix to detect cervical incompetence or the evaluation of the lower placental segment in case of placenta praevia. In contrast to transvaginal ultrasound the assessment of the foetus in the second and third trimesters remains a domain of abdominal ultrasound. However, transvaginal scanning can be a useful adjunct in cases where the foetal head is deeply engaged or for the visualisation of a foetal organ that is close to the vaginal probe. Transvaginal colour Doppler as well as transvaginal 3 D-volume scanning represent new aspects of transvaginal sonography in obstetrics and gynaecology. These techniques will provide progress especially in tumour diagnosis in the lower pelvis in the future. PMID:8023121

  12. Transumbilical placement of the vaginal probe in obese pregnant women.

    PubMed

    Rosenberg, J C; Guzman, E R; Vintzileos, A M; Knuppel, R A

    1995-01-01

    Transabdominal ultrasonography in obese pregnant women is often unsatisfactory because of the poor transmission of ultrasound through a thickened abdominal wall. We report our experience with the placement of a transvaginal probe in the umbilicus to improve resolution in obese pregnant patients. The technique, which involves filling the umbilicus with ultrasound transmission gel and inserting the transvaginal probe into the umbilicus, was applied in 25 consecutive obese patients who had unsatisfactory fetal imaging by the standard transabdominal approach. The most frequent reason for incomplete fetal survey by the standard transabdominal approach was unsatisfactory imaging of the fetal heart (19 of 25 cases, 76%). The transumbilical approach resulted in improved resolution and satisfactory cardiac examination in 18 of these 19 cases (95%). In two cases, color and pulsed Doppler interrogation of intrafetal vessels become possible. A complete fetal survey was accomplished in 96% of the cases. PMID:7800310

  13. Solar Resource Assessment

    SciTech Connect

    Renne, D.; George, R.; Wilcox, S.; Stoffel, T.; Myers, D.; Heimiller, D.

    2008-02-01

    This report covers the solar resource assessment aspects of the Renewable Systems Interconnection study. The status of solar resource assessment in the United States is described, and summaries of the availability of modeled data sets are provided.

  14. Assessing the Assessment in Emergency Care Training

    PubMed Central

    Dankbaar, Mary E. W.; Stegers-Jager, Karen M.; Baarveld, Frank; van Merrienboer, Jeroen J. G.; Norman, Geoff R.; Rutten, Frans L.; van Saase, Jan L. C. M.; Schuit, Stephanie C. E.

    2014-01-01

    Objective Each year over 1.5 million health care professionals attend emergency care courses. Despite high stakes for patients and extensive resources involved, little evidence exists on the quality of assessment. The aim of this study was to evaluate the validity and reliability of commonly used formats in assessing emergency care skills. Methods Residents were assessed at the end of a 2-week emergency course; a subgroup was videotaped. Psychometric analyses were conducted to assess the validity and inter-rater reliability of the assessment instrument, which included a checklist, a 9-item competency scale and a global performance scale. Results A group of 144 residents and 12 raters participated in the study; 22 residents were videotaped and re-assessed by 8 raters. The checklists showed limited validity and poor inter-rater reliability for the dimensions “correct” and “timely” (ICC?=?.30 and.39 resp.). The competency scale had good construct validity, consisting of a clinical and a communication subscale. The internal consistency of the (sub)scales was high (??=?.93/.91/.86). The inter-rater reliability was moderate for the clinical competency subscale (.49) and the global performance scale (.50), but poor for the communication subscale (.27). A generalizability study showed that for a reliable assessment 5–13 raters are needed when using checklists, and four when using the clinical competency scale or the global performance scale. Conclusions This study shows poor validity and reliability for assessing emergency skills with checklists but good validity and moderate reliability with clinical competency or global performance scales. Involving more raters can improve the reliability substantially. Recommendations are made to improve this high stakes skill assessment. PMID:25521702

  15. GM Risk Assessment

    NASA Astrophysics Data System (ADS)

    Sparrow, Penny A. C.

    GM risk assessments play an important role in the decision-making process surrounding the regulation, notification and permission to handle Genetically Modified Organisms (GMOs). Ultimately the role of a GM risk assessment will be to ensure the safe handling and containment of the GMO; and to assess any potential impacts on the environment and human health. A risk assessment should answer all ‘what if’ scenarios, based on scientific evidence.

  16. Innovations in Computerized Assessment.

    ERIC Educational Resources Information Center

    Drasgow, Fritz, Ed.; Olson-Buchanan, Julie B., Ed.

    Chapters in this book present the challenges and dilemmas faced by researchers as they created new computerized assessments, focusing on issues addressed in developing, scoring, and administering the assessments. Chapters are: (1) "Beyond Bells and Whistles; An Introduction to Computerized Assessment" (Julie B. Olson-Buchanan and Fritz Drasgow);…

  17. Anatomy of Assessment.

    ERIC Educational Resources Information Center

    Berko, Roy; Webster, Linda; Neher, William W.; Grew, Deborah; Tatum, Donna Surges

    1998-01-01

    The articles in this section discuss aspects of assessment: (1) "Assessment: What Is It? Why Do We Need It? How Do We Use It?" (Roy Berko and Linda Webster); (2) "Public Speaking Assessment for College Students" (William W. Neher and Deborah Grew); and (3) "Student Progress? Prove It!" (Donna Surges Tatum). (SLD)

  18. Curriculum-Based Assessment

    ERIC Educational Resources Information Center

    Hintze, John M.; Christ, Theodore J.; Methe, Scott A.

    2006-01-01

    Curriculum-based assessment (CBA) measures have become a frequently used assessment tool of school psychologists to assess the academic performance functioning of students in the basic skill areas of reading, mathematics, spelling, and written expression. The purpose of this article is to provide an overview of the different approaches to CBA,…

  19. Assessment for All

    ERIC Educational Resources Information Center

    Science Scope, 2005

    2005-01-01

    There are many ways of assessing students and the work they do, and many ways of getting them ready for those assessments. Special needs students provide an extra challenge to educators because they have difficulty preparing for assessment and often more difficulty communicating what they know. It is not enough to be a thoughtful, lab-focused…

  20. Assessments A Training Manual

    E-print Network

    for industrial clients has always been tied to the cost of energy resources. Beginning with the oil embargo the initial investment by the manufacturing concern now makes the full industrial assessment attractive. But what exactly makes the industrial assessment pay for the client? Analysis of the assessment client

  1. Defining Authentic Classroom Assessment

    ERIC Educational Resources Information Center

    Frey, Bruce B.; Schmitt, Vicki L.; Allen, Justin P.

    2012-01-01

    A commonly advocated best practice for classroom assessment is to make the assessments authentic. Authentic is often used as meaning the mirroring of real-world tasks or expectations. There is no consensus, however, in the actual definition of the term or the characteristics of an authentic classroom assessment. Sometimes, the realistic component…

  2. ECOLOGICAL ASSESSMENT PROGRAM

    EPA Science Inventory

    In 1996 the EPA published the first draft Ecological Risk Assessment Guidelines. These documents not only describe methods for conducting the more conventional single-species, chemical-based risk assessment, they describe techniques for assessing risks to ecosystems from multiple...

  3. GUIDELINES FOR EXPOSURE ASSESSMENT

    EPA Science Inventory

    The Guidelines for Exposure Assessment describe the general concepts of exposure assessment including definitions and associated units, and by providing guidance on the planning and conducting of an exposure assessment. Guidance is also provided on presenting the results of the e...

  4. Information Literacy Assessment

    ERIC Educational Resources Information Center

    Warmkessel, Marjorie M.

    2007-01-01

    This article presents an annotated list of seven recent articles on the topic of information literacy assessment. They include: (1) "The Three Arenas of Information Literacy Assessment" (Bonnie Gratch Lindauer); (2) "Testing the Effectiveness of Interactive Multimedia for Library-User Education" (Karen Markey et al.); (3) "Assessing Auburn…

  5. Contemporary Assessment for Educators.

    ERIC Educational Resources Information Center

    Chase, Clinton I.

    This book provides basic skills and knowledge about assessment so that teachers can expand their ability to deal with appraisal problems in their own settings. The first section deals with the basic principles of assessment. The second section concerns creating and applying assessment tools. The third section reviews issues in understanding and…

  6. Assessment of Biology Investigations.

    ERIC Educational Resources Information Center

    Roberts, Ros; Gott, Richard

    2003-01-01

    Makes a case for the assessment of investigations against the Concept of Evidence in written tests as a potentially more reliable and valid way of assessing the ideas used in all types of biology investigations, thus reducing the distorting effect of assessment on the curriculum. (Author/SOE)

  7. Assessing Basic Fact Fluency

    ERIC Educational Resources Information Center

    Kling, Gina; Bay-Williams, Jennifer M.

    2014-01-01

    In this article, the authors share a variety of ways to formatively assess basic fact fluency. The define fluency, raise some issues related to timed testing, and then share a collection of classroom-tested ideas for authentic fact fluency assessment. This article encourages teachers to try a variety of alternative assessments from this sampling,…

  8. Assessments East Carolina University

    E-print Network

    Gopalakrishnan, K.

    Approval Available Hours Follow-Ups Previous Audit plan Risk Assessment Process (Attch: 1) Self University How the Audit Plan is Developed #12;East Carolina University Risk Assessment Process Attch: 1 of Internal Audit Risk Assessment Preliminary Work Date: Name: Area of Responsibility: Prior to meeting

  9. GCSE Assessment Notes.

    ERIC Educational Resources Information Center

    School Science Review, 1988

    1988-01-01

    Contains three articles designed to help practitioners with practical assessment for the GCSE. Articles include: "GCSE Biology Practical Assessment--Can the End Justify the Means?"; "Investigating the Effect of Catalase: GCSE Assessment Practical"; and "An Experimental Design for GCSE Physics." (CW)

  10. assessment and recruitment of

    E-print Network

    Abrahams, I. David

    Units of assessment and recruitment of panel members July 2004 Ref RAE 03/2004 Higher Education Assessment Exercise (RAE) is to produce robust expert assessments of the quality of research undertaken Funding Council for England Scottish Higher Education Funding Council Higher Education Funding Council

  11. ASSESSMENT AND FEEDBACK POLICY

    E-print Network

    Judd, Martin

    or abilities. In line with Chapter B61 of the QAA UK Quality Code for Higher Education, assessment is taken Education (Chapter B3 on Learning and Teaching and Chapter B6 on Assessment of Students and Accreditation and Assessment (Chair), a representative from each Faculty, the USSA Vice President for Education

  12. HEALTH SECTOR ASSESSMENT

    EPA Science Inventory

    As part of the USGCRP's First National Assessment effort, EPA's Global Change Research Program sponsored the Health Sector Assessment. The Health Sector Assessment was co-chaired by Dr. Jonathan A. Patz, Director of the Program on the Health Effects of Global Environmental Change...

  13. NATIONAL ASSESSMENT DATABASE (NAD)

    EPA Science Inventory

    Resource Purpose:The National Assessment Database stores State water quality assessments that are reported under Section 305(b) of the Clean Water Act. The data are stored by individual water quality assessments. Threatened, partially and not supporting waters also have da...

  14. Assessing the assessments: Pharmaceuticals in the environment

    SciTech Connect

    Enick, O.V. Moore, M.M.

    2007-11-15

    The relatively new issue of pharmaceutical contamination of the environment offers the opportunity to explore the application of values to the construction, communication and management of risk. The still-developing regulatory policies regarding environmental contamination with pharmaceuticals provide fertile ground for the introduction of values into the definition and management of risk. In this report, we summarize the current knowledge regarding pharmaceutical contamination of the environment and discuss specific attributes of pharmaceuticals that require special consideration. We then present an analysis showing that if values are incorporated into assessing, characterizing and managing risk, the results of risk assessments will more accurately reflect the needs of various stakeholders. Originating from an acknowledgement of the inherent uncertainty and value-laden nature of risk assessment, the precautionary principle (and later, the multi-criteria, integrated risk assessment), provides a direction for further research and policy development.

  15. GM Risk Assessment.

    PubMed

    Sparrow, Penny A C

    2009-01-01

    GM risk assessments play an important role in the decision-making process surrounding the regulation, notification and permission to handle Genetically Modified Organisms (GMOs). Ultimately the role of a GM risk assessment will be to ensure the safe handling and containment of the GMO; and to assess any potential impacts on the environment and human health. A risk assessment should answer all 'what if' scenarios, based on scientific evidence. This chapter sets out to provide researchers with helpful guidance notes on producing their own GM risk assessment. While reference will be made to UK and EU regulations, the underlying principles and points to consider are generic to most countries. PMID:19009454

  16. Home Energy Assessments

    SciTech Connect

    Dispenza, Jason

    2010-01-01

    A home energy assessment, also known as a home energy audit, is the first step to assess how much energy your home consumes and to evaluate what measures you can take to make your home more energy efficient. An assessment will show you problems that may, when corrected, save you significant amounts of money over time. This video shows some of the ways that a contractor may test your home during an assessment, and helps you understand how an assessment can help you move toward energy savings. Find out more at: http://www.energysavers.gov/your_home/energy_audits/index.cfm/mytopic=11160

  17. Home Energy Assessments

    ScienceCinema

    Dispenza, Jason

    2013-05-29

    A home energy assessment, also known as a home energy audit, is the first step to assess how much energy your home consumes and to evaluate what measures you can take to make your home more energy efficient. An assessment will show you problems that may, when corrected, save you significant amounts of money over time. This video shows some of the ways that a contractor may test your home during an assessment, and helps you understand how an assessment can help you move toward energy savings. Find out more at: http://www.energysavers.gov/your_home/energy_audits/index.cfm/mytopic=11160

  18. Lessons about vulnerability assessments.

    SciTech Connect

    Johnston, R. G.

    2004-01-01

    The Vulnerability Assessment Team (VAT) at Los Alamos National Laboratory believes that physical security can only be optimized through the use of effective vulnerability assessments. As a result of conducting vulnerability assessments on hundreds of different security devices and systems in the last few years, we have identified some of the attributes of effective assessments. These, along with our recommendations and observations about vulnerability assessments, are summarized in this paper. While our work has primarily involved physical security (in contrast to, for example, computer, network, or information security), our experiences may have applicability to other types of security as well.

  19. Assessment of language acquisition.

    PubMed

    de Villiers, Peter A; de Villiers, Jill G

    2010-03-01

    This review addresses questions of what should be assessed in language acquisition, and how to do it. The design of a language assessment is crucially connected to its purpose, whether for diagnosis, development of an intervention plan, or for research. Precise profiles of language strengths and weaknesses are required for clear definitions of the phenotypes of particular language and neurodevelopmental disorders. The benefits and costs of formal tests versus language sampling assessments are reviewed. Content validity, theoretically and empirically grounded in child language acquisition, is claimed to be centrally important for appropriate assessment. Without this grounding, links between phenomena can be missed, and interpretations of underlying difficulties can be compromised. Sensitivity and specificity of assessment instruments are often assessed using a gold standard of existing tests and diagnostic practices, but problems arise if that standard is biased against particular groups or dialects. The paper addresses the issues raised by the goal of unbiased assessment of children from diverse linguistic and cultural backgrounds, especially speakers of non-mainstream dialects or bilingual children. A variety of new approaches are discussed for language assessment, including dynamic assessment, experimental tools such as intermodal preferential looking, and training studies that assess generalization. Stress is placed on the need for measures of the process of acquisition rather than just levels of achievement. Copyright © 2010 John Wiley & Sons, Ltd. For further resources related to this article, please visit the WIREs website. PMID:26271237

  20. Proceedings National Stock Assessment Workshop

    E-print Network

    Proceedings 11th National Stock Assessment Workshop Characterization of Scientific Uncertainty Stock and Habitat Assessment Workshops Incorporating Habitat Information in Stock Assessments 1st 2010 #12;#12;Proceedings 11th National Stock Assessment Workshop Characterization of Scientific

  1. Assessment of lower urinary tract function in children with Down syndrome

    PubMed Central

    Kitamura, Atsuko; Kondoh, Tatsuro; Noguchi, Mitsuru; Hatada, Teppei; Tohbu, Shohei; Mori, Ken-ichi; Matsuo, Manabu; Kunitsugu, Ichiro; Kanetake, Hiroshi; Moriuchi, Hiroyuki

    2014-01-01

    Background Despite the fact that functional lower urinary tract symptoms are common among people with Down syndrome (DS), their voiding function has not been studied precisely. Our goal was to assess the lower urinary tract functions in DS. Methods Fifty-five DS children aged 5–15 years old and 35 age-matched control children were evaluated by ultrasonography and uroflowmetry. Results Eleven (20%) DS children had no uresiesthesia, 21 (38%) were urinated under guidance, nine (16%) urinated fewer than three times a day, two (4%) urinated more than 10 times a day, three (5%) used diapers, and 26 (47%) had urinary incontinence. Seven (13%), 15 (27%), and 10 (18%) DS children had weak, prolonged and intermittent urination, respectively, and seven (13%) had urination with straining. In contrast, none of the control subjects had urinary problems. In the uroflowmetrical analysis, 10 (18%), 20 (37%), 11 (20%) and five (9%) DS children showed “bell-shaped,” “plateau,” “staccato” and “interrupted” patterns, respectively; the remaining nine (16%) could not be analyzed. In contrast, 21 (60%), one (3%), four (11%), three (9%) and two (6%) control subjects showed bell-shaped, tower-shaped, plateau, staccato and interrupted patterns, respectively; the remaining four (11%) could not be analyzed. Residual urine was demonstrated in four (7%) DS children and one (3%) control child. Conclusions Lower urinary tract symptoms and abnormal uroflowmetry findings, which can lead to further progressive renal and urinary disorders, are common in DS children. Therefore, lower urinary tract functions should be assessed at the life-long regular medical check-ups for subjects with DS. PMID:24758352

  2. Industrial Assessment Center

    SciTech Connect

    J. Kelly Kissock; Becky Blust

    2007-04-17

    The University of Dayton (UD) performed energy assessments, trained students and supported USDOE objectives. In particular, the UD Industrial Assessment Center (IAC) performed 96 industrial energy assessment days for mid-sized manufacturers. The average identified and implemented savings on each assessment were $261,080 per year and $54,790 per year. The assessments served as direct training in industrial energy efficiency for 16 UD IAC students. The assessments also served as a mechanism for the UD IAC to understand manufacturing energy use and improve upon the science of manufacturing energy efficiency. Specific research results were published in 16 conference proceedings and journals, disseminated in 22 additional invited lectures, and shared with the industrial energy community through the UD IAC website.

  3. Assessment of Relevant Learning Processes.

    ERIC Educational Resources Information Center

    Kim, JinGyu

    Criteria for relevant classroom assessments are discussed, and a biofunctional model of learning assessment is presented. In classroom assessment, the following criteria must be considered: (1) assessment approach (process-oriented and outcome-oriented); (2) assessment context (knowledge and higher-order thinking skills); (3) assessment method…

  4. Assessment of Pain

    PubMed Central

    Jeans, Mary-Ellen; Stratford, Joseph G.; Melzack, Ronald; Monks, Richard C.

    1979-01-01

    The assessment of pain presents a major problem in both research and clinical practice. Until recently our methods for evaluating pain were based on a sensory conceptual model of pain and an acute care approach to illness. These traditional views are often inadequate, particularly in relation to chronic pain syndromes. Clinical assessment of chronic pain must include extensive physical and psychological examination. New approaches to pain measurement and clinical assessment of the patient are discussed.

  5. Short Dietary Assessment Instruments

    Cancer.gov

    Short dietary assessment instruments, often called screeners, may be useful in situations that do not require assessment of the total diet or quantitative accuracy in dietary estimates. Recognizing the need for these tools, the Risk Factor Monitoring and Methods Branch (RFMMB) has developed several short instruments that assess intake of fruits and vegetables, percentage energy from fat, fiber, added sugars, whole grains, calcium, dairy products, and red and processed meats.

  6. INDUSTRIAL ASSESSMENT CENTER PROGRAM

    SciTech Connect

    ASFAW BEYENE

    2008-09-29

    Since its establishment in 1990, San Diego State University’s Industrial Assessment Center (IAC) has served close to 400 small and medium-sized manufacturing plants in Southern California. SDSU/IAC’s efforts to transfer state-of-the-art technologies to industry have increased revenues, cultivated creativity, improved efficiencies, and benefited the environment. A substantial benefit from the program has been the ongoing training of engineering faculty and students. During this funding cycle, SDSU/IAC has trained 31 students, 7 of the graduate. A total of 92 assessments and 108 assessment days were completed, resulting in 638 assessment recommendations.

  7. Risk assessment methodologies for biotechnology impact assessment

    NASA Astrophysics Data System (ADS)

    Gillett, James W.

    1986-07-01

    By combining hazard assessment of effects of a potential biotechnology product with exposure assessments based on study of the genetically engineered organism's fate, conclusions may be reached about the risk involved in release of the product to the environment. In order to make this risk assessment, criteria (including regulatory endpoints) must be established and then developed further against a data base from well-accepted tests. Other aspects requiring research and development include test evaluation, quality assurance, statistical procedures, and methods of identifying and monitoring not only the nominal organism(s) in the products, but also any contaminating material or organisms to which the genetically engineered components may be transferred in the environment. Application of microcosm technology to testing of genetically engineered organisms is expected to be important, since these systems may be used safely to understand fate and effects prior to (or in place of) testing the product in the environment. Limitations in the use of microcosms may be offset by the cost-effectiveness and incisiveness of results, as has been shown for other pollutants. Risk management for biotechnology products currently lacks an adequate background, but components of the process exist or can be developed. New resources, in terms of personnel, training, facilities, and funding, will be needed in order to apply the risk assessment paradigm used for toxic chemicals and pesticides. We will need to know:

  8. Dietary Assessment Instrument Profiles | Dietary Assessment Primer

    Cancer.gov

    The Profiles in this section of the Primer contain numerous links to other sections, including other Profiles, Key Concepts, Choosing an Approach for Dietary Assessment, Learn More, and the Glossary. Links with dashed underlines will show you terms from the Glossary. Links with solid underlines will take you to other sections of the Primer.

  9. Clinical applicability of real-time, prehospital image transmission for FAST (Focused Assessment with Sonography for Trauma).

    PubMed

    Song, Kyoung Jun; Shin, Sang Do; Hong, Ki Jeong; Cheon, Kyoung Woo; Shin, Ilhyoung; Song, Sung-Wook; Kim, Hee Chan

    2013-12-01

    We evaluated a real-time, prehospital ultrasound image transmission system for use in focused assessment with sonography for trauma (FAST). The wireless, real-time ultrasound image transmission system comprised an ultrasound scanner with a convex abdominal transducer and a notebook computer connected to a 3?G wireless network for video data transmission. In our simulation experiment, ultrasonography was performed by emergency medical technicians (EMTs) on a human body phantom with simulated haemoperitoneum. Transmitted ultrasound video clips were randomly rearranged and presented to emergency physicians to make a diagnosis of haemoperitoneum. A total of 21 ultrasound video clips was used and 13 emergency physicians participated in the study. The sensitivity and specificity were 90.0% (95% Confidence Interval, CI, 83.5-94.6) and 85.3% (95% CI 78.4-90.7) respectively, and the accuracy of detecting abnormal ultrasound results was 87.7% (95% CI 83.8-91.6). Diagnosis of hemoperitonuem in trauma patients by an emergency physician based on the transmitted video images of FAST performed by an EMT is feasible, and has an accuracy of about 88%. PMID:24197401

  10. A Case of Ovarian Pregnancy Diagnosed by MRI

    PubMed Central

    Io, Shingo; Hasegawa, Masaaki; Koyama, Takashi

    2015-01-01

    Ovarian pregnancy is a rare form of ectopic pregnancy, causing a great diagnostic challenge. We report a case of ovarian pregnancy in a 42-year-old woman, in whom MRI successfully demonstrated the implantation in the ovary. Transvaginal ultrasonography showed an echogenic mass in the right ovary but failed to demonstrate tubal pregnancy. T2-weighted MR images disclosed a gestational sac structure in the right ovary, which exhibited heterogeneous high intensity intermingled with punctate foci of distinct low intensity. MRI may be a useful tool for diagnosing ovarian pregnancy, by demonstrating a gestational sac in the ovary. PMID:26491583

  11. Cancer Risk Assessment Primer.

    ERIC Educational Resources Information Center

    Aidala, Jim

    1985-01-01

    Describes the scientific basis of cancer risk assessment, outlining the dominant controversies surrounding the use of different methods for identifying carcinogens (short-term tests, animal bioassays, and epidemiological studies). Points out that risk assessment is as much an art as it is a science. (DH)

  12. Assessing Second Language Speaking

    ERIC Educational Resources Information Center

    Fulcher, Glenn

    2015-01-01

    While the viva voce (oral) examination has always been used in content-based educational assessment (Latham 1877: 132), the assessment of second language (L2) speaking in performance tests is relatively recent. The impetus for the growth in testing speaking during the 19th and 20th centuries is twofold. Firstly, in educational settings the…

  13. Assessment after Levels

    ERIC Educational Resources Information Center

    Brown, Geraint; Burnham, Sally

    2014-01-01

    Ten years ago, two heads of department in contrasting schools presented a powerfully-argued case for resisting the use of level descriptions within their assessment regimes. Influenced both by research into the nature of children's historical thinking and by principles of assessment "for" learning, Sally Burnham and Geraint Brown…

  14. Classroom Assessment in Action

    ERIC Educational Resources Information Center

    Shermis, Mark D.; DiVesta, Francis J.

    2011-01-01

    "Classroom Assessment in Action" clarifies the multi-faceted roles of measurement and assessment and their applications in a classroom setting. Comprehensive in scope, Shermis and Di Vesta explain basic measurement concepts and show students how to interpret the results of standardized tests. From these basic concepts, the authors then provide…

  15. TENSAS ECOLOGICAL ASSESSMENT PROJECT

    EPA Science Inventory

    An ecological assessment in the Tensas River Basin, Louisiana, has been completed by the U.S. EPA in partnership with the Louisiana Department of Environmental Quality and other stakeholder groups. This assessment, conducted using landscape ecology and water quality methods, can...

  16. Diagnostic Lessons as Assessment.

    ERIC Educational Resources Information Center

    Walker, Barbara J.

    Embedded in a sensitive instructional context rather than a stifling testing atmosphere, diagnostic lessons provide assessment that is reliable, practical, valid, and efficient. In this type of assessment, there are several determiners of instructional placement: (1) students' propensity to adapt strategies as a result of specified instruction,…

  17. Closing the Assessment Loop

    ERIC Educational Resources Information Center

    Banta, Trudy W.; Blaich, Charles

    2011-01-01

    Accreditors, speakers at assessment conferences, and campus leaders all decry the fact that too few faculty are closing the loop--that is, studying assessment findings to see what improvements might be suggested and taking the appropriate steps to make them. This is difficult enough with locally developed measures; adding the need to interpret…

  18. Service Assessment HURRICANE FRAN

    E-print Network

    Service Assessment HURRICANE FRAN August 28 - September 8, 1996 U.S.Department of Commerce National-12 Visible, 753 a.m. EDT, September4, 1996. #12;Service Assessment HURRICANE FRAN August 28 Bureau Hurricane Series ERRATA NOTICE One or more conditions of the original document may affect

  19. Formative Assessment Probes

    ERIC Educational Resources Information Center

    Eberle, Francis; Keeley, Page

    2008-01-01

    Formative assessment probes can be effective tools to help teachers build a bridge between students' initial ideas and scientific ones. In this article, the authors describe how using two formative assessment probes can help teachers determine the extent to which students make similar connections between developing a concept of matter and a…

  20. Assessment and New Literacies

    ERIC Educational Resources Information Center

    Hammett, Roberta F.

    2007-01-01

    This article argues that if multimodal and new literacies are to become common practices in schools, they have to be included in both school and provincial/state large-scale assessment programmes. Building on current criterion-referenced testing in Newfoundland and Labrador which assesses a range of literacies (viewing, reading, writing,…

  1. Assessment with Pumpkins

    ERIC Educational Resources Information Center

    Sikes, Erin; Sterling, Donna R.

    2006-01-01

    This article describes a pumpkin activity that allows teachers to evaluate their students' understanding of standards-based science skills. This activity is a valuable tool for the teacher to assess all the concepts introduced in the beginning of the life science. It assesses the lab skills that have been taught in the first quarter: observation,…

  2. INTERMOUNTAIN INDUSTRIAL ASSESSMENT CENTER

    SciTech Connect

    MELINDA KRAHENBUHL

    2010-05-28

    The U. S. Department of Energy’s Intermountain Industrial Assessment Center (IIAC) at the University of Utah has been providing eligible small- and medium-sized manufacturers with no-cost plant assessments since 2001, offering cost-effective recommendations for improvements in the areas of energy efficiency, pollution prevention, and productivity improvement.

  3. Assessment Problems in Reading.

    ERIC Educational Resources Information Center

    MacGinitie, Walter H., Ed.

    The papers in this volume deal with a range of assessment problems in reading. The first paper, by Karlin, introduces the general problem of using assessment procedures to guide teaching. The next six papers deal with various aspects of this general problem. Otto discusses the distinction between norm-referenced, standardized achievement tests and…

  4. Reading Assessment and Illettrisme.

    ERIC Educational Resources Information Center

    Aubret, J.; Chartier, D.

    1988-01-01

    Discusses the global and analytical approaches to reading assessment. Points out that the first approaches reading as a self-contained activity, while the second presupposes both a reading model and a reader model. Applies each to the context of reading assessment in France. Suggests discarding the global approach as a diagnostic tool. (KO)

  5. Measurement Issues in Assessment

    ERIC Educational Resources Information Center

    Volkwein, J. Fredericks; Yin, Alexander C.

    2010-01-01

    This chapter summarizes ten selected issues and common problems that arise in most assessment research projects. These include: (1) the uses of grades in assessment; (2) institutional review boards; (3) research design as a compromise; (4) standardized testing; (5) self-reported measures; (6) missing data; (7) weighting data; (8) conditional…

  6. NRCS CSREES Watershed Assessments

    E-print Network

    of CEAP RESOURCE CONCERNS · Water Quality · Soil Quality · Water Conservation · Air Quality · WildlifeNRCS CSREES Watershed Assessments USDA NRCS Darren Hickman Jerry Lemunyon Fort Worth, Texas #12;Conservation Effects Assessment Project Please turn off the ringers on your cell phones, pagers, blackberries

  7. Balance in Assessment

    ERIC Educational Resources Information Center

    White, Richard

    2007-01-01

    The review by Black and Wiliam of national systems makes clear the complexity of assessment, and identifies important issues. One of these is "balance": balance between local and central responsibilities, balance between the weights given to various purposes of schooling, balance between weights for various functions of assessment, and balance…

  8. TIMSS 2015 Assessment Frameworks

    ERIC Educational Resources Information Center

    Mullis, Ina V. S., Ed.; Martin, Michael O., Ed.

    2013-01-01

    Now entering into its 20th year of data collection, Trends in International Mathematics and Science Study, (TIMSS) is an international assessment of mathematics and science at the fourth and eighth grades. TIMSS 2015 is the most recent in the TIMSS series, which began with the first assessments in 1995 and has continued every four years--1999,…

  9. Risk Assessment: Evidence Base

    NASA Technical Reports Server (NTRS)

    Johnson-Throop, Kathy A.

    2007-01-01

    Human systems PRA (Probabilistic Risk Assessment: a) Provides quantitative measures of probability, consequence, and uncertainty; and b) Communicates risk and informs decision-making. Human health risks rated highest in ISS PRA are based on 1997 assessment of clinical events in analog operational settings. Much work remains to analyze remaining human health risks identified in Bioastronautics Roadmap.

  10. Why Risk Assessment? Because ...

    E-print Network

    Stølen, Ketil

    Why Risk Assessment? Because ... CORAS is committed to supporting international industry can take advantage of the CORAS technology in order to give their mission critical risk assessment partners #12;CORAS delivers a tool-supported framework whose important components are: A model-based risk

  11. New Assessments, New Rigor

    ERIC Educational Resources Information Center

    Joan Herman; Robert Linn

    2014-01-01

    Researching. Synthesizing. Reasoning with evidence. The PARCC and Smarter Balanced assessments are clearly setting their sights on complex thinking skills. Researchers Joan Herman and Robert Linn look at the new assessments to see how they stack up against Norman Webb's depth of knowledge framework as well as against current state tests. The…

  12. Assessment Hotspots, 2000.

    ERIC Educational Resources Information Center

    Ahearn, Charles, Ed.; Nalley, Donna, Ed.; Marsh, Corinda, Ed.; Casbon, Christy, Ed.

    2000-01-01

    SouthEastern Regional Vision for Education (SERVE) is one of the federally funded regional educational laboratories. This annual publication captures and shares the experiences of SERVE school districts that have volunteered to share their efforts at assessment reform. This issue contains the following articles: (1) "Classroom Assessment: A…

  13. Assessment Online: Guiding Theories,

    E-print Network

    Oakleaf, Megan

    ;Outcomes should be learned and assessed at the same time. #12;Inspiration Maps App ($6.99) #12;Super Duper concept maps citation maps tutorial responses role plays lab reports blogs wikis Oakleaf, Megan Literacy. 3(2). 2010. #12;#12;#12;www.railsontrack.info #12;Learning assessment online is about outcomes

  14. Resource Assessment and Tools

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Various resource assessment strategies and tools are needed to ensure bioenergy feedstock materials are produced, harvested, and transported in a sustainable manner. This presentation highlights research accomplishments by the USDA-ARS Renewable Energy Assessment Project (REAP) team along with our u...

  15. Assessing What Matters

    ERIC Educational Resources Information Center

    Sternberg, Robert J.

    2008-01-01

    Conventional assessments do not meet the cognitive demands of the world today. WICS, an acronym for wisdom, intelligence, and creativity, synthesized, can provide a more meaningful model. Findings from the Rainbow Project, conducted by the Center for the Psychology of Abilities, Competencies, and Expertise, showed that assessing students for…

  16. Communities of Assessment

    ERIC Educational Resources Information Center

    Mundhenk, Robert T.

    2004-01-01

    Though assessment has been a topic of conversation within the academy for over 20 years, it has not, as Peter Ewell argued in a keynote address at the American Association for Higher Education (AAHE) 2002 Assessment Conference, become a "culture of use," a practice "embedded in the lives and work" of those who inhabit college campuses. Ewell…

  17. What's Worth Assessing?

    ERIC Educational Resources Information Center

    Moses, Monte

    1992-01-01

    The Cherry Creek (Colorado) Schools opted for the research assessment as being much more indepth than report writing, which calls up plagiaristic tendencies in many elementary school children. Assessment tasks must be engaging and encourage students to evaluate themselves against predefined standards. Administrators must help teachers develop a…

  18. Educational Assessment in Norway

    ERIC Educational Resources Information Center

    Tveit, Sverre

    2014-01-01

    Norway has seen major changes in the field of educational assessment over the past decade, following the 2001 '"PISA shock" that stimulated reform of the entire primary and secondary education systems: new outcome-based curricula with cross-disciplinary basic skills were accompanied by major revision of assessment regulations,…

  19. Review of Assessment Feedback

    ERIC Educational Resources Information Center

    Li, Jinrui; De Luca, Rosemary

    2014-01-01

    This article reviews 37 empirical studies, selected from 363 articles and 20 journals, on assessment feedback published between 2000 and 2011. The reviewed articles, many of which came out of studies in the UK and Australia, reflect the most current issues and developments in the area of assessing disciplinary writing. The article aims to outline…

  20. Formative Assessment as Mediation

    ERIC Educational Resources Information Center

    De Vos, Mark; Belluigi, Dina Zoe

    2011-01-01

    Whilst principles of validity, reliability and fairness should be central concerns for the assessment of student learning in higher education, simplistic notions of "transparency" and "explicitness" in terms of assessment criteria should be critiqued more rigorously. This article examines the inherent tensions resulting from CRA's links to both…

  1. Sonography Guided Percutaneous Radiofrequency Ablation of Hepatocellular Carcinoma: Effect of Cooperative Training on the Pretreatment Assessment of the Operation's Feasibility

    PubMed Central

    Kim, Min Ju; Choi, Dongil; Lee, Won Jae; Rhim, Hyun-Chul; Kim, Seonwoo

    2008-01-01

    Objective The aim of this study is to investigate the effects of cooperative training on the pretreatment assessment of the feasibility to perform Ultrasonography (US) guided percutaneous radiofrequency ablation for patients afflicted with hepatocellular carcinoma. Materials and Methods In our prospective study, 146 patients with 200 hepatocellular carcinomas were referred for radiofrequency ablation after triage by hepatologists. Three radiologists with different levels of experience performed the planning US before (group I) and after (group II) cooperative training, to evaluate whether radiofrequency ablation was feasible. The feasibility rates considered eligible according to our criteria were evaluated. In addition, we analyzed the reasons for the lack of feasibility were analyzed. The interobserver agreement for the assessment of feasibility before and after training was also calculated. Results The overall feasibility rates for both groups was 73%. No significant difference in the feasibility rates was observed. The feasibility rates of each observer for group I were 71% (observer 1), 77% (observer 2) and 70% (observer 3) and those for group II were 73%, 76% and 69%, respectively. In the tumors (n = 164) considered ineligible, the two most common causes for refraining from performing radiofrequency ablation included non-visualization of the tumor (62%) and the absence of a safe route for the percutaneous approach (38%). We found moderate interobserver agreement for all observers before cooperative training and a good agreement after training. Conclusion Although the cooperative training did not affect the feasibility rate of each observer, it improved the interobserver agreement for assessing the feasibility of performing US guided radiofrequency ablation, which may reduce unnecessary admission or delayed treatment. PMID:18253073

  2. Ultrasound assessment on selected peripheral nerve pathologies. Part I: Entrapment neuropathies of the upper limb – excluding carpal tunnel syndrome

    PubMed Central

    Sudo?-Szopi?ska, Iwona

    2012-01-01

    Ultrasound (US) is one of the methods for imaging entrapment neuropathies, post-traumatic changes to nerves, nerve tumors and postoperative complications to nerves. This type of examination is becoming more and more popular, not only for economic reasons, but also due to its value in making accurate diagnosis. It provides a very precise assessment of peripheral nerve trunk pathology – both in terms of morphology and localization. During examination there are several options available to the specialist: the making of a dynamic assessment, observation of pain radiation through the application of precise palpation and the comparison of resultant images with the contra lateral limb. Entrapment neuropathies of the upper limb are discussed in this study, with the omission of median nerve neuropathy at the level of the carpal canal, as extensive literature on this subject exists. The following pathologies are presented: pronator teres muscle syndrome, anterior interosseus nerve neuropathy, ulnar nerve groove syndrome and cubital tunnel syndrome, Guyon's canal syndrome, radial nerve neuropathy, posterior interosseous nerve neuropathy, Wartenberg's disease, suprascapular nerve neuropathy and thoracic outlet syndrome. Peripheral nerve examination technique has been presented in previous articles presenting information about peripheral nerve anatomy [Journal of Ultrasonography 2012; 12 (49): 120–163 – Normal and sonographic anatomy of selected peripheral nerves. Part I: Sonohistology and general principles of examination, following the example of the median nerve; Part II: Peripheral nerves of the upper limb; Part III: Peripheral nerves of the lower limb]. In this article potential compression sites of particular nerves are discussed, taking into account pathomechanisms of damage, including predisposing anatomical variants (accessory muscles). The parameters of ultrasound assessment have been established – echogenicity and echostructure, thickness (edema and related increase in the cross sectional area of the nerve trunk), vascularization and the reciprocal relationship with adjacent tissue. PMID:26674101

  3. Assessing Primary Science Learning: Beyond Paper and Pencil Assessment

    ERIC Educational Resources Information Center

    So, Wing Mui Winnie

    2004-01-01

    This article discusses the foundations for the assessment of primary science learning with a focus on the place of assessment in the curriculum, the association between pedagogy and assessment, and the role of formative and summative assessment. Alternative strategies are recommended for the assessment of science learning at primary level, and…

  4. Integrated assessment briefs

    SciTech Connect

    1995-04-01

    Integrated assessment can be used to evaluate and clarify resource management policy options and outcomes for decision makers. The defining characteristics of integrated assessment are (1) focus on providing information and analysis that can be understood and used by decision makers rather than for merely advancing understanding and (2) its multidisciplinary approach, using methods, styles of study, and considerations from a broader variety of technical areas than would typically characterize studies produced from a single disciplinary standpoint. Integrated assessment may combine scientific, social, economic, health, and environmental data and models. Integrated assessment requires bridging the gap between science and policy considerations. Because not everything can be valued using a single metric, such as a dollar value, the integrated assessment process also involves evaluating trade-offs among dissimilar attributes. Scientists at Oak Ridge National Laboratory (ORNL) recognized the importance and value of multidisciplinary approaches to solving environmental problems early on and have pioneered the development of tools and methods for integrated assessment over the past three decades. Major examples of ORNL`s experience in the development of its capabilities for integrated assessment are given.

  5. Musculoskeletal injuries in a resource-constrained environment: comparing diagnostic accuracy of on-the-spot ultrasonography and conventional radiography for bone fracture screening during the Paris–Dakar rally raid

    PubMed Central

    Larbi, Ahmed; Lefere, Mathieu; Perozziello, Anne; Hauger, Olivier; Pommerie, Florence; Fraboulet, Bénédicte; Jacob, Denis

    2015-01-01

    Background Ultrasound (US) is a good first-line alternative for the diagnosis of bone fractures in adults as well as children. Our study shows that, compared to X-ray, in a resource-constrained environment, on-site US has a high sensitivity (98%) and specificity (96%) in the diagnosis of bone fractures. Purpose To compare the accuracy of on-the-spot US with conventional radiography in the screening for bone fractures during the Paris–Dakar rally raid. Material and Methods Eighty-three patients (81 men, 2 women) with clinically suspected bone fractures were included in 2013 and 2014. They underwent X-ray and US on the spot, blindly interpreted by two musculoskeletal radiologists. Using X-ray as gold standard, we calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for US, for each anatomic location. The accuracy of US and radiography were also assessed, as were the number of fragments and their degree of displacement (Student’s t-test). Results Compared with X-ray, sensitivity, specificity, PPV, and NPV of on-site US were, respectively, for the presence (or absence) of fractures: 98%, 98%, 100%, and 95%. The accuracy of US was 99%. Only one radial styloid process fracture was misdiagnosed with US. There was no significant difference between US and X-ray (P?>?0.93) concerning the number of fragments and their degree of displacement. Conclusion Bedside musculoskeletal ultrasound performed by trained musculoskeletal radiologists is a useful method in determining and assessing bone fractures in a resource constrained environment. PMID:26034643

  6. Formative Assessment: Simply, No Additives

    ERIC Educational Resources Information Center

    Roskos, Kathleen; Neuman, Susan B.

    2012-01-01

    Among the types of assessment the closest to daily reading instruction is formative assessment. In contrast to summative assessment, which occurs after instruction, formative assessment involves forming judgments frequently in the flow of instruction. Key features of formative assessment include identifying gaps between where students are and…

  7. Managing Assessment in Music Education.

    ERIC Educational Resources Information Center

    Nutter, Kelly

    1999-01-01

    Discusses assessment management in music education, explaining that assessment management plans include assessment methods that are reliable, valid, and authentic, the development of an assessment schedule and assessment reports, and using results to evaluate the overall music program. Provides selected resources, the components of a plan, and…

  8. Peer Assessments in Physical Education

    ERIC Educational Resources Information Center

    Johnson, Randall

    2004-01-01

    Peer assessments are recommended for overcoming the difficulties that teachers have with providing individual feedback and assessing student progress in physical education classes. A peer assessment can be used as a learning task (in a progression) or a formative assessment. A peer assessment is a variation of peer teaching, an instructional…

  9. Health Assessment Requirements Candidate Waiver Request Health Assessment Management System

    E-print Network

    Sin, Peter

    Health Assessment Requirements Candidate Waiver Request Health Assessment Management System Please Waiver Request Health Assessment Management System PURPOSE This form is used to request a waiver: To Position #: Position Title: Environmental Health & Safety Use Only Reviewer Name

  10. Ecosystem Services as Assessment Endpoints in Ecological Risk Assessment

    EPA Science Inventory

    The focus of ecological risk assessment (ERA) is on assessment endpoints, explicit expressions of environmental values to be protected. Traditionally, the ecological entities identified in assessment endpoints have been components of ecosystems deemed by risk assessors to be impo...

  11. Tricollege Teagle Project: Departmentlevel assessment 1 ASSESSMENT TERMINOLOGY

    E-print Network

    Tricollege Teagle Project: Departmentlevel assessment 1 ASSESSMENT TERMINOLOGY 1. DIRECT methodology. In reality these are a continuum, not a dichotomy: all measures of mastery involve a subjective in that interpretation is greatly increased. 3. QUANTITATIVE VERSUS QUALITATIVE Quantitative assessment methodologies

  12. Assessment of the paraphilias.

    PubMed

    Seto, Michael C; Kingston, Drew A; Bourget, Dominique

    2014-06-01

    Paraphilias are recurrent, persistent, and intense sexual interests in atypical objects or activities. The most commonly encountered paraphilias in sexological or forensic settings are pedophilia, sexual sadism, exhibitionism, and voyeurism. Paraphilias are often comorbid with other sexual, mood, and personality disorders. Assessment and diagnosis require an integration of multiple sources of clinical information, given the limits and biases of self-report (through clinical interview or questionnaires). Clinicians ideally have access to more objective assessment methods, such as phallometric testing of sexual arousal. The accurate assessment and diagnosis of paraphilias is essential to effective treatment and management. PMID:24877702

  13. Preoperative color Doppler assessment in planning of gluteal perforator flaps.

    PubMed

    Isken, Tonguc; Alagoz, M Sahin; Onyedi, Murat; Izmirli, Hakki; Isil, Eda; Yurtseven, Nagehan

    2009-02-01

    Gluteal artery perforator flaps have gained popularity due to reliability, preservation of the muscle, versatility in flap design without restricting other flap options, and low donor-site morbidity in ambulatory patients and possibility of enabling future reconstruction in paraplegic patients. But the inconstant anatomy of the vascular plexus around the gluteal muscle makes it hard to predict how many perforators are present, what their volume of blood flow and size are, where they exit the overlying fascia, and what their course through the muscle will be. Without any prior investigations, the reconstructive surgeon could be surprised intraoperatively by previous surgical damage, scar formation, or anatomic variants.For these reasons, to confirm the presence and the location of gluteal perforators preoperatively we have used color Doppler ultrasonography. With the help of the color Doppler ultrasonography 26 patients, 21 men and 5 women, were operated between the years 2002 and 2007. The mean age of patients was 47.7 (age range: 7-77 years). All perforator vessels were marked preoperatively around the defect locations. The perforator based flap that will allow primary closure of the donor site and the defect without tension was planned choosing the perforator that showed the largest flow in color Doppler ultrasonography proximally. Perforators were found in the sites identified with color Doppler ultrasonography in all other flaps. In our study, 94.4% flap viability was ensured in 36 perforator-based gluteal area flaps. Mean flap elevation time was 31.9 minutes. We found that locating the perforators preoperatively helps to shorten the operation time without compromising a reliable viability of the perforator flaps, thus enabling the surgeon easier treatment of pressure sores. PMID:19158526

  14. RCTA capstone assessment

    NASA Astrophysics Data System (ADS)

    Lennon, Craig; Bodt, Barry; Childers, Marshal; Dean, Robert; Oh, Jean; DiBerardino, Chip; Keegan, Terence

    2015-05-01

    The Army Research Laboratory's Robotics Collaborative Technology Alliance (RCTA) is a program intended to change robots from tools that soldiers use into teammates with which soldiers can work. This requires the integration of fundamental and applied research in perception, artificial intelligence, and human-robot interaction. In October of 2014, the RCTA assessed progress towards integrating this research. This assessment was designed to evaluate the robot's performance when it used new capabilities to perform selected aspects of a mission. The assessed capabilities included the ability of the robot to: navigate semantically outdoors with respect to structures and landmarks, identify doors in the facades of buildings, and identify and track persons emerging from those doors. We present details of the mission-based vignettes that constituted the assessment, and evaluations of the robot's performance in these vignettes.

  15. GEOSPATIAL DATA ACCURACY ASSESSMENT

    EPA Science Inventory

    The development of robust accuracy assessment methods for the validation of spatial data represent's a difficult scientific challenge for the geospatial science community. The importance and timeliness of this issue is related directly to the dramatic escalation in the developmen...

  16. RISK ASSESSMENT CLOUD COMPUTING

    E-print Network

    Columbia University

    SECURITY RESEARCH PRIVACY RISK ASSESSMENT AMC DATA FISMA CLOUD COMPUTING MOBILE DEVICES OPERATIONS application hosted in the cloud · Alaska DHHS fined $1.7M ­ Portable device stolen from vehicle · Mass Eye

  17. FRMAC Assessment Manual

    SciTech Connect

    Clark, H.

    1999-12-01

    The ingestion pathway assessment procedures cited in the current version of the ``RMAC Assessment Manual'', DOE/NV/11718-061 (September 1996) have been superseded by new US Food and Drug Administration (FDA) guidance. This addendum replaces the obsolete procedures with a revised set based on the new guidance released by the FDA in August 1998. This addendum provides an overview of the new guidance, revised assessment methods, and assessment aids. It does not provide a general method of ingestion pathway analysis. The scope is limited to that covered by the new guidance titled, ``Accidental Radioactive Contamination of Human Food and Animal Feeds: Recommendations for State and Local Agencies,'' issued by the FDA in August 1998.

  18. Bioinformatics Needs Assessment

    E-print Network

    Crummett, Courtney

    2015-04-29

    An assessment of the Bioinformatics Program at MIT Libraries was conducted using quantitative and qualitative data collection methods during FY13-14. Interviews were conducted to gain insight about bioinformatics researcher’s ...

  19. A Summer Camp Assessment.

    ERIC Educational Resources Information Center

    Pratte, Janice L.; DiNardi, Salvatore R.

    1979-01-01

    Reported are the results of a project assessing the impact of a revised Massachusetts sanitary code on 500 summer camps for children. The study compared camp compliances with the proposed regulations to the level of compliance with existing regulations. (BT)

  20. Adult nutrition assessment tutorial

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This tutorial presents a systematic approach to nutrition assessment based on a modern appreciation for the contributions of inflammation that serve as the foundation for newly proposed consensus definitions for malnutrition syndromes. Practical indicators of malnutrition and inflammation have been ...