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Hysteroscopy and transvaginal ultrasonography in postmenopausal women with uterine bleeding  

Microsoft Academic Search

Objective: To evaluate the accuracy of hysteroscopy and transvaginal ultrasonography (TU), based on a histopathological report from endometrial specimens, in diagnosing endometrial pathology in menopausal women with uterine bleeding. Methods: Four-hundred and nineteen postmenopausal women with uterine bleeding underwent TU, hysteroscopy and endometrial biopsy. Hysteroscopic and sonographic findings have been evaluated on the basis of the final diagnosis established by

G Garuti; I Sambruni; F Cellani; D Garzia; P Alleva; M Luerti



Screening for early familial ovarian cancer with transvaginal ultrasonography and colour blood flow imaging  

Microsoft Academic Search

OBJECTIVE--To assess the value of transvaginal ultrasonography with colour blood flow imaging in detecting early ovarian cancer in women with a family history of the disease. DESIGN--Study of self referred symptomless women with a close relative who had developed the disease. Each woman was screened to detect persistent lesions and defined changes in ovarian volume. Morphological score and pulsatility index

T H Bourne; S Campbell; K M Reynolds; M I Whitehead; J Hampson; P Royston; T J Crayford; W P Collins



Transvaginal ultrasonography in first trimester of pregnancy and its comparison with transabdominal ultrasonography  

PubMed Central

Objectives: Examination of pregnant women in the first trimester with transvaginal ultrasonography with the aim to study various fetal development markers, e.g., gestation sac, yolk sac, fetal heart motion, CRL length, and fetal anatomy in both normal and abnormal pregnancies. Comparative evaluation of transvaginal ultrasonography vis-à-vis transabdominal scanning in the study of first trimester of pregnancy and its complications. To assess the relative merits and demerits of transvaginal ultrasonography in comparison with the transabdominal technique. Materials and Methods: The study will be conducted on 50 females patients during the first trimester of pregnancy. The study population will consist of both normal and abnormal pregnancies. These patients will be included on the basis of suspicion of or proven pregnancy of duration up to 12 weeks from LMP. The evaluation of the patients will include the following: Record of patients obstetrical history and clinical examination, record of pregnancy test and relevant investigations, ultrasonic examination of pregnancy. (a) Transabdominal ultrasound scanning will be done with moderately distended bladder by using real time scanners with low frequency probe (3/3.5 MHz); (b) transvaginal sonography will be done with the real-time sector scanner using high-frequency endovaginal probe (5/7.5 MHz), after the patient voids urine. Relevant images will be taken by using the multiformat automatic camera. Results and Conclusions: In the study of 46 normal intrauterine pregnancies, TVS showed additional information in 36 patients (78.3%) as compared to TAS, in detection of gestation sac, yolk sac, double bleb sign, or better visualization of embryonic anatomy. In the abnormal pregnancy (n=17), TVS provided more information in 11 cases (64.9%), which included detection of embryonic demise, yolk sac, double bleb sign, or subchorionic hemorrhage. Regarding ectopic gestations (n=7), TVS gave additional information in 5 cases (71.4%) which included detection of ectopic fetal pole, yolk sac, decidual cast, adnexal mass, and fluid in cul de sac. In two cases, both TAS and TVS gave equal information. However, in 2 cases TAS demonstrated the extent of intraabdominal fluid better than TVS. The other advantages of TVS over TAS are that there is no need for the patient to have uncomfortably full bladder and time is saved from having to wait for bladder to fill. Thus, the potential preoperative patient can be kept fasting. TVS is also superior in obese patients, in patients with retroverted uterus and it also bypasses obstacles such as bone, gas filled bowel, and extensive pelvic adhesions. The limitations encountered with TVS were limited manoveuribility of probe and because of the unorthodox position and angle of the transducer, correct orientation was difficult initially.

Kaur, Aneet; Kaur, Amarjit




Microsoft Academic Search

Background Transvaginal ultrasonography is a noninvasive procedure that may be used to detect en- dometrial disease. However, its usefulness in screen- ing for asymptomatic disease in postmenopausal women before or during treatment with estrogen or estrogen-progesterone replacement is not known. Methods We compared the sensitivity and speci- ficity of transvaginal ultrasonography and endome- trial biopsy for the detection of endometrial




A prospective comparison of transvaginal ultrasonography and diagnostic hysteroscopy in the evaluation of patients with abnormal uterine bleeding: Clinical implications  

Microsoft Academic Search

OBJECTIVE: We determined the diagnostic vaue of transvaginal ultrasonography for endometrial and intrauterine abnormalities in patients with abnormal uterine bleeding.STUDY DESIGN: Between June 1, 1992, and June 1, 1993, 279 consecutive patients underwent transvaginal ultrasonography. Findings were compared with the final diagnosis established by diagnostic hysteroscopy and histologic examination.RESULTS: Transvaginal ultrasonography demonstrated a sensitivity of 0.96 and a specificity of

Mark H. Emanuel; Marion J. Verdel; Kees Wamsteker; Frits B. Lammes



Comparison of Office Hysteroscopy, Transvaginal Ultrasonography and Endometrial Biopsy in Evaluation of Abnormal Uterine Bleeding  

PubMed Central

Objective: A comparison between office hysteroscopy, transvaginal ultrasonography and endometrial biopsy was performed, in terms of detection of intrauterine lesions. A secondary objective was assessment of evaluatory approach in the management of abnormal uterine bleeding in an outpatient setting. Design: Prospective observational study. Material and Methods: A total of 54 women were evaluated for abnormal uterine bleeding. Assessment included performance of an endometrial biopsy, a transvaginal ultra-sound scan followed by office hysteroscopy. Results of hysteroscopy were taken as the gold standard. Sensitivity and specificity of the investigations were assessed. The bleeding pattern was classified as heavy regular, irregular, postmenopausal and heavy or unscheduled bleeding on hormone replacement therapy. Results: The incidence of focal intrauterine lesions in patients presenting with abnormal bleeding was 52% for all ages and 31% for the postmenopausal group. Seventy-five percent of the patients with Hb < 11 gm% and 67% with an enlarged uterus harbored a focal pathology. The incidence of lesions in patients with heavy regular bleeding was 74%. The sensitivity and specificity of transvaginal ultrasound when compared with results of hysteroscopy was 0.60 and 0.88 respectively. A normal endometrial biopsy had a negative predictive value of 51%. The sensitivity and specificity of endometrial biopsy were 0.04 and 0.83, respectively. Conclusion: Both transvaginal ultrasound and endometrial biopsy exhibited poor sensitivity for detection of focal intrauterine lesions. Considering the significantly high incidence of intrauterine lesions in patients presenting with abnormal bleeding, the most cost-effective approach appears to be proceeding with hysteroscopy early in assessment.

Lapensee, L.; Toth, T.L.; Isaacson, K.B.



Texture analysis of perimenopausal and post-menopausal endo- metrial tissue in grayscale transvaginal ultrasonography  

Microsoft Academic Search

The aim of this study was to investigate the feasibility of texture analysis in characterizing endometrial tissue as depicted in two-dimensional (2D) grayscale transvaginal ultrasonography. Digital transvaginal ultrasound endometrial images were acquired from 65 perimenopausal and post-menopausal women prior to gynaecological operations; histology revealed 15 malignant and 50 benign cases. Images were processed with a wavelet-based contrast enhancement technique. Three




Accuracy of magnetic resonance imaging and transvaginal ultrasonography in the diagnosis, mapping, and measurement of uterine myomas  

Microsoft Academic Search

OBJECTIVE: The purpose of this study was to evaluate and compare the accuracy of magnetic resonance imaging and transvaginal ultrasonography in myoma diagnosis, mapping, and measurement. STUDY DESIGN: This was a double-blind study of 106 consecutive premenopausal women who underwent hysterectomy for benign reasons. Myomas (total, 257) were exactly mapped by magnetic resonance imaging and transvaginal ultrasonography; in each patient,

Margit Dueholm; Erik Lundorf; Estrid S. Hansen; Susanne Ledertoug; Frede Olesen



Screening for early familial ovarian cancer with transvaginal ultrasonography and colour blood flow imaging.  

PubMed Central

OBJECTIVE--To assess the value of transvaginal ultrasonography with colour blood flow imaging in detecting early ovarian cancer in women with a family history of the disease. DESIGN--Study of self referred symptomless women with a close relative who had developed the disease. Each woman was screened to detect persistent lesions and defined changes in ovarian volume. Morphological score and pulsatility index were recorded. SETTING--Ovarian screening clinic. SUBJECTS--1601 self referred women. INTERVENTIONS--Women with a positive screening result were recommended to have further investigations. MAIN OUTCOME MEASURES--Findings at surgery and histology of abnormal ovaries. Morphological score > or = 5 and pulsatility index < 1.0 at last scan. RESULTS--Women were aged 17 to 79 (mean 47) years; 959 (60%) were premenopausal, 469 (29%) were naturally postmenopausal, and 173 (11%) had had a hysterectomy. 157 women had a pedigree suggestive of the site specific ovarian cancer syndrome and 288 of multiple site cancers. 61 women had a positive screening result (3.8%, 95% confidence interval 2.9 to 4.9%), six of whom had primary ovarian cancer detected at surgery (five stage Ia, one stage III). Use of a high morphological score or a low pulsatility index increased the odds of finding ovarian cancer from 1:9 to about 2:5 (1:1 in the highest risk groups). Five interval cancers were reported (three ovarian and two peritoneal). Eight of the 11 cancers developed in women with pedigrees suggestive of inherited cancer. CONCLUSIONS--Transvaginal ultrasonography with colour flow imaging can effectively detect early ovarian cancer in women with a family history of the disease. The screening interval should be less than two years.

Bourne, T H; Campbell, S; Reynolds, K M; Whitehead, M I; Hampson, J; Royston, P; Crayford, T J; Collins, W P



[Significance of transvaginal Doppler ultrasonography for detection of malignant gestational trophoblastic disease].  


Transvaginal Doppler ultrasonography has an important role in detecting and confirming the gestational trophoblastic disease (GTD). It can also be helpful in early detection of the malignant cases of GTD such as the invasion and protrusion of trophoblastic tissue into the uterine wall. Ultrasonographic picture of the malignant GTD is also specific for the presence of prominent zones of vasculavization in the peritrophoblastic tissue, as well as in the uterine tissue in which malignant GTD is developed. Resistance Index (RI) values were measured at the level of blood vessels of peritrophoblastic tissue and of suspected zones in the uterine tissue to detect neovascularization, which followed the malignant process. Theca luteal cysts were often detected by Transvaginal Doppler ultrasonography. PMID:15787162

Nikoli?, Branka; Raki?, Snezana; Pavlovi?, Dejan; Popovac, Svetlana; Luki?, Relja



Transvaginal color Doppler ultrasonography and CA125 in suspicious adnexal masses  

Microsoft Academic Search

Objective: To compare diagnostic performance of color Doppler ultrasound and CA-125 in suspicious adnexal masses on B-mode sonography. Materials and methods: Data on 94 patients (mean age: 47.4 years, range: 17–79 years. Fifty-two (55.3%) premenopausal and 42 (44.7%) postmenopausal women) managed in our institution because of a suspicious adnexal mass were reviewed. All patients were evaluated by transvaginal color Doppler

J. L. Alcázar; T. Errasti; A. Zornoza; J. A. M??nguez; M. J. Galán



The use of transvaginal power Doppler ultrasonography to evaluate the relationship between perifollicular vascularity and outcome in in-vitro fertilization treatment cycles  

Microsoft Academic Search

The aim of this prospective study of the use of transvaginal power Doppler ultrasound was to assess the subjectivity of the grading system and to elucidate, on a much larger series (200) of treatment cycles, the findings of previous authors. Vascular perfusion was studied using a grading system based on the percentage of follicular circumference (grade 1 <25%, grade 2

P. S. Bhal; N. D. Pugh; D. K. Chui; L. Gregory; S. M. Walker; R. W. Shaw



Improving the diagnostic accuracy of ultrasonography in suspected acute appendicitis by the combined transabdominal and transvaginal approach.  


Transabdominal ultrasound has a lower diagnostic yield in acute appendicitis than computed tomography (CT) scanning. The addition of transvaginal sonography in women with suspected appendicitis has shown improvement in the efficacy of diagnosis, potentially providing the option of selective CT use and reducing overall investigative cost and surgical delay. Two hundred ninety-two women who underwent combined transabdominal and transvaginal ultrasound for suspected acute appendicitis were evaluated. Patients were divided into two groups; Group 1 including patients with a positive sonographic diagnosis of appendicitis who underwent operation and Group 2 including patients with a negative sonographic diagnosis. Of the 157 women in Group 1, the diagnosis of appendicitis was histologically confirmed in 144 patients with five cases having a normal appendix in whom eight other pathologies were found. Of the 135 women with negative ultrasound examinations, 14 underwent surgery in which four cases of appendicitis were found. The sensitivity of the combined approach was 97.3 per cent, the specificity 91 per cent, the positive predictive value 91.7 per cent, and the negative predictive value 97 per cent. Combined ultrasound has a high predictive value for the diagnosis of appendicitis and may assist in reduction of the use of CT scanning for diagnosis and in the negative appendectomy rate. PMID:22273324

Bondi, Moshe; Miller, Rafael; Zbar, Andrew; Hazan, Yenon; Appelman, Zvi; Caspi, Benjamin; Mavor, Eli



Assessment of transvaginal hysterotomy combined with medication for cesarean scar ectopic pregnancy.  


The objective of this retrospective study was to explore a novel surgical technique, transvaginal hysterotomy combined with methotrexate injection, for treatment of cesarean scar ectopic pregnancy in 12 patients. All patients underwent the operation. Mean (SD; 95% CI) operative time was 21.6 (7.3; 17.0-26.2) minutes, and intraoperative blood loss was 90.8 (59.6; 52.9-128.7) mL. Postoperative ultrasonography confirmed removal of the pregnancy sac. The length of hospital stay was 7.4 (3.7; 5.0-9.8) days. The first normal postoperative menstrual period was at 28.3 (5.6; 24.7-31.9) days after surgery. The serum ?-human chorionic gonadotropin concentration returned to normal at 15.8 (6.3; 11.8-19.8) days. We conclude that surgical removal of the ectopic sac via transvaginal hysterotomy combined with methotrexate injection during the operation is a potentially good new approach to treatment of cesarean scar ectopic pregnancy. The efficacy and safety of the technique need further confirmation in future studies. PMID:22935305

Wang, Zhonghai; Le, Aiwen; Shan, Lili; Xiao, Tianhui; Zhuo, Rong; Xiong, Huijuan; Shen, Yi


Three Dimentional Transvaginal ultrasound in the assessment of uterine lesions: when do we really need it?  

Microsoft Academic Search

Objective: To evaluate the use of Transvaginal 3D U\\/S in the assessment of uterine pathology and uterine cavity abnormalities. Materials and methods: We included 65 patients in our study, age range between 21-47. The main complaint of these patients was either vaginal bleeding, reproductive failure, recurrent abortion or infertility. Procedures Done were: - 2D TVS -3D TVS for all cases

Alaa N. Ebrashy; Mohamed Momtaz; Osama A. Shawky; Ehab M. Soliman; Zakareya Aboul Maat


Usefulness of ultrasonography in assessment of laryngeal carcinoma.  


Objective: To evaluate the usefulness of ultrasonography in assessing laryngeal cancer. Methods: 72 patients with laryngeal carcinoma proven by surgery and pathology were enrolled. The pre-therapeutic ultrasonography and CT images were retrospectively evaluated, including tumour detection, localisation and invasion of intra- and extralaryngeal structures. A comparative assessment was made between the detection rate, correspondence rate of localisation and sensitivity and specificity of ultrasonography and CT. The mobility of the larynx was observed on real-time ultrasonography and compared with laryngoscopy. Results: The detection rate of ultrasonography [63 (87.5%)/72] was lower than that of CT [72 (100.0%)/72] (p=0.006). The primary foci were accurately located in 59 (93.7%) of 63 lesions using ultrasonography compared with 70 (97.2%) of 72 lesions using CT (p=0.392). In the evaluation of invasion, the sensitivity and specificity of ultrasonography were similar to that of CT in most of the intra- and extralaryngeal structures (p=0.059-1.000). A higher specificity was obtained during the assessment of the paraglottic space involvement when using ultrasonography than CT (94.9% vs 66.7%, p=0.001). For vocal cord fixation, no statistical difference was found between ultrasonography and laryngoscopy (p=0.223). Conclusion: Ultrasonography could be used as a valuable supplementary imaging method to CT and laryngoscopy in the assessment of laryngeal carcinoma, even in male adults with some calcifications of the thyroid cartilage. Advances in knowledge: Our study demonstrates that ultrasonography, which has been used scarcely in the larynx, could supply useful information on the detection, localisation and intra- and extralaryngeal invasion of laryngeal carcinoma. PMID:24004487

Xia, C-X; Zhu, Q; Zhao, H-X; Yan, F; Li, S-L; Zhang, S-M



Transvaginal sonographic measurement of cervical length to predict preterm birth in asymptomatic women at increased risk: a systematic review  

Microsoft Academic Search

Objectives To estimate the ability of cervical length mea- sured by transvaginal ultrasonography in asymptomatic high-risk women to predict spontaneous preterm birth. Methods MEDLINE, PubMed, EMBASE and the Cochrane Library were searched for articles published in any language between January 1980 and July 2006, using the keywords 'transvaginal ultrasonography' or ('cervix' and ('ultrasound' or 'ultrasonography' or 'sonog- raphy')); and ('preterm'

J. M. G. Crane; D. Hutchens



The Relationship between Hysteroscopy, Endometrial Biopsy and The Results of Transvaginal Sonography in Assessing Endometrial Polyps  

PubMed Central

Objective: Transvaginal Sonography (TVS) is being used in the investigation of postmenopausal bleeding (PMB). The bleeding could be the result of a number of factors; endometrial polyps are one of the common findings in these patients. The aim was to compare the findings of TVS and hysteroscopy to determine the sensitivity of each method in detecting endometrial polyps. Methods: This was a retrospective study, designed to investigate the sensitivity and specificity of transvaginal sonography in the detection of endometrial polyps. This study was conducted from July 1992 to July 1999 and identified from the record 37 patients with PMB referred for transvaginal sonography, hysteroscopy and biopsy investigations. Results: Thirty-seven patients with PMB were scanned using TVS and hysteroscopy. The result was not specific or sensitive when using TVS alone. TVS showed 13.52 % sensitivity, hysteroscopy/biopsy showed 100% sensitivity. TVS p>0.06 was not significant. Conclusion: Using TVS alone to diagnose polyps in PMB patients is not sensitive, especially when the polyps are smaller than 6 mm. If it is combined with hysterscopy, the reliability and s sensitivity are significantly improved.

Al-Kubaisi, Saad R I



Duplex Ultrasonography in Assessing Restenosis of Renal Artery Stents  

SciTech Connect

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.

Bakker, Jeannette [Department of Radiology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Beutler, Jaap J. [Department of Nephrology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Elgersma, Otto E.H. [Department of Radiology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Lange, Eduard E. de [Department of Radiology, University of Virginia Health Sciences Center, Charlottesville, VA 22908 (United States); Kort, Gerard A.P. de; Beek, Frederik J. A. [Department of Radiology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands)



Uterine Sarcoma: A Report of 10 Cases Studied by Transvaginal Color and Pulsed Doppler Sonography  

Microsoft Academic Search

Objective: To evaluate the role of transvaginal color Doppler in differentiating uterine sarcoma from myoma. Study design: A group of 2010 women were examined by transvaginal color Doppler ultrasonography 1 day before planned hysterectomy. Ten cases with uterine sarcoma were analyzed with respect to their color Doppler sonographic patterns and compared with 150 normal and 1850 myomatous uteri. Analysis of

Asim Kurjak; Sanja Kupesic; Hesham Shalan; Stanko Jukic; Dragutin Kosuta; Marijan Ilijas



Comparison of Transvaginal Sonography and Saline Contrast Sonohysterography in Women with Abnormal Uterine Bleeding: Correlation with Hysteroscopy and Histopathology  

PubMed Central

Background: Transvaginal ultrasound is used conventionally as initial investigation of patients with abnormal uterine bleeding but saline contrast sonohysterography is a better technique to reliably distinguish focal from diffuse endometrial lesions. This study was performed to compare the ability of transvaginal ultrasonography and saline infusion sonohysterography as initial modality for the diagnosis of endometrial abnormalities in women with abnormal uterine bleeding. Patients and Methods: In a prospective study, 100 women with abnormal uterine bleeding were submitted to sequential examination by transvaginal ultrasound, and sonohysterography. The presence of focal endometrial lesions and the type of lesion (endometrial hyperplasia, polyp, submucous myoma, or malignancy) were noted. Predictive values were calculated by correlating the results with final diagnosis reached by hysteroscopy and endometrial biopsy. Results: The sonohysterography had 92.9% sensitivity and 89.7% specificity compared to 71.4% sensitivity and 67.7% specificity achieved by transvaginal sonography. There was 91% agreement between saline contrast sonohysterography and hysteroscopy as compared to 69% for TVS (p = 0.002). The diagnostic performance of sonohysterography for 3 main endometrial abnormalities (i.e. endometrial hyperplasia, polyps and submucous myoma) was better than transvaginal sonography. The best results were seen in cases of submucous myoma where sensitivity and specificity of sonohysterography reached to 100% as compared to TVS (61.55 and 97.7% respectively). Conclusion: Our results have substantiated that sonohysterography is a better tool than transvaginal sonography for the assessment of endometrial intra-cavity lesions. By providing accurate differentiation between focal and diffuse endometrial lesions, it can help in decision making regarding selection of cases for hysteroscopy and directed biopsy. We recommend that saline contrast sonohysterography should be used as an initial investigation in cases of abnormal uterine bleeding.

Aslam, Muhammad; Ijaz, Lubna; Tariq, Shamsa; Shafqat, Kausar; Meher-un-Nisa; Ashraf, Rubina; Kazmi, Tahira



A randomized trial on the use of ultrasonography or office hysteroscopy for endometrial assessment in postmenopausal patients with breast cancer who were treated with tamoxifen  

Microsoft Academic Search

OBJECTIVE: Our purpose was to compare the screening effectiveness and acceptability of transvaginal ultrasonography (with sonohysterography if endometrial thickness was >4 mm) with office hysteroscopy.STUDY DESIGN: This randomized crossover study comprised 53 consecutive asymptomatic (without vaginal bleeding) postmenopausal patients with breast cancer who had taken tamoxifen (20 or 40 mg\\/day) for at least 6 months.RESULTS: Two patients had endometrial cancer

Dirk Timmerman; Jan Deprest; Tom Bourne; Ivo Van den Berghe; William P. Collins; Ignace Vergote



Transvaginal ultrasound (image)  


Transvaginal ultrasound is a method of imaging the genital tract in females. A hand held probe is inserted directly ... vaginal cavity to scan the pelvic structures, while ultrasound pictures are viewed on a monitor. The test ...


Spontaneous transvaginal bowel evisceration.  


Transvaginal prolapse of bowel segments after major abdominal surgery is of rare occurrence and is commonly reported to follow after hysterectomy and enterocele repair. However, spontaneous bowel evisceration through vagina following cystectomy is even rare. We report and discuss a case of spontaneous transvaginal bowel evisceration in a postmenopausal woman with the intent of increasing its awareness among surgeons and proposing a precautionary measure for this entity. PMID:23956518

Chhabra, Sarabjeet; Hegde, Padmaraj



Spontaneous transvaginal bowel evisceration  

PubMed Central

Transvaginal prolapse of bowel segments after major abdominal surgery is of rare occurrence and is commonly reported to follow after hysterectomy and enterocele repair. However, spontaneous bowel evisceration through vagina following cystectomy is even rare. We report and discuss a case of spontaneous transvaginal bowel evisceration in a postmenopausal woman with the intent of increasing its awareness among surgeons and proposing a precautionary measure for this entity.

Chhabra, Sarabjeet; Hegde, Padmaraj



Can ultrasonography replace computed tomography in the initial assessment of children with blunt abdominal trauma?  

Microsoft Academic Search

The evaluation of injured children with suspected blunt abdominal trauma (BAT) is clinically challenging. Computed tomography (CT) requires that patients be sedated, stable, and transportable, and even so, it is considered the diagnostic modality of choice for children with BAT. The authors questioned whether abdominal ultrasonography (US) performed during the initial assessment of the injured child is accurate enough to

Schmuel Katz; Ludwig Lazar; Valerie Rathaus; Ilan Erez



Quantitative assessment of bladder neck compliance by using transvaginal real-time elastography of women.  


To assess the feasibility of using ultrasound real-time elastography (RTE) to measure bladder neck compliance, we performed real-time elastography measurements by manually applying repetitive compression with the transducer on the scan position of the bladder neck. Instant elastography index (EI) and mean EI of anterior and posterior lips of the bladder neck were calculated. The EI values of anterior and posterior lips of the bladder neck were analyzed in relation to age, body surface area, body mass index, detrusor wall thickness and length, width and thickness of the bladder neck in healthy women. The intra-observer and inter-observer repeatability of measurements in different parts of the bladder neck were assessed using intra-class correlation coefficients with 95% confidence intervals and Bland-Altman analysis. There were no statistically significant differences between elastography measurements made by the same or two different observers in each area measured. There was no significant difference between anterior and posterior lip thickness of the bladder neck. The distribution of the elastography measurements indicated that the anterior lip of the bladder neck was slightly harder than the posterior lip. On the whole, from the results of the study, it was clear that EIs of the bladder neck were related to age in healthy women. Stepwise multiple regression analysis results revealed that age was the only independent factor modulating compliance of the bladder neck in healthy women. It is possible to provide a reproducible semi-quantification of real-time elastography in bladder neck compliance. PMID:23849386

Ying, Huang; Da, Liu; Luo, Jiang; Li-Xia, Liu; Yu, Xia; Li-Mei, Xie; Wei-Dong, Ren



Diagnostic endoscopic ultrasonography: Assessment of safety and prevention of complications  

PubMed Central

Endoscopic ultrasonography (EUS) has gained wide acceptance as an important, minimally invasive diagnostic tool in gastroenterology, pulmonology, visceral surgery and oncology. This review focuses on data regarding risks and complications of non-interventional diagnostic EUS and EUS-guided fine-needle biopsy (EUS-FNB). Measures to improve the safety of EUS und EUS-FNB will be discussed. Due to the specific mechanical properties of echoendoscopes in EUS, there is a low but noteworthy risk of perforation. To minimize this risk, endoscopists should be familiar with the specific features of their equipment and their patients’ specific anatomical situations (e.g., tumor stenosis, diverticula). Most diagnostic EUS complications occur during EUS-FNB. Pain, acute pancreatitis, infection and bleeding are the primary adverse effects, occurring in 1% to 2% of patients. Only a few cases of needle tract seeding and peritoneal dissemination have been reported. The mortality associated with EUS and EUS-FNB is 0.02%. The risks associated with EUS-FNB are affected by endoscopist experience and target lesion. EUS-FNB of cystic lesions is associated with an increased risk of infection and hemorrhage. Peri-interventional antibiotics are recommended to prevent cyst infection. Adequate education and training, as well consideration of contraindications, are essential to minimize the risks of EUS and EUS-FNB. Restricting EUS-FNB only to patients in whom the cytopathological results may be expected to change the course of management is the best way of reducing the number of complications.

Jenssen, Christian; Alvarez-Sanchez, Maria Victoria; Napoleon, Bertrand; Faiss, Siegbert



Transvaginal laparoscopic nephrectomy: development and feasibility in the porcine model  

Microsoft Academic Search

Objectives. To assess feasibility of laparoscopic nephrectomy completed entirely by way of the vagina in the porcine model.Methods. Six transvaginal laparoscopic nephrectomies were performed in female farm pigs. Two acute and two 1-week survival animals were used for the study. Before killing the survival animals, a second transvaginal laparoscopic nephrectomy was performed on the remaining renal unit. For one renal

Matthew T Gettman; Yair Lotan; Cheryl A Napper; Jeffrey A Cadeddu



Using Thoracic Ultrasonography to Accurately Assess Pneumothorax Progression During Positive Pressure Ventilation  

PubMed Central

Background: Although thoracic ultrasonography accurately determines the size and extent of occult pneumothoraces (PTXs) in spontaneously breathing patients, there is uncertainty about patients receiving positive pressure ventilation. We compared the lung point (ie, the area where the collapsed lung still adheres to the inside of the chest wall) using the two modalities ultrasonography and CT scanning to determine whether ultrasonography can be used reliably to assess PTX progression in a positive-pressure-ventilated porcine model. Methods: Air was introduced in incremental steps into five hemithoraces in three intubated porcine models. The lung point was identified on ultrasound imaging and referenced against the lateral limit of the intrapleural air space identified on the CT scans. The distance from the sternum to the lung point (S-LP) was measured on the CT scans and correlated to the insufflated air volume. Results: The mean total difference between the 131 ultrasound and CT scan lung points was 6.8 mm (SD, 7.1 mm; range, 0.0-29.3 mm). A mixed-model regression analysis showed a linear relationship between the S-LP distances and the PTX volume (P < .001). Conclusions: In an experimental porcine model, we found a linear relation between the PTX size and the lateral position of the lung point. The accuracy of thoracic ultrasonography for identifying the lung point (and, thus, the PTX extent) was comparable to that of CT imaging. These clinically relevant results suggest that ultrasonography may be safe and accurate in monitoring PTX progression during positive pressure ventilation.

Lossius, Hans Morten; Wemmelund, Kristian; Stokkeland, Paal Johan; Knudsen, Lars; Sloth, Erik



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

Microsoft Academic Search

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

Yoshinori Katsura; Kazutaka Yamada; Takashi Ishizawa; Heiji Yoshinaka; Hisaaki Shimazu



Transvaginal sonographic diagnosis of ovarian endometrioma  

Microsoft Academic Search

Objective: To assess the efficacy of transvaginal sonography (TVS) in differentiating endometriomas from other adnexal masses. Methods: One thousand thirty-five adnexal masses undergoing laparoscopy or laparotomy were evaluated prospectively using TVS. Masses diagnosed as endometrioma according to their sonographic appearance were divided into two groups: those with a round shape, regular margins, thick walls and homogeneous, low-level echoes (group A);

M. M. Do?an; M. U?ur; S. K. Soysal; M. E. Soysal; E. Ekici; O. Gökmen



Prevalence of ovarian adrenal rest tumours and polycystic ovaries in females with congenital adrenal hyperplasia: results of ultrasonography and MR imaging  

Microsoft Academic Search

The aim of the investigation was to assess the prevalence of ovarian adrenal rest tumours and polycystic ovaries in female patients with congenital adrenal hyperplasia (CAH). Thirteen female CAH patients (median age 19.8 years, range 14.8–23.5 years) underwent transvaginal ( n=6) or transabdominal ( n=7) ultrasonography by a gynaecologist and MR imaging ( n=13) of the ovaries (pre and post

Nike M. M. L. Stikkelbroeck; Ad R. M. M. Hermus; Diana Schouten; Harold M. Suliman; Gerrit J. Jager; Didi D. M. Braat; Barto J. Otten



Progress in transvaginal hydrolaparoscopy.  


Reproductive performance is now more than ever determining the choice of treatment for each individual couple. The easy access to ART treatments, their financial benefits, and the relative high success rate per cycle are at the basis of a liberal referral to these treatments without an accurate diagnosis. The easy and comprehensive investigation by a transvaginal endoscopy as a first-line diagnostic procedure allows for an accurate diagnosis and the choice of the most appropriate treatment. PMID:15450324

Gordts, Stephan; Brosens, Ivo; Gordts, Sylvie; Puttemans, Patrick; Campo, Rudi



Transperineal Ultrasonography  

Microsoft Academic Search

\\u000a Transperineal ultrasonography is an imaging technique that is not often used; however, in the specialty of coloproctology,\\u000a it has its place. In this age of economic health reforms, this test, which is relatively cheap and accessible, is very useful\\u000a in identifying and assessing rectoceles, intussusceptions, evacuatory apparatus lesions, and perineal muscle movement. Lesions\\u000a and asynchronous movement of these muscles can

Bruno Roche; Guillaume Zufferey; Joan Robert-Yap


Ultrasonography as a diagnostic tool in assessing deltoid ligament injury in supination external rotation fractures of the ankle.  


The medial deltoid ligament is the primary stabilizing structure in the ankle joint following lateral malleolar fracture. However, medial deltoid ligament ruptures are difficult to diagnose using current imaging modalities. We hypothesized that ultrasonography can be used to accurately allow early clinical assessment of ankle fracture stability, thereby negating the need to perform plain film stress views of the acutely injured ankle. This prospective study included 12 patients (age range, 18-72) with supination external rotation fractures requiring operative fixation. Following induction of anesthesia, ultrasonography examination was performed, followed by an arthrogram under fluoroscopic screening. Radiographs, ultrasonography, and arthrographic findings were compared. There was 100% correlation between ultrasonography and arthrogram findings. Ultrasonography accurately diagnosed medial deltoid rupture with a sensitivity of 100% and specificity of 100%. Plain film radiographs of the ankle had a sensitivity of 57.1% and a specificity of 60%. The difference between these was significant (?(2)=.0091). This study demonstrates diagnostic ultrasonography to be an accurate diagnostic modality in assessing medial deltoid ligament integrity in patients with supination external rotation fractures. It offers the same sensitivity and specificity as arthrography without the need for additional invasive procedures. Its relative ease of use and lack of ionizing radiation make it a potentially useful tool, particularly in a busy trauma service. PMID:21956059

Henari, Shwan; Banks, Louisa N; Radovanovic, Ingrid; Radiovanovic, Ingrid; Queally, Joseph; Morris, Seamus



Usefulness of contrast-enhanced ultrasonography in assessing therapeutic response in hepatocellular carcinoma treated with HIFU  

NASA Astrophysics Data System (ADS)

PURPOSE: We evaluated the efficacy and change of contrast-enhanced ultrasonography after HIFU, and decided on the best timing for contrast-enhanced ultrasonography to evaluate the response of hepatocellular carcinoma with HIFU.

Fukuda, Hiroyuki; Ohto, Masao; Ito, Ryu; Shinohara, Yasushi; Sakamoto, Akio; Karasawa, Eii; Zhu, Hui; Wang, Zhi-Biao



Transvaginal ultrasound and digital examination in predicting successful labor induction  

Microsoft Academic Search

Objective:To compare transvaginal ultrasound and digital cervical examination in predicting successful induction in post-term pregnancy.Methods:Transvaginal ultrasound and digital vaginal examinations were performed on 122 women at 41 or more weeks’ gestation, immediately before labor induction. Ultrasound assessments of cervical length, dilatation, and presence of funneling were compared with the components of the Bishop score. The primary outcome was the rate

Sujata Chandra; Joan M. G Crane; Donna Hutchens; David C Young



Therapeutic response assessment of transcatheter arterial chemoembolization for hepatocellular carcinoma: ultrasonography, CT and MR imaging.  


Two randomized controlled trials identified that transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) shows a significant survival benefit compared with controls, after a long-term controversy. Thus, TACE is the current standard of care for patients presenting with multinodular HCC. Monitoring tumor response to TACE is part of the clinical management of HCC patients. Imaging, including ultrasonography, computed tomography and magnetic resonance imaging, has an important role in assessing therapeutic effects earlier and more objectively. Imaging assessment needs to detect not only a reduction in overall tumor load but also a reduction in viable tumor. Here, we give an overview of the current status of the imaging assessment of HCC response to TACE. PMID:23428860

Minami, Yasunori; Kudo, Masatoshi



Transvaginal laparoscopic donor nephrectomy.  


Laparoscopic donor nephrectomy (LDN) has numerous advantages over open donor nephrectomy. The cosmetic issues and pain that arise due to the 5 to 6-cm incisions on the abdominal wall in LDN have led to transvaginal laparoscopic donor nephrectomy (TVLDN). Between May and August 2012, we performed seven donor nephrectomies via a transvaginal approach. The mean age of the donors was 53.0 ± 9.52 years. The mean operative time was 97.29 ± 39.47 minutes and mean warm ischemia time, 220.71 ± 55.49 seconds. Donors were mobilized, began oral intake at 8 hours postoperative, and were all discharged within the first 24 hours. Except one dose of analgesic applied immediately after the operation, no additional medication was required. No infectious complications were encountered in any recipient. TVLDN may be a good alternative for female donors. Compared with LDN, TVLDN has benefits of less postoperative pain, faster recovery, shorter hospital stay, and excellent cosmetic results. PMID:23622577

Ero?lu, A; ?ener, C; Tabandeh, B; Tilif, S; Okçuo?lu Kad?o?lu, Z; Kaçar, S



Transvaginal ultrasonographic measurement of endometrial thickness in postmenopausal women receiving estrogen replacement therapy  

Microsoft Academic Search

OBJECTIVE: This study was undertaken to evaluate endometrial thickness by transvaginal ultrasonography in asymptomatic postmenopausal women receiving estrogen replacement therapy. The endometrial thickness in this study group was compared with endometrial thickness measurements in a group of women who had abnormal postmenopausal bleeding. The recent literature was reviewed.STUDY DESIGN: Asymptomatic postmenopausal women receiving estrogen replacement, seen for routine examination during

Thomas R. Holbert



Ultrasonography assessment of vocal cords mobility in children after cardiac surgery  

PubMed Central

Objectives Upper airway obstruction after pediatric cardiac surgery is not uncommon. In the cardiac surgical population, an important etiology is vocal cord paresis or paralysis following extubation. In this study, we aimed to evaluate the feasibility and accuracy of ultrasonography (US) assessment of the vocal cords mobility and compare it to fiber-optic laryngoscope (FL). Material and methods A prospective pilot study has been conducted in Pediatric Cardiac ICU (PCICU) at King Abdulaziz Cardiac Center (KACC) from the 1st of June 2009 till the end of July 2010. Patients who had cardiac surgery manifested with significant signs of upper airway obstruction were included. Each procedure was performed by different operators who were blinded to each other report. Results of invasive (FL) and non-invasive ultrasonography (US) investigations were compared. Results Ten patients developed persistent significant upper airway obstruction after cardiac surgery were included in the study. Their mean ± SEM of weight and age were 4.6 ± 0.4 kg and 126.4 ± 51.4 days, respectively. All patients were referred to bedside US screening for vocal cord mobility. The results of US were compared subsequently with FL findings. Results were identical in nine (90%) patients and partially different in one (10%). Six patients showed abnormal glottal movement while the other four patients demonstrated normal vocal cords mobility by FL. Sensitivity of US was 100% and specificity of 80%. Conclusion US assessment of vocal cord is simple, non-invasive and reliable tool to assess vocal cords mobility in the critical care settings. This screening tool requires skills that can be easily obtained.

Shaath, Ghassan A.; Jijeh, Abdulraouf; Alkurdi, Ahmad; Ismail, Sameh; Elbarbary, Mahmoud; Kabbani, Mohamed S.



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

SciTech Connect

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.

Catalano, Orlando; Esposito, Maria; Lobianco, Roberto; Cusati, Bianca; Altei, Francesco; Siani, Alfredo [Department of Radiology, S. Maria delle Grazie Hospital, via Domitiana, Loc. La Schiana, Pozzuoli, I-80078 Naples (Italy)



A comparison of transvaginal artificial insemination procedures for use in commercially farmed deer  

Microsoft Academic Search

The site of semen deposition (vaginal, cervical or uterine) and the time required for transvaginal artificial insemination (AI) using the Gourley Scope method of AI vs. a standard speculum-guided AI gun was assessed in three species of farmed deer (fallow, red and white-tailed deer). Pregnancy rates using these two transvaginal AI methods were also compared in a commercial herd of

S. T. Willard; D. A. Neuendorff; A. W. Lewis; R. D. Randel



Using functional transcranial Doppler ultrasonography to assess language lateralisation: Influence of task and difficulty level  

PubMed Central

Language is lateralised to the left hemisphere in most people, but it is unclear whether the same degree and direction of lateralisation is found for all verbal tasks and whether laterality is affected by task difficulty. We used functional transcranial Doppler ultrasonography (fTCD) to assess the lateralisation of language processing in 27 young adults using three tasks: word generation (WG), auditory naming (AN), and picture story (PS). WG and AN are active tasks requiring behavioural responses whereas PS is a passive task that involves listening to an auditory story accompanied by pictures. We also examined the effect of task difficulty by a post hoc behavioural categorisation of trials in the WG task and a word frequency manipulation in the AN task. fTCD was used to measure task-dependent blood flow velocity changes in the left and right middle cerebral arteries. All of these tasks were significantly left lateralised: WG, 77% of individuals left, 5% right; AN, 72% left: 4% right; PS, 56% left: 0% right. There were significant positive relationships between WG and AN (r = 0.56) as well as AN and PS (r = .76) but not WG and PS (r = ?0.22). The task difficulty manipulation affected accuracy in both WG and AN tasks, as well as reaction time in the AN task, but did not significantly influence laterality indices in either task. It is concluded that verbal tasks are not interchangeable when assessing cerebral lateralisation, but that differences between tasks are not a consequence of task difficulty.

Badcock, Nicholas A.; Nye, Abigail; Bishop, Dorothy V. M.



Appendicitis Diagnosed by Emergency Physician Performed Point-of-Care Transvaginal Ultrasound: Case Series  

PubMed Central

Lower abdominal pain in females of reproductive age continues to be a diagnostic dilemma for the emergency physician (EP). Point-of-care ultrasound (US) allows for rapid, accurate, and safe evaluation of abdominal and pelvic pain in both the pregnant and non-pregnant patient. We present 3 cases of females presenting with right lower quadrant and adnexal tenderness where transvaginal ultrasonography revealed acute appendicitis. The discussion focuses on the use of EP- performed transvaginal US in gynecologic and intra-abdominal pathology and discusses the use of a staged approach to evaluation using US and computed tomography, as indicated.

Bramante, Robert; Radomski, Marek; Nelson, Mathew; Raio, Christopher



Advanced ultrasonography technologies to assess the effects of radiofrequency ablation on hepatocellular carcinoma  

PubMed Central

Background Radiofrequency ablation (RFA) is a curative therapy for hepatocellular carcinoma (HCC). In RFA, ultrasonography (US) is most commonly used to guide tumor puncture, while its effects are assessed using dynamic computed tomography or magnetic resonance. The differences in modalities used for RFA and assessment of its effects complicate RFA. We developed a method for assessing the effects of RFA on HCC by combining contrast-enhanced (CE) US and real-time virtual sonography with three-dimensional US data. Patients and methods Before RFA, we performed a sweep scan of the target HCC nodule and the surrounding hepatic parenchyma to generate three-dimensional US data. After RFA, we synchronized multi-planar reconstruction images derived from stored three-dimensional US data with real-time US images on the same US monitor and performed CEUS and real-time virtual sonography. Using a marking function, we drew a sphere marker along the target HCC nodule contour on pre-treatment US- multi-planar reconstruction images so that the automatically synchronized sphere marker represented the original HCC nodule contour on post-treatment real-time CEUS images. Ablation was considered sufficient when an avascular area with a margin of several millimeters in all directions surrounded the sphere marker on CEUS. Results This method was feasible and useful for assessing therapeutic effects in 13 consecutive patients with HCC who underwent RFA. In 2 patients who underwent multiple sessions of RFA, HCC-nodule portions requiring additional RFA were easily identified on US images. Conclusions This method using advanced US technologies will facilitate assessment of the effects of RFA on HCC.

Toshikuni, Nobuyuki; Shiroeda, Hisakazu; Ozaki, Kazuaki; Matsue, Yasuhiro; Minato, Takahiro; Nomura, Tomoe; Hayashi, Nobuhiko; Arisawa, Tomiyasu; Tsutsumi, Mikihiro



Reproductive assessment of male elephants (Loxodonta africana and Elephas maximus) by ultrasonography.  


Transrectal ultrasonography was performed on five wild and two captive male African elephants (Loxodonta africana) and four captive male Asian elephants (Elephas maximus) to develop standards for assessment of reproductive health and status. The entire internal urogenital tract was visualized ultrasonographically by using a 3.5 MHz or a 7.5-MHz transducer in combination with a probe extension adapted for elephant anatomy. The findings were verified by postmortem ex situ ultrasound examinations in several individuals of each species. Each part of the internal urogenital tract was sonographically detectable except for the bulbourethral glands and the cranial portion of the ureters and ductus deferentes, which were only observed in situ in the neonate. Each structure visualized was measured and described. The size and morphology of the urogenital structures, especially the accessory glands, were indicative of breeding status, if known. There was a notable difference between African and Asian males in the size and morphology of the prostate gland and a slight difference in the shape of the ampullae. No other structure showed significant species differences. The detection of the location and description of the testes may provide information for modifying present castration procedures. Furthermore, ultrasound examination of the male accessory glands may aid in the identification of potential semen donors for assisted reproduction programs in captive elephants. PMID:9732024

Hildebrandt, T B; Göritz, F; Pratt, N C; Schmitt, D L; Quandt, S; Raath, J; Hofmann, R R



Accurate Preoperative Diagnosis of Ovarian Pregnancy with Transvaginal Scan  

PubMed Central

Ovarian pregnancy is a rare variant of ectopic pregnancy, and an accurate preoperative diagnosis is very challenging. Dr. Saint Monnissey described the first reported case of ovarian pregnancy in 17th century. Transvaginal ultrasonography is a valuable tool in identifying an ovarian pregnancy from other types of ectopic pregnancies. Management with laparoscopy or laparotomy is required in all cases, and in almost all cases, ovary can be preserved since implantation is usually superficial (Koo et al.; 2011). A single case of an ovarian pregnancy, consistent with Spiegelberg's criteria is presented here. This case history demonstrates the use of ultrasonography (USG) and surgery in the diagnosis and treatment, respectively, of the ovarian pregnancy. As we step into an era where in vitro fertilization rate is on its hike, one should be aware that incidence of ovarian pregnancy is also increasing, necessitating a high index of suspicion.

Gupta, Natasha; Gupta, Anu; Onyema, Godwin; Pantofel, Yelena; Ying, Shan-Ching; Garon, Jack E.; Lampley, Charles; Blankstein, Josef



Evaluation of the uterine cavity with magnetic resonance imaging, transvaginal sonography, hysterosonographic examination, and diagnostic hysteroscopy  

Microsoft Academic Search

Objective: To evaluate and compare the diagnostic accuracy of magnetic resonance imaging (MRI), transvaginal ultrasonography (TVS), hysterosonographic examination (HSE), and hysteroscopy in the evaluation of the uterine cavity.Design: Independent double-blind study.Setting: University medical hospital.Patient(s): One hundred six consecutive premenopausal women who underwent hysterectomy for benign diseases.Intervention(s): Results of MRI, TVS, HSE, and hysteroscopy were compared with the results of histopathologic

Margit Dueholm; Erik Lundorf; Estrid S Hansen; Susanne Ledertoug; Frede Olesen



Transvaginal culdosuspension: technique and results  

Microsoft Academic Search

Objectives. Numerous techniques have been described for supporting the vaginal vault after enterocele repair and hysterectomy. We describe a transvaginal culdosuspension that obliterates the cul-de-sac and supports the vaginal cuff high on the levator plate. The normal vaginal axis is restored, and adequate vaginal depth is provided for normal sexual activity.Methods. One hundred four patients, aged 48 to 90 years

Craig V Comiter; Sandip P Vasavada; Shlomo Raz



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

PubMed Central

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.

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



[Ovestin in preparation for transvaginal surgeries].  


The trial of the efficiency of the drug estriol-ovestin in preoperative preparation of patients to transvaginal operations included 118 patients (mean age 48.6 years). 82 patients received ovestin as a vaginal suppository and creams in a daily dose of 500 mu for 2-3 weeks before the operation. 36 control patients did not receive ovestin in their preoperative preparation. Effectiveness of ovestin was assessed by duration of pain symptom in the postoperative period, duration of the vaginal postoperative discharge, duration of dysuria after removal of a urethral catheter, the time of renewal of sexual intercourses. The results of the study proved effectiveness of ovestin in preoperative preparation of patients for vaginal surgery. PMID:12402774

Pushkar', D Iu; D'iakov, V V; Godunov, B N; Gvozdev, M Iu


Pediatric ultrasonography  

SciTech Connect

Two leading experts explore the benefits and limitations of pediatric ultrasonography, explaining the latest techniques for optimal imaging of specific body regions: the head, chest, abdomen, pelvis, extremities, and soft tissues. Numerous illustrations emphasize significant points and combine with the text to show specifically what to look for when imaging children.

Hayden, C.K. Jr.; Swischuk, L.E.



Ultrasonography in inflammatory rheumatic disease: an overview  

Microsoft Academic Search

Modern ultrasonography enables clinicians to sensitively assess the progression of inflammatory joint and tendon disease, and to investigate vasculitides, connective tissue diseases and nerve lesions. Despite the advantages of musculoskeletal ultrasonography for diagnostic, prognostic and monitoring purposes, fewer than 10% of European rheumatologists use this technique in routine clinical practice. The reliability and limitations of rheumatic ultrasonography remain a concern,

Christina Duftner; Wolfgang A. Schmidt; Christian Dejaco; Michael Schirmer



Assessment of internal diameters of abdominal and femoral blood vessels in 250 living subjects using color Doppler ultrasonography.  


Acquiring data about venous or arterial vessel size is important for several reasons, given the increasing incidence of thomboembolic phenomena and arterial aneurysms and the emerging new vascular techniques. We studied 250 healthy subjects (125 men and 125 women; age range: 50 to 91 years) with no known vascular pathology, nor hypertension, nor diabetes. We assessed the caliber of abdominal aorta, inferior vena cava, iliac and femoral arteries and viens by color doppler ultrasonography, and analyzed the results with regard to sex, height, weight and body surface of each subject. The mean caliber measure of the large abdominal vessels appeared lower than the value obtained from cadavers. There was a direct proportion between the left and right vessels of the same subject. The difference in vessel caliber between male and female subjects was statistically significant. There was no correlation between vessel caliber and age, height or body surface area. PMID:21287972

Valecchi, Debora; Bacci, Duccio; Gulisano, Massimo; Sgambati, Eleonora; Sibilio, Maurizio; Lipomas, Mario; Macchi, Claudio



[Transvaginal penetrating fetal head injury].  


In utero head traumas are extremely rare and are usually caused by penetrating injuries in the thoracic or abdominal wall that affect the uterine cavity. Transvaginal fetal head injuries have been reported in exceptional cases. This is a case-report of a fetus affected by penetrating head trauma with skull fracture and intra-ventricular hemorrhage after his mother's self-insertion of a blunt object, violently through the vagina. Trauma disrupted the integrity of intrauterine membranes and precipitated preterm labor. After birth, there was a debridement of the scalp and surgical management of the fracture was performed; nevertheless, the patient died four weeks later, due to neonatal sepsis. Management of these wounds must not only be focused on repairing the primary wound, but on preventing the infectious complications. PMID:23070195

Moscote Salazar, Luis Rafael; Alcalá-Cerra, Gabriel; Castellar Leones, Sandra Milena; Gutiérrez Paternina, Juan José



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

PubMed Central

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.

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



Understanding EUS (Endoscopic Ultrasonography)  


Understanding EUS (Endoscopic Ultrasonography) You've been referred to have an endoscopic ultrasonography, or EUS, which will help your doctor, evaluate or treat your condition. What is EUS? Endoscopic ultrasonography (EUS) allows your doctor to examine your esophageal ...


Duplex ultrasonography, magnetic resonance angiography, and computed tomography angiography for diagnosis and assessment of symptomatic, lower limb peripheral arterial disease: systematic review  

PubMed Central

Objectives To determine the diagnostic accuracy of duplex ultrasonography, magnetic resonance angiography, and computed tomography angiography, alone or in combination, for the assessment of lower limb peripheral arterial disease; to evaluate the impact of these assessment methods on management of patients and outcomes; and to evaluate the evidence regarding attitudes of patients to these technologies and summarise available data on adverse events. Design Systematic review. Methods Searches of 11 electronic databases (to April 2005), six journals, and reference lists of included papers for relevant studies. Two reviewers independently selected studies, extracted data, and assessed quality. Diagnostic accuracy studies were assessed for quality with the QUADAS checklist. Results 107 studies met the inclusion criteria; 58 studies provided data on diagnostic accuracy, one on outcomes in patients, four on attitudes of patients, and 44 on adverse events. Quality assessment highlighted limitations in the methods and quality of reporting. Most of the included studies reported results by arterial segment, rather than by limb or by patient, which does not account for the clustering of segments within patients, so specificities may be overstated. For the detection of stenosis of 50% or more in a lower limb vessel, contrast enhanced magnetic resonance angiography had the highest diagnostic accuracy with a median sensitivity of 95% (range 92-99.5%) and median specificity of 97% (64-99%). The results were 91% (89-99%) and 91% (83-97%) for computed tomography angiography and 88% (80-98%) and 96% (89-99%) for duplex ultrasonography. A controlled trial reported no significant differences in outcomes in patients after treatment plans based on duplex ultrasonography alone or conventional contrast angiography alone, though in 22% of patients supplementary contrast angiography was needed to form a treatment plan. The limited evidence available suggested that patients preferred magnetic resonance angiography (with or without contrast) to contrast angiography, with half expressing no preference between magnetic resonance angiography or duplex ultrasonography (among patients with no contraindications for magnetic resonance angiography, such as claustrophobia). Where data on adverse events were available, magnetic resonance angiography was associated with the highest proportion of adverse events, but these were mild. The most severe adverse events, although rare, were mainly associated with contrast angiography. Conclusions Contrast enhanced magnetic resonance angiography seems to be more specific than computed tomography angiography (that is, better at ruling out stenosis over 50%) and more sensitive than duplex ultrasonography (that is, better at ruling in stenosis over 50%) and was generally preferred by patients over contrast angiography. Computed tomography angiography was also preferred by patients over contrast angiography; no data on patients' preference between duplex ultrasonography and contrast angiography were available. Where available, contrast enhanced magnetic resonance angiography might be a viable alternative to contrast angiography.

Burch, Jane; Cranny, Gillian; Aguiar-Ibanez, Raquel; Craig, Dawn; Wright, Kath; Berry, Elizabeth; Gough, Michael; Kleijnen, Jos; Westwood, Marie



Feasibility of Using Intravascular Ultrasonography for Assessment of Giant Cavernous Aneurysm after Endovascular Treatment: A Technical Report  

PubMed Central

Introduction Intravascular ultrasonography (IVUS) has been shown as a valuable adjunct imaging tool during endovascular procedures but its value in detection of any recurrence during follow up after endovascular coil embolization of large and giant intracranial aneurysms is not reported. Methods A 41 years old man who had been treated using stent assisted coil embolization for cavernous segment aneurysm of the left internal carotid artery underwent 60 month angiographic follow up. Concurrently, IVUS catheter was advanced under fluoroscopic guidance inside the cavernous portion of the left internal carotid artery. Then IVUS images were used to visualize the stent, coil loops, and aneurysm neck. Results The angiographic images were limited because of superimposition of the aneurysm on the parent vessel in all projections. IVUS images demonstrated that the stent was patent along its whole length and there was no sign of stent deformity or in-stent thrombosis. Loops of the coil were visualized as hyperechoic signals inside the aneurysm and there was no sign of herniated loops of coil inside the stent. Conclusion In this case report, we observed that adjunct use of IVUS can provide valuable information not ascertained by angiography during follow up assessment of coil embolized aneurysm.

Majidi, Shahram; Grigoryan, Mikayel; Tekle, Wondwossen G; Watanabe, Masaki; Qureshi, Adnan I



Conceptus ecobiometry and triplex Doppler ultrasonography of uterine and umbilical arteries for assessment of fetal viability in dogs.  


The objectives were to: 1) evaluate blood flow in the uterine (UA) and umbilical (Uma) arteries in the pregnant bitch, by measuring the resistive index (RI) and pulsatility index (PI); 2) to note the presence or absence of the early diastolic notch and diastolic flow in the UA and Uma flow waveforms, respectively; and 3) perform conceptus ecobiometry for fetal growth assessment during pregnancy. Six healthy bitches were examined on approximately Days -44, -42, -36, -31, -28, -25, -21, -18, -14, -8, -4, and -2 of pregnancy (whelping = Day 0). Triplex Doppler and B-mode ultrasonography were used to assess blood flow and conceptus ecobiometry. All pregnancies ended with a normal whelping and birth of live puppies. Prior to whelping, all conceptus dimensions increased significantly, whereas RI and PI of both the Uma and UA decreased significantly. For the UA, RI and PI were (mean +/- SEM) 0.95 +/- 0.02 and 2.75 +/- 0.41, respectively, on Day -44, and were 0.60 +/- 0.01 and 0.99 +/- 0.03 on Day -4. For the Uma, RI and PI were 0.99 +/- 0.01 and 2.42 +/- 0.03 on Day -31, and were 0.62 +/- 0.01 and 1.15 +/- 0.02 on Day -4. The complete disappearance of the early diastolic notch in the UA, and the appearance of diastolic flow in the Uma occurred on Days -16 +/- 5 and -21 +/- 1. The authors concluded that UA and Uma perfusion were important end points to assess fetal vitality in bitches. Furthermore, the current reference values provided a baseline for monitoring normal and abnormal pregnancies in bitches. PMID:20494430

Miranda, S A; Domingues, S F S



[Retrospective analysis of effectiveness of transvaginal ultrasound in the detection of ectopic pregnancy].  


Objective: To evaluate the effectiveness of transvaginal ultrasonographic (US) scan in own group of patients.Design: Retrospective analysis.Setting: Department of Gynaecology and Obstetrics, 3rd Faculty of Medicine, Charles University and Faculty Hospital Kralovské Vinohrady, Prague.Methods: We retrospectively evaluated the history, laboratory and ultrasound findings in a group of 115 patients, that have undergone a surgical procedure due to a positive diagnose or suspicion of ectopic pregnancy (EP). In all cases the diagnose of ectopic pregnancy was histologically confirmed. Results: 67% of our patients were nulliparous, 10% of patients had a positive personal history of previous ectopic pregnancy, only 5% of pacients had a record of pelvic inflammatory disease in the past. Histological examination confirmed 96.5% (111/115) tubal, 1.7% (2/115) interstitial, 0.9% (1/115) ovarian and 0.9% (1/115) cervical ectopic pregnancy. Our transvaginal ultrasonography (TVUS) scan was successful in 76.5% (88/115). A pathological adnexal mass was visualised in 67% (77/115) cases. A negative ultrasound finding was observed in 23.5% (27/115) cases. Conclusion: The US detection of ectopic pregnancy by a single TVUS examination was successful in 76.5% (88/115) cases. Early detection of ectopic pregnancy by TVUS decreases the risk of rupture of different types of EP, decreases the rate of surgical interventions and also promotes conservative management of ectopic pregnancies. Keywords: diagnosis - ectopic pregnancy - transvaginal ultrasound - blob sign - bagel sign. PMID:24040980

Kubešová, B; Líbalová, P; Simonová, V; Bucharová, J; Záhumenský, J



Utility and feasibility of musculoskeletal ultrasonography (MSK US) in rheumatology practice in Canada: needs assessment.  


The utility of musculoskeletal ultrasound (MSK US) is being extensively explored and evaluated amongst European rheumatologists. However, utilization of MSK US by rheumatologists in Canada is much less common. This study aimed to evaluate the current use of MSK US in Canadian rheumatology practice, to determine beliefs and attitudes towards MSK US, and to determine factors that may encourage or limit its use. A 13-question needs assessment questionnaire was developed. All Canadian rheumatologists were invited via e-mail to participate in the survey. The overall response rate was 156/470 (33%). Fifty-one percent of participants used MSK US in their clinical practice. Lack of training appeared to be the main obstacle to its current use. Eighty-three percent believed that MSK US should be performed by rheumatologists and expressed a willingness to learn the technique. Skills offering greatest clinical utility were the assessment of inflammatory arthritis in small joints (i.e., hands (metacarpophalyngeal and proximal interphalangeal joints), wrists, feet (metatarsophalyngeal), shoulders, and ankles. Limited available time, equipment costs, and difficulties with billing were the main obstacles to MSK US utilization in the clinical setting. There is a great level of interest in learning and applying MSK US in Canadian rheumatology practice. The balance between added clinical value and lack of remuneration, equipment associated costs, and time to complete training is the major limiting factor influencing rheumatologists' willingness to take on MSK US. Training programs must be relevant to rheumatologists' needs before MSK US will be adopted into routine clinical practice in Canada. PMID:21484225

Larché, Maggie J; McDonald-Blumer, Heather; Bruns, Alessandra; Roth, Johannes; Khy, Visithan; de Brum-Fernandes, Artur J; Wakefield, Richard J; Brown, Andrew K; Bykerk, Vivian



Risk assessment of renal cortical scarring with urinary tract infection by clinical features and ultrasonography  

PubMed Central

AIMS—To address some of the issues in the ongoing debate over the optimal diagnostic imaging following childhood urinary tract infection (UTI), by determining the risk of missing renal cortical scarring which would be detected on a technetium-99m dimercaptosuccinic acid (DMSA) gold standard if ultrasound alone were used, factoring for clinical features (upper or lower tract), UTI recurrence, and age group (infants, preschool, or school age).?METHODS—Details of UTI clinical features and recurrence were recorded for 990 children with a proven UTI, and their DMSA and ultrasound results were compared for each kidney.?RESULTS—The risks of missing DMSA scarring varied between 0.4% (school age children with solitary lower tract UTI) and 11.1% (infants with recurrent upper tract UTI).?CONCLUSIONS—UTI clinical features are important in assessing the need for DMSA imaging. Current UK imaging guidelines are endorsed, although preschool children with solitary lower tract UTI remain a controversial group and more attention needs to focused on children with recurrent UTI.??

Christian, M; McColl, J; MacKenzie, J; Beattie, T



Quantitative ultrasonography for assessment of bone mineral density in the canine radius and tibia.  


Quantitative ultrasound allows noninvasive assessment of cortical bone density. Potential applications include monitoring of fracture healing, rehabilitation, and skeletal diseases. The objectives of this study were to determine the three most accessible portals to obtain speed of sound measurements of the radius and tibia with an Omnisense multisite quantitative ultrasound device and to determine probe-dependent intra- and interoperator variability for speed of sound measurements of the radius and tibia in six healthy hounds. The radius was most accessible at the cranial proximal metaphysis, the cranial middiaphysis, and medial distal metaphysis. Speed of sound measurements were possible at these sites on the radius with acceptable intra- and interoperator variation (1.6-4.6%). Measurements differed significantly when performed with different probes at the cranial proximal radial metaphysis. The tibia was most accessible at the cranial proximal metaphysis, the medial middiaphysis, and medial distal metaphysis. The medial middiaphyseal and mediodistal tibial sites allowed measurements with lowest intra- and interoperator variation (< 3.5%). A smaller probe allowed tibial measurements with lowest interoperator variation. Measurements did not differ significantly at each tibial site when different probes were used. Measurements did not differ significantly between observers when measuring with the same probe at each specific site on radius and tibia. A medium-size probe allowed for most time-efficient measurements and the least number of failed measurements on the radius and tibia. Speed of sound can be consistently measured by different observers on the radius and tibia in healthy hounds. PMID:19241763

Lauer, Susanne K; Davies, Emma S; Hosgood, Giselle; Cremer, Jeannette


Duplex-Doppler ultrasonography in the assessment of portal hypertension. Utility of the measurement of maximum portal flow velocity.  


To assess the utility of Duplex-Doppler ultrasonography (DDUS) in the evaluation of portal haemodynamics we studied 52 patients with compensated liver cirrhosis (mean age 53.9 +/- 9.2 years, males 32, females 20) diagnosed by laparoscopy and biopsy. All patients underwent laparoscopy and oesophageal-gastro-duodenoscopy (OGDS): we postulated that haemodynamically significant portal hypertension (PH) was present if varices were detected at OGDS and/or if collateral veins were revealed at laparoscopy. DDUS was performed with a strictly standardized method and maximum portal flow velocity (PFV) was measured in all patients. Max-PFV ranged between 3.5 and 33.4 cm/s. Overall, 36 patients (69%) had a max-PFV lower than 20.3 cm/s (normal max-PFV range in our laboratory is 20.3-33.3 cm/s), while 16 patients (31%) had normal max-PFV values. Five patients (9.6%) had no signs of PH at laparoscopy and/or OGDS and all five had normal max-PFV values. The other 47 patients (90.4%) had collateral circuli at laparoscopy and 29/47 (61.7%) exhibited also varices at OGDS: max-PFV was lower than 20.3 cm/s in 36/47 patients (76.6%). The measurement of max-PFV demonstrated a 76.6% sensitivity and a 100% specificity in detecting PH, with 100% positive predictive value and 31% negative predictive value. Three patients with PH and apparently normal max-PFV values exhibited a recanalization of the umbilical vein.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8223681

D'Alimonte, P; Cioni, G; Cristani, A; Ferrari, A; Ventura, E; Romagnoli, R



Assessment of renal volume by three-dimensional ultrasonography in pregnant bitches: an experimental study using virtual organ computer-aided analysis  

PubMed Central

Background To assess and to compare the renal volume evolution in bitches during pregnancy by two-dimensional (2D) ultrasonography using the ellipsoid technique (volume?=?length x width x depth x 0.523) and three-dimensional (3D) ultrasonography using the Virtual Organ Computer-aided AnaLysis (VOCAL) method. A longitudinal prospective study was performed with 17 normal Golden Retrievers bitches during pregnancy from heat to the last third of gestation. The ultrasound scans were performed by two veterinarians. The left and right kidneys were assessed in three moments (day 0?=?non-pregnant bitches; days 1st to 20th of pregnancy and days 21st to 40th of pregnancy) by three techniques (ellipsoid; VOCAL 12° and VOCAL 30°). For reproducibility calculations, we used the intraclass correlation coefficient (ICC). Results The inferential result of the volumes in ANOVA revealed the interaction effect between side and moment (p?=?0.009). The 3D techniques showed, in average, the same renal volumes (p?=?0.137) regardless of the side and moment. Considering the right side, the renal volume in the day 0 was smaller than the day 21st to 40th (p?=?0.029). Considering the left side, the renal volume at day 0 was smaller than the day 1st to 20th (p?=?0.020) and day 21st to 40th (p?=?0.007). It was found good intra observer reproducibility (ICC?>?0.9) and none of the three techniques showed a good inter observer reproducibility (ICC?ultrasonography using the VOCAL method (12° and 30°) had good correlation with the volume obtained by 2D ultrasonography method.



Assessment of fetal and placental blood flow in primates using contrast enhanced ultrasonography.  


Ultrasonographic contrast agents that stay within the vascular space and do not cross the placenta may permit differentiation between the maternal and fetal portions of the placenta and may be clinically useful for diagnosis of placental abnormalities. This study was performed to assess the effects of Levovist (Schering AG, Berlin) on the placental circulation and to determine whether hemodynamic effects on the fetus occur. Ten studies were performed in five pregnant macaques (median weight, 9.15 kg; range, 6.15 to 11 kg; median gestational age, 121 days; range, 34 days to term) under anesthesia. Gray scale, color, and duplex Doppler sonographic scans of the fetus and placenta were acquired using a 5 MHz curved array transducer. Fetal heart rate, resistive index, and systolic-diastolic ratios were measured in the fetal middle cerebral artery, aorta, umbilical artery, and uterine artery before and after administration of contrast agent. The following dose regimen was tested: 5 ml of physiologic saline solution followed by 0.1 ml/kg of 300 mg/ml Levovist (diagnostic dose), 0.5 ml/kg of 400 mg/ml Levovist (maximum dose), and 5 ml physiologic saline solution. The order of diagnostic dose and maximal dose was randomized among animals. Color enhancement of the basal portions of the placenta was documented after administration of contrast agent. Heart rate and middle cerebral artery systolic-diastolic ratio did not change between baseline and injections. A 7% decrease of the resistive index from baseline to maximum dose was measured in the uterine artery (not significant). A 7.7% decrease in the systolic-diastolic ratio from baseline to maximum dose was recorded in the umbilical artery. However, an identical change was measured after saline solution was injected. The resistive index in the aorta increased by 2.6% from baseline to maximum dose, a change that was not significant (P > 0.5). Ultrasonographic contrast enhancement of the maternal circulation in placenta is demonstrated to be without significant effects on the fetal circulation as measured in this limited population. PMID:9527576

Schmiedl, U P; Komarniski, K; Winter, T C; Luna, J A; Cyr, D R; Ruppenthal, G; Schlief, R



Transvaginal fetal biometry in early pregnancy  

Microsoft Academic Search

Objective: To produce reference charts for fetal size with transvaginal sonography that are potentially helpful in evaluating normal and abnormal early pregnancies. Design: A prospective cross-sectional study. Subjects: 1081 normal singleton pregnancies with a normal fetal karyotype or normal healthy baby at delivery, at 9–16 weeks' gestation. Measurements included crown rump length, biparietal diameter, transverse cerebellar diameter, head and abdominal

Paolo Rosati; Lorenzo Guariglia



Transvaginal sonographic findings of chronic ectopic pregnancy  

Microsoft Academic Search

Chronic ectopic pregnancy is not precisely defined in gynecologic and sonographic texts. The diagnosis of this enigmatic clinical condition is frequently not made until laparotomy. In the present retrospective study, we evaluated the transvaginal sonographic findings of cases who were diagnosed as chronic ectopic pregnancy intraoperatively and\\/or postoperatively. The incidence of chronic ectopic pregnancy was found to be 20.3% (62305)

Cem Turan; Mustafa Ugur; Muammer Dogan; Eyüp Ekici; Kubilay Vicdan; Oya Gökmen



Ocular ultrasonography in companion animals: a pictorial review  

Microsoft Academic Search

ULTRASONOGRAPHY of the eye aids the assessment and management of many ocular conditions, and is well tolerated by most dogs and cats. The principal indication for ocular ultrasonography is inability to see into the eye because of conditions affecting the cornea, anterior chamber or lens. Ultrasonography may also help to distinguish between various anterior segment entities that may appear similar

Denise Moore; Chris Lamb



Discrepancy between Ultrasonography and Hysteroscopy and Histology of Endometrium in Postmenopausal Breast Cancer Patients Using Tamoxifen  

Microsoft Academic Search

Background.The increased risk of endometrial carcinoma following the use of tamoxifen has stimulated studies on endometrial diagnostic screening methods. In tamoxifen users the endometrial thickening observed with transvaginal ultrasonography (TVU) frequently cannot be confirmed by hysteroscopy or histology.Objective.The aim was to investigate the relationship between TVU and hysteroscopic and histologic endometrial findings in postmenopausal patients using tamoxifen.Methods.Fifty-three asymptomatic postmenopausal tamoxifen-using

Marian J. E Mourits; Ate G. J Van der Zee; Pax H. B Willemse; Klaske A Ten Hoor; Harry Hollema; Elisabeth G. E De Vries



Utility of First Trimester Ultrasonography before 11 Weeks of Gestation: A Retrospective Study  

PubMed Central

We showed the utility of first trimester ultrasonography before 11 weeks of gestation for antenatal followup. We retrospectively analyzed 1295 records of patients who underwent first trimester ultrasonography (transvaginal/abdominal) in our antenatal clinic in Ankara, Turkey. Maternal age, parity, gestational age, and maternal gestational history were compared with ultrasonographic findings. Patients were divided into 12 groups based on ultrasonographic diagnoses in the first ultrasonographic scan, and called for a control examination within 10 days if the diagnostic findings were abnormal. The data were statistically analyzed using Kruskal-Wallis and chi-square tests. We noted 81.3% patients to have single, viable, intrauterine pregnancies, while 18.7% had abnormal or complicated pregnancies with uterine anomalies, ovarian cysts, fibroids, or subchorionic hematomas. Normal and anembryonic pregnancies had significantly lower median diagnostic period in the control ultrasonography than in the first examination. First trimester ultrasonography before 11 weeks of gestation is valuable in determining pregnancy outcomes.

Celen, Sevki; Dover, Necmiye; Seckin, Berna; Goker, Ufuk; Yenicesu, Okan; Danisman, Nuri



Detection of appendicitis by transvaginal ultrasound: a case report.  


Transvaginal ultrasound was performed in a 35-year-old woman with right iliac fossa discomfort in whom initial transabdominal images revealed no abnormality. A thickened hyperemic appendix with appendicolith was identified; subsequent surgery and pathological examination confirmed appendicitis. Transvaginal ultrasound may be valuable in women with suspected appendicitis when standard views are normal or equivocal. PMID:8774104

Larcos, G



Transvaginal ultrasound, uterine biopsy and hysteroscopy for postmenopausal bleeding  

Microsoft Academic Search

Objectives: To determine the importance of endometrial biopsy and transvaginal ultrasound in patients with postmenopausal bleeding. Methods: Eighty patients with postmenopausal bleeding were submitted to transvaginal ultrasound followed by endometrial biopsy. Hysteroscopy and dilatation and curettage were carried out to confirm normality of the uterine cavity. Results: The endometrial echo could be visualized in all patients with postmenopausal bleeding. The

M. G. Giusa-Chiferi; W. J. Gonçalves; E. G. Baracat; L. Cavalcanti de Albuquerque Neto; C. C. R. Bortoletto; G. Rodrigues de Lima



Tuboovarian Abscess Caused by Atopobium vaginae following Transvaginal Oocyte Recovery  

PubMed Central

A 39-year-old woman with tubarian sterility fell ill with acute pelvic inflammatory disease 2 months after transvaginal oocyte recovery. Laparotomy revealed a large tuboovarian abscess, from which Atopobium vaginae, an anaerobic gram-positive coccoid bacterium of hitherto unknown clinical significance, was isolated. The microbial etiology and the risk of pelvic infections following transvaginal punctures are discussed.

Geissdorfer, Walter; Bohmer, Christoph; Pelz, Klaus; Schoerner, Christoph; Frobenius, Wolfgang; Bogdan, Christian



Assessment of in vivo calculation with ultrasonography compared to physical sections in vitro: a stereological study of prostate volumes.  


We compared three methods for the determination of prostate volume: prostate volume measured via transrectal ultrasonography (TRUS); the Cavalieri method for measuring physical sections; and volume by displacement. TRUS volumes were calculated by the prolate ellipsoid volume formula. Five patients underwent TRUS examination of the prostate prior to radical prostatectomy; specimens were measured when freshly excised. Mean prostate volume by fluid displacement, before formalin fixation was 52.8 ± 21.5 cm(3), and after formalin fixation 50.4 ± 20.9 cm(3). Volumes determined by the Cavalieri principle (point-counting and planimetry) were 47.8 ± 19.3 and 49.1 ± 20.5 cm(3); volume measured by TRUS was 42.9 ± 21.9 cm(3). Thus TRUS underestimated prostate volume by 21.4%, but excellent agreement was found between actual volume and point counting techniques. We believe that the classic ellipsoid formula is inadequate for determining prostate volume. PMID:20734181

Acer, Niyazi; Sofikerim, Mustafa; Ertekin, Tolga; Unur, Erdo?an; Çay, Mahmut; Öztürk, Figen



Ultrasonography of the uterus and ovaries.  


Ultrasonography is the most frequently used imaging investigation in the assessment of the female genital tract. Most often the uterus and ovaries are evaluated with the help 2D transabdominal or endovaginal ultrasonography. The interpretation of the ultrasonographic data in order to establish the diagnosis of the main uterine and ovarian pathologies requires information about the examination technique and proper knowledge of the female genital tract ultrasound anatomy. PMID:21894299

Mihu, Dan; Mihu, Carmen Mihaela



Ultrasonography in gastrointestinal disease in cattle  

Microsoft Academic Search

Ultrasonography is an ideal diagnostic tool for investigating gastrointestinal disorders in cattle. It is performed on standing non-sedated cattle using a 3.5MHz linear transducer. In animals with traumatic reticuloperitonitis, inflammatory fibrinous changes, and abscesses can be imaged; however, magnets and foreign bodies are difficult to visualize because of the gas content of the reticulum. Ultrasonography can be used to assess

U. Braun



Serum human chorionic gonadotropin measurement in the diagnosis of ectopic pregnancy when transvaginal sonography is inconclusive  

Microsoft Academic Search

Objective: To assess the accuracy of initial and repeated serum hCG measurements in the diagnosis of ectopic pregnancy (EP) in patients in whom transvaginal sonography is inconclusive and to evaluate whether patient characteristics influence the accuracy of serum hCG measurements.Design: Prospective study.Setting: Two large teaching hospitals in Amsterdam, the Netherlands.Patient(s): Three hundred fifty-four consecutively seen pregnant patients with suspected EP

Ben W. J Mol; Petra J Hajenius; Simone Engelsbel; Willem M Ankum; Fulco Van der Veen; Douwe J Hemrika; Patrick M. M Bossuyt



Ultrasonography assessment of hepatobiliary abnormalities in 3359 subjects with Opisthorchis viverrini infection in endemic areas of Thailand.  


A cross sectional study on hepatobiliary abnormalities in opisthorchiasis was performed in 8936 males and females aged from 20 to 60 years from 90 villages of Khon Kaen province, Northeast Thailand. All were stool-examined for Opisthorchis viverrini infection by standard quantitative formalin/ethyl acetate concentration technique. Of these, 3359 participants with stool egg positive underwent ultrasonography of the upper abdomen. The hepatobiliary abnormalities detected by ultrasound are described here. This study found a significantly higher frequency of advanced periductal fibrosis in persons with chronic opisthorchiasis (23.6%), particularly in males. Risks of the fibrosis included intensity of infection, and age younger than 30 years. Height of left lobe of the liver, cross-section of the gallbladder dimensions post fatty meal, sludge, and, interestingly, intrahepatic duct stones were significantly associated with the advanced periductal fibrosis. Eleven suspected cholangiocarcinoma (CCA) cases were observed. This study emphasizes the current status of high O. viverrini infection rate and the existence of hepatobiliary abnormalities including suspected CCA in opisthorchiasis endemic areas of Thailand. PMID:21771664

Mairiang, Eimorn; Laha, Thewarach; Bethony, Jeffrey M; Thinkhamrop, Bandit; Kaewkes, Sasithorn; Sithithaworn, Paiboon; Tesana, Smarn; Loukas, Alex; Brindley, Paul J; Sripa, Banchob



Assessment of Carotid Atherosclerosis in Type 2 Diabetes Mellitus Patients with Microalbuminuria by High-Frequency Ultrasonography  

PubMed Central

The aim of this study is to evaluate carotid atherosclerosis in patients of type 2 diabetes mellitus with microalbuminuria (MA) by high-frequency ultrasonography. Two hundred and fifty patients of type 2 diabetes mellitus were divided into two groups according to urinary albumin excretion rate (UAER): normoalbuminuria group (130 cases) and microalbuminuria group (120 cases). The intimal-medial thickness (IMT) and the atherosclerotic plaques of carotid artery were observed in both groups by high-frequency ultrasound. Fasting blood glucose (FBG), hemoglobin A1c, and lipid profiles were measured. The values of IMT of microalbuminuria group were significantly higher than those of normoalbuminuria group (P < 0.05). In univariate analysis, IMT was positively and significantly associated with age (r = 0.265, P < 0.05), waist circumference (r = 0.263, P < 0.05), body mass index (r = 0.285, P < 0.05), systolic blood pressure (r = 0.276, P < 0.05), UAER (r = 0.359, P < 0.05), HbA1c (r = 0.462, P < 0.05) and, duration of diabetes (r = 0.370, P < 0.05). In multivariate linear regression analysis, UAER and HbA1c were independent predictors of IMT (P < 0.05 for all). In the two groups, the rate of soft plaques was higher than that of dense plaques and calcified plaques. In conclusion, there is a significant association between microalbuminuria and IMT which is regarded as the early sign of carotid atherosclerosis in type 2 diabetic patients.

Zhang, Yu-Hong; Gao, Yuan; Mao, Xin; Shang, Jing; Su, Ben-Li



Transvaginal collection and ultrastructure of Llama ( Lama glama ) oocytes  

Microsoft Academic Search

Ultrasound-guided transvaginal follicle aspiration has been described as a noninvasive and repeatable procedure for oocyte collection in several species, but its use has not been described for any of the members of the family, Camelidae. A study was designed to determine the feasibility of an ultrasound-guided transvaginal approach for oocyte collection in llamas. Fifteen non-pregnant, adult female llamas (10 non-stimulated

G. M. Brogliatti; A. T. Palasz; H. Rodriguez-Martinez; R. J. Mapletoft; G. P. Adams



Transvaginal sonography and hysteroscopy in women with postmenopausal bleeding  

Microsoft Academic Search

Objective: To make a prospective comparison between endometrial thickness determined by transvaginal sonography (TVS) and hysteroscopic findings in women with postmenopausal bleeding with histologic findings obtained by dilatation and curettage (D&C). Methods: Eighty-one patients who had not received hormonal replacement therapy were scanned by transvaginal probe, and double-layer endometrial thickness was measured 1 day before hysteroscopy and D&C. Results: The

H. Haller; N. Matej?i?; B. Rukavina; M. Kraševi?; S. Rup?i?; D. Mozeti?



Ultrasonography, magnetic resonance imaging, radiography, and clinical assessment of inflammatory and destructive changes in fingers and toes of patients with psoriatic arthritis.  


The aim of the present study was to assess ultrasonography (US) for the detection of inflammatory and destructive changes in finger and toe joints, tendons, and entheses in patients with psoriasis-associated arthritis (PsA) by comparison with magnetic resonance imaging (MRI), projection radiography (x-ray), and clinical findings. Fifteen patients with PsA, 5 with rheumatoid arthritis (RA), and 5 healthy control persons were examined by means of US, contrast-enhanced MRI, x-ray, and clinical assessment. Each joint of the 2nd-5th finger (metacarpophalangeal joints, proximal interphalangeal [PIP] joints, and distal interphalangeal [DIP] joints) and 1st-5th metatarsophalangeal joints of both hands and feet were assessed with US for the presence of synovitis, bone erosions, bone proliferations, and capsular/extracapsular power Doppler signal (only in the PIP joints). The 2nd-5th flexor and extensor tendons of the fingers were assessed for the presence of insertional changes and tenosynovitis. One hand was assessed by means of MRI for the aforementioned changes. X-rays of both hands and feet were assessed for bone erosions and proliferations. US was repeated in 8 persons by another ultrasonographer. US and MRI were more sensitive to inflammatory and destructive changes than x-ray and clinical examination, and US showed a good interobserver agreement for bone changes (median 96% absolute agreement) and lower interobserver agreement for inflammatory changes (median 92% absolute agreement). A high absolute agreement (85% to 100%) for all destructive changes and a more moderate absolute agreement (73% to 100%) for the inflammatory pathologies were found between US and MRI. US detected a higher frequency of DIP joint changes in the PsA patients compared with RA patients. In particular, bone changes were found exclusively in PsA DIP joints. Furthermore, bone proliferations were more common and tenosynovitis was less frequent in PsA than RA. For other pathologies, no disease-specific pattern was observed. US and MRI have major potential for improved examination of joints, tendons, and entheses in fingers and toes of patients with PsA. PMID:18001463

Wiell, Charlotte; Szkudlarek, Marcin; Hasselquist, Maria; Møller, Jakob M; Vestergaard, Aage; Nørregaard, Jesper; Terslev, Lene; Østergaard, Mikkel



Ultrasonography, magnetic resonance imaging, radiography, and clinical assessment of inflammatory and destructive changes in fingers and toes of patients with psoriatic arthritis  

PubMed Central

The aim of the present study was to assess ultrasonography (US) for the detection of inflammatory and destructive changes in finger and toe joints, tendons, and entheses in patients with psoriasis-associated arthritis (PsA) by comparison with magnetic resonance imaging (MRI), projection radiography (x-ray), and clinical findings. Fifteen patients with PsA, 5 with rheumatoid arthritis (RA), and 5 healthy control persons were examined by means of US, contrast-enhanced MRI, x-ray, and clinical assessment. Each joint of the 2nd–5th finger (metacarpophalangeal joints, proximal interphalangeal [PIP] joints, and distal interphalangeal [DIP] joints) and 1st–5th metatarsophalangeal joints of both hands and feet were assessed with US for the presence of synovitis, bone erosions, bone proliferations, and capsular/extracapsular power Doppler signal (only in the PIP joints). The 2nd–5th flexor and extensor tendons of the fingers were assessed for the presence of insertional changes and tenosynovitis. One hand was assessed by means of MRI for the aforementioned changes. X-rays of both hands and feet were assessed for bone erosions and proliferations. US was repeated in 8 persons by another ultrasonographer. US and MRI were more sensitive to inflammatory and destructive changes than x-ray and clinical examination, and US showed a good interobserver agreement for bone changes (median 96% absolute agreement) and lower interobserver agreement for inflammatory changes (median 92% absolute agreement). A high absolute agreement (85% to 100%) for all destructive changes and a more moderate absolute agreement (73% to 100%) for the inflammatory pathologies were found between US and MRI. US detected a higher frequency of DIP joint changes in the PsA patients compared with RA patients. In particular, bone changes were found exclusively in PsA DIP joints. Furthermore, bone proliferations were more common and tenosynovitis was less frequent in PsA than RA. For other pathologies, no disease-specific pattern was observed. US and MRI have major potential for improved examination of joints, tendons, and entheses in fingers and toes of patients with PsA.

Wiell, Charlotte; Szkudlarek, Marcin; Hasselquist, Maria; M?ller, Jakob M; Vestergaard, Aage; N?rregaard, Jesper; Terslev, Lene; ?stergaard, Mikkel



Bench-to-bedside review: Contrast enhanced ultrasonography - a promising technique to assess renal perfusion in the ICU  

Microsoft Academic Search

Acute kidney injury (AKI) is common in critically ill patients and associated with important morbidity and mortality. Although\\u000a alterations in renal perfusion are thought to play a causative role in the pathogenesis of AKI, there is, to date, no reliable\\u000a technique that allows the assessment of renal perfusion that is applicable in the ICU. Contrast-enhanced ultrasound (CEUS)\\u000a is an ultrasound

Antoine Schneider; Lynne Johnson; Mark Goodwin; Anthony Schelleman; Rinaldo Bellomo



Screening for pre-eclampsia and fetal growth restriction in twin pregnancies at 23 weeks of gestation by transvaginal uterine artery Doppler  

Microsoft Academic Search

Objective To assess the value of transvaginal uterine artery Doppler at 23 weeks of gestation in predicting the develop- ment of adverse perinatal outcomes in twin pregnancies. Patients and methods Women with twin pregnancies attending for routine ultrasound examination at 23 weeks in any one of seven hospitals underwent Doppler assessment of the uterine arteries. The right and left uterine

C. K. H. Yu; A. T. Papageorghiou; A. Boli; A. M. Cacho; K. H. Nicolaides



Perineal body measurement improves evaluation of anterior sphincter lesions during endoanal ultrasonography  

Microsoft Academic Search

Endoanal ultrasonography has become an important tool in the evaluation of patients with anal incontinence. However, the extent of anterior defects is sometimes difficult to quantitate during endoanal ultrasonography. PURPOSE: This study was designed to evaluate perineal body measurement during endoanal ultrasonography in assessing patients with obstetric anal sphincter injuries. METHODS: Forty-two patients with anal incontinence because of obstetric sphincter

Jan P. Zetterström; Anders Mellgren; Robert D. Madoff; Donald G. Kim; W. Douglas Wong



Prevalence screening for ovarian cancer in postmenopausal women by CA 125 measurement and ultrasonography  

Microsoft Academic Search

OBJECTIVE--To assess the performance of the sequential combination of serum CA 125 measurement and ultrasonography in screening for ovarian cancer. DESIGN--The serum CA 125 concentration of each subject was determined and those with a concentration > or = 30 U\\/ml were recalled for abdominal ultrasonography. If ultrasonography gave abnormal results surgical investigation was arranged. Volunteers were followed up by annual

I Jacobs; A P Davies; J Bridges; I Stabile; T Fay; A Lower; J G Grudzinskas; D Oram



Transvaginal laparo-endoscopic single-site sigmoidectomy.  


We report a case of sigmoid colon resection by single-incision laparoscopic surgery using transvaginal access. The patient was a 54-year-old woman with early stage sigmoid cancer who had no previous surgery and had a body mass index of 23.5 kg/m(2). The operative time was 270 min, and the blood loss was negligible. We used only transvaginal access, since no transabdominal assistance was required. No complications occurred. Minimal postoperative pain and a rapid recovery of gastrointestinal function were observed. As novel equipment is introduced into clinical practice, transvaginal laparoscopic procedures will most likely become increasingly popular in abdominal surgery. In particular, this type of procedure will have a more defined role in colorectal surgery. Indeed, in the future, it may become an alternative for natural orifice transluminal endoscopic surgery. PMID:22358498

Shelygin, Y A; Frolov, S A; Achkasov, S I; Sushkov, O I; Shakhmatov, D G



Transvaginal nephrectomy with a multichannel laparoscopic port: a cadaver study.  


OBJECTIVE To determine whether a novel port (QuadPort, Advanced Surgical Concepts, Wicklow, Ireland) can facilitate transvaginal nephrectomy (TN), a natural orifice transluminal surgery (NOTES) procedure, using standard and articulating laparoscopic instruments. MATERIALS AND METHODS Four fresh female cadavers were used in this feasibility study with a plan to perform two right-sided and two left-sided TN. Exclusion criteria were a history of nephrectomy and a height of >1.82 m. The cadaver was placed in the lithotomy position with the target side up 30-45 degrees . A three-channel R-port (Advanced Surgical Concepts) was placed in the umbilicus to monitor the transvaginal procedure. The four-channel QuadPort was placed through the posterior fornix into the peritoneal cavity. Regular laparoscopic instruments were used transvaginally to mobilize the colon, dissect the ureter, identify and divide the renal artery between clips, and divide the renal vein with a laparoscopic stapler. Remaining attachments of the kidney were divided and the specimen entrapped in a plastic bag before transvaginal extraction. RESULTS Three (two right- and one left-sided) TNs were performed successfully; one left-sided TN was aborted in the last cadaver due to dense pelvic adhesions from previous pelvic surgery. In the first two cadavers we required assistance from the umbilical port only to divide the attachments between the upper pole of the kidney and the diaphragm supero-posteriorly. In the third case we were able to perform this dissection completely transvaginally using a flexible gastroscope. CONCLUSIONS A completely NOTES-based TN in humans is challenging. Robust laparoscopic instruments have the requisite tensile strength when deployed through a large calibre, secure, multichannel transvaginal port. Extra-long laparoscopic instruments are helpful. The cephalad aspect of the hilum and the upper pole attachments are difficult areas. Novel and robust flexible instruments still need to be developed. PMID:19489791

Aron, Monish; Berger, Andre K; Stein, Robert J; Kamoi, Kazumi; Brandina, Ricardo; Canes, David; Sotelo, Rene; Desai, Mihir M; Gill, Inderbir S



Assessment of fetal well-being in cattle by ultrasonography in normal, high-risk, and cloned pregnancies  

PubMed Central

This study determined ultrasonographic parameters of fetuses and uterine adnexa in late pregnancy in normal, cloned, and high-risk pregnancies in relation to perinatal and neonatal outcome. Ten cows with normal pregnancies (CONTROL, mean pregnancy length 273 d), 10 sick cows with potentially compromised pregnancies (HIGH-RISK, mean pregnancy length 267 d), and 10 heifers with cloned pregnancies (CLONED, mean pregnancy length 274 d) were examined at more than 260 d of gestation. There was no difference in mean fetal heart rates among the groups. The cloned calves were heavier (57 ± 8 kg) than calves from CONTROL group (36 ± 7 kg), and calves from HIGH-RISK group (37 ± 13 kg) (P = 0.003). The diameter of the thoracic aorta was positively correlated (R = 0.62) with fetal birth weight in the CONTROL group (P = 0.01). Fetal activity was not associated with survival. The results suggest that transabdominal ultrasonographic assessment of the fetal well-being may serve as a potential tool for evaluation of the fetoplacental unit.

Buczinski, Sebastien; Fecteau, Gilles; Lefebvre, Rejean C.; Smith, Lawrence C.



Assessment of carotid artery stenosis by ultrasonography, conventional angiography, and magnetic resonance angiography: Correlation with ex vivo measurement of plaque stenosis  

Microsoft Academic Search

Purpose: Several studies have investigated the correlation between Doppler ultrasonography (DUS), angiography (CA), and magnetic resonance angiography (MRA) in the evaluation of stenosis of the carotid bifurcation. However, these studies suffer from the lack of a true control—the lesion itself—and therefore conclusions about the diagnostic accuracy of each method remain relative. To determine the absolute accuracy of these modalities, we

Xian M. Pan; David Saloner; Linda M. Reilly; Jon C. Bowersox; Stephen P. Murray; Charles M. Anderson; Gretchen A. W. Gooding; Joseph H. Rapp



Additional Value of External Ultrasonography of the Neck after CT and PET Scanning in the Preoperative Assessment of Patients with Esophageal Cancer  

Microsoft Academic Search

Introduction: Lymphatic dissemination of a (non-cervical) esophageal tumor to the neck is generally considered as distant metastasis. The aim of this study was to determine the additional value of external ultrasonography (US) to detect lymphatic metastasis to the neck after normal CT scan (CT) with or without normal PET scan (PET). Methods: Between January 2003 and December 2005, 306 patients

J. M. T. Omloo; M. van Heijl; N. J. Smits; S. S. K. S. Phoa; M. I. van Berge Henegouwen; G. W. Sloof; J. J. B. van Lanschot



Three-dimensional transvaginal sonography in third-trimester evaluation of placenta previa.  


In cases of placenta previa, the distance from the placental edge to the internal os is determinant in deciding on the mode of delivery that will minimize the risk of hemorrhage. The reproducibility and interobserver reliability of this measure are unknown. The internal os is not a point, as two-dimensional (2D) ultrasonography might suggest, but an oval patch that has a measurable width, which may be as wide as the distance separating it from the placenta. It is therefore difficult to determine the exact location of the os using a 2D sectional plane. We report the case of a nulliparous woman admitted for vaginal bleeding at 37 weeks' gestation in whom transvaginal ultrasound examination showed placenta previa, but for which two sonographers reported different measurements for the distance between the placental edge and the internal os. We describe a technique to measure this distance using multiplanar three-dimensional (3D) ultrasound imaging, which allows the smallest distance between the middle of the os and the edge of the placenta, which appears as a line, to be determined. In this case, measurement using 3D ultrasound showed a shorter distance than was suggested by 2D examination. This led us to schedule a Cesarean section delivery, during which there was minimal bleeding. Standardization of 3D measurements should make it possible to define more relevant cut-offs for determining the management of cases of placenta previa. PMID:22262488

Simon, E G; Fouche, C J; Perrotin, F



Transvaginal approach for repair of rectovaginal fistulae complicating Crohn's disease.  

PubMed Central

The management of rectovaginal fistulae complicating Crohn's disease is difficult and often unsatisfactory. Between December 1983 and November 1988, 13 patients with Crohn's disease underwent repair of rectovaginal fistulae via a transvaginal approach. All patients had a diverting intestinal stoma either as part of the initial step in the staged management of intractable perianal disease or concurrent with the repair of the rectovaginal fistula. Each of the patients had low or mid septal fistulae; high fistulae generally are treated transabdominally and are not the focus of this discussion. Fistulae were eradicated in 12 of the 13 women and did not recur during the follow-up period, which averaged 50 months (range, 9 to 68 months). The only treatment failure was a patient who had a markedly diseased colon from the cecum to the rectum and a very low-lying fistula. It is concluded that a modified transvaginal approach is an effective method for repair of rectovaginal fistulae secondary to Crohn's disease.

Bauer, J J; Sher, M E; Jaffin, H; Present, D; Gelerent, I



[Translabial ultrasonography in pelvic floor prolapse and urinary incontinence diagnostics].  


Technological advances in the construction of sonographic devices and increasingly universal access to such tests considerably widens the range of diagnostic application of the sonographic examination. This situation also refers to pelvic organs prolapse. At present, sonographic sets used in everyday obstetrical-gynecological practice allow for insight into the structures forming the female pelvic floor, and the obtained images constitute a valuable addition to the physical examination. Positioning the sonographic transducer on a the perineum enables to visualize the three compartments of the female pelvis minor. After freezing the image, it is possible to assess the position of anatomical structures in relation to bones and designated surfaces, establish mutual distances and measure appropriate angles. Most information can be obtained in this manner within the range of the frontal compartment, whose damage is often linked with urinary incontinence. The examination standards developed so far, including the analysis of the quantitative parameters, greatly minimize the potential subjectivity of the assessment of the existing disorders. Apart from its low costs, the main value of the sonographic examination of the pelvic floor is the possibility to dynamically assess the changes in statics which take place during functional testing. Not only does it have a cognitive significance, but also it allows to adjust the scope of the surgical correction to the existing damages. Thus, indirectly it can contribute to the reduction of a number of subsequent remedial surgeries. Three-dimensional sonography allows to thoroughly examine the construction and functioning of the anal levators and to detect their possible damage. It is the trauma to these muscles--occurring, among others, during childbirth--that is one of the major causes of pelvic organs descent and prolapse in women. Sonographic examination also enables to visualize the artificial material, the use of which is increasingly frequent in the surgical treatment of pelvic organs prolapse. The remedial kits currently in use are not visible in classic X-ray examinations and CT however, they can be easily visualized by means of a sonographic test. This way it is possible to locate the positioned tapes or meshes and to establish their orientation towards the urethra, the bladder and the anus. It is also possible to observe the complications (e.g. hematomas) following the surgical procedures via the transvaginal access. Transperineal sonography is a relatively inexpensive method that may be performed in almost every ultrasonographic laboratory Its value, approaching the MRI diagnostic value in the assessment of the pelvic floor defects and its low cost, place ultrasonography on the first place among the methods of imaging the pelvic and uro-genital diaphragm. The results of diagnostics of pelvic organs prolapse obtained by placing the sonographic head on the patient's perineum may also help in establishing the changes of the support apparatus for the uterus and the vagina, bladder urethra and perineum during functional testing and, thus, to verify the clinically established degree of the prolapse. It seems, also, that this method may be used during peri-urethral injections of specific substances and post-application follow-up, an increasingly frequently employed method of urinary incontinence treatment. PMID:23342899

Pietrus, Mi?osz; Pity?ski, Kazimierz; Ba?ajewicz-Nowak, Marta; Wieche?, Marcin; Knafel, Anna; Ludwin, Artur; Dziechciowski, Marek; Nocu?, Agnieszka



Ultrasonography of jumper's knee.  


The aim of the study was to evaluate the role of ultrasonography (US) in the management of jumper's knees. Sixty-two cases of clinically suggested jumper's knees, 52 asymptomatic contralateral knees and 100 asymptomatic knees of healthy middle aged men were examined. In the symptomatic group US was normal in 25 cases, all recovered with conservative therapy. In 31 symptomatic knees the findings were consistent with jumper's knee as a hypoechoic lesion located in the upper insertion of the patellar tendon in 23 cases and in the distal insertion in one case. In 7 cases the lesion was situated in the insertion of the quadriceps tendon. Surgery was performed on 20 knees and in all of them there was a lesion matching the lesion detected by US. In 6 cases US findings were pathologic, but different from jumper's knee. US findings consistent with jumper's knee could not be detected in the asymptomatic group. PMID:2196922

Myllymäki, T; Bondestam, S; Suramo, I; Cederberg, A; Peltokallio, P



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

PubMed Central

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.

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



Intraoperative endovascular ultrasonography  

NASA Astrophysics Data System (ADS)

The early experience using intra-operative endovascular ultrasonography (EU) is reported in eight patients undergoing lower extremity revasularization. In four patients, intra-operative EU successfully characterized inflow stenoses that were inadequately imaged with pre- operative arteriography. Two patients were found to have hemodynamically significant inflow stenoses, and were treated with intra-operative balloon angioplasty followed by repeat EU. The other two patients were found to have non-hemodynamically significant inflow stenoses requiring no treatment. Additional outflow procedures were required in all four patients. In the remaining four patients, EU was used to evaluate the completeness of TEC rotary atherectomy, of Hall oscillatory endarterectomy, of thrombectomy of the superficial femoral and popliteal arteries, and of valve lysis during in situ saphenous vein grafting, respectively. In the latter case, the valve leaflets were not clearly seen. In the other cases, EU assisted the surgeon. Angioscopy and angiography were available for comparison. In one case, angioscopy failed because of inability to clear the field while inspecting retrograde the limb of an aorto-bi-femoral graft. EU however was possible. No complications of EU occurred. EU is a safe procedure indicated when characterization of a lesion is needed prior to an intervention or when evaluation of the intervention's success is desired. We did not find it useful in valve lysis for in-site grafting.

Eton, Darwin; Ahn, Samuel S.; Baker, J. D.; Pensabene, Joseph; Yeatman, Lawrence S.; Moore, Wesley S.



Patients with prior second-trimester loss: Prophylactic cerclage or serial transvaginal sonograms?  

Microsoft Academic Search

Objective: To compare management with prophylactic cerclage versus serial transvaginal sonograms of the cervix in patients with prior second-trimester loss. Study Design: Singleton pregnancies with prior second-trimester spontaneous loss between 14 and 24 weeks' gestation were retrospectively reviewed. At the obstetricians' discretion, some were managed with prophylactic cerclage and some with serial transvaginal sonograms of the cervix, starting at 14

Vincenzo Berghella; Susan Haas; Inna Chervoneva; Terry Hyslop



Fundamentals of diagnostic ultrasonography.  


Diagnostic ultrasonography uses acoustical waves in the frequency range of 1 to 20 MHz. These waves obey Snell's law of reflection and refraction, which are rules ordinary to wave behavior. In ultrasound, the analogy to momentum is acoustic impedance. The acoustic impedance, Z, is equal to the density, p, times velocity, v. The ultrasound transducer converts electrical energy into ultrasound energy and vice versa. The transducer usually consists of a piezoelectric crystal composed of such ceramic materials as barium titanate, lead titanate, zirconate, or lead metaniobate. Five basic ultrasonic scanning modes play the major roles in clinical applications. A-mode, or amplitude-mode, scanning measures the tissue discontinuity along the scan axis. B-mode scanning produces a two-dimensional image of the tissue under study by combining A-mode signals from various directions through mechanical transducer scanning. M-mode, or time motion scanning, is an extension of the A-mode approach in which a single stationary transducer is used. The depth of the echo is displayed on the vertical axis; the brightness of the oscilloscope display is modulated by the echo amplitude. Real-time scanning, or rapid B-scanning, techniques provide continuous data acquisition at a rate sufficient to give the impression of the instantaneous motion of moving structures. Doppler scanning relies on the presence of motion. The Doppler effect occurs when there is relative motion between the source of sound and the receiver of the sound, causing a change in the detected frequency of the sound source. PMID:2261584

Noce, J P


Antiretroviral therapy and pregnancy: effect on cortical bone status of human immunodeficiency virus-infected Caucasian women as assessed by quantitative ultrasonography.  


Treatment with antiretroviral agents (ARVs) during pregnancy is important to prevent mother-to-child transmission of the human immunodeficiency virus (HIV), but their use has been associated with low bone mineral density in adult patients. Currently, there are no data regarding the bone status of HIV-infected women who received ARV during pregnancy. The aim of this study was to evaluate cortical bone status at delivery in a group of HIV-infected women who received ARV during pregnancy and to monitor the changes occurring during the first year postpartum. We studied 33 HIV-infected and 116 HIV-uninfected healthy Caucasian women within 4 days from delivery. Follow-up measurements were performed at 4 and 12 months postpartum in 17 HIV-infected and 55 healthy women. Cortical bone status was evaluated by quantitative ultrasonography at the mid-tibia, and bone measurements were expressed as the speed of sound (SOS). HIV-infected women after delivery had a median SOS of 3,985 (3,567-4,242) m/s, while the median SOS of healthy women was 4,025 (3,643-4,250) m/s. The difference was not significant (t = 0.39, P = 0.69). No significant differences were observed between ARV-exposed and control subjects at 4 and 12 months. Our data suggest that ARV during pregnancy and the first year after delivery does not affect negatively cortical bone status. PMID:23307187

Mora, Stefano; Diceglie, Cecilia; Viganò, Alessandra; Giacomet, Vania; Manfredini, Valeria; Stucchi, Sara; Fabiano, Valentina; Mameli, Chiara; Coletto, Sonia; Zuccotti, Gian V



Ultrasonographically guided transvaginal aspiration of tuboovarian abscesses and pyosalpinges: an optional treatment for acute pelvic inflammatory disease.  


The experience of 15 women with acute pelvic inflammatory disease (PID) suggests that ultrasonographically guided transvaginal aspiration of pyosalpinges and tuboovarian abscesses is a simple, safe, and effective treatment that can avert the need for laparoscopy or laparotomy. The mean age of these women was 28.5 years (range, 23-37 years). Twelve women had a prior history of PID. In seven women, vaginal ultrasonography detected inflammatory cystic swelling that was not evident from clinical examination. The mean diameter of the pelvic cystic masses was 67.3 mm (range, 40-90 mm). Aspiration of the abscess cavity was performed by suction. Only one patient required anesthesia. The antibiotic cefotaxime was injected directly into the abscess cavity. The procedure took a maximum of 15 minutes. An average of 57.7 ml of fluid was aspirated and Escherichia coli was identified in 12 patients. There was a marked decrease in leukocyte count and C-reactive protein after 3-7 days. Six patients left the hospital the day of the procedure; the remaining nine were hospitalized for 1-3 days. Systemic antibiotics were provided for use in the recovery period. All patients were symptom free at the six-month follow-up, although pelvic cystic swelling was observed in six women. PMID:7755062

Aboulghar, M A; Mansour, R T; Serour, G I



Ultrasonography in stress urinary incontinence  

Microsoft Academic Search

Evaluation of the urethrovesical junction in stress urinary incontinence is essential. For this reason the Q-tip test, a clinical test with debatable specificity; lateral cystourethrography, a conventional method; and videourethrocystography, a sophisticated method, have been in use. Because ultrasonography is inexpensive, reliable, easy to apply and free of any contrast material and X-ray exposure, it has practically replaced all the

F. Demirci; P. M. Fine



Muscle ultrasonography to predict survival in amyotrophic lateral sclerosis.  


The authors assessed the prognostic value of muscle ultrasonography in 31 patients with amyotrophic lateral sclerosis (ALS) and compared it with accepted prognostic variables like functional capacity (measured with the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS)) and muscle strength. Each patient was examined once. The following ultrasonography parameters were determined: muscle thickness, echo intensity (EI) and the presence of fasciculations. Correlations between baseline measurements, preslope values and survival were calculated. EI, disease duration, muscle strength preslope and ALSFRS-R preslope correlated with survival. Using a stepwise multivariate analysis, the combination of EI preslope and ALSFRS-R preslope was shown to have the best predictive value for survival. PMID:20392981

Arts, Ilse M P; Overeem, Sebastiaan; Pillen, Sigrid; Schelhaas, Helenius Jurgen; Zwarts, Machiel J



Ultrasonography guided percutaneous radiofrequency ablation for hepatic cavernous hemangioma  

Microsoft Academic Search

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

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



Transcranial Doppler ultrasonography predicts cardiovascular events after TIA  

Microsoft Academic Search

BACKGROUND: Transient ischemic attack (TIA) patients are at high vascular risk. We assessed the value of extracranial (ECD) and transcranial (TCD) Doppler and duplex ultrasonography to predict clinical outcome after TIA. METHODS: 176 consecutive TIA patients admitted to the Stroke Unit were recruited in the study. All patients received diffusion-weighted imaging, standardized ECD and TCD. At a median follow-up of

Katrin Holzer; Suwad Sadikovic; Lorena Esposito; Angelina Bockelbrink; Dirk Sander; Bernhard Hemmer; Holger Poppert



Diagnosis of uterine vein thrombosis on transvaginal ultrasound.  


Deep venous thrombosis (DVT) is a potentially serious medical disorder, which may result in pulmonary embolism and death. Compression ultrasound is the investigation modality of choice for the diagnosis of DVT of the lower limb. Diagnosis of proximal thrombosis involving the pelvic veins is difficult and is usually made only after the thrombus extends into the veins of the lower limb. We present six cases of incidental uterine vein thrombosis diagnosed by transvaginal ultrasound. Our aim is to describe the technique of the examination of pelvic veins and criteria that could be used to diagnose uterine vein thrombosis. We also highlight difficulties in the management of women diagnosed with asymptomatic uterine vein thrombi as there is little evidence to guide clinicians in choosing between different treatment options. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. PMID:23716379

Mavrelos, D; Cohen, H; Pateman, K; Hoo, W; Foo, X; Jurkovic, D



Transvaginal Hydrolaparoscopic Ovarian Drilling Using Bipolar Electrosurgery to Treat Anovulatory Women with Polycystic Ovary Syndrome  

Microsoft Academic Search

Study ObjectiveTo verify the value, feasibility, and reliability of transvaginal hydrolaparoscopic ovarian drilling using the bipolar VersaPoint system to treat clomiphene-resistant, anovulatory women with polycystic ovary syndrome.

Alessandro Casa; Francesco Sesti; Massimiliano Marziali; Lorenza Gulemì; Emilio Piccione



Transvaginal single-port natural orifice transluminal endoscopic surgery for benign uterine adnexal pathologies.  


Transvaginal natural orifice transluminal endoscopic surgery (NOTES) with pneumoperitoneum has been used in cholecystectomies, appendectomies, and nephrectomies, but transvaginal NOTES using a single port in gynecologic procedures has not been described despite gynecologist familiarity with the vaginal approach. We performed transvaginal single-port NOTES in 10 women with benign uterine adnexal disease: oophorectomy in 3 patients, salpingostomy and salpingectomy in 2 each, and ovarian cystectomy, paratubal cystectomy, and ovarian wedge resection in 1 each. The patients were discharged at 1 or 2 days postoperatively, and were satisfied, with minimal pain, no abdominal scar, and no complications at 2-month follow-up. We conclude that transvaginal single-port NOTES to treat benign uterine adnexal disease is a feasible and attractive option. PMID:22763314

Ahn, Ki Hoon; Song, Jae Yun; Kim, Sun Haeng; Lee, Kyu Wan; Kim, Tak



MR-guided Transvaginal Cryotherapy of Uterine Fibroids with a Horizontal Open MRI System: Initial Experience  

Microsoft Academic Search

Purpose: We evaluated the feasibility of MR-guided transvaginal cryotherapy for treating intramural, submucosal, and sub-serosal uterine fibroids with a horizontal open MRI system. Materials and Methods: Using an MR-compatible cryotherapy system and a horizontal magnetic open-configuration MR scanner, we performed transvaginal cryotherapies using a Cusco speculum on eight uterine fibroids whose longest diameter ranged from 2.9 to 10.0 cm. We

Michiko Dohi; Junta Harada; Takuji Mogami; Kunihiko Fukuda; Shigemitsu Kobayashi; Makoto Yasuda


Predictive value of transvaginal sonography performed before routine diagnostic hysteroscopy for evaluation of infertility  

Microsoft Academic Search

Objective: To compare transvaginal sonography with hysteroscopy for the evaluation of intrauterine disorders.Design: Clinical study.Setting: Academic research environment.Patient(s): Patients who were undergoing initial evaluation for primary or secondary infertility or investigation after three failed IVF attempts.Intervention(s): Transvaginal sonography was performed, followed by hysteroscopy, between January 1998 and April 1999. The endometrial findings at sonography were compared with those at hysteroscopy,

Josef Shalev; Israel Meizner; Itay Bar-Hava; Dov Dicker; Reuben Mashiach; Zion Ben-Rafael



Abdominal ultrasonography, 2nd Ed  

SciTech Connect

This volume is a new and updated edition of an extensively illustrated text and reference on the capabilities and imaging of gray scale ultrasonography for each major abdominal organ. Each major organ system is treated separately, including liver, gallbladder and bile ducts, pancreas, kidney, retroperitoneum, abdominal vasculature, and more. There are over 500 illustrations and ten pages of full color plates for cross sectional anatomy.

Goldberg, B.B.



Three-Dimensional Hysterosonography for the Study of Endometrial Tumors: Comparison with Conventional Transvaginal Sonography, Hysterosalpingography, and Hysteroscopy  

Microsoft Academic Search

We studied endometrial thickness and homogeneity in 36 patients with postmenopausal bleeding using three-dimensional ultrasound following distention of the uterine cavity with a sterile saline solution (3D-SHSG). Results with 3D-SHSG were compared with findings using transvaginal sonography, transvaginal sonohysterography, transvaginal color Doppler, and hysteroscopy. Sixteen patients (including three on tamoxifen) were undergoing hormone therapy at the time when they were

Fernando Bonilla-Musoles; Francisco Raga; Newton G. Osborne; Javier Blanes; F. Coelho



Ultrasonography aids decision-making in children with abdominal pain  

PubMed Central

INTRODUCTION Although regular clinical assessment of the acute abdomen is considered best practice, ultrasonography confirming the presence of appendicitis will add to the decision-making process. The aim of this study was to assess the accuracy of ultrasonography and its usefulness in diagnosing acute appendicitis in a regional paediatric surgical institution. METHODS Retrospectively and in this order, radiology, theatre and histopathology databases were searched for patients who had presented with acute abdominal pain, patients who had undergone an appendicectomy and all appendix specimens over a two-year period. The databases were cross-referenced against each other. RESULTS A total of 273 non-incidental appendicectomies were performed over the study period. The negative appendicectomy rate was 16.5% and the perforation rate 23.7%. Thirty-nine per cent of children undergoing an appendicectomy had at least one pre-operative ultrasound scan. Ultrasonography as a diagnostic tool for acute appendicitis in children had a sensitivity of 83.3%, a specificity of 97.4 %, a positive predictive value of 92.1% and a negative predictive value of 94.0%. CONCLUSIONS Ultrasonography is used liberally to aid in the decision making process of equivocal and complicated cases of acute appendicitis and it achieves good measures of accuracy. As a diagnostic tool it is unique in its ability to positively predict as well as exclude. A high negative predictive value suggests that more patients could be managed on an outpatient basis following a negative scan.

Scammell, S; Lansdale, N; Sprigg, A; Campbell, D; Marven, S



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

Microsoft Academic Search

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)

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



Assessment of the Fetal Heart at 12-14 Weeks of Pregnancy Using B-Mode, Color Doppler, and Spatiotemporal Image Correlation via Abdominal and Vaginal Ultrasonography.  


This study aimed to evaluate the effect that combining multiple ultrasonographic imaging methods has on the proportion of tests with a satisfactory fetal heart assessment at 12-14 weeks of pregnancy using B-mode, color Doppler, and spatiotemporal image correlation software (STIC) via both the abdominal and vaginal routes. This cross-sectional prospective study involved healthy pregnant women at 12-14 weeks of pregnancy with a crown-rump length (CRL) of 84 mm or shorter. The following four cardiac views were assessed: four-chamber, left and right ventricular outflow tract, and aortic arch views. The same examiner sought to identify these four views using B-mode, color Doppler, and STIC via both the vaginal and abdominal routes. The study determined the proportion of cases and the respective 95 % confidence intervals (CIs) in which all four views were identified. The presence of significant differences in comparisons between methods was analyzed using McNemar's test. Although 57 pregnant women at 12-14 weeks of pregnancy agreed to participate in the study, 4 were not included because they presented with a CRL longer than 84 mm. Thus, 53 pregnant women were thoroughly assessed and included in the analysis. The combination of B-mode, color Doppler, and STIC via both the abdominal and vaginal routes enabled the highest proportion of identification of the four views (90.6 %; 95 % CI, 79.8-95.9 %). The lowest proportions were observed when B-mode was used alone via both the vaginal route (30.2 %; 95 % CI, 19.5-43.5 %) and the abdominal route (37.7 %; 95 % CI, 25.9-51.2 %). The abdominal route showed results slightly better than those of the vaginal route with all the methods, but the differences were not statistically significant. In the vast majority of the cases, the fetal hearts were properly assessed at 12-14 weeks of pregnancy when several methods were combined using both the abdominal and vaginal routes. However, only one-third of them would have had adequate heart assessment if the B-mode via either the abdominal or the vaginal route had been used alone. PMID:23479309

Lima, Angélia Iara Felipe; Araujo Júnior, Edward; Martins, Wellington P; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes; Pares, David Baptista Silva



Adnexal and cul-de-sac abnormalities: transvaginal sonography.  


Sixty-seven patients selectively chosen from 354 undergoing conventional transabdominal (TA) sonography for evaluation of a clinically suspected adnexal mass subsequently underwent transvaginal (TV) sonography either because the TA sonograms were technically suboptimal or because it was not possible to characterize with certainty an abnormality identified with TA sonography. TV sonography added diagnostically useful information in 25 of 28 patients with cystic pathologic changes in the adnexa uteri. Eight of 12 patients with tuboovarian abscess and nonspecific adnexal masses visualized with TA sonography had tube-shaped fluid collections characteristic of pyosalpinx identified with TV sonography. TV sonography added diagnostically useful information in all seven patients with diseases of the cul-de-sac (rectouterine fossa) and allowed differentiation of adnexal from primary uterine disease in three patients with TA sonograms on which findings were equivocal. It also expedited the diagnosis of a tubal pregnancy in ten of 14 patients and was useful in the detection of adhesions and perforated intrauterine devices. These results indicate that adjunctive TV sonography can provide important diagnostic information. PMID:3275977

Lande, I M; Hill, M C; Cosco, F E; Kator, N N



Comparison of ultrasonography with computed tomography in the diagnosis of nasal bone fractures  

PubMed Central

Objectives The aim of this study is to compare ultrasonography with CT in the diagnosis of nasal bone fractures. Methods 40 patients (9 female and 31 male) with mid-facial fractures, which were suspected nasal bone fractures, were included. All of the patients had mid-facial CT images. Ultrasonography with a 7.5 MHz transducer (Aloka 3500, Tokyo, Japan) was used to evaluate the nasal bone fractures. All of the sonograms were compared with CT findings for sensitivity, specificity and predictive values. A ?2 test was applied to the data to assess statistical significance. Results CT diagnosed nasal bone fractures in 24 of the 40 patients (9 unilateral fractures and 15 bilateral fractures) while ultrasonography diagnosed the fractured bones in 23 patients (9 unilateral fractures and 14 bilateral fractures). Ultrasonography missed one fractured bone in a bilateral fractured case and a unilateral fracture was also missed (two false-negative results). The sensitivity and specificity of ultrasonography in assessing nasal bone fracture in comparison with CT were 94.9% and 100%, respectively. The positive predictive value (PPV) and the negative predictive value (NPV) of ultrasonographic evaluation of the nasal bone fractures were 100% and 95.3%, respectively. The ?2 test did not show any significant difference between CT and ultrasonography in diagnosis of nasal bone fractures (P = 0.819). Conclusion Ultrasonography can be used as a first line of diagnostic imaging for evaluating nasal bone fractures, especially in children and pregnant women.

Javadrashid, R; Khatoonabad, M; Shams, N; Esmaeili, F; Jabbari Khamnei, H



The role of chest ultrasonography in the management of respiratory diseases: document I  

PubMed Central

Chest ultrasonography can be a useful diagnostic tool for respiratory physicians. It can be used to complete and widen the general objective examination also in emergency situations, at the patient’s bedside. The aim of this document is to promote better knowledge and more widespread use of thoracic ultrasound among respiratory physicians in Italy. This document I is focused on basic knowledge of chest ultrasonography technique, physical basis, aims and characteristics, fields of application. Document I shows how chest ultrasonography can be useful to detect and monitor pleural diseases, pleural effusions and pneumothorax and how it can assess diaphragmatic kinetics and pathologies.



Transvaginal Chorionic Villus Sampling Using Transabdominal Ultrasound Guidance: A New Technique for First-Trimester Prenatal Diagnosis  

Microsoft Academic Search

Transvaginal chorionic villus sampling (CVS) using concurrent transabdominal ultrasound guidance was performed in 20 women who desired CVS but could not be offered transcervical or transabdominal approaches because of uterine position and placental location. Satisfactory amounts of chorionic villi were obtained in all 20 cases with no maternal discomfort, an occurrence that contrasts with our experience in transvaginal CVS using

Lee P. Shulman; Joe Leigh Simpson; Sherman Elias; Richard E. Felker; Donald S. Emerson; Owen. P Phillips



Selected topics in pediatric ultrasonography--1992.  


In children, ultrasonography has been valuable in demonstrating a wide range of congenital lesions that were previously seen indirectly or only after more invasive procedures. It has replaced many studies that necessitated oral or vascular contrast and ionizing radiation. Real-time ultrasonography has found a role in the evaluation of the diaphragm, gastroesophageal reflux, bowel peristalsis, and hip stability. PMID:1518926

Fernbach, S K; Feinstein, K A



Hybrid NOTES transvaginal cholecystectomy: operative and long-term results after 18 cases  

Microsoft Academic Search

Purpose  Natural orifice transluminal endoscopic surgery (NOTES) is a novel technique that aims at reducing or abolishing skin incisions\\u000a and potentially also postoperative pain. The purpose of this study was to analyse operative and long-term results of a series\\u000a of hybrid transvaginal cholecystectomy.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  Between July 2007 and May 2009, transvaginal NOTES cholecystectomy for symptomatic cholelithiasis was performed by a

Raffaele Pugliese; Antonello Forgione; Fabio Sansonna; Giovanni Carlo Ferrari; Stefano Di Lernia; Carmelo Magistro



A New Implantation Procedure of Artificial Sphincter for Anal Incontinence: The Transvaginal Approach  

Microsoft Academic Search

A destroyed or severely scarred anterior perineum predicts difficult healing and risk of perineal erosion and remains a contraindication\\u000a for the implantation of an artificial anal sphincter via a perineal approach. This report describes the first implantations of an artificial anal sphincter via a transvaginal approach in female patients with anal incontinence. Between 2003 and 2005, the Acticon Neosphincter? was

Francis Michot; Jean-Jacques Tuech; Benoit Lefebure; Valerie Bridoux; Philippe Denis



The Efficacy of Transvaginal Sonographic Screening in Asymptomatic Women at Risk for Ovarian Cancer  

Microsoft Academic Search

Objective. The purpose of this study was to determine the efficacy of annual transvaginal sonography (TVS) as a screening method for ovarian cancer.Methods. Annual TVS screening was performed on 14,469 asymptomatic women from 1987 to 1999. Eligibility criteria included (1) all women ? 50 years of age and (2) women ? 25 years of age with a family history of

J. R. van Nagell; P. D. DePriest; M. B. Reedy; H. H. Gallion; F. R. Ueland; E. J. Pavlik; R. J. Kryscio



Transvaginal Sonography as a Screening Method for the Detection of Early Ovarian Cancer  

Microsoft Academic Search

From December 1987 to December 1993, 6470 women underwent screening with transvaginal sonography (TVS) as part of the University of Kentucky Ovarian Cancer Screening Project. Two groups of women were eligible to participate in this investigation: (i) asymptomatic postmenopausal patients or patients >50 years of age, and (ii) asymptomatic women >30 years of age with a family history of ovarian

P. D. Depriest; H. H. Gallion; E. J. Pavlik; R. J. Kryscio; J. R. van Nagell



Comparison of intraoperative completion flowmeter versus duplex ultrasonography and contrast arteriography for carotid endarterectomy.  


Intraoperative completion studies of the internal carotid artery following carotid endarterectomy are recommended to ensure technical perfection of the repair. Transit time ultrasound flowmeter does not require trained technicians, requires less time than other completion studies such as duplex ultrasonography and contrast arteriography, and is noninvasive. Flowmetry was compared with duplex ultrasonography and contrast arteriography to determine if the relatively simpler flowmetry could replace these two more widely accepted completion studies in the intraoperative assessment of carotid endarterectomy. Comparative intraoperative assessment was performed in 116 carotid endarterectomies using all three techniques between December 1, 2000 and November 30, 2003. Eversion endarterectomy was performed in 51 cases and standard endarterectomy with prosthetic patching in 65 cases. Patients underwent completion flowmetry, duplex ultrasonography, and contrast arteriography studies of the exposed arteries, which were performed by vascular fellows or senior surgical residents under direct supervision of board-certified vascular surgeons. Duplex ultrasonography surveillance was performed 1 and 6 months postoperatively and annually thereafter. Mean follow-up was 18 months (range, 6-42 months). The combined ipsilateral stroke and death rate was 0%. The mean internal carotid artery flow using flowmetry was 249 mL/min (range, 60-750 mL/min). Five (4.3%) patients had flow < 100 mL/min as measured with flowmetry, but completion contrast arteriography and duplex ultrasonography were normal and none of the arteries were re-explored. One carotid endarterectomy was re-explored based on completion duplex ultrasonography that showed markedly elevated internal carotid artery peak systolic velocity (> 500 cm/sec); however, exploration was normal and completion flowmetry and contrast arteriography were normal. Duplex ultrasonography studies revealed internal carotid artery peak systolic velocities > 150 cm/sec in 15 patients, but flowmetry and contrast arteriography were normal in all 15 cases and none of the arteries were re-explored. There was no correlation between flow rates measured using flowmetry and peak systolic velocities measured using duplex ultrasonography. One abnormal contrast arteriogram showed an intimal flap that was revised, but duplex ultrasonography and flowmetry were normal. Severe recurrent internal carotid artery stenosis developed in 2 patients at 6 and 9 months, but all 3 completion intraoperative studies at the time of the original operation were normal. Based on these results, wide variability in flowmetry values limits its potential usefulness to detect non-flow-limiting lesions and replace contrast arteriography or duplex ultrasonography as an intraoperative carotid endarterectomy completion study. Duplex ultrasonography was also of limited to no value, whereas contrast arteriography rarely documented a lesion that required repair. PMID:17202095

Winkler, Gabor A; Calligaro, Keith D; Kolakowski, Steven; Doerr, Kevin J; McAffee-Bennett, Sandy; Muller, Kathy; Dougherty, Matthew J


[Ultrasonography in acute pelvic pain].  


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

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



Antenatal depiction of fetal digits with three-dimensional ultrasonography  

Microsoft Academic Search

OBJECTIVE: The effectiveness of three-dimensional ultrasonography in visualizing fetal digits was examined. STUDY DESIGN: The digits of 72 fetuses, including 2 with skeletal dysplasia, were examined prospectively with both conventional and three-dimensional ultrasonography. RESULTS: Complete visualization of all fetal digits was obtained more often with three-dimensional ultrasonography than with two-dimensional ultrasonography. CONCLUSION: Three-dimensional ultrasonography has the potential to facilitate depiction

Ploeckinger-Ulm; Ulm; Kratochwil; Bernaschek



Transthoracic ultrasonography for the respiratory physician.  


Transthoracic ultrasonography is still not utilized to its full potential by respiratory physicians, despite being a well-established and validated imaging modality. It allows for an immediate and mobile assessment that can potentially augment the physical examination of the chest. Ultrasound (US)-assisted procedures can be performed by a single clinician with no sedation and with minimal monitoring, even outside of theatre. The main indications for the use of transthoracic US are: the qualitative and quantitative description of pleural effusions, pleural thickening, diaphragmatic dysfunction and chest-wall and pleural tumours. It may also be used to visualise lung tumours and other parenchymal pulmonary processes provided they abut the pleura. It is at least as sensitive as chest radiographs as far as the detection of a pneumothorax is concerned. It is the ideal tool to assist with thoracocentesis and drainage of effusions. The US-assisted fine-needle aspiration and/or cutting-needle biopsy of extrathoracic lymph nodes, lesions arising from the chest wall, pleura, peripheral lung and mediastinum, are safe and have a high yield in the hands of chest physicians. US may also guide the aspiration and biopsy of diffuse pulmonary infiltrates, consolidations and lung abscesses, provided the chest wall is abutted. Advanced applications of transthoracic US include the diagnosis of pulmonary embolism. PMID:22832423

Koegelenberg, Coenraad F N; von Groote-Bidlingmaier, Florian; Bolliger, Chris T



Portable ultrasonography in mass casualty incidents: The CAVEAT examination  

PubMed Central

Ultrasonography used by practicing clinicians has been shown to be of utility in the evaluation of time-sensitive and critical illnesses in a range of environments, including pre-hospital triage, emergency department, and critical care settings. The increasing availability of light-weight, robust, user-friendly, and low-cost portable ultrasound equipment is particularly suited for use in the physically and temporally challenging environment of a multiple casualty incident (MCI). Currently established ultrasound applications used to identify potentially lethal thoracic or abdominal conditions offer a base upon which rapid, focused protocols using hand-carried emergency ultrasonography could be developed. Following a detailed review of the current use of portable ultrasonography in military and civilian MCI settings, we propose a protocol for sonographic evaluation of the chest, abdomen, vena cava, and extremities for acute triage. The protocol is two-tiered, based on the urgency and technical difficulty of the sonographic examination. In addition to utilization of well-established bedside abdominal and thoracic sonography applications, this protocol incorporates extremity assessment for long-bone fractures. Studies of the proposed protocol will need to be conducted to determine its utility in simulated and actual MCI settings.

Stawicki, Stanislaw Peter; Howard, James M; Pryor, John P; Bahner, David P; Whitmill, Melissa L; Dean, Anthony J



Transvaginal Sonographic Fetal Biparietal Diameter\\/Kidney Length Ratio in Early Pregnancy as a Screening Tool for Renal Malformations  

Microsoft Academic Search

Objective: The aim of the study was to produce by 7.0 MHz high resolution transvaginal scan early in pregnancy normal values of biparietal diameter\\/kidney length ratio that can be used as reference ranges. Methods: In this prospective cross-sectional study, a transvaginal high-resolution sonography was performed between 11 and 16 weeks’ gestation in 807 pregnant women with a history of regular

Lorenzo Guariglia; Paolo Rosati



Transvaginal Liver Surgery Using a Tethered Magnet and a Laparoscopic Rein  

PubMed Central

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.

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



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


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

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



Ultrasonography of the hand, wrist, and elbow.  


High-frequency diagnostic ultrasonography of the hand, wrist and elbow has significant potential to improve the quality of diagnosis and care provided by neuromuscular and musculoskeletal specialists. In patients referred for weakness, pain and numbness of the hand, wrist or elbow, diagnostic ultrasonography can be an adjunct to electrodiagnosis and help in identifying ruptured tendons and treating conditions such as carpal tunnel syndrome or trigger finger. Use of a small high-frequency (>10-15 MHz) transducer, an instrument with a blunt pointed tip to enhance sonopalpation and a model of the hand, wrist and elbow is advised to enhance visualization of small anatomical structures and complex bony contours. A range of conditions, including tendon and ligament ruptures, trigger finger, de Quervain tenosynovitis, intersection syndrome, lateral epicondylitis, and osteoarthritis, is described along with detailed ultrasonography-guided injection techniques for carpal tunnel syndrome and trigger finger. PMID:20797547

Bodor, Marko; Fullerton, Brad



Transvaginal 3D Image-Guided High Intensity Focused Ultrasound Array  

Microsoft Academic Search

The goal of this project is to develop a transvaginal image-guided High Intensity Focused Ultrasound (HIFU) device using piezocomposite HIFU array technology, and commercially-available ultrasound imaging. Potential applications include treatment of uterine fibroids and abnormal uterine bleeding. The HIFU transducer was an annular phased array, with a focal length range of 30-60 mm, an elliptically-shaped aperture of 35×60 mm, and

Robert Held; Thuc Nghi Nguyen; Shahram Vaezy



Improved Techniques for First-Trimester Fetal Reduction Using Simultaneous Abdominal and Transvaginal Ultrasonographic Guidance  

Microsoft Academic Search

Simultaneous transabdominal injection of potassium chloride (KC1) assisted by transvaginal ultrasonographic guidance was evaluated in 5 patients who conceived due to various assisted reproductive techniques and ovarian stimulation. All 5 underwent first-trimester fetal reduction for multiplicity of high-order pregnancies. Four sets of triplets were reduced to twin, and 1 twin pregnancy was reduced to a singleton. Less than 2 ml

Arie Herman; Ron Maymon; Raphael Ron-El; Reuvit Halperin; Shlomo Ariely; Ian Bukovsky; Zwi Weinraub



The Use of Transvaginal Sonography and Vaginoscopic Hysteroscopy in Women on Tamoxifen  

PubMed Central

Background and Objectives: Long-term administration of tamoxifen causes endometrial changes. The aim of this study was to evaluate the role of transvaginal sonography and vaginoscopic hysteroscopy in the screening of patients on tamoxifen. Methods: Seventy patients with breast cancer treated with tamoxifen 20 mg daily underwent transvaginal sonography and vaginoscopic hysteroscopy, a modified relatively painless approach, at the beginning of the treatment and at a follow-up visit approximately 9 months after its initiation. Results: At the follow-up visit, the mean uterine dimensions and mean endometrial thickness as measured by ultrasound were significantly larger, and pulsatility and resistance indices of the uterine arteries as measured by Doppler were significantly lower. Sonography revealed abnormal endometrial thickness in 73% (51 of 70) of the patients, and 83% (58 of 70) had hysteroscopical changes. Sonography missed 1 case of endometrial adenocarcinoma. Conclusions: Vaginoscopic hysteroscopy, an approach that causes reduced pain, can add significantly to the sensitivity of transvaginal sonography for the detection of endometrial changes in patients with breast cancer receiving tamoxifen. It is recommended for every patient prior to the initiation of treatment and at the follow-up visits.

Kontostolis, Emmanuel; Lolis, Evangelos D.; Koliopoulos, George; Alamanos, Yannis; Paraskevaidis, Evangelos



Prospective controlled study of endoscopic ultrasonography and endoscopic retrograde cholangiography in patients with suspected common-bileduct lithiasis  

Microsoft Academic Search

SummaryBackground Endoscopic sphincterotomy is sometimes done unnecessarily in patients with suspected choledocholithiasis. Our aims were to assess the diagnostic accuracy of endoscopic ultrasonography and endoscopic retrograde cholangiography (ERC) and to find out whether endoscopic ultrasonography may help to prevent unnecessary sphincterotomy or surgical explorations.Methods We recruited 119 patients aged 70·4 (SD 16·1) years with strongly suspected choledocholithiasis who presented to

F Prat; G Amouyal; P Amouyal; G Pelletier; J Fritsch; A. D Choury; C Buffet; J-P Etienne



A smart diagnostic system for Doppler ultrasonography  

Microsoft Academic Search

This paper proposes an automated diagnostic approach for a Doppler ultrasonography system (DUS) using the spectrogram features and image information. Various boundary and moment features of the spectrogram are fed to a supervised ANN to diagonise the localized arterial condition. This local data is given to a Bayesian probabilistic inferencing engine for end diagnosis. Simultaneously, arterial contour variation in the

B. Das; S. Banerjee



Diagnostic laparoscopy and laparoscopic ultrasonography optimize the staging and resectability of intraabdominal neoplasms  

Microsoft Academic Search

Background  Despite technical improvements, preoperative imaging studies often fail to predict intraoperative findings. We investigated\\u000a the potential use of diagnostic laparoscopy (DL) and laparoscopic ultrasonography (LUS) for the assessment of disease in patients\\u000a with abdominal neoplasms.\\u000a \\u000a \\u000a \\u000a Methods  Fifty consecutive patients with abdominal neoplasms underwent spiral computed tomography with oral and intravenous contrast\\u000a using 5-mm contiguous sections. In addition, eight patients underwent ultrasonography,

G. J. Tsioulias; T. F. Wood; M. H. Chung; D. L. Morton; A. Bilchik



Preperitoneal fat deposition estimated by ultrasonography in patients with non-insulin-dependent diabetes mellitus  

Microsoft Academic Search

Preperitoneal fat is an indicator of visceral fat deposition, which is closely related to atherosclerosis and coronary heart disease in obese patients. We assessed the relationship of preperitoneal fat deposition and various clinical characteristics in 90 patients with non-insulin-dependent diabetes mellitus (NIDDM). Preperitoneal and subcutaneous fat deposition were measured by ultrasonography. In both the male and female diabetics, preperitoneal fat

Kazumi Tayama; Toshihiko Inukai; Yohnosuke Shimomura



The Sensitivity and Specificity of Transcricothyroid Ultrasonography to Confirm Endotracheal Tube Placement in a Cadaver Model  

Microsoft Academic Search

Confirmation of endotracheal (ET) tube placement is critical when performing emergency airway management. No single confirmation strategy has emerged as ideal in all circumstances. Our objective in this study was to assess the sensitivity and specificity of a novel approach to verify endotracheal intubation using transcricothyroid ultrasonography (US). We performed a prospective, randomized double-blinded trial in a human cadaver model.

Gene Ma; Daniel P. Davis; James Schmitt; Gary M. Vilke; Theodore C. Chan; Stephen R. Hayden



Imaging of tophaceous gout: computed tomography provides specific images compared with magnetic resonance imaging and ultrasonography  

Microsoft Academic Search

Objective: To determine the usefulness of computed tomography (CT), magnetic resonance imaging (MRI), and Doppler ultrasonography (US) in providing specific images of gouty tophi.Methods: Four male patients with chronic gout with tophi affecting the knee joints (three cases) or the olecranon processes of the elbows (one case) were assessed. Crystallographic analyses of the synovial fluid or tissue aspirates of the

J C Gerster; M Landry; L Dufresne; J Y Meuwly



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


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

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



Can ultrasound replace dilation and curettage? A longitudinal evaluation of postmenopausal bleeding and transvaginal sonographic measurement of the endometrium as predictors of endometrial cancer  

Microsoft Academic Search

Objective: The purpose of this study was to evaluate postmenopausal bleeding and transvaginal sonographic measurement of endometrial thickness as predictors of endometrial cancer and atypical hyperplasia in women whose cases were followed for ?10 years after referral for postmenopausal bleeding. Study design: Women (n = 394) who had postmenopausal bleeding from November 1987 to October 1990 underwent transvaginal sonographic measurement

B. Gull; B. Karlsson; I. Milsom; S. Granberg



Chronic cervical lymphadenopathy in children: Role of ultrasonography  

PubMed Central

Aim: To assess the usefulness of ultrasonography in the differentiation of causes of chronic cervical lymphadenopathy in children. Materials and Methods: Children with palpable cervical lymph nodes were included. An ultrasonographic examination was performed to delineate multiple lymph nodes, irregular margins, tendency towards fusion, internal echos, the presence of strong echoes and echogenic thin layer. Results: The total number of patients was 120. Echogenic thin layer and strong internal echoes were specific for tuberculosis. Long axis to short axis (L/S) ratio was more than 2 in most of the tubercular nodes (85.71%). Hilus was present in 50 (73.53%) tubercular lymphadenitis, 12 (40%) lymphoma and 10 (62.5%) cases with metastatic lymph nodes. Hypoechoic center was present in 60 (88.24%) tubercular lymphadenitis cases followed by 62.5% metastatic and 60% malignant lymphoma cases. Conclusions: Ultrasonography is a non-invasive tool for lymph nodal evaluation in children. It may be used to differentiate cervical lymphadenopathy with different etiologies in children. When correlated clinically, it may avoid biopsy in a patient.

Pandey, Anand; Kureel, Shiv N.; Pandey, Jigyasa; Wakhlu, Ashish; Rawat, Jiledar; Singh, Tej Bali



Endoscopic Color Doppler Ultrasonography for Esophagogastric Varices  

PubMed Central

Esophagogastric varices are considered to be the most common complication in patients with portal hypertension. Endoscopic ultrasonography not only visualizes the surface of the varices but also provides detailed information about their internal structure. The direction of blood flow can be determined and its velocity measured only via endoscopic color Doppler ultrasonography (ECDUS). This can show graphically esophageal varices, paraesophageal veins, and passageways in esophageal variceal patients and gastric varices, perigastric collateral veins in gastric variceal patients. It is important to evaluate the hemodynamics of the portal venous system when treating the esophago-gastric varices. ECDUS is a useful modality for the evaluation of the detailed hemodynamics and the therapeutic effects of esophago-gastric varices.

Sato, Takahiro; Yamazaki, Katsu



Endoscopic ultrasonography-guided ablation therapy  

Microsoft Academic Search

Endoscopic ultrasonography (EUS) imaging has undergone extensive technological advancement since its development in the 1980s,\\u000a including improvement of echoendoscopes with larger channels and accessories.These advancements enable not only tissue procurement\\u000a for diagnosis but also therapeutic interventions that hitherto would have required surgery, with its attendant risks. A wide\\u000a array of interventional procedures are performed under EUS guidance, including celiac plexus

Jessica M. Trevino; Shyam Varadarajulu



Ultrasonography of the pancreas. 7. Intraoperative imaging  

Microsoft Academic Search

The usefulness of intraoperative ultrasonography (IOUS) has been documented in the Literature since the Eighties and, although\\u000a its main applications are in hepatobiliary and pancreatic surgery, it has been used also in neurosurgery, cardiovascular and\\u000a endocrine surgery. The continuous technical developments have led to an increase in the diagnostic accuracy of IOUS from the\\u000a Eighties to now. The use of

M. D’Onofrio; F. Vecchiato; N. Faccioli; M. Falconi; R. Pozzi Mucelli



Endoscopic ultrasonography-guided tumor ablation.  


With the introduction of curvilinear endosonoscopes, endoscopic ultrasonography (EUS) has achieved the role of a therapeutic modality as well as diagnostic procedure. EUS-guided tumor ablation is one such therapeutic modality. Various techniques of EUS-guided tumor ablation have been described, including radiofrequency ablation, photodynamic therapy, laser ablation, and ethanol injection. Most of the currently described techniques are experimental. Development and continuous improvement of devices, as well as establishment of indications for EUS-guided tumor ablations, are mandatory. PMID:22632957

Yoon, Won Jae; Brugge, William R



Transvaginal ultrasonographic measurement of cervical length as a predictor of preterm birth: a systematic review with meta-analysis.  


The advent of effective interventions to prevent preterm delivery such as 17 hydroxyprogesterone and cerclage serve as an impetus to determine whether routine second trimester transvaginal cervical length screening can identify which women would benefit from these therapies. A systematic review was conducted, 957 abstracts were screened, 234 articles underwent full-text review, and 23 studies were included in the final analysis including 26,792 women. Data from relevant studies were pooled to produce summary estimates of sensitivity, specificity, and likelihood ratios using a random effects model. The ideal criteria of transvaginal cervical length measurements to predict preterm delivery are discussed. PMID:21084959

Domin, Christannah M; Smith, Erica J; Terplan, Mishka



Diagnostic value of single complete compression ultrasonography in pregnant and postpartum women with suspected deep vein thrombosis: prospective study  

PubMed Central

Objective To assess the safety of using single complete compression ultrasonography in pregnant and postpartum women to rule out deep vein thrombosis. Design Prospective outcome study. Setting Two tertiary care centres and 18 private practices specialising in vascular medicine in France and Switzerland. Participants 226 pregnant and postpartum women referred for suspected deep vein thrombosis. Methods A single proximal and distal compression ultrasonography was performed. All women with a negative complete compression ultrasonography result did not receive anticoagulant therapy and were followed up for a three month period. Main outcome measures Symptoms of venous thromboembolism, second compression ultrasonography or chest imaging, a thromboembolic event, and anticoagulant treatment. Results 16 women were excluded, mainly because of associated suspected pulmonary embolism. Deep vein thrombosis was diagnosed in 22 out of the 210 included women (10.5%). 10 patients received full dose anticoagulation despite a negative test result during follow-up. Of the 177 patients without deep vein thrombosis and who did not receive full dose anticoagulant therapy, two (1.1%, 95% confidence interval 0.3% to 4.0%) had an objectively confirmed deep vein thrombosis during follow-up. Conclusions The rate of venous thromboembolic events after single complete compression ultrasonography in pregnant and postpartum women seems to be within the range of that observed in studies in the non-pregnant population. These data suggest that a negative single complete compression ultrasonography result may safely exclude the diagnosis of deep vein thrombosis in this setting. Trial registration NCT00740454.



Transvaginal natural-orifice transluminal endoscopic surgery (NOTES) in adnexal procedures.  


From August 2010 to June 2011, 10 consecutive patients underwent transvaginal NOTES of the adnexa, including tubal sterilization in 3, salpingectomy because of ectopic pregnancy in 3, and ovarian tumor enucleation in 4. The mean (SD; 95% CI) age of the patients was 34.8 (9.7; 27.9-41.8) years, and their body mass index was 21.6 (2.8; 19.4-23.8). In 9 of the 10 patients, the procedure was completed. The 3 tubal sterilization procedures were completed in 18 to 30 minutes, with negligible blood loss. Operative time for the 3 salpingectomies because of ectopic pregnancy was 62 to 116 minutes. One of these procedures included management of 2000 mL hemoperitoneum. Three of the 4 attempts at ovarian enucleation were successfully completed within 64 to 162 minutes, with estimated blood loss ? 50 mL. One NOTES procedure failed because of a misdiagnosed peritoneal mucinous tumor located anterior to the uterus and inaccessible, leading to subsequent conversion to transabdominal laparoscopy. Our preliminary results show that purely transvaginal NOTES is feasible and safe for use in performing uterine adnexal procedures in selected patients. However, the procedure cannot be used in patients with cul-de-sac disease, and could have limited use in treating lesions located anterior to the uterus. PMID:22425142

Lee, Chyi-Long; Wu, Kai-Yun; Su, Hsuan; Ueng, Shir-Hwa; Yen, Chih-Feng



Obturator approach in the surgical treatment of stress urinary incontinence using tension-free transvaginal tape.  


The study reviews the surgical treatment results of urinary stress incontinence in the group of 51 female patients, in whom the tension-free transvaginal tape was placed beneath the middle part of urethra using obturator approach during the period from 2005 to 2009. The method of surgery applied in all patients was obturator approach ("inside-out" method sec. de Leval), using a synthetic tension-free transvaginal prolen tape. After the sub-urethral tunnel had been created by scissors, the obturator membrane was perforated, then the placement of wing guides followed, through which helical needles with synthetic tape were brought to the skin. The following complications were observed in 8 (15.7%) patients: erosion of tape in 2 (3.9%), urine retention in 2 (3.9%), bleeding from the site of incision in 1 (1.9%) and transitory leg pain in 3 (5.8%) cases. Two years after the surgery, 43 (84.3%) patients were dry, 4 (7.8%) patients showed a significant improvement, while the recurrence was recorded in 4 (7.8%) operated patients. PMID:22452238

Durdevi?, Srdan; Mladenovi?, Segedi Ljiljana; Curci?, Aleksandar; Panteli?, Milos; Maksimovi?, Marko


[Value in gynecology of transvaginal pulsed and color Doppler. Study of ovarian vascularization].  


Recently, pulsed Doppler has become available on high resolution vaginal ultrasound probes for studying ovarian blood flow. Doppler studies of ovarian blood flow are based on: semiquantitative analysis of Doppler flow waves recorded over the ovarian artery at its entry into the ovary; color Doppler mapping of intraovarian vessels. Semiquantitative analysis of the ovarian artery Doppler flow waves suffers from frequent difficulties at properly identifying the ovarian artery, particularly in multiparous women. Mapping of intraovarian vessels however, appears a most promising feature of vaginal Doppler for studying ovarian blood flow, provided that the proper ultrasound equipment is used. Specifically, transvaginal color Doppler mapping of intraovarian vessels allows for a positive visual detection of the onset of the ovulatory process prior to the actual follicular rupture. Thus, color Doppler mapping of ovarian vessels permits an improved and simplified approach for timing intercourses and inseminations in infertility patients. In controlled ovarian hyperstimulation (COH) used for in vitro fertilization (IVF), mapping of intraovarian vessels by color Doppler offers a fascinating new insight into normal and pathological responses of ovarian follicles to hCG. Finely, color Doppler appears a very promising asset to transvaginal ultrasounds for sorting suspicious ovarian cysts from their benign counter parts. In conclusion, we think that vaginal Doppler should be considered as a marvelous refinement of ultrasounds rather than as a truly new diagnostic tool. Yet vaginal color Doppler carries the potential for markedly improving the sensitivity and the specificity of vaginal ultrasound, particularly for diagnosing benign from potentially malignant ovarian conditions. PMID:7951598

de Ziegler, D; Bessis, R; Caetano, J; Frydman, R



Ultrasonography after the first febrile urinary tract infection in children.  


The importance of ultrasonography after the first febrile urinary tract infection has been recently challenged. The aim of this study was to evaluate the role of ultrasonography in detection of significant non-reflux abnormalities in the kidneys and the urinary tract, and to determine whether these findings influence treatment in these children. The clinical data and ultrasonography results of 155 children admitted to a university hospital with the first febrile urinary tract infection were analysed retrospectively. Renal ultrasonography was abnormal in 23 patients (14.8%). The major portion of these patients (81%) were younger than 2 years of age. Management of nine of these patients was changed based primarily on ultrasonography findings. Four of these patients were treated operatively. Conclusion: Our findings indicate that ultrasonography performed after the first urinary tract infection may offer clinically important information about non-reflux abnormalities in the kidneys and urinary tract that can affect the management of children with these complications. PMID:16565830

Jahnukainen, Timo; Honkinen, Olli; Ruuskanen, Olli; Mertsola, Jussi



Transvaginal sonography, saline contrast sonohysterography and hysteroscopy for the investigation of women with postmenopausal bleeding and endometrium > 5 mm  

Microsoft Academic Search

Objectives To determine the ability of transvaginal ultra- sound, with or without saline infusion, to detect focally growing lesions in the uterine cavity in women with postmeno- pausal bleeding and endometrium > 5 mm, and to determine the accuracy of conventional ultrasound, saline contrast sonohysterography and diagnostic hysteroscopy under general anesthesia to diagnose endometrial polyps, submucous myomas and uterine malignancy.

E. Epstein; A. Ramirez; L. Skoog; L. Valentin



Ultrasonography of diffuse liver disease. A review.  


Radiographically, the liver may appear normal even if severely diseased. Ultrasonography can be an important adjunct in the evaluation of diffuse parenchymal hepatic disease. Diffuse liver disease appears ultrasonographically as a change in liver echogenicity from normal when compared with the renal cortex or spleen. Diffuse liver disease can be characterized as either hyperechoic due to fatty change, steroid hepatopathy, and cirrhosis or hypoechoic due to congestion, suppurative hepatitis, and lymphoma. Ultrasonographic diagnosis of diffuse liver disease should be substantiated by biopsy and histopathologic evaluation. PMID:1588544

Biller, D S; Kantrowitz, B; Miyabayashi, T


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

PubMed Central

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.

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



Natural orifice transluminal endoscopic surgery: The transvaginal route moving forward from cholecystectomy  

PubMed Central

The advent of minimally invasive surgery and the advances in endoluminal flexible endoscopy have converged to generate a new concept in digestive surgery, whose acronym natural orifice transluminal endoscopic surgery (NOTES), has become a familiar term in the surgical community. NOTES has been performed through the mouth, the bladder, the rectum and the vagina. Of these four approaches, the vagina has gained most popularity for several reasons. It is not only readily accessible and easy to decontaminate but it also provides safe entry and simple closure. The transvaginal approach has been described in the experimental and the clinical setting as an option for cholecystectomy, nephrectomy, splenectomy, segmental gastrectomy, retroperitoneal exploration and bariatric surgery. However, larger series are needed to delineate the exact risks of this approach, and to transcend cultural barriers that impede its wider introduction. Prospective randomized trials will shed light on the definitive role of the vaginal approach in minimal invasive surgery of the future.

Targarona, Eduardo M; Maldonado, Edgar Mauricio; Marzol, Jose Antonio; Marinello, Franco



Methodological Parameters Influence the Detection of Right-to-Left Shunts by Contrast Transcranial Doppler Ultrasonography  

Microsoft Academic Search

Background and Purpose—Contrast transcranial Doppler ultrasonography is a new method to detect intracardiac right-to-left shunts, such as the patent foramen ovale. However, the methodology of the procedure varies considerably among investigators. This study was undertaken to assess the influence of methodological parameters on the results of the contrast transcranial Doppler examination in the detection of right-to-left shunts. Methods—A total of

J. J. Schwarze; D. Sander; C. Kukla; I. Wittich; V. L. Babikian; J. Klingelhofer



Ultrasonography: an important tool in captive breeding management in elephants and rhinoceroses  

Microsoft Academic Search

Nearly two decades ago, modern wildlife medicine started to gradually use the advantages of the non-invasive ultrasonography,\\u000a which was already well established in human and classical veterinary medicine. For more than one decade now, the application\\u000a of imaging ultrasound for reproductive assessments and as a supportive tool during assisted reproduction procedures such as\\u000a artificial insemination (AI) in elephants and rhinoceroses

Thomas B. Hildebrandt; Frank Göritz; Robert Hermes



Pretreatment Evaluation with Contrast-Enhanced Ultrasonography for Percutaneous Radiofrequency Ablation of Hepatocellular Carcinomas with Poor Conspicuity on Conventional Ultrasonography  

PubMed Central

Objective To determine whether pretreatment evaluation with contrast-enhanced ultrasonography (CEUS) is effective for percutaneous radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) with poor conspicuity on conventional ultrasonography (US). Materials and Methods This retrospective study was approved by the institutional review board and informed consent was waived. From June 2008 to July 2011, 82 patients having HCCs (1.2 ± 0.4 cm) with poor conspicuity on planning US for RFA were evaluated with CEUS prior to percutaneous RFA. We analyzed our database, radiologic reports, and US images in order to determine whether the location of HCC candidates on planning US coincide with that on CEUS. To avoid incomplete ablation, percutaneous RFA was performed only when HCC nodules were identified on CEUS. The rate of technical success was assessed. The cumulative rate of local tumor progression was estimated with the use of the Kaplan-Meier method (mean follow-up: 24.0 ± 13.0 months). Results Among 82 patients, 73 (89%) HCCs were identified on CEUS, whereas 9 (11%) were not. Of 73 identifiable HCCs on CEUS, the location of HCC on planning US corresponded with that on CEUS in 64 (87.7%), whereas the location did not correspond in 9 (12.3%) HCCs. Technical success was achieved for all 73 identifiable HCCs on CEUS in a single (n = 72) or two (n = 1) RFA sessions. Cumulative rates of local tumor progression were estimated as 1.9% and 15.4% at 1 and 3 years, respectively. Conclusion Pretreatment evaluation with CEUS is effective for percutaneous RFA of HCCs with poor conspicuity on conventional US.

Kim, Ah Yeong; Rhim, Hyunchul; Cha, Dong Ik; Choi, Dongil; Kim, Young-sun; Lim, Hyo Keun; Cho, Seong Whi



Insufficient cholecystectomy diagnosed by endoscopic ultrasonography.  


Recurrent attacks of upper right quadrant pain after cholecystectomy are not infrequent. In most of these cases, the cause of the pain remains undiagnosed. Insufficient cholecystectomy has been described as a rare cause of post-cholecystectomy pain, although the true incidence is unknown. It is difficult to diagnose a residual gallbladder or a large cystic duct with residual stones, due to the size of the remaining structures. This report presents three patients who had experienced a long period of agonizing biliary-type pain after cholecystectomy. Abdominal ultrasound examinations, and magnetic resonance cholangiopancreatography (MRCP) in one patient, were normal. Endoscopic ultrasonography (EUS) demonstrated the presence of a small cystic structure with echogenic foci compatible with a residual gallbladder containing small gallstones. Two of the three diagnoses were confirmed by repeat surgery. EUS thus appears to be a valuable method for diagnosing insufficient cholecystectomy, and should be considered in patients with persistent pain attacks after cholecystectomy. PMID:14986224

Hassan, H; Vilmann, P



Shoulder Ultrasonography: Performance and Common Findings  

PubMed Central

Ultrasound (US) of the shoulder is the most commonly requested examination in musculoskeletal US diagnosis. Sports injuries and degenerative and inflammatory processes are the main sources of shoulder pain and functional limitations. Because of its availability, low cost, dynamic examination process, absence of radiation exposure, and ease of patient compliance, US is the preferred mode for shoulder imaging over other, more sophisticated, and expensive methods. Operator dependence is the main disadvantage of US examinations. Use of high range equipment with high resolution transducers, adhering to a strict examination protocol, good knowledge of normal anatomy and pathological processes and an awareness of common pitfalls are essential for the optimal performance and interpretation of shoulder US. This article addresses examination techniques, the normal sonographic appearance of tendons, bursae and joints, and the main pathological conditions found in shoulder ultrasonography.

Gaitini, Diana



Interventional musculoskeletal ultrasonography: Precautions and contraindications  

PubMed Central

In recent years ultrasonography (US) has emerged as the imaging technique of choice for guiding diagnostic and therapeutic procedures including those related to the musculoskeletal system. However, the absence of ionizing radiation and the elevated safety of the method must not lead us to forget that there are precautions and contraindications to keep in mind, which are crucial to the protection of both the patient and the physician. Among these precautions it is first of all essential to obtain the patient’s accurate clinical history including current medication, particularly if it involves drugs influencing the blood clotting, and information related to possible allergies. The patient should furthermore receive detailed information concerning the procedure (sterile precautions as well as possible side-effects of the drugs which will be injected). In addition to this, there must be a close contact between the radiologist and the patient’s general physician (GP) in order to obtain the best possible result of the procedure.

Draghi, F.; Robotti, G.; Jacob, D.; Bianchi, S.



Value of duplex and color doppler ultrasonography in the evaluation of orbital vascular flow and resistance in sickle cell disease  

Microsoft Academic Search

The aim of the present study was to assess and to compare the orbital and retinal vascular flow dynamics and resistance in patients with homozygous sickle cell disease with controls by means of duplex and color Doppler ultrasonography. Forty-six patients with homozygous sickle cell disease (SCD) and 20 healthy subjects were included in the study. None of the patients had

Kairgeldy Aikimbaev; Birol Guvenc; Abdullah Canataroglu; Hatice Canataroglu; Fikri Baslamisli; Mahmut Oguz



Adverse prognostic significance of infraclavicular lymph nodes detected by ultrasonography in patients with locally advanced breast cancer  

Microsoft Academic Search

Background: Ultrasonography is increasingly used to evaluate the nodal status of breast cancer patients and specialized positioning permits assessment of the infraclavicular fossa. However, the incidence and significance of infraclavicular (level III) adenopathy detected sonographically in locally advanced breast cancer (LABC) has not been defined.Methods: The study population consisted of 146 LABC patients registered in a prospective trial of induction

Lisa A Newman; Henry M Kuerer; Bruno Fornage; Nadeem Mirza; Kelly K Hunt; Merrick I Ross; Frederick C Ames; Aman U Buzdar; S. Eva Singletary



Lack of correlation between ultrasonography and histologic staging of the endometrium in in vitro fertilization (IVF) patients  

Microsoft Academic Search

In 53 patients of an in vitro fertilization (IVF) program with unsuccessful fertilization of oocytes, an endometrial biopsy was carried out on the day of the intended embryo transfer. The results were compared with the thickness (assessed on the very same day by means of ultrasonography) and the echo pattern of the endometrium, which was classified into four grades (A

Karl Sterzik; Dieter Grab; Volker Schneider; Erwin J. Strehler; Friedrich Gagsteiger; Bernd E. Rosenbusch



Role of conventional ultrasonography and color flow-doppler sonography in predicting malignancy in 'cold' thyroid nodules  

Microsoft Academic Search

The aim of the present study was to establish the usefulness of conventional thyroid ultrasonography (US) and color flow-doppler (CFD) sonography in the assessment of 'cold' thyroid nodules. One hundred and four consecutive patients with thyroid nodules who were to undergo surgery were examined by US and CFD before thyroidectomy. Conventional US evaluated the presence of a halo sign, hypoechogenicity

T Rago; P Vitti; L Chiovato; S Mazzeo; A De Liperi; P Miccoli; P Viacava; F Bogazzi; E Martino; A Pinchera



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...


Recurrent incarceration of the retroverted gravid uterus at term - two times transvaginal caesarean section: a case report  

PubMed Central

Introduction Persistent retroversion of a gravid uterus (incarceration) in the third trimester is an extremely rare diagnosis and is only scarcely been described. Its prevalence may lead to increased foetal mortality and maternal morbidity. Case presentation We present a case where a 35-year-old patient had undiagnosed (recurrent) uterine incarceration at term. Operative delivery proved difficult due to distorted anatomy. Therefore, in our case delivery of the fetus through transvaginal caesarean section was required. Conclusion This case report discusses the diagnosis and management of (recurrent) incarceration of the retroverted uterus at term resulting in two successful transvaginal caesarean sections. In presenting this case, we aim at improving awareness, diagnosis and treatment of the retroverted incarcerated gravid uterus.



A preliminary study of diagnostic color Doppler ultrasonography in equine superficial digital flexor tendonitis.  


We hypothesized that semi-quantitative determinations of changeable blood flows in granulation and scar tissues during tendon healing could be helpful for differentiation between the acute phase rich in blood vessels and the remodeling phase with fewer vessels. Ten Thoroughbreds with injured superficial digital flexor tendon (SDFT) in a forelimb were used for evaluation of blood flows in the injured tendons of racehorses using color Doppler (CD) ultrasonography. Using longitudinal CD images, features of maximum color activities were defined. These were rhythmically blinking, tiny to small signals (grade 1), pulsatile expanded dots (grade 2), and dynamic streams (grade 3). Grade of color activity in CD ultrasonography could be useful for quantitative assessment of equine SDFT repair. PMID:22813929

Murata, Daiki; Misumi, Kazuhiro; Fujiki, Makoto



Transvaginal natural orifice translumenal endoscopic surgery (NOTES): a survey of women’s views on a new technique  

Microsoft Academic Search

Background  Laparoscopic and minimally invasive surgery has changed the surgical landscape irrevocably. Natural orifice translumenal endoscopic\\u000a surgery (NOTES) offers the possibility of surgery without visible scars. Transvaginal entry offers potential benefits because\\u000a it gains access to the peritoneal cavity without the need to open an abdominal viscus. Much of the discussion pertaining to\\u000a NOTES focuses on technical and training issues, with

Andrew D. Strickland; Michael G. A. Norwood; Fariba Behnia-Willison; Santosh A. Olakkengil; Peter J. Hewett



[Examination of fetal developmental abnormalities by routine transvaginal ultrasonic screening in the 12th week of pregnancy].  


The increased resolution of transvaginal sonography allows a detailed evaluation of fetal anatomy in the first trimester of pregnancy. According to the authors experiences screening for fetal anomalies is a real possibility when the fetus is bigger than 50 mms in size (crownrump-length). A prospective study was started in February 1992. Since that time transvaginal sonography has been offered to every woman in the 12th week of their pregnancies. Twenty structural anomalies have been diagnosed in 18 fetuses during a 17-month period. Besides of detecting "classical" congenital anomalies, nuchal oedema is considered to be a promising sign for screening chromosomal abnormalities especially Down syndrome. In this series 4 cases of trisomy 21 has been diagnosed by karyotyping in the presence of nuchal oedema. The results of their study suggest, that more and more fetal anomalies can be detected in the first trimester of pregnancy, therefore transvaginal sonography is offered to use as a screening method, being a powerful diagnostic tool for early diagnosis. PMID:8058293

Hernádi, L; Töröcsik, M; Pláyerné Dorkó, A



Is the image guidance of ultrasonography beneficial for neurosurgical routine?  

Microsoft Academic Search

BackgroundIntraoperative US has been widely used in neurosurgical procedures. However, images are often difficult to read. In the present study, we evaluate whether the image guidance of ultrasonography is helpful for the interpretation of US scans.

Dorothea Miller; Stefan Heinze; Wuttipong Tirakotai; Oliver Bozinov; Oguzkan Sürücü; Ludwig Benes; Helmut Bertalanffy; Ulrich Sure



Ultra som X gamagrafia. (Ultrasonography X gamma radiography).  

National Technical Information Service (NTIS)

The accumulated experience in the last ten years of substitution to essays by gamma radiography to essay by ultrasonography, starting of the systematic comparison and tabulation of the results obtained by both essays applied in welding joints, in field, i...

A. M. Mello Campos



Routine ultrasonography in utero and subsequent handedness and neurological development  

Microsoft Academic Search

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.

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



Transcutaneous abdominal ultrasonography in the staging of lung cancer  

PubMed Central

BACKGROUND: There is limited information available regarding the relationship between clinical indicators of widespread disease in patients with lung cancer and the findings of transcutaneous ultrasonography. METHODS: A retrospective survey was made of 279 consecutive patients with lung cancer. By reviewing the patients' records the clinical findings were divided into symptoms, signs, and laboratory tests indicative of metastatic disease. All patients had been examined by abdominal ultrasonography. RESULTS: The patients included 19% with small cell carcinoma. The frequency of abdominal metastases by ultrasonography in those with small cell carcinoma was 40%, in the other patients it was 8%. Regardless of histological group, all the 40 patients with abdominal metastases by ultrasonography had at least one clinical category indicative of widespread disease and 38 (95%) had two or all three clinical categories positive. Fifty nine patients had no clinical indicators of metastases and none of these had abdominal metastases by ultrasonography. CONCLUSIONS: The results of this study indicate that abdominal metastases are found in lung cancer patients with clinical findings indicative of widespread disease. No abdominal metastases were found in patients with a negative clinical evaluation. The results indicate that transcutaneous ultrasonography of the abdomen is not necessary in the initial staging if the clinical evaluation is unremarkable. ?????

Bakke, P. S.; Taule, M.; Lillo, E.; Melgren, G.; Magnussen, I. J.; Halvorsen, O. J.



[Possibilities of ultrasonography in the diagnosis of sex differentiation disorders in children].  


Ninety-five children with different forms of hermaphroditism aged 3 months to 14 years were examined to assess the potentialities of echography. Ultrasonic examinations of the kidneys, adrenals, pelvic organs (with full bladder, during and after miction), scrotum, and inguinal area were carried out. Echographic picture of urogenital organs in mixed ovarian dysgenesis, congenital deficiency of testosterone biosynthesis or metabolism due to enzymatic deficit, testicular feminization, congenital adrenocortical dysfunction was analyzed and criteria of differential diagnosis of these conditions discussed. The informative value of the method was assessed. Ultrasonic findings were compared with the data other diagnostic methods and reliability and high sensitivity of ultrasonography was demonstrated. PMID:8571531

Filippkin, M A; Pykov, M I; Okulov, A B; Kondakov, V T; Ivanchenko, O F


Transvaginal sonographic evaluation at different menstrual cycle phases in diagnosis of uterine lesions  

PubMed Central

Purpose: Intrauterine lesions (IULs) are a common finding in women of reproductive age, particularly infertile women. Transvaginal sonography (TVS) is a popular tool for IUL detection, but there are conflicting data with respect to its accuracy. Methods: Five hundred and six women were enrolled into the study. Of these, 496 underwent hysterosalpingography and subsequent TVS six different times during the course of their menstrual cycle. If a lesion was detected, it was further evaluated by sonohysterography (SHG) and hysteroscopy. Results: Of 496 women, 41 were shown to have IULs by TVS and those lesions were confirmed in 39 by SHG and hysteroscopy. All 39 lesions were detectable during the ovulatory and early luteal phase (days 16–19) of the menstrual cycle. Accuracy of TVS during different phases was largely dependent on the size of the lesion. TVS falsely detected two lesions and missed fine adhesions in two patients. Conclusion: Accuracy of TVS in detection of IULs is highly dependent on the menstrual cycle phase, with the ovulatory and early luteal phase being the optimal time for this examination.

Hajishaiha, Masomeh; Ghasemi-rad, Mohammad; Karimpour, Nazila; Mladkova, Nikol; Boromand, Farzaneh



A review of complications following transvaginal oocyte retrieval for in-vitro fertilization.  


Transvaginal ultrasound guided oocyte retrieval (TVOR) during in vitro fertilization (IVF) treatment was first described in 1985. By virtue of its simplicity and effectiveness, it has gained widespread popularity and has now become the gold standard for IVF therapy. Nevertheless, despite the advantages, the aspiration needle may injure the adjacent pelvic organs and structures leading to serious complications. The most common complications are haemorrhage, trauma and injury of pelvic structures, and pelvic infection. Other complications described include adnexal torsion, rupture of endometriotic cysts, anaesthetic, and even vertebral osteomyelitis. In the last two decades, several reports have described the complications associated with this technique, and tried to address the risk factors and safety issues. However there is wide variation in the way this common procedure is performed, with room for improvement through published guidelines. This article reviews the most common complications reported in literature, summarizes the recommendations made to minimize their occurrence, and raises some of the controversial issues related to the procedure especially that of pelvic infection. PMID:15223762

El-Shawarby, Salem; Margara, Raul; Trew, Geoffrey; Lavery, Stuart



Improved monitoring of ovarian stimulation using 3D transvaginal ultrasound plus automated volume count.  


Two-dimensional transvaginal ultrasound (2D) is typically performed to monitor follicle growth in IVF and to determine the optimal time for administering human chorionic gonadotrophin. However, 2D only provides an approximation of the real volume of follicles and therefore cannot be used to guarantee standards for follicular measurement. The automated measurement of follicular size in three dimensions (3D) using a software programme that identifies and quantifies hypoechoic regions within a 3D dataset might provide an objective, fast, valid and reliable standard for such measurements. A prospective controlled study (group I: 20 patients, 2D; group II: 20 patients, 3D) investigated how the criteria for triggering oocyte maturation that are normally used in 2D compare to the new and more accurate method of measuring follicles using 3D-based automated volume count. Significantly more oocytes were fertilized (group 1: 7.1 +/- 4.5, group 2: 11.5 +/- 6.4; P < 0.03) when using 3D technology and automated volume count. The study assumes that the automated volume count more closely mirrors the biological reality, which means that it can also be used to guarantee the quality standards established by the European Union directive on tissues and cells (2004/23/EC). This new technology therefore holds great promise of becoming the new standard for monitoring follicular growth in IVF. PMID:20021717

Murtinger, Maximilian; Aburumieh, Alexander; Rubner, Paul; Eichel, Verena; Zech, Mathias H; Zech, Nicolas H



Ultrasonography-guided ethanol ablation of predominantly solid thyroid nodules: a preliminary study for factors that predict the outcome  

PubMed Central

Objectives The aim of this study was to evaluate the success rate in ultrasonography-guided ethanol ablation (EA) of benign, predominantly solid thyroid nodules and to assess the value of colour Doppler ultrasonography in prediction of its success. Methods From January 2008 to June 2009, 30 predominantly solid thyroid nodules in 27 patients were enrolled. Differences in the success rate of EA were assessed according to nodule vascularity, nodule size, ratio of cystic component, amount of injected ethanol, degree of intranodular echo-staining just after ethanol injection and the number of EA sessions. Results On follow-up ultrasonography after EA for treatment of thyroid nodules, 16 nodules showed an excellent response (90% or greater decrease in volume) and 2 nodules showed a good response (50–90% decrease in volume) on follow-up ultrasonography. However, 5 nodules showed an incomplete response (10–50% decrease in volume) and 7 nodules showed a poor response (10% or less decrease in volume). Statistical analysis revealed a significant association of nodule vascularity (p = 0.002) and degree of intranodular echo-staining just after ethanol injection (p = 0.003) with a successful outcome; however, no such association was observed with regard to nodule size, ratio of cystic component, amount of infused ethanol and the number of EA sessions. No serious complications were observed during or after EA. Conclusion The success rate of EA was 60%, and nodule vascularity and intranodular echo-staining on colour Doppler ultrasonography were useful in predicting the success rate of EA for benign, predominantly solid thyroid nodules.

Kim, D W; Rho, M H; Park, H J; Kwag, H J



Clinical application of ultrasonography in the diagnosis of intussusception.  


Sixty-five consecutive patients seen in a pediatric emergency department, in whom the diagnosis of intussusception was considered, had an ultrasound examination of the abdomen before a barium enema. The mean age of the patients was 1.7 years (range 2 weeks to 5 years). Intussusception was detected by ultrasonography in all 20 cases proved by barium enema. There were three false-positive ultrasound results (sensitivity = 100%, confidence interval (Cl) = 86% to 100%; specificity = 93%, Cl = 86% to 96%). Normal findings on ultrasonography correlated with a negative barium enema results in 42 of 42 cases (negative predictive value = 100%, Cl = 94% to 100%). No intussusception was missed by ultrasonography. To determine which patients would most benefit from ultrasonography, we divided patients into either a high-risk group (81% with intussusception) or a low-risk group (14% with intussusception) on the basis of clinical symptoms (p less than 0.01). If each high-risk child had a barium enema and each low-risk child had an ultrasound study as their initial diagnostic test, 89% of the patients in this study would have undergone only one examination. We conclude that ultrasonography can be used as a rapid, sensitive screening procedure in the diagnosis or exclusion of childhood intussusception. Children considered at low risk of having intussusception on the basis of clinical symptoms should initially have an ultrasound examination; patients at high risk should have an immediate barium enema. PMID:1640281

Bhisitkul, D M; Listernick, R; Shkolnik, A; Donaldson, J S; Henricks, B D; Feinstein, K A; Fernbach, S K



Acrania/encephalocele sequence (exencephaly) associated with 92,XXXX karyotype: early prenatal diagnosis at 9(+5) weeks by 3D transvaginal ultrasound and coelocentesis.  


A 27-year-old pregnant woman was diagnosed by 3D transvaginal ultrasound as carrying a fetus of 9(+5) weeks gestation affected by acrania/encephalocele (exencephaly) sequence. A 2D transvaginal ultrasound-guided aspiration of 5 mL of extra-coelomic fluid was performed under cervical block before uterine suction. Conventional cytogenetic analysis demonstrated a 92,XXXX karyotype. Transvaginal 2D ultrasound-guided coelocentesis for rapid karyotyping can be proposed to women who are near to miscarriage or in cases where a prenatal ultrasound diagnosis of congenital anomaly is performed at an early stage of development. Genetic analysis can be performed using traditional cytogenetic analysis or can be aided by fluorescence in situ hybridization (FISH). Coelocentesis may become an integral part of first trimester armamentarium and may be clinically useful in the understanding of the pathogenesis of early prenatally diagnosed congenital anomalies. PMID:20002903

Tonni, Gabriele; Ventura, Alessandro; Bonasoni, Maria Paola



A novel approach of robotic-assisted anterior resection with transanal or transvaginal retrieval of the specimen for colorectal cancer  

Microsoft Academic Search

Background  The surgical robot (da Vinci S) is superior to conventional laparoscopy; it provides clearer, three-dimensional images and\\u000a an extended range of motion for the instruments. We used this robot for laparoscopic surgery to perform a totally intracorporeal\\u000a resection of the rectum and colorectal anastomosis, with transanal or transvaginal retrieval of specimens.\\u000a \\u000a \\u000a \\u000a Methods  We prospectively collected data on 13 patients who underwent

Gyu-Seog Choi; In Ja Park; Byung Mo Kang; Kyoung Hoon Lim; Soo-Han Jun



Diagnosis of aortic aneurysms by scintigraphy and ultrasonography  

SciTech Connect

Angioscintigraphy, performed on 50 patients suspected of aortic aneurysm and complemented by abdominal ultrasonography in 31 cases, disclosed: - Three cases of thoracic aortic aneurysm, 2 of which were confirmed by arteriography and surgery. It was impossible to perform surgery in the third case, no arteriography was done. Strict agreement with standard thoracic images had made the angioscintigraphic diagnosis seem correct. Twenty-seven cases of abdominal aortic aneurysms were confirmed by arteriography or surgery. Ultrasonography disclosed an abdominal aortic aneurysm in 26 cases, 20 of which were confirmed. The agreement of the two procedures in 10 unconfirmed cases led us to consider the diagnosis as correct. Angioscintigraphy appears to be a reliable procedure for detecting thoracic and abdominal aortic aneurysms. Ultrasonography is the simplest and least costly procedure for study of abdominal aortic aneurysms.

Caille, G. (Centre Hospitalier, Saint-Nazaire (France)); Chatal, J.F.; Tellier, J.L.; Talmant, C.; Guihard, R. (Centre Rene-Gauducheau, 44 - Nantes (France))



Routine second-trimester ultrasonography in the United States: A cost-benefit analysis  

Microsoft Academic Search

Objective:The objective of this study was to perform a cost-benefit analysis of routine second-trimester screening ultrasonography in the United States as compared with performing ultrasonography only in the presence of indications.

Anthony M. Vintzileos; John C. Smulian; Tryfon Beazoglou; Robert A. Knuppel



Transvaginal 3D Image-Guided High Intensity Focused Ultrasound Array  

NASA Astrophysics Data System (ADS)

The goal of this project is to develop a transvaginal image-guided High Intensity Focused Ultrasound (HIFU) device using piezocomposite HIFU array technology, and commercially-available ultrasound imaging. Potential applications include treatment of uterine fibroids and abnormal uterine bleeding. The HIFU transducer was an annular phased array, with a focal length range of 30-60 mm, an elliptically-shaped aperture of 35×60 mm, and an operating frequency of 3 MHz. A pillow-shaped bag with water circulation will be used for coupling the HIFU energy into the tissue. An intra-cavity imaging probe (C9-5, Philips) was integrated with the HIFU array such that the focal axis of the HIFU transducer was within the image plane. The entire device will be covered by a gel-filled condom when inserted in the vaginal cavity. To control it, software packages were developed in the LabView programming environment. An imaging algorithm processed the ultrasound image to remove noise patterns due to the HIFU signal. The device will be equipped with a three-dimensional tracking system, using a six-degrees-of-freedom articulating arm. Necrotic lesions were produced in a tissue-mimicking phantom and a turkey breast sample for all focal lengths. Various HIFU doses allow various necrotic lesion shapes, including thin ellipsoidal, spherical, wide cylindrical, and teardrop-shaped. Software control of the device allows multiple foci to be activated sequentially for desired lesion patterns. Ultrasound imaging synchronization can be achieved using hardware signals obtained from the imaging system, or software signals determined empirically for various imaging probes. The image-guided HIFU device will provide a valuable tool in visualization of uterine fibroid tumors for the purposes of planning and subsequent HIFU treatment of the tumor, all in a 3D environment. The control system allows for various lesions of different shapes to be optimally positioned in the tumor to cover the entire tumor volume. Real-time ultrasound imaging for guidance and monitoring of HIFU treatment provides an effective method for outpatient-based procedures.

Held, Robert; Nguyen, Thuc Nghi; Vaezy, Shahram



Comparison of transabdominal and transvaginal sonography in the evaluation of uterine mass with histopathological correlation.  


A cross-sectional study was conducted to demonstrate the role of transvaginal (TVS) and transabdominal sonography (TAS) to detect clinically suspected uterine mass in 53 patients which could not be differentiated clinically. The sonographic findings were compared and correlated with the findings of histopathology. TAS and TVS revealed 20(37.7%) & 20(37.7%) had leiomyoma, 12(22.6%) & 14(26.4%) had Ca cervix, 6(11.3%) & 7(13.2%) had endometrial carcinoma, 1(1.9%) & 1(1.9%) had hydatidiform mole respectively. TAS revealed 5(9.4%) had thickened endometrium, and no detectable mass were detected in 9(17.0%) cases. TVS revealed polyp in 7(13.2%), and no detectable mass were detected in 4(7.5%) cases. Histopathologically confirmed leiomyoma were in 18(34.0%) cases, Ca cervix in 14(26.4%), endometrial carcinoma in 6(11.3%), adenomyosis in 1(1.9%), polyp in 7(13.2%), chronic cervicitis in 2(3.8%), hydatidiform mole in 1(1.9%) and no detectable mass were detected in 4(7.5%) cases. Sensitivity of TAS and TVS to diagnose uterine mass were 83.7% and 95.9%, specificity 25.0% and 50.0%, positive predictive value 93.2% and 95.9%, negative predictive value 11.1% and 50.0% and accuracy 79.2% and 92.5% respectively. Sensitivity of TAS & TVS to diagnose leiomyoma was 88.9% & 94.9%, specificity 88.6% & 91.4%, positive predictive value 80.0% & 85.0%, negative predictive value 93.9% & 97.0%, and accuracy 88.7% & 92.5% respectively. Sensitivity of TAS & TVS to diagnose Ca cervix were 57.1% & 78.6%, specificity 89.7% & 92.3%, positive predictive value 66.9% & 78.6%, negative predictive value 85.4% & 92.3%, and accuracy 81.1% & 88.7% respectively. So, uterine mass can be evaluated more accurately by TVS than TAS. PMID:23416812

Dipi, R M; Amin, M S; Islam, M N; Khan, N A; Chaiti, M M; Hossain, M M



Photoacoustic ultrasonography and its potential application in mammography  

Microsoft Academic Search

This thesis studied photoacoustic ultrasonography (PAUS) and investigated its applicability in breast cancer detection. PAUS employs a short pulse of electromagnetic energy, at either near infrared or microwave frequency, to heat breast tissue. Rapid heating, resulting from inhomogeneous absorption of the energy pulse, generates ultrasonic waves. The energy absorption patterns can be reconstructed from these pressure waves recorded at a

Yuncai Fang



Liver metastases in cancer: detection with contrast-enhanced ultrasonography  

Microsoft Academic Search

In patients with known or suspected malignancy, ultrasonography (US) is often the first choice for liver imaging because of its widespread availability and low cost. Compared with contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI), the sensitivity of conventional US for detecting hepatic metastases is relatively poor. The advent of microbubble contrast agents changed this situation. Sensitivity and specificity

J. Hohmann; T. Albrecht; A. Oldenburg; J. Skrok; K.-J. Wolf



Breast cancer measurements with magnetic resonance imaging, ultrasonography, and mammography  

Microsoft Academic Search

Summary Background: Accurate measurement of the size of breast cancers becomes more important as breast cancer therapy advances. This study reports the accuracy of magnetic resonance imaging (MRI), ultrasonography and mammography for measuring the largest breast cancer diameter in comparison to the pathology measurement.

Peter L. Davis; Melinda J. Staiger; Kathleen B. Harris; Marie A. Ganott; Jolita Klementaviciene; Kenneth S. McCarty; Hector Tobon



SEPARATE, BUT LESS UNEQUAL:Fetal Ultrasonography and the Transformation of Expectant Mother\\/Fatherhood  

Microsoft Academic Search

Fetal ultrasonography has made women's and men's relationship to the fetus more equal. Drawing on information obtained from multiple conjoint interviews with 62 childbearing couples, I suggest that although women and men are both advantaged by fetal ultrasonography, expectant fathers' experience of the fetus is always enhanced, whereas pregnant women's experience may also be attenuated. For men, fetal ultrasonography is




Contrast enhanced and Doppler ultrasonography in the characterization of the microcirculation. Expectancies and performances.  


Normal and pathological vascularization can be examined using imaging methods. The use of contrast agents (CA), tracers or markers within the bloodstream, has gained more and more applications in the last years. The dynamics of the CA passing through a region of interest is directly correlated with the morphological and functional characteristics of the bloodstream in that particular area. Doppler ultrasonography provides information only regarding the flow within large vessels, the method having limited spatial resolution and sensitivity in the assessment of the capillary flow. Contrast-enhanced ultrasonography (CEUS) enables the detection of very slow blood flow or stagnating blood in vessels measuring as little as 40 microns. This feature is extremely valuable in the characterization of a circulatory bed and for the evaluation of the tumoral angiogenesis process. CEUS may be used both for diagnosis and for the assessment of treatment efficiency. Further on various aspects regarding this method, its advantages and limitations and arguments for its systematic use in oncology, will be presented in this review. PMID:23243644

Badea, Radu; Ciobanu, Lidia



Endometrial status in post-menopausal women on long-term continuous combined hormone replacement therapy (Kliofem ®) a comparative study of endometrial biopsy, outpatient hysteroscopy and transvaginal ultrasound  

Microsoft Academic Search

Forty post-menopause women using a preparation of 2 mg 17 ?-oestradiol and 1 mg norethisterone acetate (Kliofem®) for a mean duration of 2.9 years were investigated in an open, prospective, method comparison study. Main outcome measures were the histology of endometrial biopsy in comparison with clinical evaluation of the endometrium during panoramic hysteroscopy and endometrial thickness measured by transvaginal ultrasound.

Karin Piegsa; Ann Calder; Jonathan A. Davis; David McKay-Hart; Michael Wells; Fiona Bryden



Clinical characteristics of papillary thyroid microcarcinoma less than or equal to 5 mm on ultrasonography.  


Management of papillary thyroid microcarcinoma sized ?5 mm identified on ultrasonography is controversial. In this study, we evaluated the clinical characteristics of papillary thyroid microcarcinoma sized ?5 mm on ultrasonography in comparison to those >5 mm and sought to present rationales for optimal management in papillary thyroid microcarcinoma ?5 mm. The medical records of 396 patients who underwent surgery for papillary thyroid carcinoma between 2009 and 2011 were retrospectively analyzed. The patients were grouped into A (?5 mm, n = 132) or B (>5 mm, n = 264) and the clinicopathologic characteristics of the patients were reviewed and compared between the two groups. Tumor capsular invasion (45.5 vs. 59.8 %, p = 0.007) and cervical lymph node metastasis (18.2 vs. 29.2 %, p = 0.018) were more frequent in group B. Nonetheless, group A presented lymph node metastasis in 42.3 % of multifocal cases showing no difference to that of group B (41.5 %, p = 0.946) and also included five cases (3.8 %) of lateral neck metastasis. Multifocality was the only predictive factor for lymph node metastasis in group A (p < 0.001). Over half (55.3 %) of the patients of group A were diagnosed with papillary carcinoma in private clinics; however, only 5.5 % of these patients underwent assessment of lateral neck lymph nodes initially. In conclusion, higher risk of cervical lymph node metastasis should be considered in evaluation and surgical decision of papillary thyroid microcarcinoma ?5 mm identified on ultrasonography with multifocality. Evaluation of the cervical lymph nodes including the lateral neck should not be overlooked when suspicious thyroid nodule suggesting malignancy sized ?5 mm shows multifocal lesions. PMID:23873032

Lee, Hyoung Shin; Park, Hyo Sang; Kim, Sung Won; Choi, Gwan; Park, Hun-Su; Hong, Jong-Chul; Lee, Sung-Geun; Baek, Seon Mi; Lee, Kang Dae



Study on the Characteristics of Contrast-Enhanced Ultrasound and Its Utility in Assessing the Microvessel Density in Ovarian Tumors or Tumor-Like Lesions  

PubMed Central

Angiogenesis is a critical factor in tumor growth and metastasis, and microvessel density (MVD) was an important parameter for assessing vessels in tumors. However, radiologic assessment of tumor vascularity is not yet well established. In our study, we aimed at investigating the efficacy of contrast-enhanced ultrasonography (CEUS) in exploring the vascularity of the ovarian tumors or tumor-like lesions to assess the relationship between the parameters of the peak intensity (PI) and area under curve (AUC) on CEUS and MVD in ovarian masses. Compared to the contrast-enhanced ultrasound technique, conventional ultrasound shows limitation in differentiating benign and malignant ovarian tumors. The former is promising in improving the sensitivity of detecting small vessels and blood flow in ovarian tumors. Our results showed clear differences in enhancement patterns between benign and malignant ovary tumors or tumor-like lesions. The PI and AUC in the malignant tumors were significantly higher than those in the benign tumors or tumor-like lesions (p=0.001 and =0.01, respectively). The MVD was 43.1 ± 20.4 in the benign tumors or tumor-like lesions and was 65.3 ± 22.3 in the malignant ones (p= 0.01). In both the benign and malignant groups, the PI and AUC were correlated significantly with the MVD (r=0.595, p = 0.001; r =0.533, p = 0.003, respectively). The PI and AUC in CEUS can reflect the MVD in ovarin tumors. The PI and AUC of the ovarian masses in the contrast transvaginal sonography show significant correlation with the angiogenesis and may help in assessing tumor vascularity in ovarian masses.

Wang, Junyan; Lv, Faqin; Fei, Xiang; Cui, Qiuli; Wang, Longxia; Gao, Xuewen; Yuan, Zhixian; Lin, Qian; Lv, Yali; Liu, Aijun



Persistent cerebral blood flow by transcranial Doppler ultrasonography in an asphyxiated newborn meeting brain death diagnosis: case report and review of the literature.  


We want to illustrate the difficulty of establishing a brain death diagnosis in newborn children and how an easy and useful tool, the transcranial Doppler ultrasonography, can leave an unexpected result that complicates the process despite the rest of the diagnostic tests. We describe a 36-week gestation newborn male who was diagnosed of brain death after asphyxiated and offered for donation. After initial stabilization at admission, we established brain death diagnosis by checking and meeting every criterion. The donation process was complicated because of persistent blood flow on transcranial Doppler ultrasonography. Transcranial Doppler ultrasonography is a very useful method to assess cerebral blood flow. However, caution and individualization are needed when interpreting this complementary exam, especially in highly conflictive situations like brain death diagnosis. PMID:22643293

Mata-Zubillaga, D; Oulego-Erroz, I



Use of Ultrasonography to Evaluate Schistosoma japonicum-Related Morbidity in Children, Sichuan Province, China, 2000-2007  

PubMed Central

Liver ultrasonography is a convenient way to evaluate Schistosoma japonicum-related morbidity; however, no consensus standards exist, and data on use in Chinese children are scant. We describe 7 years of ultrasound findings in a prospective cohort of 151 children from an endemic area in Sichuan Province, China and evaluate technical aspects of the ultrasound methodology. Although prevalence of infection decreased over time, prevalence of hepatomegaly increased, which was likely caused by re-infections. The prevalence of late findings such as parenchymal fibrosis and splenomegaly were rare and did not increase over time; however, when present, they were associated with stunting. The use of adult thresholds versus height-adjusted standards underestimated pathology in children. Reliability of all measures except parenchymal grade was poor to fair. Our findings highlight the importance of early intervention and screening. We also suggest methodological refinements to improve reliability of ultrasonography for large-scale assessment of S. japonicum-related subclinical morbidity in children.

Hsiang, Michelle S.; Carlton, Elizabeth J.; Zhang, Yi; Zhong, Bo; Dongchuan, Qiu; Cohen, Pierre-Alain; Stewart, Christopher C.; Spear, Robert C.



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

PubMed Central

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

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



Imaging features of ischial bursitis with an emphasis on ultrasonography  

Microsoft Academic Search

Objective. The aim of this study was to evaluate the imaging features of ischial bursitis with an emphasis on ultrasonography (US). Design and patients. Our study included 31 patients with a painful mass or tenderness in their buttock who underwent US (n=27), CT (n=1), or MR imaging (n=4). A needle aspiration (n=6) or a bursal excision (n=5) was performed in

S. Kim; M. Shin; K. Kim; J. Ahn; K. Cho; J. Chang; S. Lee; R. Chhem



[Prenatal diagnosis by ultrasonography. A randomized study of 3000 patients].  


From January through December, 1990 at Hospital de Ginecoobstetricia Tlatelolco, 3,000 pregnant women were subjected to ultrasonography at random using a real time, B mode apparatus with a 3.5 MHz lineal transducer. Fetal malformation were diagnosed, some of which would have passed undetected in the labor room with consequent delay of treatment and false raise of perinatal morbidity and mortality rates. PMID:1797617

García Roig, F; Hicks Gomez, J J



Evaluation of abdominal lymphadenopathy in children by ultrasonography  

Microsoft Academic Search

Background. There may be uncertainty as to whether enlarged abdominal lymph nodes (LNs) in children are normal or abnormal. Objective. To compare, by ultrasonography (US), enlarged abdominal LNs in healthy children with those in children with acute abdominal\\u000a pain or acute gastroenteritis. Materials and methods. One hundred and twenty-two asymptomatic children were selected by questionnaire and compared with 44 children

Mamie Watanabe; Eiichi Ishii; Yoshinori Hirowatari; Yutaka Hayashida; Takafumi Koga; Kouhei Akazawa; Sumio Miyazaki



Ultrasonography of reproductive structures and hormonal correlates of follicular development in female American alligators, Alligator mississippiensis, in southwest Louisiana.  


Ultrasonography has been used effectively to study reproduction in a variety of reptile species, but its application to crocodilians has been relatively limited. We present results from a study testing the efficacy of using ultrasonography to monitor reproduction in the American alligator, Alligator mississippiensis. Ultrasound results were then compared with plasma hormone levels. A total of 124 females were examined during March, April, May, and early June (2001-2003). Ultrasound results were validated on a series of reproductive females (n=14) necropsied for other studies. Previtellogenic follicles, vitellogenic follicles, recently shelled eggs, fully developed well-calcified eggs, and atretic follicles were readily discernible with ultrasound in mature females. Reproductive structures were observed in 57 females of which 43 were actively reproductive, while 14 were non-reproductive, but contained large atretic follicles from prior years. Oviducts were discernible in females with eggs. Ovarian state was also correlated with hormone levels. These results are in agreement with previous studies that showed that 50% or less of the adult female alligator population is reproductively active in a given year. Ultrasonography can be used to make an accurate assessment of reproductive condition in wild alligator populations. PMID:19344723

Lance, Valentine A; Rostal, David C; Elsey, Ruth M; Trosclair, Phillip L



Parallel Doppler assessment of yolk sac and intervillous circulation in normal pregnancy and missed abortion  

Microsoft Academic Search

This study assessed yolk sac morphology and vascularity and intervillous blood flow in normal early pregnancy and missed abortion. Transvaginal colour and pulsed Doppler were used in a prospective analysis of 87 normal pregnancies and 48 missed abortions between 6 and 12 weeks gestation. The Kruskal-Wallis rank test was used to calculate the difference in yolk sac diameter and vascularity

A. Kurjak; S. Kupesic



Ultrasonography of the reticulum in cows.  


The reticulum and adjacent organs were examined ultrasonographically in 51 cows by use of a 3.5-MHz linear transducer applied to the ventral aspect of the thorax over the sixth and seventh intercostal spaces. Examination included assessment of the contour of the reticulum, of reticular contractions, and of the organs adjacent to the reticulum. The normal reticulum appeared as a half-moon-shaped structure with a smooth contour; it contracted at regular intervals and was situated immediately adjacent to the diaphragm and ventral portion of the abdominal wall when relaxed. Contents of the reticulum could not normally be imaged because of its partly gaseous composition. The ruminoreticular groove, craniodorsal blind sac of the rumen, and the ventral sac of the rumen were observed caudally. The distal aspect of the spleen and parts of the omasum, abomasum, and liver could be imaged. Reticular motility was characterized by a biphasic contraction pattern. Four biphasic reticular contractions usually were observed during a 4-minute period. During the first (incomplete) contraction, the reticulum contracted by a mean of 7.2 +/- 2.30 cm. There was then low-grade, incomplete relaxation of the reticulum, followed immediately by the second reticular contraction, during which the reticulum usually disappeared from the 17.5-cm-deep screen. The reticulum then reappeared in its normal position. The first reticular contraction lasted a mean of 2.6 +/- 0.33 seconds and the second contraction lasted 3.9 +/- 0.55 seconds. The mean interval between 2 biphasic contractions was 44.9 +/- 10.53 seconds. The speed of the first reticular contraction was 5.4 +/- 1.32 cm/s.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8192253

Braun, U; Götz, M



Early detection (9+6 weeks) of cardiac failure in a fetus diagnosed as Turner syndrome by 2D transvaginal ultrasound-guided coelocentesis.  


A 28-year-old woman was diagnosed by transvaginal ultrasound at 9+6 weeks with early fetal cardiac failure (hydrothorax and bradycardia). Doppler analysis of ductus venosus showed a negative A-wave pattern. The follow-up sonogram obtained at 11+6 weeks documented a missed abortion. A transvaginal ultrasound-guided coelocentesis was performed under local cervical anesthesia before uterine suction and 8 mL of clear extracoelomic fluid were successfully aspirated. Cytogenetic analysis demonstrated a 45,X karyotype. Ultrasound and Doppler waveform analysis of ductus venosus allowed early diagnosis of fetal cardiac failure. Coelocentesis may be the method of choice for early fetal karyotyping and may be used in the future to induce immunologic tolerance. PMID:19337987

Tonni, Gabriele; Azzoni, Daniela; Ventura, Alessandro; De Felice, Claudio; Marinelli, Maria



Automatic distance measurement of abdominal aorta for ultrasonography-based visceral fat estimation.  


Ultrasonography-based visceral fat estimation is a promising method to assess central obesity, which is associated with metabolic syndrome. The key to this method is to measure three types of distance in the ultrasound image. The most important one is the distance from the skin surface to the posterior wall of the abdominal aorta. We present a novel automatic measurement method to calculate this distance using 1D ultrasound signal processing. It is different from the conventional 2D image processing based methods which have high failure rate when the target is blurred or partially imaged. The proposed method identifies the waveforms of the aorta along a group of ultrasound scan lines and a rating mechanism is introduced to choose the best waveform for distance calculation. The robustness and accuracy of the method were evaluated by experiments based on clinical data. PMID:24111227

Wang, Junchen; Zhou, You; Koizumi, Norihiro; Kubota, Naoto; Asano, Takeharu; Yuhashi, Kuzuhito; Mitake, Tsuyoshi; Itani, Kazunori; Takahashi, Toshiaki; Takeishi, Shigemi; Sasaki, Shiro; Kadowaki, Takashi; Sakuma, Ichiro; Liao, Hongen



Ultrasonography of the reticulum in 30 healthy Saanen goats  

PubMed Central

Background The reticulum plays a crucial role in the ruminant digestive tract because the primary cycle of rumen motility always starts with a reticular contraction. In contrast to cattle, there are only few results on the ultrasonographic examination of the reticulum in goats. Therefore, it was the goal of the present study, to describe the results of ultrasonography of the reticulum of 30 healthy Saanen goats. Methods Ultrasonography was carried out on standing, non-sedated animals using a 5.0 MHz linear transducer. The shape, contour and motility of the reticulum were investigated. A nine-minute video recording of the reticulum was made for each goat and the frequency, duration and amplitude of reticular contractions were calculated as described for cattle. Results The reticulum appeared as a crescent-shaped structure with a smooth contour located immediately adjacent to the diaphragm. 0.8 to 2.1 (1.41 ± 0.31) reticular contractions were seen per minute. In all goats, biphasic reticular contractions were observed. 90% of the goats also had monophasic reticular contractions, and two had triphasic contractions. During the nine-minute observation periods, there were 0 to 6 monophasic reticular contractions and 6 to 15 biphasic contractions per goat. The duration of the biphasic contractions was 6.56 ± 0.74 s, which was significantly longer than the monophasic contractions at 4.31 ± 0.81 s. The average interval between two reticular contractions was 45.06 ± 12.57 s. Conclusion Ultrasonography of the reticulum in goats is a valuable tool to characterise the appearance and motility of this organ. In addition to the biphasic motility pattern seen in cattle the reticular motility of goats is characterized by monophasic reticular contractions. The results of the present study are an important contribution for better understanding of the reticular motility in goats.



Contrast-enhanced ultrasonography of the normal canine adrenal gland.  


Contrast-enhanced ultrasonography is useful in differentiating adrenal gland adenomas from nonadenomatous lesions in human patients. The purposes of this study were to evaluate the feasibility and to describe contrast-enhanced ultrasonography of the normal canine adrenal gland. Six healthy female Beagles were injected with an intravenous bolus of a lipid-shelled contrast agent (SonoVue(®) ). The aorta enhanced immediately followed by the renal artery and then the adrenal gland. Adrenal gland enhancement was uniform, centrifugal, and rapid from the medulla to the cortex. When maximum enhancement was reached, a gradual homogeneous decrease in echogenicity of the adrenal gland began and simultaneously enhancement of the phrenicoabdominal vessels was observed. While enhancement kept decreasing in the adrenal parenchyma, the renal vein, caudal vena cava, and phrenicoabdominal vein were characterized by persistent enhancement until the end of the study. A second contrast enhancement was observed, corresponding to the refilling time. Objective measurements were performed storing the images for off-line image analysis using Image J (ImageJ(©) ). The shape of the time-intensity curve reflecting adrenal perfusion was similar in all dogs. Ratios of the values of the cortex and the medulla to the values of the renal artery were characterized by significant differences from initial upslope to the peak allowing differentiation between the cortex and the medulla for both adrenal glands only in this time period. Contrast-enhanced ultrasonography of the adrenal glands is feasible in dogs and the optimal time for adrenal imaging is between 5 and 90 s after injection. PMID:21521396

Pey, Pascaline; Vignoli, Massimo; Haers, Hendrik; Duchateau, Luc; Rossi, Federica; Saunders, Jimmy H



Suture Granuloma Mimicking Recurrent Thyroid Carcinoma on Ultrasonography  

PubMed Central

Although high resolution ultrasonography (US) is helpful in the differentiation of suture granulomas from recurrent thyroid cancer in most cases, a definite diagnosis cannot always be made. We report a case that mimicked recurrent thyroid cancer on US and 2-[fluorine-18] fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET), but diagnosis of a suture granuloma was confirmed by a US-guided fine needle aspiration biopsy (FNAB). In order to avoid unnecessary operations, the differential diagnosis between postoperative suture granulomas and recurrent cancer is important.

Chung, Yong Eun; Kim, Min Jung; Yun, Mijin; Hong, Soon Won



The role of endoluminal ultrasonography in urology: current perspectives.  


Endoluminal ultrasonography (ELUS) is a noninvasive diagnostic technique used in urology to image tubular structures of the urinary tract. Through advancements in technology, modern ELUS is able to create three-dimensional images, which provide valuable clinical information for the diagnosis and treatment of urologic disorders. The efficiency and accuracy of this technology is confirmed through validation studies using human and animal models. Although a relatively new method, the clinical application of this technique holds great promise in the field of endourology. The technology, advantages, limitations, validation studies, clinical applications, and future of ELUS are explored through this comprehensive review of current urologic literature. PMID:15703087

Kondabolu, Sirish; Khan, Sardar A; Whyard, Jennifer; Diblasio, Christopher; Ayyala, Manasa; Pentyala, Srinivas


Ultrasonography and cystic hyperplasia-pyometra complex in the bitch.  


Cystic endometrial hyperplasia-pyometra complex is the most frequent and important endometrial disorder encountered in bitches. The pathogenesis of the disease is related to the activity of progesterone [Feldman and Nelson, Canine and Feline Endocrinology and Reproduction (1996) W.B. Saunders, Philadelphia]. Cystic endometrial hyperplasia (CEH) is an abnormal response of the bitch's uterus to ovarian hormones [De Bosschere et al. Theriogenology (2001) 55, 1509]. CEH is considered by many authors to be an exaggerated response of the uterus to chronic progestational stimulation during the luteal phase of the oestrous cycle, causing an abnormal accumulation of fluid within the endometrial glands and uterine lumen (De Bosschere et al. 2001). The resulting lesions of pyometra are due to the interaction between bacteria and hormones. The aim of this study was to evaluate if transabdominal uterine ultrasonography can be a useful and reliable diagnostic method to confirm Dow's [Veterinary Record (1958) 70, 1102] and De Bosschere's histopathological classification of CEH-pyometra complex. The study was carried out on 45 bitches with pyometra, 10 purebreds and 35 crossbreeds, 1-15 years old, 20% of which had whelped at least once. None of these animals had received exogenous oestrogen or progesterone treatment. On admission the 45 animals were in the luteal phase of the oestrus cycle. Clinical signs, blood parameters, uterine ultrasonography, bacterial swabs and uterine histopathological results were recorded. Results suggest that ultrasonographic examination is a useful and reliable tool for the diagnosis of cystic endometrial hyperplasia. PMID:15182288

Bigliardi, E; Parmigiani, E; Cavirani, S; Luppi, A; Bonati, L; Corradi, A



Screening for fetal anomalies in the 12th week of pregnancy by transvaginal sonography in an unselected population.  


The advantages and limitations of transvaginal (TV) sonography in detecting fetal anomalies in the 12th week of pregnancy were examined in a prospective screening study of an unselected population. During a 3-year period, 3991 examinations were performed and 35 fetuses were identified as having 43 anomalies (0.9 per cent). Most of these malformations were either severe structural disorders or isolated nuchal changes when karyotyping revealed chromosomal aberration in six cases. Twenty-one pregnancies were terminated and three fetuses died. Routine transabdominal (TA) ultrasonographic examinations were performed at 18 and 30 weeks in all those pregnancies where the TV scan had not found fetal anomalies. TA sonography identified 19 abnormal fetuses and ten cases remained undetected. TV sonography detected 51 per cent of malformed fetuses which were diagnosed prenatally (not including cases with nuchal oedema) and 41 per cent of the total were found in this study. Besides offering the possibility of early termination, first trimester screening has the advantage of identifying a transient sonographic sign, nuchal oedema, which can be used as a marker in screening for fetal chromosomal abnormalities. However, standard mid-second-trimester TA scanning is still recommended, since a significant number of malformations cannot be detected so early in pregnancy. PMID:9267899

Hernádi, L; Töröcsik, M



Giant abdominal stromal cell tumour diagnosed at endoscopic ultrasonography: is there a need for systematic use of endoscopic ultrasonography in submucosal gastric tumours?  

Microsoft Academic Search

A giant abdominal stromal cell tumour was diagnosed at endosonography performed for a relatively small gastric submucosal lesion. Although the case is rare, it draws attention to the need for systematic investigations with endoscopic ultrasonography in any submucosal lesion.

R. Sassatelli; L. Roncoroni; R. Conigliaro; G. Bedogni



Increased wall thickness using ultrasonography is associated with inflammation in an animal model of experimental colitis  

PubMed Central

Experimentally induced colitis is used in animals to investigate pathophysiological mechanisms in inflammatory bowel disease. When following disease course and treatment effects, it should be possible to perform repeated measurements without harming the animals. This pilot study was performed to investigate whether transabdominal ultrasound using a clinical scanner could be used on rats to demonstrate bowel inflammation in an experimental colitis model. Colitis was induced by either 5% dextran sodium sulfate (DSS) in drinking water for 7 days or a single dose of intracolonic trinitrobenzene sulfonic acid (TNBS). Using ultrasonography, wall thickness of distal colon, cecum, and small bowel was recorded prior to and after DSS, and prior to, 2, and 7 days after TNBS. Blood (tumor necrosis factor [TNF]-alpha) and fecal samples (HemoFEC occult blood) were taken from each group on the same days as sonography. Thereafter, rats were killed and specimens for histology were taken. Wall thickness of distal colon, not of cecum or small bowel, increased significantly after 7 days of DSS, and wall thickness of both distal colon and small bowel increased on day 2 and 7 after TNBS. TNF-alpha increased after 7 days in the latter group only. There was a significant correlation between ultrasonographic measurements and combined histology score of distal colon in the DSS group. HemoFEC was also positive in accordance with sonographic and histological features. Increased intestinal wall thickness in response to both DSS- and TNBS-induced colitis was able to be visualized by transabdominal sonography. Moreover, ultrasound findings, occult blood sampling, and histological findings supported each other, indicating that ultrasonography can be used to assess inflammation in a rat experimental model.

Lied, Gulen Arslan; Milde, Anne Marita; Nylund, Kim; Mujic, Maja; Grimstad, Tore; Hausken, Trygve; Gilja, Odd Helge



MR Sialographic Evaluation of Sialectasia of Stensen's Duct: Comparison with X-ray Sialography and Ultrasonography  

Microsoft Academic Search

We describe a patient with unilateral sialectasia of Stensen's duct. X-ray sialography, MR sialography, and ultrasonography showed multiple stenoses and rosary dilatation of Stensen's duct during stimulation of the parotid gland. Before stimulation, Stensen's duct showed focal dilatation as indicated by MR sialography and ultrasonography. The patient also had ipsilateral masseter hypertrophy (BMH), which may be a cause of sialectasia.

Hiroko Shojaku; Hideo Shojaku; Masashi Shimizu; Hikaru Seto; Yukio Watanabe


MR sialographic evaluation of sialectasia of Stensen's duct: comparison with X-ray sialography and ultrasonography.  


We describe a patient with unilateral sialectasia of Stensen's duct. X-ray sialography, MR sialography, and ultrasonography showed multiple stenoses and rosary dilatation of Stensen's duct during stimulation of the parotid gland. Before stimulation, Stensen's duct showed focal dilatation as indicated by MR sialography and ultrasonography. The patient also had ipsilateral masseter hypertrophy (BMH), which may be a cause of sialectasia. PMID:10888049

Shojaku, H; Shojaku, H; Shimizu, M; Seto, H; Watanabe, Y


A blind comparison of the effectiveness of endoscopic ultrasonography and endoscopy in staging early gastric cancer  

PubMed Central

BACKGROUND/AIMS—Endoscopic ultrasonography is expected to be useful for invasion depth staging of early gastric cancer. A prospective blind study of the staging characteristics of endoscopy and endoscopic ultrasonography for early gastric cancer was performed. ?METHODS—Findings of endoscopy and endoscopic ultrasonography using a 20 MHz thin ultrasound probe were independently reviewed and the results of 52 early gastric cancer lesions analysed. ?RESULTS—The overall accuracy rates in invasion depth staging of early gastric cancer were 63% for endoscopy and 71% for endoscopic ultrasonography. No statistically significant differences were observed in overall accuracy. Endoscopic ultrasonography tended to overstage, and lesions that were classified as mucosal cancer by endoscopic ultrasonography were very likely (95%) to be limited to the mucosa on histological examination. All 16 lesions staged as mucosal cancer independently but coincidentally by both methods were histologically limited to the mucosa. ?CONCLUSIONS—Endoscopic ultrasonography is expected to compensate for the understaging of lesions with submucosal invasion that are endoscopically staged as mucosal cancer. ?? Keywords: early gastric cancer; endoscopic ultrasonography; endoscopy

Yanai, H; Noguchi, T; Mizumachi, S; Tokiyama, H; Nakamura, H; Tada, M; Okita, K



Endoscopic ultrasonography (EUS) as a method used in spatial localization of digestive tract tumors  

Microsoft Academic Search

The subject of the paper is devoted to a modern diagnostic method called the endoscopic ultrasonography (EUS) that is still not widely implemented in many countries. This method bases on two imaging techniques: videoendoscopy and ultrasonography, making possible effective aiding of diagnostics as well as evaluating possibilities of performing radical surgical therapy. Rotating USG probes enable acquiring images vertical to

Pawel Skrzywanek; Aleksander Sowier; Anna R. Cysewska-Sobusiak



An economic evaluation of second-trimester genetic ultrasonography for prenatal detection of Down syndrome  

Microsoft Academic Search

Objective: The objective of this study was to perform an economic evaluation of second-trimester genetic ultrasonography for prenatal detection of Down syndrome. More specifically, we sought to determine the following: (1) the diagnostic accuracy requirements (from the cost-benefit point of view) of genetic ultrasonography versus genetic amniocentesis for women at increased risk for fetal Down syndrome and (2) the possible

Anthony M. Vintzileos; Cande V. Ananth; Allan J. Fisher; John C. Smulian; Debra Day-Salvatore; Tryfon Beazoglou; Robert A. Knuppel



Choroid plexus cysts: Is biochemical testing a valuable adjunct to targeted ultrasonography?  

Microsoft Academic Search

Objective: We sought to determine whether biochemical testing is a valuable adjunct to ultrasonography in selecting patients with fetal choroid plexus cysts for amniocentesis. Study Design: The study population consists of 128 patients who had fetal choroid plexus cysts detected during ultrasonography performed between 18 and 22 weeks’ gestation. The patients had genetic counseling, and amniocentesis and biochemical testing were

Amy Sullivan; Thomas Giudice; Fotini Vavelidis; Siva Thiagarajah



Magnetic resonance imaging for preoperative evaluation of breast cancer: a comparative study with mammography and ultrasonography  

Microsoft Academic Search

BackgroundThe widespread use of mammographic screening has led to increased detection of small tumors that are often difficult to diagnose with conventional imaging modalities such as mammography and ultrasonography. Intraductal spread of breast cancer, a principle risk factor for local recurrence, is also difficult to diagnose with mammography and ultrasonography. We investigated the clinical usefulness of magnetic resonance imaging of

Tunetake Hata; Hiromasa Takahashi; Kenichi Watanabe; Masato Takahashi; Kazunori Taguchi; Tomoo Itoh; Satoru Todo



Utility of magnetic resonance imaging and ultrasonography in diagnosing breast implant rupture.  


We prospectively evaluated 81 patients (with 160 implants) who subsequently had implants removed to determine sensitivity and specificity of both magnetic resonance imaging and ultrasonography. Positive and negative predictive values were also calculated to determine whether a statistically beneficial interaction existed when ultrasonography and magnetic resonance imaging were used in combination to examine an implant. Finally, the misdiagnoses were retrospectively evaluated to identify the pitfalls of the investigations. Positive diagnostic criteria were described. The sensitivity and specificity of ultrasonography were 47% and 83%, respectively, and of MRI, 46% and 88%, respectively. On retrospective review by the radiologist, the sensitivity and specificity of ultrasonography were 70% and 90%, respectively, and of magnetic resonance imaging, 75.6% and 94%, respectively. Although definite conclusions could not be obtained, there did not seem to be an additive benefit from using both ultrasonography and magnetic resonance imaging. PMID:7793779

Weizer, G; Malone, R S; Netscher, D T; Walker, L E; Thornby, J



Liver Involvement in Obese Children (Ultrasonography and Liver Enzyme Levels at Diagnosis and During Follow-up in an Italian Population)  

Microsoft Academic Search

Our aim was to evaluate incidence and riskfactors of liver involvement in obese Italian childrenas assessed by both ultrasonographic and biochemicalparameters. In seventy-five consecutive obese children (age 9.5 ± 2.9 years, males\\/females41\\/34), serum levels of enzymes and ultrasonography ofthe liver were evaluated. Tests were repeated one,three, and six months after starting a moderatehypocaloric diet and an exercise program. Three obese

Maria Carmela Saviano; Francesco Brunetti; Armido Rubino; Adriana Franzese; Pietro Vajro; Alessandro Argenziano; Alessandro Puzziello; Maria Pina Iannucci



Non-contact photoacoustic tomography and ultrasonography for tissue imaging  

PubMed Central

The detection of ultrasound in photoacoustic tomography (PAT) and ultrasonography (US) usually relies on ultrasonic transducers in contact with the biological tissue. This is a major drawback for important potential applications such as surgery and small animal imaging. Here we report the use of remote optical detection, as used in industrial laser-ultrasonics, to detect ultrasound in biological tissues. This strategy enables non-contact implementation of PAT and US without exceeding laser exposure safety limits. The method uses suitably shaped laser pulses and a confocal Fabry-Perot interferometer in differential configuration to reach quantum-limited sensitivity. Endogenous and exogenous inclusions exhibiting optical and acoustic contrasts were detected ex vivo in chicken breast and calf brain specimens. Inclusions down to 0.5 mm in size were detected at depths well exceeding 1 cm. The method could significantly expand the scope of applications of PAT and US in biomedical imaging.

Rousseau, Guy; Blouin, Alain; Monchalin, Jean-Pierre



Live adult worms detected by ultrasonography in human Bancroftian filariasis.  


Ultrasonographic examination of the scrotal area was performed in 14 asymptomatic individuals with bancroftian filariasis and microfilaremia. While in seven subjects (50%) the ultrasonographic findings were normal, lymphatic dilation and tortuosity were observed in the other seven. In these vessels, structures with peculiar aleatory movements (filaria dance sign) were detected. A segment of the lymphatic tract containing these mobile intraluminal structures that was resected surgically from the left spermatic cord of one individual confirmed that these structures were living Wuchereria bancrofti adult worms (two females and one male). Our study demonstrates for the first time the feasibility of using a low-cost, widely available, noninvasive technique (ultrasonography) to detect and monitor living adult worms and lymphatic dilation in patients with bancroftian filariasis. PMID:8024070

Amaral, F; Dreyer, G; Figueredo-Silva, J; Noroes, J; Cavalcanti, A; Samico, S C; Santos, A; Coutinho, A



Cholangiocarcinoma in Magnetic Resonance Cholangiopancreatography and Fascioliasis in Endoscopic Ultrasonography  

PubMed Central

Fascioliasis is a worldwide zoonotic infection with Fasciola hepatica and Fasciola gigantica. The zoonoses are particularly endemic in sheep-raising countries and are also endemic in Iran. Typical symptoms that may be associated with fascioliasis can be divided by phases of the disease, including the acute or liver phase, the chronic or biliary phase, and ectopic or pharyngeal fascioliasis. Cholestatic symptoms may be absent, and in some cases diagnosis and treatment may be preceded by a long period of abdominal pain, eosinophilia and vague gastrointestinal symptoms. We report a case with epigastric and upper quadrant abdominal pain for the last 4 years, with imaging suggesting cholangiocarcinoma. Considering a new concept of endoscopic ultrasonography, at last F. hepatica was extracted with endoscopic retrograde cholangiography.

Alizadeh, Amir Houshang Mohammad; Roshani, Mohammad; Lahmi, Farhad; Davoodi, Nasrin Ahangar; Nejad, Mohammad Rostami; Seyyedmajidi, Mohammad Reza; Zali, Mohammad Reza



Cholangiocarcinoma in magnetic resonance cholangiopancreatography and fascioliasis in endoscopic ultrasonography.  


Fascioliasis is a worldwide zoonotic infection with Fasciola hepatica and Fasciola gigantica. The zoonoses are particularly endemic in sheep-raising countries and are also endemic in Iran. Typical symptoms that may be associated with fascioliasis can be divided by phases of the disease, including the acute or liver phase, the chronic or biliary phase, and ectopic or pharyngeal fascioliasis. Cholestatic symptoms may be absent, and in some cases diagnosis and treatment may be preceded by a long period of abdominal pain, eosinophilia and vague gastrointestinal symptoms. We report a case with epigastric and upper quadrant abdominal pain for the last 4 years, with imaging suggesting cholangiocarcinoma. Considering a new concept of endoscopic ultrasonography, at last F. hepatica was extracted with endoscopic retrograde cholangiography. PMID:22110417

Mohammad Alizadeh, Amir Houshang; Roshani, Mohammad; Lahmi, Farhad; Davoodi, Nasrin Ahangar; Rostami Nejad, Mohammad; Seyyedmajidi, Mohammad Reza; Zali, Mohammad Reza



Interventional ultrasonography of the chest: Techniques and indications  

PubMed Central

Thoracic ultrasonography can be used for diagnostic purposes as well as a guide for diagnostic and therapeutic interventions. When the lesion or fluid collection has been located and the patient properly positioned, the angle of the needle is identified with respect to the transducer. The insertion tract should transgress the smallest possible area of aerated parenchyma. The needle can be introduced with a free-hand technique or with the aid of a needle guide. Correct planning of the procedure reduces intervention time and decreases the risk of complications. The main indications are superficial masses that require biopsy, pleural and parenchymal lesions formerly biopsied with CT or fluoroscopic guidance, and fluid collections that need to be drained. Ultrasound, thanks to its widespread use, simple execution, and low costs, represents a safe, manageable guide for thoracic interventions.

Almolla, J.; Balconi, G.



Prenatal diagnosis of limb abnormalities: role of fetal ultrasonography  

PubMed Central

Fetal ultrasonografy is the most important tool to provide prenatal diagnosis of fetal anomalies. The detection of limb abnormalities may be a complex problem if the correct diagnostic approch is not established. A careful description of the abnormality using the rigth nomenclature is the first step. Looking for other associated abnormalities is the threshold to suspect chromosomal abnormalities or single gene disorder. According to the patogenic point of view, limb abnormalities may be the result of malformation, deformation, or disruption. The prenatal diagnosis and the management of limb abnormalities involve a multidisciplinary team of ostetrician, radiologist/sonologist, clinical geneticist, neonatologist, and orthopedic surgeons to provide the parents with the information regarding etiology of the disorder, prognosis, option related to the pregnancy and recurrence risk for future pregnancies. The aim of this review is to describe the importance of detailed fetal ultrasonography in prenatal diagnosis of limb abnormalities.

Ermito, Santina; Dinatale, Angela; Carrara, Sabina; Cavaliere, Alessandro; Imbruglia, Laura; Recupero, Stefania



Understanding abdominal ultrasonography in horses: which way is up?  


The recent introduction of more affordable and portable ultrasound equipment makes it possible to perform transabdominal ultrasonography on equine patients in the field. Clipping the hair is not always necessary: intraabdominal structures can be quickly evaluated by soaking hair with isopropyl alcohol and using a 3.0- to 3.5-MHz curvilinear transducer. The ultrasonographer must be acquainted with the location and architecture of normal intraabdominal structures and simultaneously mindful of the depth of the viewing field, the tissue interface densities, the orientation of the transducer relative to the patient, and the image projected on the monitor. A clinician's working knowledge of these elements is the key to building confidence in distinguishing normal from abnormal ultrasonographic findings. PMID:21993992

Henry Barton, Michelle



Miniprobe Endoscopic Ultrasonography Has Limitations in Determining the T Stage in Early Colorectal Cancer  

PubMed Central

Background/Aims Mini-probe endoscopic ultrasonography (mEUS) is a useful diagnostic tool for accurate assessment of tumor invasion. The aim of this study was to estimate the accuracy of mEUS in patients with early colorectal cancer (ECC). Methods Ninety lesions of ECC underwent mEUS for pre-treatment staging. We divided the lesions into either the mucosal group or the submucosal group according to the mEUS findings. The histological results of the specimens were compared with the mEUS findings. Results The overall accuracy for assessing the depth of tumor invasion (T stage) was 84.4% (76/90). The accuracy of mEUS was significantly lower for submucosal lesions compared to mucosal lesions (p=0.003) and it was lower for large tumors (?2 cm) (p=0.034). The odds ratios of large tumors and submucosal tumors affecting the accuracy of T staging were 3.46 (95% confidence interval [CI], 1.05 to 11.39) and 6.25 (95% CI, 1.85 to 25.14), respectively. When submucosal tumors were combined with large size, the odds ratio was 14.67 (95% CI, 1.46 to 146.96). Conclusions The overall accuracy of T stage determination with mEUS was considerably high in patients with ECC; however, the accuracy decreased when tumor size was >2 cm or the tumor had invaded the submucosal layer.

Tsung, Pei Chuan; Park, Jong Hyeok; Kim, Sun Young; Park, Won Wo; Kim, Hyun Tae; Kim, Jin Nam; Kang, Yun Kyung; Moon, Jeong Seop



Complex ovarian cysts in postmenopausal women are not associated with ovarian cancer risk factors  

Microsoft Academic Search

Objective: We assessed whether asymptomatic ovarian abnormalities detected on ultrasonography in postmenopausal women are precursors to ovarian cancer. Study Design: We compared the transvaginal ultrasonographic findings from the initial examination of 20,000 postmenopausal women enrolled to date in an ongoing randomized trial of cancer screening with data on the established risk factors for ovarian cancer obtained from self-administered questionnaires. We

Patricia Hartge; Richard Hayes; Douglas Reding; Mark E. Sherman; Philip Prorok; Mark Schiffman; Saundra Buys



A comparison of methods for preoperative discrimination between malignant and benign adnexal masses: The development of a new logistic regression model  

Microsoft Academic Search

Objective: The aim of this study was to assess the complementary use of ultrasonographic end points with the level of circulating CA 125 antigen by multivariate logistic regression analysis algorithms to distinguish malignant from benign adnexal masses before operation. Study Design: One hundred ninety-one patients aged 18 to 93 years with overt adnexal masses were examined by transvaginal ultrasonography with

Dirk Timmerman; Thomas H. Bourne; Anil Tailor; William P. Collins; Herman Verrelst; Kamiel Vandenberghe; Ignace Vergote



Duplex Ultrasonography After Prostaglandin E1 Injection of the Clitoris in a Case of Hyperreactio Luteinalis  

Microsoft Academic Search

We report an unusual case of persistent postpartum clitorimegaly due to ovarian hyperreactio luteinalis. Duplex ultrasonography of the clitoris after intracorporeal injection of prostaglandin E1 revealed marked clitoral erection and increased arterial flow, as in the penis.

Emre Akkus; Serge Carrier; Charles Turzan; To-Nao Wang; F. Lue



Comparison of Radiography and Ultrasonography for Diagnosis of Diaphragmatic Hernia in Bovines  

PubMed Central

The present study was conducted on 101 animals suffering from thoracoabdominal disorders; out of which twenty seven animals (twenty six buffaloes and one cow) were diagnosed with diaphragmatic hernia based on clinical signs, radiography, ultrasonography, and left flank laparorumenotomy. Radiography alone confirmed diaphragmatic hernia in 18 cases (66.67%) with a sac-like structure cranial to the diaphragm. In 15 animals the sac contained metallic densities while in three cases a sac-like structure with no metallic densities was present. Ultrasonography was helpful in confirming diaphragmatic hernia in 23 cases (85.18%) and ultrasonographically reticular motility was evident at the level of 4th/5th intercostal space in all the animals. B+M mode ultrasonography was used for the first time for diagnosis of diaphragmatic hernia in bovines and the results suggested that ultrasonography was a reliable diagnostic modality for diaphragmatic hernia in bovines.

Athar, Hakim; Mohindroo, Jitender; Singh, Kiranjeet; Kumar, Ashwani; Raghunath, Mulinti



Transcutaneous high-intensity focused ultrasonography can cure testicular cancer in solitary testis  

Microsoft Academic Search

ObjectivesTo report the long-term results in 7 patients (including the 5-year results in 3 patients) after high-intensity focused ultrasonography (HIFU) combined with irradiation to treat testicular tumors in a solitary testis.

C. Kratzik; G. Schatzl; J. Lackner; M. Marberger



Effectiveness of routine ultrasonography in detecting fetal structural abnormalities in a low risk population  

Microsoft Academic Search

OBJECTIVE--To review the efficacy of routine prenatal ultrasonography for detecting fetal structural abnormalities. DESIGN--Retrospective study of the ultrasonographic findings and outcome of all pregnancies in women scanned in 1988-9. SETTING--Maternity ultrasonography department of a district general hospital. SUBJECTS--8785 fetuses. MAIN OUTCOME MEASURES--Correlation of prenatal ultrasonographic findings with outcome in the neonate. RESULTS--8733 babies were born during 1988-9, and 52 pregnancies

L S Chitty; G H Hunt; J Moore; M O Lobb



The Value of Power Doppler Ultrasonography in Achilles TendinopathyA Prospective Study  

Microsoft Academic Search

Background: Neovascularization, detected with power Doppler ultrasonography (PDU), is thought by some to play a central role in pathogenesis of Achilles tendinopathy.Hypothesis: Power Doppler ultrasonography neovascularization score is correlated with clinical severity at baseline and after conservative treatment.Study Design: Cohort study (prognosis); Level of evidence, 2.Methods: Seventy tendons from 58 patients with chronic midportion Achilles tendinopathy were included, and 63

Robert-Jan de Vos; Adam Weir; Lodewijk P. J. Cobben; Johannes L. Tol



Ultrasonography in the evaluation of hemoperitoneum in war casualties.  


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

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



Ultrasonography: Ariadne's Thread in the Diagnosis of the Cardiorenal Syndrome.  


The term cardiorenal syndrome (CRS) describes a broad spectrum of clinical conditions with four combinations of acute and chronic heart and kidney failure. Based on the pathophysiological primum movens, the actual classification recognizes five CRS types: in type I and II CRS, the initiating event is heart failure (acute or chronic), while it is kidney failure in type III and IV CRS; type V is linked to systemic diseases. Ultrasound techniques (echocardiography and ultrasonography of the kidney, inferior vena cava and chest) can be extremely helpful in establishing a prompt diagnosis and a correct CRS classification. Basic echocardiography allows evaluation of ventricular diastolic and systolic functions, investigates pulmonary congestion and pericardial effusion, and describes volume overload. On the other hand, renal ultrasound helps clinicians to distinguish between acute and chronic renal failure, excludes urinary tract dilation or pathological bladder repletion, and provides crucial information regarding kidney volume or echogenicity. Applying basic knowledge of echocardiography and renal ultrasound, nephrologists may be in a better position for patient treatment and management, bearing in mind that doctors can properly use a stethoscope although not being a cardiologist. PMID:22493598

Di Lullo, Luca; Floccari, Fulvio; Granata, Antonio; D'Amelio, Alessandro; Rivera, Rodolfo; Fiorini, Fulvio; Malaguti, Moreno; Timio, Mario



Bedside ultrasonography by emergency physicians for anterior talofibular ligament injury  

PubMed Central

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.

Gun, Cem; Unluer, Erden Erol; Vandenberk, Nergiz; Karagoz, Arif; Senturk, Guldehen Ozmen; Oyar, Orhan



Ultrasonography: Ariadne's Thread in the Diagnosis of the Cardiorenal Syndrome  

PubMed Central

The term cardiorenal syndrome (CRS) describes a broad spectrum of clinical conditions with four combinations of acute and chronic heart and kidney failure. Based on the pathophysiological primum movens, the actual classification recognizes five CRS types: in type I and II CRS, the initiating event is heart failure (acute or chronic), while it is kidney failure in type III and IV CRS; type V is linked to systemic diseases. Ultrasound techniques (echocardiography and ultrasonography of the kidney, inferior vena cava and chest) can be extremely helpful in establishing a prompt diagnosis and a correct CRS classification. Basic echocardiography allows evaluation of ventricular diastolic and systolic functions, investigates pulmonary congestion and pericardial effusion, and describes volume overload. On the other hand, renal ultrasound helps clinicians to distinguish between acute and chronic renal failure, excludes urinary tract dilation or pathological bladder repletion, and provides crucial information regarding kidney volume or echogenicity. Applying basic knowledge of echocardiography and renal ultrasound, nephrologists may be in a better position for patient treatment and management, bearing in mind that doctors can properly use a stethoscope although not being a cardiologist.

Di Lullo, Luca; Floccari, Fulvio; Granata, Antonio; D'Amelio, Alessandro; Rivera, Rodolfo; Fiorini, Fulvio; Malaguti, Moreno; Timio, Mario



Management of gall bladder perforation evaluation on Ultrasonography  

PubMed Central

Background: Perforation of the gall bladder with cholecystohepatic communication is a rare cause of liver abscess. We are reporting here six rare cases of gall bladder perforation with variable clinical presentations. Materials and Methods: Most patients presented with right hypochondrium pain and fever but two patients presented with only pain in the abdomen. Ultrasonography (USG) and Computed Tomography (CT) were used for diagnosis. The patients were also successfully treated. Results: There was a gall bladder perforation with cholecystohepatic communication, leading to liver abscess formation in most cases on USG and CT. The final diagnosis was confirmed on surgery. Conclusion: The perforation of the gall bladder which leads to liver abscess is a rare complication of acute, chronic or empyema gall bladder. USG and CT scans are the most important diagnostic tool in diagnosing this rare complication. In the set up, where advanced options are not available, the only treatment of choice is the conservative one or surgery, according to the status of the patients.

Rikki, Singal; Amit, Mittal; Samita, Gupta; Bir, Singh; Parul, Jain



Non-contact photoacoustic tomography and ultrasonography for brain imaging  

NASA Astrophysics Data System (ADS)

Photoacoustic tomography (PAT) and ultrasonography (US) of biological tissues usually rely on transducer arrays for the detection of ultrasound. Obtaining the best sensitivity requires a physical contact with the tissue using an intermediate coupling fluid (water or gel). This type of contact is a major drawback for several applications such as neurosurgery. Laser-ultrasonics is an established optical technique for the non-contact generation and detection of ultrasound in industrial materials. In this paper, the non-contact detection scheme used in laser-ultrasonics is adapted to allow probing of ultrasound in biological tissues while remaining below laser exposure safety limits. Both non-contact PAT (NCPAT) and non-contact US (NCUS) are demonstrated experimentally using a single-frequency detection laser emitting suitably shaped pulses and a confocal Fabry-Perot interferometer. It is shown that an acceptable sensitivity is obtained while remaining below the maximum permissible exposure (MPE) of biological tissues. Results obtained ex vivo with a calf brain specimen show that sub-mm endogenous and exogenous inclusions can be detected at depths exceeding 1 cm. When fully developed, the technique could be a unique diagnostic tool in neurosurgery providing deep imaging of blood vessels, blood clots and blood oxygenation.

Rousseau, Guy; Blouin, Alain; Monchalin, Jean-Pierre



Non-contact photoacoustic tomography and ultrasonography for biomedical imaging  

NASA Astrophysics Data System (ADS)

Photoacoustic tomography (PAT) and ultrasonography (US) of biological tissues usually rely on ultrasonic transducers for the detection of ultrasound. For an optimum sensitivity, transducers require a physical contact with the tissue using a coupling fluid (water or gel). Such a contact is a major drawback in important potential applications such as surgical procedures on human beings and small animal imaging in research laboratories. On the other hand, laser ultrasonics (LU) is a well established optical technique for the non-contact generation and detection of ultrasound in industrial materials. In this paper, the remote optical detection scheme used in industrial LU is adapted to allow the detection of ultrasound in biological tissues while remaining below laser exposure safety limits. Both non-contact PAT (NCPAT) and non-contact US (NCUS) are considered experimentally using a high-power single-frequency detection laser emitting suitably shaped pulses and a confocal Fabry-Perot interferometer in differential configuration. It is shown that an acceptable sensitivity is obtained while remaining below the maximum permissible exposure (MPE) of biological tissues. Results were obtained ex vivo on chicken breast specimens with embedded inclusions simulating blood vessels optical properties. Sub-mm inclusions are readily detected at depths approaching 1 cm. The method is expected to be applicable to living tissues.

Rousseau, Guy; Lévesque, Daniel; Blouin, Alain; Monchalin, Jean-Pierre



Application of transvaginal and abdominal three-dimensional ultrasound for the detection or exclusion of malformations of the fetal face.  


In a total of 618 pregnant women between 9 and 37 weeks' gestation, the fetal face was evaluated by two-dimensional and three-dimensional ultrasound imaging as part of a level III screening evaluation for fetal anomalies. A three-dimensional endovaginal probe (5 MHz) was used for examinations at between 9 and 15 weeks, and an abdominal three-dimensional probe (3.5 MHz) was used after 15 weeks. Three different three-dimensional image display modes were employed: (1) the orthogonal display; (2) the surface display; and (3) the transparent display. When we studied the three-dimensional orthogonal displays in a 125 cases evaluated by abdominal ultrasound, we found that the facial profile shown in the two dimensional image represented the true mid-sagittal profile in only 69.6% of the cases. In the remaining 30.4%, the profile view deviated from a true mid-sagittal section by up to 20 degrees in one or two planes. In a total of 25 facial anomalies detected by abdominal ultrasound, 20 were clearly demonstrated by both two-dimensional and three-dimensional technology. In the remaining five cases, three-dimensional ultrasound revealed or confirmed an additional defect or abnormality: a narrow cleft lip in an unfavorable position of the fetal face (n = 2), a unilateral orbital hypoplasia (n = 1), a cranial ossification defect (n = 1) and a flat profile in the presence of marked oligohydramnios (n = 1). When transvaginal scanning was used, there were cases in which a detailed surface image of the fetal face could be obtained as early as 9 weeks' gestation. Abdominal scanning routinely yielded high-quality surface images by 20 weeks. Three-dimensional ultrasound consistently displayed facial abnormalities with greater accuracy and clarity than conventional two-dimensional imaging. This particularly applied to chromosomal aberrations and syndromes associated with subtle facial abnormalities requiring a detailed evaluation. Not only does three-dimensional ultrasound help in appreciating the severity of a fetal defect, but it can also provide more convincing evidence of a normal fetus than conventional two-dimensional sonograms. PMID:9168575

Merz, E; Weber, G; Bahlmann, F; Miric-Tesanic, D



Role of transrectal ultrasonography (TRUS) in focal therapy of prostate cancer: report from a Consensus Panel.  


What's known on the subject? and What does the study add? Focal therapy techniques are emerging in prostate cancer treatment. However, several key questions about patient selection, treatment and monitoring still have to be addressed. The concept of focal therapy is barely discussed in current urological guidelines. In the present manuscript, we report the results of a consensus meeting focused on ultrasonography, the most common used urological imaging method, in relation to focal therapy of prostate cancer. • To establish a consensus on the utility of ultrasonography (US) to select patients for focal therapy. Topics were the current status of US to determine focality of prostate cancer, to monitor and assess outcome of focal therapy and the diagnostic advantages of new US methods. In addition, the biopsy techniques required to identify focal lesions were discussed. • Urological surgeons, radiation oncologists, radiologists, and basic researchers from Europe and North America participated in a consensus meeting on the use of transrectal US (TRUS) in focal therapy of prostate cancer. The consensus process was face-to-face and specific clinical issues were raised and discussed with agreement sought when possible. • TRUS is commonly used and essential for diagnosing men with prostate cancer. It is particularly useful for targeting specific anatomical regions or visible lesions. However, it has several limitations and there is a need for improvement. Newer visualisation techniques, e.g. colour Doppler US, contrast-enhanced US and elastography, are being developed but currently there is no US technique that can accurately characterise a cancer suitable for focal therapy. Systematic biopsy is the only known procedure that allows the identification of prostate cancers suitable for focal therapy. Scarce data exist about the role of US for monitoring patients during or after ablative therapy. • Consensus was reached on all key aspects of the meeting. • US cannot reliably identify focal prostate cancer. New US methods show promising results in identifying prostate cancer focality. • Currently selecting appropriate candidates for focal therapy should be performed using dedicated protocols and biopsy schemes. PMID:22462566

Smeenge, Martijn; Barentsz, Jelle; Cosgrove, David; de la Rosette, Jean; de Reijke, Theo; Eggener, Scott; Frauscher, Ferdinand; Kovacs, Gyoergy; Matin, Surena F; Mischi, Massimo; Pinto, Peter; Rastinehad, Ardeshir; Rouviere, Olivier; Salomon, Georg; Polascik, Thomas; Walz, Jochen; Wijkstra, Hessel; Marberger, Michael



Urinary tract infection: is there a need for routine renal ultrasonography?  

PubMed Central

Aims: To assess the yield of routine renal ultrasound (RUS) in the management of young children hospitalised with first uncomplicated febrile urinary tract infection (UTI). Methods: All children aged 0–5 years who had been hospitalised over a two year period with first uncomplicated febrile UTI in a medium size institutional regional medical centre were included. Children with known urinary abnormalities and/or who had been treated with antibacterial agents within seven days before admission were excluded. All included children underwent renal ultrasonography during hospitalisation and voiding cystouretrography (VCUG) within 2–6 months. The yield of RUS was measured by its ability to detect renal abnormalities, its sensitivity, specificity, and positive and negative predictive values for detecting vesicoureteral reflux (VUR), and by its impact on UTI management. Results: Of 255 children that were included in the study, 33 children had mild to moderate renal pelvis dilatation on RUS suggesting VUR, of whom only nine had VUR on VCUG. On the other hand, in 36 children with VUR on VCUG the RUS was normal. The sensitivity, specificity, positive predictive value, and negative predictive value of abnormal RUS for detecting VUR were 17.7%, 87.6%, 23.5%, and 83.2% respectively. In none of the patients with abnormal RUS was a change in the management at or following hospitalisation needed. Conclusion: Results show that the yield of RUS to the management of children with first uncomplicated UTI is questionable.

Zamir, G; Sakran, W; Horowitz, Y; Koren, A; Miron, D



Correlation of Masseter Muscle Thickness and Intermolar Width - An Ultrasonography Study  

PubMed Central

Background: To determine the association between the thickness of masseter muscle and the maxillary dental arch width. To explore the influence of gender on masseter muscle thickness. Materials & methods: Seventy subjects (35 females and 35 males) of age 18 to 25 years were selected for the study based on class I molar relationship. The masseter muscle thickness of the right and left sides in every subject were found out through ultrasound scanning of the muscle, in both relaxed and clenched states. The maxillary dental arch width was measured on the study model with an electronic caliper. Student t test, Pearson’s Correlation Coefficient was performed to assess the sample. Results: Masseter Muscle Thickness showed a positive correlation with Maxillary Dental Arch Width r ?0.74. The masseter muscle thickness is greater in male subjects in both relaxed (0.001

Ultrasonography Study. J Int Oral Health 2013; 5(2):28-34.

Tircoveluri, Saritha; Singh, Johar Rajvinder; Rayapudi, Naveen; Karra, Arjun; Begum, Mohammadi; Challa, Padmalatha



Evaluation of Antral Follicle Growth in the Macaque Ovary during the Menstrual Cycle and Controlled Ovarian Stimulation by High-Resolution Ultrasonography  

PubMed Central

To date, ultrasonography of monkey ovaries is rare and typically of low resolution. The objectives of this study were to use state-of-the-art, high-resolution, transabdominal ultrasonography with real-time Doppler capabilities to: (1) determine whether one can reliably detect in real time the large dominant follicle, the corpus luteum (CL), and small (<2 mm) antral follicles on the ovaries of rhesus monkeys during the natural menstrual cycle; and (2) predict the follicular response of rhesus ovaries to controlled ovarian stimulation (COS) protocols. Rhesus monkeys were selected for transabdominal ultrasonography using a GE Voluson 730 Expert Doppler System at discrete stages of the menstrual cycle. Subsequently, serial ultrasound scanning was employed to observe growth of antral follicles and the CL. Finally, females were scanned to assess follicular growth during COS. The dominant structure and small antral follicles (<2 mm) were reliably visualized in real time. The follicle destined to ovulate could be identified by size differential by day 3 of the follicular phase. The number of small antral follicles present before onset of COS protocol correlated positively with the number of metaphase II-stage oocytes collected after treatment. The results of this study demonstrate that the population dynamics of antral follicle pools can be noninvasively evaluated in monkeys during natural and pharmacologic ovarian cycles.




Evaluation of antral follicle growth in the macaque ovary during the menstrual cycle and controlled ovarian stimulation by high-resolution ultrasonography.  


To date, ultrasonography of monkey ovaries is rare and typically of low resolution. The objectives of this study were to use state-of-the-art, high-resolution, transabdominal ultrasonography with real-time Doppler capabilities to: (1) determine whether one can reliably detect in real time the large dominant follicle, the corpus luteum (CL), and small (<2 mm) antral follicles on the ovaries of rhesus monkeys during the natural menstrual cycle; and (2) predict the follicular response of rhesus ovaries to controlled ovarian stimulation (COS) protocols. Rhesus monkeys were selected for transabdominal ultrasonography using a GE Voluson 730 Expert Doppler System at discrete stages of the menstrual cycle. Subsequently, serial ultrasound scanning was employed to observe growth of antral follicles and the CL. Finally, females were scanned to assess follicular growth during COS. The dominant structure and small antral follicles (<2 mm) were reliably visualized in real time. The follicle destined to ovulate could be identified by size differential by day 3 of the follicular phase. The number of small antral follicles present before onset of COS protocol correlated positively with the number of metaphase II-stage oocytes collected after treatment. The results of this study demonstrate that the population dynamics of antral follicle pools can be noninvasively evaluated in monkeys during natural and pharmacologic ovarian cycles. PMID:19189308

Bishop, Cecily V; Sparman, Michelle L; Stanley, Jessica E; Bahar, Alistair; Zelinski, Mary B; Stouffer, Richard L



Morphometry of ovarian structures by transrectal ultrasonography in Serrana goats.  


The accuracy of transrectal real-time ultrasonography (RTU) scanning technique to detect ovarian structures (follicles and corpus luteum) of Serrana goats was compared to the data obtained by observation of ovarian sequential slices. This slicing technique (SLI) was considered as reference method. The laparoscopy and laparotomy techniques were also used for corpora lutea identification. For this purpose the ovaries of 14 females were observed, 7-8 days after ovulation, by transrectal ultrasonography followed by laparoscopic examination. Then ovaries were removed and studied by slicing. In the sliced sections of each ovary (n=28), follicles and corpus luteum (CL) were identified and counted. CL and follicular diameters were measured using a millimetre scale. The total number of follicles, counted by RTU, was significantly lower than that observed by SLI (P <0.01). This difference was mainly due to the under estimation of <2 mm follicles category. The correlation coefficient between category data obtained by RTU and SLI methods for the number of follicles > or =3 mm was high (r2=0.95, P <0.001), which highlights the use of UTR as a potential methodology to study the follicular dynamic of goats. There were no significant differences (P >0.05) between the average number (mean +/- S.D.) of corpus luteum identified per ovary by RTU (0.71 +/- 0.75), laparoscopy (0.58 +/- 0.71), laparotomy (0.67 +/- 0.76) or SLI (0.83 +/- 0.76) methods. The accuracy for the identification of ovulation, validated by CL detection on D7-D8 by SLI (100%), was 91.7%, 87.5% and 83.3% by RTU, laparotomy and laparoscopy, respectively. The negative predictive value of RTU, laparotomy and laparoscopy to verify the absence of a CL in the ovary was 81.8%, 75.0% and 69.2%, respectively. The specificity of all three methods for the CL identification was 100%. No significant differences (P >0.05) were found in the probability to detect the exact number of CL (0, 1 or 2) counted in each ovary between the RTU (87.5%), laparotomy (83.3%) and laparoscopy (75.0%) methods when compared with the reference method. The diameter of spherical CL could be estimated with reliability (r2=0.86; P <0.001). The real-time ultrasonographic scanning proved to be a highly accurate method for detection and measurement of several categories of follicles and CL size in Serrana goats. The results of the present study show that laparoscopy and RTU are similarly reliable techniques for CL detection. However, the RTU represents a non-traumatic technique with advantages to animal welfare both in experimental and reproductive evaluation of the size of ovarian structures. PMID:15581510

Simões, J; Potes, J; Azevedo, J; Almeida, J C; Fontes, P; Baril, G; Mascarenhas, R



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

SciTech Connect

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.

Gurel, Kamil [Abant Izzet Baysal University, Izzet Baysal School of Medicine, Department of Radiology (Turkey)], E-mail:; Karabay, Oguz [Abant Izzet Baysal University, Izzet Baysal School of Medicine, Department of Clinical Microbiology and Infectious Diseases (Turkey); Gurel, Safiye [Abant Izzet Baysal University, Izzet Baysal School of Medicine, Department of Radiology (Turkey); Hildebolt, Charles [Washington University, Mallinckrodt Institute of Radiology (United States)



Bedside ultrasonography of musculoskeletal complications in brain injured patients  

PubMed Central

Introduction The aim of this study was to evaluate the role of bedside ultrasonography (US) in early diagnosis of musculoskeletal complications (MSC) of acquired brain injuries, to describe its incidence and US features in a neurorehabilitation setting. Materials and methods All 163 patients admitted in tertiary-level neurorehabilitation unit with diagnosis of stroke or severe brain injury (SBI), with symptoms or signs of musculoskeletal pathology, underwent bedside US. Results MSC were diagnosed in 51.5%. In 86.9% US clarified diagnosis and/or modified therapeutic approach. Shoulder pain was observed in 27.6%. US showed a shoulder subluxation in 73.3% and a frozen shoulder in 8.8% of painful shoulders. In all the cases rotator cuff abnormalities were noted. Wrist-hand syndrome was observed in 29.4%. US showed mild effusion in wrist joints and tendon sheaths and subcutaneous edema without significant vascularity. Neurogenic heterotopic ossification was observed in 1.8%. US demonstrated the “zone phenomenon” or heterogeneously hypoechoic mass with low resistance vessels within the lesions. Contractures and spasticity were observed in 18.4%. US allowed reliable guidance for Botulinum toxin A injection. Relapsing osteoarthritis and acute arthritis were diagnosed in 15.3% and 7.3% respectively. Patients with MSC had lower Functional Independence Measurement (FIM) and Katz index scores in discharge (p < 0.04 and p < 0.0294 respectively) and more length of hospital stay (p = 0.0024). Discussion Musculoskeletal pathology frequently complicates the course of acquired brain injuries and it delays functional recovery. Bedside US is a cheap and sensitive diagnostic tool and it can aid clinicians to define diagnosis and to choose therapeutic approach.

Falsetti, P.; Acciai, C.; Carpinteri, F.; Palilla, R.; Lenzi, L.



Clinical anatomy of the lingual nerve and identification with ultrasonography.  


Our objective was to investigate the pathway of the lingual nerve and find out whether it can be identified using ultrasonography (US) intraorally. It is a dominant sensory nerve that branches from the posterior division of the mandibular aspect of the trigeminal nerve, and is one of the two most injured nerves during oral surgery. Its anatomy in the region of the third molar has been associated with lingual nerves of variable morphology. If surgeons can identify its precise location using US, morbidity should decrease. We searched published anatomical and specialty texts, journals, and websites for reference to its site and US. Cadavers (28 nerves) were dissected to analyse its orientation at the superior lingual alveolar crest (or lingual shelf). Volunteers (140 nerves) had US scans to identify the nerve intraorally. Our search of published books and journals found that descriptions of the nerve along the superior lingual alveolar crest were inadequate. We found no US studies of the nerve in humans. Dissections showed that the nerve was above (n=6, 21%) and below (n=22, 79%) the crest of the lingual plate. US scans showed 140 lingual nerves intraorally in 70 volunteers. The nerve lay either above or below the superior lingual alveolar crest, which led us to develop a high/low classification system. US can identify the lingual nerve and help to classify it preoperatively to avoid injury. Our results suggest that clinical anatomy of the lingual nerve includes the superior lingual alveolar crest at the third and second molars because of its surgical importance. US scans can successfully identify the nerve intraorally preoperatively. PMID:23182453

Benninger, Brion; Kloenne, Jessica; Horn, Jean Lois



Diaphragmatic movement in hemiplegic patients measured by ultrasonography.  

PubMed Central

BACKGROUND--It is known that automatic breathing is controlled by centres in the lower brain stem, whereas volitional breathing is controlled by the cerebral cortical centres. In hemiplegia, lesions above the brain stem result in paralysis of limb muscles. This study was performed to determine whether the diaphragm might also be affected in patients with hemiplegia. METHODS--Studies were performed in six normal control subjects and in eight patients with complete hemiplegia caused by a lesion above the brain stem, all with no known chest disease. Full lung function tests were performed. Diaphragmatic excursion and inspired volume (VT) were measured simultaneously by M mode ultrasonography and respiratory airflow measurements. Recordings of diaphragmatic excursion were performed on each side separately during volitional and automatic breathing at a similar range of VT. RESULTS--Lung function tests lay within the normal range in all the control subjects. In the hemiplegic patients mean (SD) vital capacity was 79 (18)% and residual volume was 123(30)% of predicted. Total lung capacity and functional residual capacity were in the normal range. In the control subjects no significant difference in diaphragmatic excursion was found between volitional and automatic breathing for the same range of inspired volume. By contrast, there was a significant decrease in diaphragmatic excursion during volitional breathing compared with automatic breathing on the affected side in four of the eight hemiplegic patients. CONCLUSIONS--In four of eight hemiplegic patients reduced diaphragmatic movement was present on the paralysed side during volitional inspiration when compared with automatic inspiration. The hemidiaphragm may be involved on the affected side in patients with hemiplegia.

Cohen, E; Mier, A; Heywood, P; Murphy, K; Boultbee, J; Guz, A



Evaluation of the diagnostic and prognostic utility of ultrasonography at first diagnosis of presumptive bovine respiratory disease  

PubMed Central

This project investigated the use of ultrasonography at first diagnosis of presumptive early bovine respiratory disease (BRD) in feedlot cattle from western Canada. One hundred seventy-four cattle (116 cases and 58 controls) at high risk of developing BRD were enrolled in a prospective longitudinal study over 2 y (2006–2007). Cattle with clinical signs relating to the respiratory system and assessed as sick at the time of feedlot arrival (arrival fever cases) or assessed as sick in the pen 3 to 30 d post-arrival (post-arrival fever cases, post-arrival no fevers cases) were eligible for enrollment. Control animals were identified at the time of case enrollments. Ultrasonography was done using a 3.5 sector transducer at enrollment and at 2, 4, and 6 wk post-enrollment. Lung lesions were identified at least 1 time over the course of the trial in 32/116 (28%) cases and 9/58 (16%) controls. At enrollment, lung lesions were identified in 20/115 (17%) cases and 2/55 (4%) controls (data unreadable n = 4). Post-arrival fever cases (14/48) were the most likely to have a lesion identified using ultrasound. In arrival fever cases, average daily gain (enrollment to last ultrasound, average 34 d) was improved (P = 0.007) in cattle identified with a lesion at enrollment using ultrasound compared with those not identified with a lesion at that time, potentially demonstrating the effects of gut fill at arrival weighing, as these sicker animals may have eaten less prior to arrival and, therefore, had more room for improvement in weight over time due to restoration of normal gut fill. None of the ultrasound time points explored (enrollment, 2, 4, or 6 wk post-enrollment) were associated with the animal health outcomes of interest (subsequent treatment, chronicity, wastage, or mortality) for cattle enrolled at arrival or post-arrival. Ultrasonography using a 3.5 sector transducer was not particularly effective as a prognostic/diagnostic tool for early detection of BRD, but may be useful in targeted populations of animals with respiratory disease of longer duration (such as chronic pens).

Abutarbush, Sameeh M.; Pollock, Colleen M.; Wildman, Brian K.; Perrett, Tye; Schunicht, Oliver C.; Fenton, R. Kent; Hannon, Sherry J.; Vogstad, Amanda R.; Jim, G. Kee; Booker, Calvin W.



Initial imaging assessment of severe blunt trauma  

Microsoft Academic Search

Objectives: Total body computed tomography (CT) scan is increasingly used in traumatised patients, but the need for an initial rapid imaging assessment beforehand remains unknown. To address this problem, we assessed the value of an initial imaging assessment (chest X-ray, pelvic X-ray, abdominal ultrasonography) in severely traumatised patients in a prospective study. Design and setting: Prospective study of a cohort

E. Peytel; F. Menegaux; P. Cluzel; O. Langeron; P. Coriat; B. Riou



Transvaginal Administration of Progesterone  

Microsoft Academic Search

Objective: To examine the endometrial effects of three different doses of progesterone administered vaginally.Methods: Forty women 25–41 years old deprived of ovarian function received estradiol (E2) for 28 days. From days 15 to 27, a new mucus-like vaginal gel of progesterone was administered every other day, randomly, dosed at 45 mg (group A, n = 14), 90 mg (group B,

Renato Fanchin; Dominique de Ziegler; Christine Bergeron; Claudia Righini; Carlo Torrisi; René Frydman



Efficacy of Ultrasonography-Guided Injections in Patients with Facet Syndrome of the Low Lumbar Spine  

PubMed Central

Objective To investigate the efficacy of ultrasonography (US)-guided injections in patients with low lumbar facet syndrome, compared with that in patients who received fluoroscopy (FS)-guided injections. Method Fifty-seven subjects with facet syndrome of the lumbar spine of the L4-5 and L5-S1 levels were randomly divided into two groups to receive intraarticular injections into the facet joint. One group received FS-guided facet joint injections and the other group received US-guided facet joint injections. Treatment effectiveness was assessed using a visual analogue scale (VAS), physician's and patient's global assessment (PhyGA, PaGA), and the modified Oswestry Disability Index (MODI). All parameters were evaluated four times: before injections, and at a week, a month, and three months after injections. We also measured, in both groups, how long it took to complete the whole procedure. Results Each group showed significant improvement from the facet joint injections on the VAS, PhyGA, PaGA, and MODI (p<0.05). However at a week, a month, and three months after injections, no significant differences were observed between the groups with regard to VAS, PhyGA, PaGA, and MODI (p>0.05). Statistically significant differences in procedure time were observed between groups (FS: 248.7±6.5 sec; US: 263.4±5.9 sec; p=0.023). Conclusion US-guided injections in patients with lumbar facet syndrome are as effective as FS-guided injections for pain relief and improving activities of daily living.

Yun, Dong Hwan; Kim, Hee-Sang; Yoo, Seung Don; Kim, Dong Hwan; Chon, Jinn Man; Choi, Seong He; Hwang, Dae Gyu



In vitro randomized comparison of a standard and novel echogenic needle for ultrasonography-guided renal targeting.  


Abstract Background and Purpose: Urologists are becoming increasingly aware of the importance of pretreatment percutaneous renal biopsy of small renal cortical neoplasms. A barrier to the routine performance of ultrasonography-guided percutaneous renal biopsy has been the technical challenges associated with the procedure. We evaluated a new modified needle, which incorporates an echogenic needle tip designed to improve the needle tip's visibility under ultrasonographic visualization. We evaluated and compared the ultrasonographic imaging quality of the echogenic needle (EN) and a standard needle (SN). Methods: Forty-eight participants were recruited to perform ultrasonography-guided needle targeting and drainage of a simulated cyst within a phantom model. The simulated cysts were embedded in an opaque gel mold. Each participant was blinded to the type of needle being deployed and was asked to identify and aspirate the simulated cyst with each needle under ultrasonography guidance. Each needle was tested at three ultrasound-aiming angles, (0, 15, and 30 degrees). The quality of needle visibility under ultrasonographic imaging was assessed via a questionnaire, including needle preference and a visibility score (1-10) at each aiming angle. Participants were stratified by level of ultrasound experience. Results: For each angle tested, the EN received higher visibility ratings. The mean visibility scores for the EN vs the SN were 6.44 vs 5.52 at 0 degrees (P=0.001), 7.77 vs 6.96 at 15 degrees (P=0.0004) and 8.33 vs 7.54 at 30 degrees (P=0.0001). Participants reported significantly greater comfort using the EN needle compared with the SN (P=0.001). These results held true regardless of the sequence of needle tested first. Also, there was a significant difference in visibility scores by angle (P=0.0001). Larger angles (30>15>0) resulted in higher scores. Conclusions: In this in vitro trial, the application of the EN improved needle visibility for users of all levels of experience. Clinical correlation is pending. PMID:23799803

Nguyen, Vien; Menhadji, Ashleigh; Chu, Ringo; Cho, Jane; Osann, Kathryn; Bucur, Philip; Patel, Puja; Okhunov, Zhamshid; Lusch, Achim; McDougall, Elspeth; Landman, Jaime



Combined metabolic and morphologic imaging in thyroid carcinoma patients with elevated serum thyroglobulin and negative cervical ultrasonography: role of 124 I-PET\\/CT and FDG-PET  

Microsoft Academic Search

Purpose  This study sought to compare iodine-124 positron emission tomography\\/computed tomography (124I-PET\\/CT) and 2-[18F]fluoro-2-deoxy-d-glucose- (FDG-) PET in the detection of recurrent differentiated thyroid carcinoma (DTC) lesions in patients with increasing\\u000a serum thyroglobulin (Tg), Tg-antibodies, or both, but without pathological cervical ultrasonography. We assessed the lesion\\u000a detection accuracy of 124I-PET alone, CT alone, 124I-PET\\/CT, FDG-PET, and all these modalities combined.\\u000a \\u000a \\u000a \\u000a Material and

L. S. Freudenberg; G. Antoch; A. Frilling; W. Jentzen; S. J. Rosenbaum; H. Kühl; A. Bockisch; R. Görges



Prenatal diagnosis of thanatophoric dysplasia in the second trimester: ultrasonography and other diagnostic modalities.  


Thanatophoric dysplasia is the most common type of neonatal lethal osteochondrodysplasias, with an estimated frequency of nearly of 1 in 20,000 births. It is a disorder characterized by extremely short ribs, tubular bones and macrocephaly. The prenatal diagnosis of thanatophoric dysplasia has been well established by ultrasonography in the second trimester; however it is not always possible to differentiate the thanatophoric dysplasia fetuses from the others with skeletal dysplasias like fibrochondrogenesis or atelosteogenesis by ultrasonography. Recently, mutations in the fibroblast growth factor receptor 3 gene, located on the short arm of chromosome 4 have been identified as a cause of thanatophoric dysplasia. In this article we described the prenatal diagnosis of two fetuses with thanatophoric dysplasia at 18 and 24 weeks of gestation by ultrasonography. Postpartum radiological and histological analysis confirmed our prenatal diagnosis. Our purpose was to remind the differential prenatal diagnosis with other skeletal dysplasias and new prenatal diagnostic modalities. PMID:14605823

Sahinoglu, Zeki; Uludogan, Mehmet; Gurbuz, Ayse; Karateke, Ates



Image of tumor metastasis and inflammatory lymph node enlargement by contrast-enhanced ultrasonography  

PubMed Central

AIM: To compare the difference between tumor-induced lymph node enlargement and inflammation-induced lymph node enlargement by contrast-enhanced ultrasonography and pathological findings. METHODS: A model of tumor-induced lymph node metastasis was prepared by embedding a VX2 tumor into the hind paws of white rabbits. A model of inflammation-induced enlargement was prepared by injecting a suspension of Escherichia coli into separate hind paws of white rabbits. Then, a solution of Sonazoid™ (GE Healthcare, Oslo, Norway) was injected subcutaneously in the proximity of the lesion followed by contrast-enhanced ultrasonography of the enlarged popliteal lymph nodes. RESULTS: In the contrast-enhanced ultrasonography of the tumor-induced metastasis model, the sentinel lymph node was imaged. An area of filling defect was observed in that enlarged lymph node. In the histology examination, the area of filling defect corresponded to the metastatic lesion of the tumor. Contrast-enhanced ultrasonography of the model on inflammation-induced lymph node enlargement, and that of the acute inflammation model performed 3-7 d later, revealed dense staining that was comparatively uniform. The pathological findings showed acute lymphadenitis mainly due to infiltration of inflammatory cells. Contrast-enhanced ultrasonography that was performed 28 d post-infection in the acute inflammation model showed speckled staining. Inflammation-induced cell infiltration and fiberization, which are findings of chronic lymphadenitis, were seen in the pathological findings. CONCLUSION: Sentinel lymph node imaging was made possible by subcutaneous injection of Sonazoid™. Contrast-enhanced ultrasonography was suggested to be useful in differentiating tumor-induced enlargement and inflammation-induced enlargement of lymph nodes.

Aoki, Takaya; Moriyasu, Fuminori; Yamamoto, Kei; Shimizu, Masafumi; Yamada, Masahiko; Imai, Yasuharu



Validation of trans-rectal ultrasonography for counting preovulatory follicles in weaned sows.  


The present study investigated the accuracy of trans-rectal ultrasonography (TRU) for assessing the exact number of preovulatory follicles (POFs, with a diameter from 6 to 10mm) present in the ovaries of weaned sows. The ovaries of 63 hormonally treated (1500 IU of eCG) weaned sows were checked with TRU (7.5-MHz multiple scan angle transducer) in two successive scanning sessions performed at 26-27 and 30-31h after the beginning of oestrus signs, and the maximum number of POFs were counted. Sows were subjected to laparoscopy (LAP) immediately after the last TRU scan to confirm the number of POFs. The differences (mean+/-S.D.) in the number of POFs counted with TRU and LAP on each ovary were analyzed as a whole and after sorting the ovaries into three classes according to the number of POFs visualized by LAP: (1) less than 7; (2) from 7 to 13; and (3) more than 13. A significant correlation (P<0.01) was found between TRU and LAP for both the whole data set (126 ovaries) and in each of the three ovarian classes. Despite the significant correlation, TRU underestimated the number of POFs by 1.40+/-1.67 compared with LAP (P<0.001). However, the underestimation varied among the ovarian classes. This difference was not significant (P>0.05) in class 1 and was significant (P<0.001) in classes 2 (1.11+/-1.30 less POFs than counted by TRU) and 3 (3.19+/-1.54 less POFs than counted by TRU). In conclusion, TRU is a valuable tool to count the number of POFs present in the ovaries of weaned sows, but a certain degree of underestimation should be expected when the number of POFs is large. PMID:18684575

Bolarin, Alfonso; Vazquez, Juan M; Parrilla, Inmaculada; Vazquez, Jose L; Martinez, Emilio A; Roca, Jordi



Arterial-phase contrast-enhanced ultrasonography for evaluating anti-angiogenesis treatment: A pilot study  

PubMed Central

AIM: To verify whether arterial-phase contrast-enhanced ultrasonography (CEUS) of tumor parenchymal tissue is useful for evaluation of anti-angiogenesis agents. METHODS: Rabbits with liver tumor were subjected to CEUS, and images of the nodular maximal diameter in vascular phase were recorded. Image analysis was performed to plot the time intensity curve (TIC) at the tumor parenchyma, which set the diameter of the region of interest of intensity measurement. The TIC was calculated to obtain the time to peak intensity (TPI) and the magnitude of PI. Rabbits were randomly assigned to a treatment group with sorafenib and a control group. Two weeks later, the same ultrasound examination was repeated followed by pathological testing to assess the effect of sorafenib on the liver tumor. RESULTS: In four rabbits in the treatment group, the rate of change of tumor size was decreased compared with that of the control (the rate 2.3 vs 7.9, P = 0.02). The TPI of the treatment group elongated significantly (the rate 3.1 vs 1.1, P = 0.07 for SonoVue, 2.0 vs 0.88, P = 0.09 for Sonazoid). The magnitude of PI showed no significant changes. In pathological examination, capillary diameters in the treatment group were significantly smaller than those in the control group (26.4 vs 42.8 ?m, P = 0.013). CONCLUSION: Analysis of the TIC in the arterial phase of tumor tissue could evaluate the efficacy of anti-angiogenesis drug treatment in liver tumor.

Yoshida, Keiko; Hirokawa, Tomihiko; Moriyasu, Fuminori; Liu, Longzhong; Liu, Guang-Jian; Yamada, Masahiko; Imai, Yasuharu



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

PubMed Central

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.



Emergency department diagnosis of a quadriceps intramuscular loculated abscess/pyomyositis using dynamic compression bedside ultrasonography  

PubMed Central

Introduction A 73-year-old man with a past medical history of myelodysplastic syndrome and recent chemotherapy presented to the emergency department with a 1-week history of progressively increasing left thigh pain and swelling. His physical examination revealed left anterolateral diffuse thigh swelling with no erythema or warmth to palpation. The anterolateral quadriceps was markedly tender to palpation. Emergency department bedside dynamic compression ultrasonography that was performed on the left anterolateral thigh revealed a quadriceps intramuscular abscess with loculated yet movable pus. Conclusion Bedside dynamic compression ultrasonography can assist the emergency or critical care physician in the diagnosis of quadriceps intramuscular abscess or pyomyositis.



Ultrasonography as an adjunct in the diagnosis of acute appendicitis: a 4-year experience.  


This study was designed to evaluate the sensitivity and specificity of abdominal ultrasonography as a diagnostic modality in a large series of children who presented with possible appendicitis. From August 1990 to July 1994, 452 children (203 boys, 249 girls) with an average age of 11 years (range, 1 to 20 years) underwent graded compression ultrasonography of the right lower quadrant of the abdomen for the evaluation of possible appendicitis. In the first 18 months of the study all patients with the possible diagnosis of appendicitis (group I; 180 patients) had abdominal ultrasonography after members of the surgical team evaluated and documented their findings in the medical record. In the second study period (30 months), abdominal ultrasonography was recommended only when the clinical diagnosis of acute appendicitis was equivocal (group II; 272 patients). Abdominal ultrasonography was performed using the graded compression technique with a 5.0-MHz linear array transducer. A positive ultrasound study for appendicitis was defined as the presence of an enlarged noncompressible appendix with an outer wall to outer wall diameter of greater than 6 mm, the presence of a complex mass, or the presence of an appendicolith. The sonographic data were correlated with surgical and pathological findings. Appendicitis was confirmed in 112 of the 452 cases. In 17 of these, the appendix was perforated. In the overall group of 452 children, abdominal ultrasonography had a sensitivity of 90%, specificity of 96%, and accuracy of 95%. There was no significant morbidity in the 11 patients with a false-negative study result. All 11 patients had an uncomplicated appendectomy. There were 11 false-positive results; 10 of these patients had a negative laparotomy result (negative laparatomy rate, 8.9%). For the two groups, the sensitivity and specificity of ultrasonography in the diagnosis of appendicitis were equivalent (group 1: 88% sensitivity, 96% specificity; group 2: 92% sensitivity, 97% specificity). On the basis of the high sensitivity and specificity rates, ultrasonography of the appendix can be a useful adjunct to standard examination in the diagnosis of acute appendicitis. PMID:8632272

Ramachandran, P; Sivit, C J; Newman, K D; Schwartz, M Z



Incidental detection of bowel herniation with ultrasonography and fluoroscopy during a caudal block  

Microsoft Academic Search

Background  In contrast to fluoroscopy, ultrasonography allows visualization of structures such as muscles, tendons, vessels, and nerves.\\u000a We describe a case where ultrasonography in conjunction with fluoroscopy led to the incidental diagnosis of bowel herniation\\u000a in a patient undergoing a caudal block.\\u000a \\u000a \\u000a \\u000a \\u000a Clinical features  A 71-yr-old woman presented to our chronic pain clinic with a long-standing history of coccydynia for which she

Shubada Dugani; De Q. H. Tran; Roderick J. Finlayson




NSDL National Science Digital Library

This module outlines a variety of techniques for assessing student learning. It includes strategies for integrating assessment into different learning settings and at different points in the learning process.

Slattery, Bill


Performance of abdominal ultrasonography in pediatric blunt trauma patients: a meta-analysis  

Microsoft Academic Search

Objective: The objective of the study was to obtain the best estimates of the test performance of abdominal ultrasonography (US) for identifying children with intraabdominal injuries (IAIs). Methods: We gathered studies on the use of abdominal US in injured children from the following sources: a MEDLINE and Embase search, hand searches of 5 specialty journals and 4 clinical textbooks, the

James F. Holmes; Aaron Gladman; Cindy H. Chang


Contrast ultrasonography for 2-D opacification of heart cavities, peripheral vessels, kidney and muscle  

Microsoft Academic Search

Contrast ultrasonography of peripheral vessels and peripheral organs has been only sparsely used to evaluate peripheral tissue blood flow. The purpose of the study was to characterize intraluminal opacification of renal and femoral arteries and veins, of skeletal muscle and renal parenchyma after intraarterial (IA) injection of BY963, a newly developed ultrasound contrast agent being evaluated in Phase II and

Andreas L. Strauss; Klaus-Dieter Beller



Is post-mortem ultrasonography a useful tool for forensic purposes?  


Purpose To investigate the interest of post-mortem ultrasonography in the diagnosis of pathological background, and manner and cause of death. Methods Post-mortem ultrasonography exams were carried out on 38 fresh human adult cadavers referred to the Department of Forensic Medicine and Pathology (Garches, France). Data obtained from ultrasonography were independently compared with further forensic autopsy findings. Results Two important limitations relative to ultrasound utilization appeared: hyper-echoic abdominal and thoracic walls, with gas distension of the whole digestive tube and subcutaneous tissues (due to precocious putrefactive gas releasing); and difficulty in accessing lateral and posterior structures (i.e. liver, spleen, kidneys, lung bases, aorta) due to rigor mortis and evident non-compliance of the subject. Post-mortem diagnoses (moderate ascites, gallbladder stones, bladder globe, chronic kidney disease, cirrhosis, thyroid gland cysts and hypertrophy, intrauterine device), were strongly limited. False negative diagnoses comprised fatty liver, pleural effusion, thoracic aortic dissection, and focal organ and/or soft tissues lesions (for example, wounds or infarcts). Conclusion According to the results, post-mortem ultrasonography seems to have a very limited role for forensic purposes. Other post-mortem utilizations are cited, proposed, and discussed. PMID:23945259

Charlier, Philippe; Chaillot, Pierre-Fleury; Watier, Laurence; Ménétrier, Mélissa; Carlier, Robert; Cavard, Stéphanie; Hervé, Christian; Grandmaison, Geoffroy Lorin de la; Huynh-Charlier, Isabelle



Correlation between power Doppler ultrasonography and clinical severity in Achilles tendinopathy  

Microsoft Academic Search

Twenty-five patients with chronic Achilles tendinopathy were clinically and ultrasonographically evaluated. A positive correlation existed between power Doppler ultrasonography (PDU) and tendon thickness (r=0.63, pr=0.40, pr=?0.57, pr=?0.46, p

Koen H. E. Peers; Peter P. M. Brys; Roeland J. J. Lysens



Diagnostic Impact of Early Transcranial Doppler Ultrasonography on the TOAST Classification Subtype in Acute Cerebral Ischemia  

Microsoft Academic Search

Objective: The impact of early transcranial Doppler ultrasonography (TCD) upon stroke subtype diagnosis is unknown and may affect therapeutic strategies. In this study, the diagnostic usefulness of TCD in stroke subtype diagnosis according to the criteria of the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) study was investigated in patients with acute cerebral ischemia. Methods: TCD examination within

Christine A. C. Wijman; Nichol A. McBee; Penelope M. Keyl; Panayiotis N. Varelas; Michael A. Williams; John A. Ulatowski; Daniel F. Hanley; Robert J. Wityk; Alexander Y. Razumovsky



Duplex ultrasonography scanning for chronic venous disease: Patterns of venous reflux  

Microsoft Academic Search

Purpose: Patterns of flow in superficial and deep veins and outward flow in medial calf perforators were studied by duplex ultrasonography scanning in 1653 lower limbs in 1114 consecutive patients. This study compares results in 776 limbs with primary uncomplicated varicose veins with those in 166 limbs with the complications of lipodermatosclerosis or past venous ulceration.Methods: Duplex scanning determined whether

Kenneth A. Myers; Robert W. Ziegenbein; Ge Hua Zeng; P. Geoffrey Matthews



Development of a Flexible System for Measuring Muscle Area Using Ultrasonography  

Microsoft Academic Search

Muscular strength can be estimated by quantification of muscle area. For this purpose, we developed a flexible measuring system for muscle area using ultrasonography. This method is com- pletely safe and is particularly suitable for elderly people because the subjects are not required to perform any muscular contraction during measurement. The ultrasound probe is installed on a me- chanical arm,

Kiyotaka Fukumoto; Osamu Fukuda; Masayoshi Tsubai; Satoshi Muraki



Validation of ultrasonography for hepatic schistosomiasis using a porcine Schistosoma japonicum model  

Microsoft Academic Search

Ultrasonography is increasingly used to record hepatosplenic involvement in schistosomiasis. However, questions remain unsolved regarding diagnostic accuracy in mild hepatic disease and under influence of confounders like co-infections. We report on a study to evaluate the suitability of a pig model of schistosomiasis japonica to investigate such problems. Nine pigs (12 weeks of age) were infected with 1000 Schistosoma japonicum

Rüdiger Kardorff; Lis Eriksen; Dorte Hald Nielsen; Maria Vang Johansen



Ultrasonography for the evaluation of forearm interosseous membrane disruption in a cadaver model  

Microsoft Academic Search

Recognition of interosseous membrane disruption associated with radial head injury and Essex-Lopresti injury is important, especially if radial head excision is contemplated. Because a widely accepted method to diagnose interosseous membrane disruption does not exist, we evaluated the accuracy of ultrasonography to diagnose this injury in a cadaver model. Nine pairs of cadaver forearms were randomized into 2 groups. The

Juha I. Jaakkola; David H. Riggans; Gary M. Lourie; Christopher J. Lang; Bassam El hassem; Stanton J. Rosenthal



Transcranial Doppler Ultrasonography Monitoring of Cerebral Hemodynamics During Performance of Cognitive Tasks: A Review  

Microsoft Academic Search

The examination of blood flow velocity (BFV) changes during the performance of mental tasks is one of the applications of transcranial Doppler (TCD) ultrasonography. The purpose of this review is to summarize the results of the functional TCD literature, to investigate the effects of methodological differences between studies, and to provide guidelines for future research. It is concluded that larger

Nathalie Stroobant; Guy Vingerhoets



Comparison of the sensitivity for detecting foreign bodies among conventional plain radiography, computed tomography and ultrasonography  

PubMed Central

Objective The purpose of this study was to compare the sensitivity for detecting foreign bodies among conventional plain radiography, CT and ultrasonography in in vitro models. Methods Seven different materials were selected as foreign bodies with dimensions of approximately 1×1×0.1 cm. These materials were metal, glass, wood, stone, acrylic, graphite and Bakelite. These foreign bodies were placed into a sheep's head between the corpus mandible and muscle, in the tongue and in the maxillary sinus. Conventional plain radiography, CT and ultrasonography imaging methods were compared to investigate their sensitivity for detecting these foreign bodies. Results Metal, glass and stone can be detected with all the visualization techniques used in the study in all of the zones. In contrast to this, foreign bodies with low radiopacity, which could be detected in air with CT, became less visible or almost invisible in muscle tissue and between bone and muscle tissue. The performance of ultrasonography for visualizing foreign bodies with low radiopacity is relatively better than CT. Conclusions Ultrasonography detects and localizes superficial foreign bodies with low radiopacity in the tissues of the body more effectively than CT and conventional plain radiography. However, CT is a more effective technique for visualization of foreign bodies in air than ultrasound and conventional plain radiography.

Aras, M H; Miloglu, O; Barutcugil, C; Kantarci, M; Ozcan, E; Harorli, A



Role of endoscopic ultrasonography in the diagnosis of acute and chronic pancreatitis.  


Endoscopic ultrasonography (EUS) can be a useful tool for detecting underlying causes of acute pancreatitis and establishing the severity of fibrosis in chronic pancreatitis. Ancillary techniques include fine needle aspiration and core biopsy, bile collection for crystal analysis, pancreatic function testing, and celiac plexus block. This review focuses on the role of EUS in the diagnosis of acute and chronic pancreatitis. PMID:24079787

Stevens, Tyler



Magnetic resonance angiography of spontaneous vertebral artery dissection suspected on Doppler ultrasonography  

Microsoft Academic Search

Spontaneous vertebral artery dissection (VAD) is a rare but well-known cause of cerebrovascular disease and is often difficult to diagnose even using conventional arteriography. While noninvasive tests such as Doppler ultrasonography and magnetic resonance imaging (MRI) have failed to provide reliable criteria for the diagnosis of VAD, the diagnostic value of magnetic resonance angiography (MRA) has not yet been undetermined.

Joachim Röther; Andreas Schwartz; Wolfgang Rautenberg; Michael Hennerici



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

ERIC Educational Resources Information Center

|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.…

Chi-Fishman, Gloria



Transperineal 125iodine seed implantation in prostatic cancer guided by transrectal ultrasonography  

Microsoft Academic Search

A new method is described for precise transperineal insertion of radioactive 125iodine seeds in patients with prostatic cancer. The procedure is done under transrectal ultrasonography guidance using a special multichannel puncture attachment and a simple, efficient insertion technique. The advantages of the method are 1) the patients are spared the inconvenience and risk of an operation, 2) improved dose calculations




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

ERIC Educational Resources Information Center

|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…

Ivanusic, Jason; Cowie, Brian; Barrington, Michael



Sustained esophageal contraction: A marker of esophageal chest pain identified by intraluminal ultrasonography  

Microsoft Academic Search

Background & Aims: Intraluminal pressure recording systems have not demonstrated predictable esophageal motor correlates of unexplained chest pain. This study used continuous high-frequency intraluminal ultrasonography to characterize esophageal contraction at the time of spontaneous and provoked chest pain. Methods: Intraluminal pressure, pH, and ultrasound images of the esophagus were recorded for a maximum of 24 hours in 10 subjects with

David H. Balaban; Yoshihiro Yamamoto; Jianmin Liu; Nonko Pehlivanov; Ralph Wisniewski; Dennis DeSilvey; Ravinder K. Mittal



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

SciTech Connect

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.

Kablak-Ziembicka, Anna, E-mail:; Przewlocki, Tadeusz; Pieniazek, Piotr; Musialek, Piotr; Kozanecki, Artur; Stopa, Ireneusz; Zalewski, Jaroslaw; Tracz, Wieslawa [The John Paul II Hospital, Institute of Cardiology, Collegium Medicum Jagiellonian University, Department of Cardiac and Vascular Diseases (Poland)



Effectiveness of routine ultrasonography in detecting fetal structural abnormalities in a low risk population.  

PubMed Central

OBJECTIVE--To review the efficacy of routine prenatal ultrasonography for detecting fetal structural abnormalities. DESIGN--Retrospective study of the ultrasonographic findings and outcome of all pregnancies in women scanned in 1988-9. SETTING--Maternity ultrasonography department of a district general hospital. SUBJECTS--8785 fetuses. MAIN OUTCOME MEASURES--Correlation of prenatal ultrasonographic findings with outcome in the neonate. RESULTS--8733 babies were born during 1988-9, and 52 pregnancies were terminated after a fetal malformation was identified. 8432 (95%) of the fetuses were examined by ultrasonography in the second trimester. 130 fetuses (1.5%) were found to have an abnormality at birth or after termination of pregnancy, 125 of which had been examined in the second trimester. In 93 cases the abnormality was detected before 24 weeks (sensitivity 74.4%, 95% confidence interval to 66.7% to 82.1%. Two false positive diagnoses occurred, in both cases the pregnancies were not terminated and apparently normal infants were born. This gives a specificity of 99.98% (99.9% to 99.99%). The positive predictive value of ultrasonography in the second trimester was 97.9% (92.6% to 99.7%). Of the 125 abnormalities, 87 were lethal or severely disabling; 72 of the 87 were detected by the routine screening programme (sensitivity 82.8%, 73.2% to 90.0%). CONCLUSION--Routine fetal examination by ultrasonography in a low risk population detects many fetal structural abnormalities but can present several dilemmas in counselling.

Chitty, L S; Hunt, G H; Moore, J; Lobb, M O



Assessment of coronary thrombolysis  

SciTech Connect

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.

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



Transvaginal follicular aspiration and embryo development in superstimulated early postpartum beef cows and subsequent fertility after artificial insemination.  


This study was conducted to investigate in early postpartum suckled beef cows with and without FSH pre-stimulation: (i) the influence of the postpartum period on the number and quality of oocytes recovered by ovum pick-up (OPU), (ii) the overall efficiency of the OPU/IVP embryos from days 30 to 80 postpartum and (iii) if repeated OPU negatively affect fertility following a fixed-time artificial insemination protocol. After parturition suckled Angus cows (n = 30) were divided in three groups (n = 10 group(-1)). All cows were anestrous at the commencement of experimental treatments (30.0 +/- 3.2 days postpartum, mean +/- SD; range 25-34 days). Group 1 treatments included: dominant follicle ablation (DFA), FSH treatment and OPU procedure 5 days after DFA. A total of 9 mg FSH (Ovagen) was administered s.c. once a day over 2 days at equal doses (4.5 + 4.5mg). For fertility test the cows received an intravaginal progesterone treatment from Days 78 to 86 postpartum and were fixed-time artificially inseminated (FTAI) at 56 and 72 h after device removal. Group 2: as cited for Group 1 with no FSH treatment. In both groups, OPU was repeated four times (Days 35, 49, 63 and 77 postpartum) and the collected oocytes classified as viable were in vitro matured, fertilized and presumptive embryos cultured for 8 days. Group 3 (Control FTAI): cows that had not previously aspirations were FTAI as Groups 1 and 2. Pregnancy was diagnosed by means ultrasonography 39 days after FTAI. The numbers (mean +/- SEM) of follicles visible and aspirated at the time of OPU in FSH-treated cows were greater (P < 0.05) than in non-treated cows (10.6 +/- 0.6 and 8.4 +/- 0.4 vs. 8.0 +/- 0.5 and 4.6 +/- 0.3, respectively). Following FSH treatment, the number (mean +/- SEM) of recovered oocytes per cow per OPU session and percentage of viable oocytes were greater in the treated (P < 0.05) than in non-treated animals (3.0 +/- 0.1 and 39.5% vs. 1.5 +/- 0.1 and 30.0%). The cleavage and embryo development rates were similar (P > 0.05) for both groups (14.8 and 6.4% vs. 16.6 and 5.5%). After FTAI the pregnancy rates were not different (P > 0.05) among groups (70, 60 and 90% for Groups 1, 2 and 3, respectively). We can conclude that (1) FSH-treated suckled postpartum cows can be a source of oocytes for in vitro fertilization and (2) repeated DFA/OPU applied during postpartum period did not affect the subsequent fertility following FTAI. PMID:20036087

Aller, J F; Mucci, N C; Kaiser, G G; Ríos, G; Callejas, S S; Alberio, R H



The impact of computed tomography and ultrasonography on the management of patients with carcinoma of the ovary.  

PubMed Central

We have carried out a prospective study on the impact of computed tomography (CT) and ultrasonography (US) on the management of patients with carcinoma of the ovary. Seventy-eight CT and 88 US scans were performed on 94 patients. Clinicians decided patient management prospectively at the time the CT and/or US was ordered. Clinical assessment differed from the result obtained by CT or US in 45% of cases (35/78 and 40/88, respectively). CT and US altered patient management in only a minority of cases (14/78, 18% and 9/88, 10% respectively). Even when the scan and clinical assessments differed, management was only altered on 14/35 (40%) occasions after CT and on 9/40 (23%) occasions after US, a difference which was not significant. In patients with clinically undetectable disease, management was altered by CT on 17% of occasions and by US on 10%. We conclude that in patients with carcinoma of the ovary CT and US alters patient management in a minority of cases. In view of current financial restrictions in health care, clinicians should be more selective in the use of these imaging techniques. Furthermore, we recommend that similar prospective studies are performed for other clinical situations.

Gore, M. E.; Cooke, J. C.; Wiltshaw, E.; Crow, J. M.; Cosgrove, D. O.; Parsons, C. A.



Ultrasonography of the reticulum, rumen, omasum, and abomasum in 10 calves before, during, and after ingestion of milk.  


The reticulum, rumen, omasum, and abomasum were assessed via ultrasonography before, during, and 15, 30, and 120 minutes after feeding milk to 10 healthy calves. The ultrasonographic examinations were conducted using a 5.0 MHz linear transducer. Loops were recorded on video for further evaluation. The reticulum could be visualised before feeding in seven calves. Its appearance and pattern of contractions were similar to those in adult cattle, although the amplitude (1.7 ± 0.75 cm) and velocity (2.7 ± 1.34 cm/s) of the first contraction were smaller than in adult cattle. The reticulum could not be visualised in any of the calves during feeding as it was displaced cranially and laterally and therefore being obscured by the lungs as the abomasum expanded with the ingested milk. 2 hours post ingestion it remained obscured in 5 individual and was visualized again the other 5. The position and size of the entire rumen including the dorsal and ventral sacs and the ruminal contents were assessed. There were no changes in the ultrasonographic appearance of the rumen during or after feeding. Except for its smaller size, the ultrasonographic appearance of the omasum of calves was similar to that of adult cattle. Milk flow through the omasum could not be seen in any of the calves, and there were no changes in the appearance of the omasum during and after feeding. 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. The flow of milk into the abomasum and milk clotting, which occurred 15 minutes after feeding, could be seen in all calves. The milk clots started to slowly disintegrate 30 minutes after the start of feeding, and by 2 hours post feeding, this process was greatly advanced but remained incomplete. Ultrasonography is an ideal tool for the evaluation of the reticulum, rumen, omasum, and abomasum before, during, and after the ingestion of milk in calves. PMID:22753252

Braun, U; Gautschi, A



Endorectal ultrasonography in rectal cancer: a preliminary Barbadian experience.  


Preoperative staging of rectal cancer assists in surgical decision making regarding the suitability of curative local excision as well as in the selective use of preoperative adjuvant radiation and chemoradiation, both of which have been shown to reduce the incidence of loco-regional cancer recurrence substantially. Most colorectal units employ endorectal ultrasound (ERUS) in the assessment to define tumour depth (T) and nodal (N) status. The preliminary Barbadian experience of 40 such cases showing an accuracy for T stage of 85% and for N stage of 50% in keeping with international reports is presented The interpretation and limitations of this technology are presented PMID:17373297

Zbar, A P



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

PubMed Central

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.

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



Spontaneous rectus sheath hematoma diagnosed by point-of-care ultrasonography.  


ABSTRACTSpontaneous rectus sheath hematoma is an uncommon condition that can mimic other conditions associated with an acute abdomen. We report the case of a patient with a spontaneous rectus sheath hematoma due to a ruptured inferior epigastric artery pseudoaneurysm who presented with hypotension and severe abdominal pain and was diagnosed using emergency department point-of-care ultrasonography. Point-of-care ultrasonography has been increasingly used in the evaluation of emergency department patients with acute abdomen and hypotension to expedite the diagnosis and management of aortic aneurysm and intraperitoneal bleeding. Resuscitation and urgent surgical and interventional radiology consultations resulted in the successful embolization of a branch of the inferior epigastric artery and a good outcome. PMID:23458146

Shokoohi, Hamid; Boniface, Keith; Reza Taheri, M; Pourmand, Ali



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

PubMed Central

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.

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



Usefulness and limitation of ultrasonography in the diagnosis of intestinal intussusception in cows.  


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

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



Evaluation of acute radiation optic neuropathy by B-scan ultrasonography  

SciTech Connect

We studied the accuracy of B-scan ultrasonography to diagnose radiation-induced optic neuropathy in 15 patients with uveal melanoma. Optic neuropathy was diagnosed by an observer masked as to clinical and photographic data. We analyzed planimetry area measurements of the retrobulbar nerve before and after irradiation. The retrobulbar area of the optic nerve shadow on B-scan was quantitated with a sonic digitizer. Increased optic nerve shadow area was confirmed in 13 of 15 patients who had radiation optic neuropathy (P less than .004). The correct diagnosis was confirmed when the results of ultrasound were compared to fundus photography and fluorescein angiography. In 13 patients there was acute radiation optic neuropathy. Two patients did not show an enlarged retrobulbar optic nerve, and the clinical appearance suggested early progression to optic atrophy. Ultrasonography documents the enlargement of the optic nerve caused by acute radiation changes.

Lovato, A.A.; Char, D.H.; Quivey, J.M.; Castro, J.R. (Univ. of California, San Francisco (USA))



Pelvic congenital arteriovenous malformation diagnosed by transrectal ultrasonography: A case report  

PubMed Central

Arteriovenous malformations (AVMs) of the pelvis are relatively rare and difficult to treat because of multiple and extensive feeding vessels. We report the case of a 69-year-old male with pelvic congenital AVM that was detected during tests for dysuria. He visited our hospital complaining of voiding difficulty. Digital rectal examination revealed a pulsating mass that was palpable on the right side of the prostate. Transrectal ultrasonography showed multiple hypoechoic lesions adjacent to the prostate and colour Doppler ultrasonography revealed the flow regions corresponded to the hypoechoic lesions. Computed tomography demonstrated large-to-small tubular vessels adjacent to the prostate, while pelvic angiography showed many small feeder arteries extending mainly from the right internal iliac artery. He was diagnosed as having pelvic congenital AVM. Uroflowmetry revealed slight voiding difficulty without residual urine. The patient decided against treatment and requested we monitor his clinical course.

Suzuki, Kenjiro; Tanaka, Nobuyuki; Ebine, Takashi; Momma, Tetsuo



Prediction of ovarian response and IVF\\/ICSI outcome by three-dimensional ultrasonography and power Doppler angiography  

Microsoft Academic Search

ObjectiveThe objective was to evaluate whether three-dimensional ultrasonography (3D-US) and power Doppler angiography (PDA) measurements can predict ovarian response and\\/or are associated with IVF\\/ICSI outcome.

Luis T. Mercé; María J. Barco; Santiago Bau; Juan M. Troyano



Low intensity pulsed ultrasonography for fractures: systematic review of randomised controlled trials  

Microsoft Academic Search

Objective To determine the efficacy of low intensity pulsed ultrasonography for healing of fractures.Design Systematic review of randomised controlled trials.Data sources Electronic literature search without language restrictions of CINAHL, Embase, Medline, HealthSTAR, and the Cochrane Central Registry of Controlled Trials, from inception of the database to 10 September 2008.Review methods Eligible studies were randomised controlled trials that enrolled patients with

Jason W Busse; Jagdeep Kaur; Brent Mollon; Mohit Bhandari; Paul Tornetta; Holger J Schünemann; Gordon H Guyatt



Diagnostic imaging in abdominal neuroblastoma: Is there a complementary role of MIBG-scintigraphy and ultrasonography?  

Microsoft Academic Search

In a retrospective study we evaluated the agreement between the results of meta-iodo benzylguanidine (MIBG) scintigraphy\\u000a and abdominal ultrasonography (US) in the diagnosis and follow up of neuroblastoma (NBL) with respect to the abdominal region.\\u000a Data of 28 consecutive paediatric patients with NBL or suspected NBL were included (16?M\\/12?F, mean age 2.9?years, range 3?weeks\\u000a – 13.4?years). The results (as judged

M. Petjak; M. M. C. Tiel-van Buul; C. R. Staalman; J. C. Greve; J. de Kraker; E. A. van Royen



Prenatal diagnosis of thanatophoric dysplasia in the second trimester: ultrasonography and other diagnostic modalities  

Microsoft Academic Search

.  \\u000a Thanatophoric dysplasia is the most common type of neonatal lethal osteochondrodysplasias, with an estimated frequency of\\u000a nearly of 1 in 20,000 births. It is a disorder characterized by extremely short ribs, tubular bones and macrocephaly. The\\u000a prenatal diagnosis of thanatophoric dysplasia has been well established by ultrasonography in the second trimester; however\\u000a it is not always possible to differentiate

Zeki Sahinoglu; Mehmet Uludogan; Ayse Gurbuz; Ates Karateke



Intussusception: indications for ultrasonography and an explanation of the doughnut and pseudokidney signs  

Microsoft Academic Search

Ultrasonography has been shown to be valuable in the detection of intussusception [9–13], but a question arises, as to just\\u000a when this study should be performed. Should it be a general screening procedure or should it be utilized for specific cases\\u000a only? Upon reviewing the literature, and the findings in 14 of our patients, we feel that it should be

L. E. Swischuk; C. K. Hayden; T. Boulden



Diagnostic quality of dynamic high-resolution ultrasonography of the TMJ—a pilot study  

Microsoft Academic Search

The aim of this study was to compare sensitivity, specificity, accuracy and positive and negative predictive value for high-resolution ultrasonography (HR-US) in diagnosing degenerative changes, effusion and disk displacement using magnetic resonance imaging (MRI) as a reference. Over a period of 6 months, 100 patients with TMJ disorders (200 TMJs) were investigated by an experienced radiologist with HR-US and magnetic

S. Jank; R. Emshoff; B. Norer; M. Missmann; A. Nicasi; H. Strobl; R. Gassner; A. Rudisch; G. Bodner



Abdominal ultrasonography in the diagnostic work-up in children with recurrent abdominal pain  

Microsoft Academic Search

We report on our experience with routine abdominal ultrasonography in 120 children (aged 3–15 years) with recurrent abdominal\\u000a pain, in order to determine the diagnostic value of this investigation. Eight children (7%) revealed sonographic abnormalities:\\u000a gallbladder stone (n?=?2), splenomegaly (n?=?1) and urogenital abnormalities (n?=?5). The recurrent abdominal pain could be explained by these findings in only two (may be three)

V. Wewer; C. Strandberg; A. Pærregaard; P. A. Krasilnikoff



Comparing Doppler Ultrasonography and Cerebral Oximetry as Indicators for Shunting in Carotid Endarterectomy  

Microsoft Academic Search

To determine the thresholds of selective shunting in ca- rotid endarterectomy during general anesthesia, we compared transcranial Doppler ultrasonography and cerebral oximetry (RSO2). During carotid cross- clamping, RSO2 and mean blood flow velocity in the middle cerebral artery (Vm,mca) was simultaneously monitored in 55 of 59 patients. A relative decrease in Vm,mca to ,20% of preclamp velocity was the indica-

Georg Grubhofer; Michael Skolka; Martin Czerny; Marek Ehrlich; Andrea Lassnigg



The Predictive Diagnostic Value of Serial Daily Bedside Ultrasonography for Severe Dengue in Indonesian Adults  

PubMed Central

Background Identification of dengue patients at risk for progressing to severe disease is difficult. Significant plasma leakage is a hallmark of severe dengue infection which can suddenly lead to hypovolemic shock around the time of defervescence. We hypothesized that the detection of subclinical plasma leakage may identify those at risk for severe dengue. The aim of the study was to determine the predictive diagnostic value of serial ultrasonography for severe dengue. Methodology/Principal Findings Daily bedside ultrasounds were performed with a handheld ultrasound device in a prospective cohort of adult Indonesians with dengue. Timing, localization and relation to dengue severity of the ultrasonography findings were determined, as well as the relation with serial hematocrit and albumin values. The severity of dengue was retrospectively determined by WHO 2009 criteria. A total of 66 patients with proven dengue infection were included in the study of whom 11 developed severe dengue. Presence of subclinical plasma leakage at enrollment had a positive predictive value of 35% and a negative predictive value of 90% for severe dengue. At enrollment, 55% of severe dengue cases already had subclinical plasma leakage, which increased to 91% during the subsequent days. Gallbladder wall edema was more pronounced in severe than in non-severe dengue patients and often preceded ascites/pleural effusion. Serial hematocrit and albumin measurements failed to identify plasma leakage and patients at risk for severe dengue. Conclusions/Significance Serial ultrasonography, in contrast to existing markers such as hematocrit, may better identify patients at risk for development of severe dengue. Patients with evidence of subclinical plasma leakage and/or an edematous gallbladder wall by ultrasonography merit intensive monitoring for development of complications.

Michels, Meta; Sumardi, Uun; de Mast, Quirijn; Jusuf, Hadi; Puspita, Mita; Dewi, Intan Mauli Warma; Sinarta, Sylvia; Alisjahbana, Bachti; van der Ven, Andre J. A. M.



Role Of Ultrasonography in Predicting Malignancy in Patients with Thyroid Nodules  

Microsoft Academic Search

The use of ultrasonography (USG) has become an essential part of endocrine surgical practice. We evaluated the value of USG\\u000a in predicting malignancy of thyroid nodules. The accuracy of USG in 857 patients who underwent fine-needle aspiration (FNA)\\u000a with or without surgery was analyzed in a prospective setting. The diagnostic accuracy of USG was compared to that of FNA\\u000a and

Hyeong-Gon Moon; Eun-Jung Jung; Soon-Tae Park; Woo-Song Ha; Sang-Kyung Choi; Soon-Chan Hong; Young-Joon Lee; Young-Tae Joo; Chi-Young Jeong; Dae-Seob Choi; Jae-Wook Ryoo



Indications for hepatic ultrasonography in breast cancer staging and follow-up  

Microsoft Academic Search

Retrospective analysis of the medical records of 6649 breast cancer patients seen over an 11-year period found 438 patients (6.6%) with liver metastases (LM) and 432 patients (6.5%) with benign liver lesions (BLL). Liver ultrasonography (LUS) and liver function tests had been performed for all patients. LM were the first manifestation of metastatic spread in 20.1% of the 438 patients;

Jean-Noël Bruneton; Catherine Balu-Maestro; Charles Raffaelli; Michel-Yves Mourou; Pierre Cambon; Claire Granon



Role of prenatal ultrasonography in women with positive screen for Down syndrome on the basis of maternal serum markers  

Microsoft Academic Search

OBJECTIVE: Our purpose was to evaluate the usefulness of prenatal ultrasonography among women with a positive screen for fetal Down syndrome on the basis of three biochemical markers—maternal serum ?-fetoprotein, human chorionic gonadotropin, and unconjugated estriol.STUDY DESIGN: A total of 395 women underwent prenatal ultrasonography at a single institution after being identified as screen positive (midtrimester risk ?1:195) on the

David A. Nyberg; David A. Luthy; Edith Y. Cheng; Robert C. Sheley; Robert G. Resta; Michelle A. Williams



Imaging in chronic achilles tendinopathy: a comparison of ultrasonography, magnetic resonance imaging and surgical findings in 27 histologically verified cases  

Microsoft Academic Search

Objective. To compare information gained by ultrasonography and magnetic resonance imaging (MRI) in chronic achilles tendinopathy with\\u000a regard to the nature and severity of the lesion. Design. Imaging of both achilles tendons with ultrasonography and MRI was performed prior to unilateral surgery. Operative findings\\u000a and histological biopsies together served as a reference. Patients. Twenty-seven patients (22 men, 5 women; mean

M. Åström; Carl-Fredrik Gentz; Paul Nilsson; A. Rausing; Staffan Sjöberg; Nils Westlin



Small hepatocellular carcinomas: ultrasonography guided percutaneous radiofrequency ablation.  


Current guidelines advocate percutaneous radiofrequency (RF) ablation as a standard treatment of early stage hepatocellular carcinoma (HCC) for up to three tumors ?3 cm in diameter. The local efficacy evaluated with short-term radiological examination may be overrated, whereas that assessed by histopathological measure might be underestimated. Long-term clinical follow-up studies guarantee the effectiveness of RF ablation for small HCC, which is now almost comparable in benefits to surgical resection. US is the most common guiding modality for percutaneous RF ablation for small HCC. However, the technical feasibility is often limited due to poor conspicuity of the index tumor on US. Implementation of artificial ascites, contrast-enhanced harmonic US, and fusion imaging of US with CT/MR can be helpful to enhance the technical feasibility of US-guided RF ablation of small HCC. PMID:22467060

Kim, Young Jun; Lee, Min Woo; Park, Hee Sun



Hemodialysis access flow measurement. Comparison of ultrasound dilution and duplex ultrasonography.  


Decreased hemodialysis access flow is associated with an increased risk of access thrombosis. Duplex ultrasonography can measure access flow and select a subset of patients at increased risk for access failure. With in-line techniques (ultrasound dilution), access flow can be measured during hemodialysis. This study attempted to determine if access flow measured by ultrasound dilution (QA-T) was comparable to that measured by duplex ultrasonography (QA-S). The authors performed 66 simultaneous measurements of hemodialysis access flow in 19 patients by ultrasound dilution and duplex ultrasound with time-domain correlation during 19 hemodialysis treatments. The mean access flow was 1,086 +/- 505 ml/min by ultrasound dilution and 1,026 +/- 513 ml/min with duplex ultrasonography (NS). Regression analysis revealed a linear relationship between the two techniques described by the equation QAT = 246.14 + 0.8104(QAS) (correlation coefficient of 0.83; p < 0.0001). Measurement of hemodialysis access flow by ultrasound dilution was essentially equivalent to that obtained by duplex ultrasound. Additional studies are needed to determine if regular in-line flow measurements can predict and prevent future access thrombosis and decreased the cost of access management. PMID:8945015

Sands, J; Glidden, D; Miranda, C


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

SciTech Connect

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.

Tercan, Fahri [Baskent Universitesi, Adana Arastirma ve Uygulama Merkezi (Turkey)], E-mail:; Oguzkurt, Levent; Ozkan, Ugur [Baskent University Faculty of Medicine, Department of Radiology (Turkey); Eker, Hatice Evren [Baskent University Faculty of Medicine, Department of Anesthesiology (Turkey)



Measurement of Carotid Stenosis Using Duplex Ultrasonography with a Microconvex Array Transducer: A Validation with Cerebral Angiography.  


BACKGROUND: We aimed to evaluate the validity of duplex ultrasonography (DUS) using a microconvex array transducer (MAT) with enhanced flow imaging (EFI) for visualization of the distal, internal carotid artery (ICA) and the accurate assessment of ICA stenosis. METHODS: Patients who underwent both DUS and digital subtraction angiography (DSA) were registered for this study. DUS was performed by using a linear array transducer (LAT) and an MAT with EFI. The visibility of the ICA was compared between the 2 transducers. ICA stenosis was evaluated by the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method on DUS, and the peak systolic flow velocity (PSV) was evaluated by using an MAT. These results were compared with DSA. RESULTS: In 238 internal carotid arteries, the average length of visualized ICA was longer for DUS using an MAT than an LAT (38.7 ± 11.7 mm versus 25.8 ± 9.8 mm, P < .0001). In 68 stenotic, internal carotid arteries, the degree of ICA stenosis detected by the NASCET method on DUS was correlated to that on DSA (P < .0001, r = .969, and adjusted r(2) = .938). PSV also correlated to NASCET method on DSA (P < .0001, r = .804, and adjusted r(2) = .640). CONCLUSIONS: DUS using an MAT with EFI technology could reveal more extended distal views of the ICA and was strongly correlated with NASCET method on DSA. PMID:23608369

Tateishi, Yohei; Tsujino, Akira; Hamabe, Jumpei; Tasaki, Osamu; Morikawa, Minoru; Horie, Nobutaka; Hayashi, Kentaro; Nagata, Izumi



Urinary continence following laparoscopic radical prostatectomy: Association with postoperative membranous urethral length measured using real-time intraoperative transrectal ultrasonography  

PubMed Central

Urinary incontinence is a major complication following radical prostatectomy. The aim of the present study was to assess the association between urinary continence following laparoscopic radical prostatectomy (LRP) and various factors measured using real-time intraoperative transrectal ultrasonography (TRUS). Patients (n=53) with localized prostate cancer underwent LRP in combination with real-time intraoperative TRUS navigation and were evaluated for urinary continence for more than 6 months following LRP. Prostate size, membranous urethral length (MUL) and bladder-urethra angle were measured using real-time intraoperative TRUS immediately before and after surgery. Urinary continence was regained by 4, 15 and 27 patients 1, 3 and 6 months after LRP, respectively. Longer postoperative MUL was significantly correlated with recovery of urinary continence 1, 3 and 6 months after LRP. In addition, an increase in difference between preoperative and postoperative MUL was also associated with superior continence. No correlation was observed between postoperative MUL and the rate of tumor-positive surgical margins. Larger prostate volume was correlated to postoperative continence 6 months after surgery. Shorter operation time and less blood loss resulted in postoperative urinary continence 1 month after LRP. Preoperative MUL, bladder-urethra angle, age and body mass index had no correlation with urinary continence. Postoperative MUL was the most significant factor for early recovery of urinary continence following LRP. These results indicate that preservation of longer urethra during surgery may be recommended without tumor-positive surgical margins.




High resolution ultrasonography of the hand and wrist: three-year experience at a District General Hospital Trust.  


A retrospective analysis of 227 patients undergoing ultrasonography (US) of the hand/wrist over a three-year period in a district general hospital trust was performed. The usefulness in each case was assessed by two independent reviewers using a qualitative rating system, as (A) Useful: determines management, (B) Useful: contributory, (C) Not useful: not misleading, or (D) Not useful: misleading/potentially harmful. US was useful in 74.8% of cases but misleading/potentially harmful in 13.1%. Misleading rates exceeding 10% in sub-categories including tendinopathy, carpal tunnel syndrome, foreign body and lumps, where US findings may influence the decision to operate or not, are particularly worrying. There were a number of cases where US led to unnecessary operations or suggested operating on the wrong structures, and also cases where US findings wrongly suggested that surgery was unnecessary. Various recommendations aimed to improve the usefulness of US in the Hand and Wrist, including mandatory/formal musculoskeletal US training, are made. PMID:21089192

Chan, J K K; Choa, R M; Chung, D; Sleat, G; Warwick, R; Smith, G D



Performance criteria for quantitative ultrasonography and image parameterisation.  


For the purpose of assessing and comparing the practical performance of various specific approaches to quantitative tissue characterisation, three sets of performance criteria are proposed, relating respectively to contrast resolution, spatial resolution, and speed of presentation. In each case numerical performance targets are suggested: in particular that spatial resolution should preferably be within a linear factor of three of the best achievable anatomical resolution of the associated imaging techniques and that presentation speed should be 'real time' (i.e. about 10 Hz). In the light of these criteria and performance targets the main existing approaches to ultrasonic tissue characterisation are then considered. These are classified in two groups: first those approaches based on measurements of bulk properties of tissues and secondly those related to parameters of the structural organisation of tissues. Examination of available evidence suggests that the latter group are more promising than the former. Finally it is argued that ultrasonic methods of tissue characterisation have substantial practical potential but that the realisation of such potential is contingent on achieving consensus on choice of a single, optimised and generally applicable approach that would carry with it the linked benefits of industrial standardisation and broad sharing of clinical experience. PMID:2286049

Hill, C R; Bamber, J C; Cosgrove, D O



A critique of current practice of transvaginal pudendal nerve blocks: a prospective audit of understanding and clinical practice.  


Pudendal nerve blocks are a pre-requisite to forceps delivery without regional anaesthesia. Their efficacy is dependent on introducing local anaesthetic in close proximity to the pudendal nerve and allowing sufficient time for its onset of action. An audit of 57 obstetricians evaluated their clinical technique against standards using both a questionnaire and adapted model pelvis. The majority of participants were unable to describe correctly the point of infiltration and were unaware of the lag time required to effect adequate analgesia. We identify a deficiency in training and describe a method by which training can be facilitated and assessed. PMID:23815197

Ford, J M; Owen, D J; Coughlin, L B; Byrd, L M



The diagnostic value of ultrasonography-derived edema of the temporal artery wall in giant cell arteritis: a second meta-analysis  

Microsoft Academic Search

BACKGROUND: Ultrasonography of temporal arteries is not commonly used in the approach of patients with suspected giant cell arteritis (GCA) in clinical practice. A meta-analysis of primary studies available through April 2004 concluded that ultrasonography could indeed be helpful in diagnosing GCA. We specifically re-examined the diagnostic value of the ultrasonography-derived halo sign, a dark hypoechoic circumferential thickening around the

Aikaterini Arida; Miltiades Kyprianou; Meletios Kanakis; Petros P Sfikakis



Automatic thickness estimation for skeletal muscle in ultrasonography: evaluation of two enhancement methods  

PubMed Central

Background Ultrasonography is a convenient technique to investigate muscle properties and has been widely used to look into muscle functions since it is non-invasive and real-time. Muscle thickness, a quantification which can effectively reflect the muscle activities during muscle contraction, is an important measure for musculoskeletal studies using ultrasonography. The traditional manual operation to read muscle thickness is subjective and time-consuming, therefore a number of studies have focused on the automatic estimation of muscle fascicle orientation and muscle thickness, to which the speckle noises in ultrasound images could be the major obstacle. There have been two popular methods proposed to enhance the hyperechoic regions over the speckles in ultrasonography, namely Gabor Filtering and Multiscale Vessel Enhancement Filtering (MVEF). Methods A study on gastrocnemius muscle is conducted to quantitatively evaluate whether and how these two methods could help the automatic estimation of the muscle thickness based on Revoting Hough Transform (RVHT). The muscle thickness results obtained from each of the two methods are compared with the results from manual measurement, respectively. Data from an aged subject with cerebral infarction is also studied. Results It’s shown in the experiments that, Gabor Filtering and MVEF can both enable RVHT to generate comparable results of muscle thickness to those by manual drawing (mean?±?SD, 1.45?±?0.48 and 1.38?±?0.56 mm respectively). However, the MVEF method requires much less computation than Gabor Filtering. Conclusions Both methods, as preprocessing procedure can enable RVHT the automatic estimation of muscle thickness and MVEF is believed to be a better choice for real-time applications.



Experience of Ultrasonography-Guided Percutaneous Core Biopsy for Renal Masses  

PubMed Central

Purpose We evaluated the safety and accuracy of ultrasonography-guided percutaneous core biopsy collection in patients with renal masses. Materials and Methods From June 2008 to August 2012, 30 percutaneous core biopsies of renal masses were performed. The biopsies obtained were small tumors (<4 cm) with ambiguous radiologic findings or that met classic renal biopsy indications. The biopsy results were compared with the final pathological results after definitive surgical treatment. Ultrasonography was performed on the day after biopsy collection to rule out any complications. Results The mean age of the patients was 57.7 years, and the mean tumor size was 3.39 cm. Twelve of the lesions were in the left kidney, and 18 were in the right kidney. All but one core biopsy contained sufficient material for histopathological analysis. The biopsy results showed 17 renal cell carcinomas (56.7%), 3 angiomyolipomas (10.0%), 2 oncocytomas (6.7%), 1 adenocarcinoma (3.3%), and 7 benign lesions (23.3%). A total of 18 cases underwent surgery, and the pathological results confirmed the initial biopsy diagnosis for 17 of 18 cases (94.4%). The one (5.9%) inaccurate biopsy result was found to be a urothelial carcinoma of the kidney. No needle tract seeding was found in the pathological specimens or on follow-up imaging. A small perinephric hematoma (1-2 cm) was seen in 5 cases (16.7%), but all patients remained hemodynamically stable. Conclusions Ultrasonography-guided renal biopsy is a safe, effective, and accurate method for evaluating small renal masses. This procedure may help in selecting treatment modalities for small renal masses.

Lee, Seung Woo; Lee, Min Ho; Yang, Hee Jo; Yang, Won Jae; Kim, Doo Sang; Lee, Nam Kyu



Resected specimen evaluation, anorectal manometry, endoanal ultrasonography and clinical follow-up after STARR procedures  

PubMed Central

AIM: To investigate stapled transanal rectal resection (STARR) procedures as surgical techniques for obstructed defecation syndrome (ODS) by analyzing specimen evaluation, anorectal manometry, endoanal ultrasonography and clinical follow-up. METHODS: From January to December 2007, we have treated 30 patients. Fifteen treated with double PPH-01 staplers and 15 treated using new CCS 30 contour. Resected specimen were measured with respect to average surface and volume. All patients have been evaluated at 24 mo with clinical examination, anorectal manometry and endoanal ultrasonography. RESULTS: Average surface in the CCS 30 group was 54.5 cm2 statistically different when compared to the STARR group (36.92 cm2). The average volume in the CCS 30 group was 29.8 cc, while in the PPH-01 it was 23.8 cc and difference was statistically significant. The mean hospital stay in the CCS 30 group was 3.1 d, while in the PPH-01 group the median hospital stay was 3.4 d. As regards the long-term follow-up, an overall satisfactory rate of 83.3% (25/30) was achieved. Endoanal ultrasonography performed 1 year following surgery was considered normal in both of the studied groups. Mean resting pressure was higher than the preoperative value (67.2 mmHg in the STARR group and 65.7 mmHg in the CCS30 group vs 54.7 mmHg and 55.3 mmHg, respectively). Resting and squeezing pressures were lower in those patients not satisfied, but data are not statistically significant. CONCLUSION: The STARR procedure with two PPH-01 is a safe surgical procedure to correct ODS. The new Contour CCS 30 could help to increase the amount of the resected tissue without differences in early complications, post-operative pain and in hospital stay compared to the STARR with two PPH-01 technique.

Naldini, Gabriele; Cerullo, Guido; Menconi, Claudia; Martellucci, Jacopo; Orlandi, Simone; Romano, Nicola; Rossi, Mauro



Brain ultrasonography findings in neonates with exposure to cocaine during pregnancy  

Microsoft Academic Search

Background  Cocaine exposure during pregnancy has been reported to have detrimental effects on the fetus.\\u000a \\u000a \\u000a \\u000a Objective  To describe the findings on cranial ultrasonography (CUS) as part of a neonatal screening programme for exposed neonates.\\u000a \\u000a \\u000a \\u000a Materials and methods  The study was a semiprospective analysis of a 12-year cohort of neonates born to mothers who had used cocaine during their\\u000a pregnancy and who had follow-up

Marian van Huis; Anne A. M. W. van Kempen; Myrthe Peelen; Maaike Timmers; Kees Boer; Bert J. Smit; Rick R. Van Rijn



Emergency department ultrasonography guided long-axis antecubital intravenous cannulation: How to do it  

PubMed Central

An 85-year-old woman with a past medical history of severe peripheral vascular disease and right below knee amputation presented to the emergency department with a 1-day history of non-positional dizziness and weakness. The patient required intravenous access to work up her dizziness and weakness. The patient had multiple failed blind ED peripheral IV attempts performed in the past. Emergency department bedside ultrasonography with a high frequency linear array vascular probe was used to guide antecubital brachial vein cannulation on the first attempt using the long-axis approach.



Juvenile papillomatosis (JP) of the female breast (Swiss Cheese Disease) -- role of breast ultrasonography.  


This report summarises the imaging findings of juvenile papillomatosis (JP) in a 16-year-old woman. Sonographically, the lesion was oval, well defined, heterogeneous with multiple small, cystic spaces. Ultrasonography can be helpful in differentiating between JP and similar cystic lesions, fibroadenomas, phyllodes tumours, intracystic papillomas and carcinomas. A core needle biopsy is still needed to confirm the diagnosis. An open biopsy with excision of the lesion is mandatory, mere observation is inadequate because of insufficient knowledge about the direct relationship between JP and subsequent cancer. PMID:15700227

Ohlinger, R; Schwesinger, G; Schimming, A; Köhler, G; Frese, H



Ultrasonography and the Ultrasound-Based Management of Thyroid Nodules: Consensus Statement and Recommendations  

PubMed Central

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.

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



Ultrasonography in pregnant women with antiphospholipid syndrome using salicylic acid and heparin  

Microsoft Academic Search

Purpose  The objective of the present study was to evaluate fetal biometry, Doppler values, and perinatal outcomes in pregnant women\\u000a with antiphospholipid syndrome treated with acetylsalicylic acid and heparin.\\u000a \\u000a \\u000a \\u000a \\u000a Study design  Twenty-five pregnant women with antiphospholipid syndrome using 100 mg\\/day acetylsalicylic acid and 5,000 IU heparin every\\u000a 12 h were evaluated in this prospective observational study. Ultrasonography was performed between 24 and 38 weeks of gestational\\u000a age

Ana Carolina S. Calderon; Aderson T. Berezowski; Alessandra Cristina Marcolin; Wellington P. Martins; Geraldo Duarte; Ricardo C. Cavalli



Emergency department diagnosis of upper extremity deep venous thrombosis using bedside ultrasonography  

PubMed Central

A 27-year-old man presents to the emergency department with a 1-day history of severe right upper extremity pain and swelling. The patient's status is post open reduction internal fixation for a left tibial plateau fracture, which was complicated by methicillin-sensitive Staphylococcus aureus osteomyelitis. A peripherally inserted central catheter (PICC) line was subsequently placed for intravenous antibiotic therapy. Emergency department bedside ultrasound examination of both the right axillary vein and subclavian vein near the PICC line tip revealed deep venous thrombosis of both veins. Bedside upper extremity vascular ultrasonography can assist in the rapid diagnosis of upper extremity deep venous thrombosis in the emergency department.



Comparison of Ultrasonography- and Fluoroscopy-Guided Facet Joint Block in the Lumbar Spine  

PubMed Central

Study Design Retrospective study. Purpose Facet joint block is performed for diagnostic or therapeutic purposes and generally carried out under computerd tomography (CT) or radiologic fluoroscopy guidance. Ultrasonography-guided facet block has recently been attempted. So, we compared the results of ultrasonography-guided facet joint block with the results of fluoroscopy-guided facet joint block. Overview of Literature Because fluoroscopic or CT guided facet joint block has been reported side effects, we performed spinal facet block using a fluoroscopy-guided method. Methods We selected 133 patients who had lumbar pain or referred pain. They were diagnosed as having spinal stenosis and hospitalized from January 2008 to June 2008. As the subjects, we selected 105 patients who had been follow-up for more than 6 months and carried out a prospective study. Twenty six subjects were male and 25 were female in the fluoroscopy group (group 1) and their mean age was 56.1 years (range, 45 to 79 years). Twenty one were male and 33 were female in the ultrasonography-guided group (group 2). Their mean age was 58.3 years (range, 47 to 83 years). We studied the average time of the procedures, complications, the difference of the therapeutic cost between the two groups. We also evaluated the visual analogue scale (VAS) score and the Oswestry disability index. Results The procedure in group 2 averaged 4 minutes and 25 seconds, and in group 1, 4 minutes and 7 seconds. The coast was an average of 38,000 won in group 2 and 25,000 won in group 1. The VAS score was improved from an average of 7.5 (range, 5 to 9) to 2.8 (range, 2 to 6) in group 2 and from 7.8 (range, 4 to 10) to 2.7 (range, 2 to 5) in group 1. The Oswestry disability index was improved from an average of 32.3 (range, 28 to 41) to 23.5 (range, 17 to 26) in group 2 and from 34.2 (range, 29 to 43) to 24.8 (range, 18 to 28) in group 1. As for complications, worsening of lumbar pain, paresthesia, headache and allergic reaction were detected in 5 cases of group 2 and in 3 of group 1. Those symptoms were improved within several hours. One case of superficial infection that developed in group 2 was improved within several days. Conclusions We should consider that ultrasonography-guided facet joint block is a minimal invasive procedure that is easily carried out without radiation exposure.

Ha, Dae Ho; Shim, Dae Moo; Kim, Tae Kyun; Choi, Sang Su



Ultrasonography of the extremities and pelvic girdle and correlation with computed tomography  

SciTech Connect

Ultrasonography was performed on 54 patients with lesions of the extremities and pelvic girdle. Computed tomography (CT) was employed in 8 patients. Focal space-occupying lesions such as tumors, abscesses, hematomas, aneurysms, and popliteal cysts (dissecting or otherwise) were delineated by ultrasound and their extent defined. Differentiation from diffuse changes such as lymphedema, cellulitis, or phlebitis and diagnosis of aneurysms were possible. Popliteal cysts were ususally quite characteristic, while correlation with the clinical features suggested the correct diagnosis in the case of the other lesions. CT correlated well with ultrasound, except for one tumor of the forearm which was not shown by CT.

Yeh, H.C.; Rabinowitz, J.G.



Image Analysis of Endosocopic Ultrasonography in Submucosal Tumor Using Fuzzy Inference  

PubMed Central

Endoscopists usually make a diagnosis in the submucosal tumor depending on the subjective evaluation about general images obtained by endoscopic ultrasonography. In this paper, we propose a method to extract areas of gastrointestinal stromal tumor (GIST) and lipoma automatically from the ultrasonic image to assist those specialists. We also propose an algorithm to differentiate GIST from non-GIST by fuzzy inference from such images after applying ROC curve with mean and standard deviation of brightness information. In experiments using real images that medical specialists use, we verify that our method is sufficiently helpful for such specialists for efficient classification of submucosal tumors.

Kim, Kwang Baek; Kim, Gwang Ha



Arteriovenous fistula after femoral artery puncture leading to pulmonary edema: the role of ultrasonography.  


Local complications of arterial puncture include hematoma, pseudoaneurysm and formation of arteriovenous fistula (AVF). The latter could cause ischemia of the particular extremity or can be hemodynamically significant especially in patients suffering from congestive heart failure. We report a case of femoro-femoral AVF after thin needle arterial puncture for blood drawing. The development of this iatrogenic AVF led to pulmonary edema. The patient stabilized completely after surgical closure of the AVF. The AVF was diagnosed by duplex Doppler ultrasonography and this method was also used for estimation of blood flow through the AVF. We discuss the role of ultrasound AVF diagnostics and the method of flow calculation. PMID:22373805

Malík, J; Holaj, R; Krupi?ková, Z; Janota, T



Anticipation of Uterine Bleeding in Placenta Previa Based on Vaginal Sonographic Evaluation  

Microsoft Academic Search

Objectives: The aim of this study was to predict massive uterine bleeding during pregnancy and cesarean section in women with placenta previa using transvaginal ultrasonography. Methods: Transvaginal ultrasonography was performed prospectively at and after 28 gestational weeks with follow-up scans at 5- to 7-day intervals until cesarean section in 35 women with placenta previa. The patients were classified into 3

Megumu Saitoh; Kaisuke Ishihara; Takao Sekiya; Tsutomu Araki



Making paracentesis safer: a proposal for the use of bedside abdominal and vascular ultrasonography to prevent a fatal complication.  


Paracentesis has been considered a relatively safe procedure; however, hemorrhagic complications do occur and can be fatal, especially in the context of coagulopathy. We describe the case of a 47-year-old man with coagulopathy secondary to end-stage liver disease, whose hospital course was complicated by paracentesis-related hemoperitoneum leading to abdominal compartment syndrome. Emergent laparotomy revealed left inferior epigastric artery laceration caused by paracentesis. Despite operative control of bleeding, postoperatively, the patient developed severe metabolic acidosis, disseminated intravascular coagulation, and ultimately died from complications of hemorrhagic shock. Understanding key anatomic structures is essential for patient safety in the setting of paracentesis. While recognizing the lack of clinical studies demonstrating the effectiveness of ultrasonography use in paracentesis, we discuss the benefit of bedside abdominal ultrasonography to locate ascites and avoid intraabdominal structures, as well as vascular ultrasonography, during needle insertion to avoid abdominal wall vessels. PMID:23546486

Sekiguchi, Hiroshi; Suzuki, Jun; Daniels, Craig E



Use of ultrasonography as a rescue technique for failed radial artery cannulation.  


Radial artery cannulation may be unsuccessful in the most experienced of hands using the conventional palpation method. Repeated attempts may render the standard wrist site difficult to cannulate due to vasospasm, hematoma formation, or intimal dissection. Cannulation of other arterial sites may be difficult due to inaccessibility or more prone to adverse outcomes. The radial artery at a proximal location runs deep to the brachioradialis muscle and is difficult to palpate; however, it can be easily imaged using real-time ultrasonography. A needle-mounted cannula can then be advanced in the plane of the probe and the pulsating artery until the needle tip is within the artery. The cannula is advanced over the needle so that it lies within the arterial lumen. As the trajectory is in full view of the ultrasound probe, the technique has a very high success rate. We have used ultrasonography in over 30 cases as a rescue technique after unsuccessful attempts at radial artery cannulation. The technique is described here illustrated with 3 typical cases. PMID:16563334

Sandhu, NavParkash S; Patel, Biraj



Transrectal ultrasonography for prostatic cancer. II. The response of the prostate to definitive radiotherapy  

SciTech Connect

Transrectal ultrasonography was used to monitor the response of adenocarcinoma of the prostate to radiotherapy before and 6 to 15 months after treatment combining implantation of radioactive gold seeds with external beam irradiation. Data gathered before and after irradiation therapy suggested that the two most sensitive measures for monitoring the primary tumor are the calculated volume of the prostate and the integrity of the prostatic capsule. The calculated volume of the prostate decreased significantly in all patients by 6 months after radiotherapy. The rate and degree of reduction correlated significantly (P less than 0.05) with the histologic grade of the tumor (poorly differentiated tumors shrinking most rapidly), as well as with the outcome of treatment (P less than 0.05). However, there was no such correlation with stage. After treatment, the average number of sites of capsular disruption decreased steadily, reaching 50% of the pretreatment number by 15 months. Transrectal ultrasonography is a practical, inexpensive, noninvasive tool for monitoring the response of prostatic cancer to definitive radiotherapy, and may provide a means of identifying patients who will respond poorly to treatment.

Fujino, A.; Scardino, P.T.



Ultrasonography: an alternative to x-ray-guided needle localization of nonpalpable breast masses.  


Preoperative ultrasonography was used as an alternative to x-ray mammography to localize 92 breast lesions encountered in 82 patients. Recommendation for biopsy was made on the basis of the ultrasonographic finding of a nonpalpable mass or an area of architectural distortion, or in the presence of equivocal physical findings if sonomammography demonstrated a solid or an anechoic mass. Sonomammography was performed in the operating room, just before anticipated biopsy, with a hand-held high-resolution scanner. When the suspicious area was imaged and its precise location noted, the breast was then prepared and draped in the usual manner, and a biopsy was performed. If the suspicious area could not be easily localized after the incision was made and the breast explored, the transducer was "gowned" and used directly in the wound to help find the lesion. This technique has proven effective and accurate. In selected patients ultrasonography may be used as well as, or instead of, x-ray needle localization for the precise excision of nonpalpable breast lesions, excluding calcifications. PMID:3055396

Schwartz, G F; Goldberg, B B; Rifkin, M D; D'Orazio, S E



EULAR report on the use of ultrasonography in painful knee osteoarthritis. Part 1: Prevalence of inflammation in osteoarthritis  

PubMed Central

Objectives: To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint effusion at ultrasonography (US); and to evaluate the correlation between synovitis, effusion, and clinical parameters. Methods: A cross sectional, multicentre, European study was conducted under the umbrella of EULAR-ESCISIT. Subjects had primary chronic knee OA (ACR criteria) with pain during physical activity ?30 mm for at least 48 hours. Clinical parameters were collected by a rheumatologist and an US examination of the painful knee was performed by a radiologist or rheumatologist within 72 hours of the clinical examination. Ultrasonographic synovitis was defined as synovial thickness ?4 mm and diffuse or nodular appearance, and a joint effusion was defined as effusion depth ?4 mm. Results: 600 patients with painful knee OA were analysed. At US 16 (2.7%) had synovitis alone, 85 (14.2%) had both synovitis and effusion, 177 (29.5%) had joint effusion alone, and 322 (53.7%) had no inflammation according to the definitions employed. Multivariate analysis showed that inflammation seen by US correlated statistically with advanced radiographic disease (Kellgren-Lawrence grade ?3; odds ratio (OR) = 2.20 and 1.91 for synovitis and joint effusion, respectively), and with clinical signs and symptoms suggestive of an inflammatory "flare", such as joint effusion on clinical examination (OR = 1.97 and 2.70 for synovitis and joint effusion, respectively) or sudden aggravation of knee pain (OR = 1.77 for joint effusion). Conclusion: US can detect synovial inflammation and effusion in painful knee OA, which correlate significantly with knee synovitis, effusion, and clinical parameters suggestive of an inflammatory "flare".

D'Agostino, M; Conaghan, P; Le Bars, M; Baron, G; Grassi, W; Martin-Mola, E; Wakefield, R; Brasseur, J; So, A; Backhaus, M; Malaise, M; Burmester, G; Schmidely, N; Ravaud, P; Dougados, M; Emery, P



Practical diagnostic management of patients with clinically suspected deep vein thrombosis by clinical probability test, compression ultrasonography, and D-dimer test  

Microsoft Academic Search

PurposeTo evaluate a new noninvasive diagnostic strategy for ruling out deep vein thrombosis consisting of either a combination of low clinical probability and normal ultrasonography or a combination of moderate-to-high clinical probability, normal ultrasonography, and a normal D-dimer test.

Lidwine W Tick; Evelien Ton; Theo van Voorthuizen; Marcel M. C Hovens; Ivonne Leeuwenburgh; Sacha Lobatto; Pieter J Stijnen; Cees van der Heul; Peter M Huisman; Mark H. H Kramer; Menno V Huisman



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

|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…

Akkoc, Yesim; Cinar, Yasemin; Kismali, Erkan



[Effects of Calorie Mate Jelly eating before abdominal ultrasonography on the diagnosis--an evaluation in healthy adults].  


In transabdominal ultrasonography, the production of gas in the gastro-intestinal tract and contraction of the gallbladder have to be prevented to obtain clear observation images of any lesions. Therefore, patients avoid food and drink for many hours from the night before the examination. However, long-term fasting exacerbates energy homeostasis in patients with cirrhosis. Thus, it is necessary to develop a method of transabdominal ultrasonography allowing the shortening of the fasting time. In this study, subjects ingested Calorie Mate Jelly three hours before transabdominal ultrasonography. Then, we studied the effect of the Jelly on ultrasonographic images. Three hours after its consumption, imaging diagnosis involving the liver, in liver, gallbladder, pancreas, spleen, and kidney could be successfully carried out in all healthy adults. Thus, our observations indicated that the abdominal organs can be effectively observed by transabdominal ultrasonography if Calorie Mate Jelly is consumed up to three hours before the examination. Calorie Mate Jelly may help to prevent worsening energy homeostasis in patients who are required to fast for a prolonged period. PMID:21560405

Takizawa, Yoshinori; Suzuki, Kazutomo; Kawamura, Kenya; Shibazaki, Mitsuei; Haruki, Kosuke



Retinal Detachment Due to Facial Gunshot Wound: The Utility of Ultrasonography in a Medically Austere Environment  

Microsoft Academic Search

BackgroundRetinal detachment is one complication of ocular trauma. Retinal detachments resulting from gunshot wounds are typically associated with significant facial trauma, orbital trauma, or globe penetration. Ultrasonography has been shown to be of diagnostic utility in the evaluation of retinal detachments.

Denise A. Whitfield; Steven J. Portouw


Radiofrequency Ablation with the Real-Time Virtual Sonography System for Treating Hepatocellular Carcinoma Difficult to Detect by Ultrasonography  

PubMed Central

Radiofrequency ablation has been applied to treat hepatocellular carcinoma, with favorable therapeutic outcomes. Nevertheless, practitioners have approached radiofrequency ablation with some reluctance due to the difficulty of identifying isoechoic tumors and recurrent tumors. The aim of the present study is to investigate the efficacy of Real-time Virtual Sonography to treat hepatocellular carcinoma difficult to detect by conventional ultrasonography. Real-time Virtual Sonography is a system generating multiplanar reconstruction images in real-time using the Hitachi medico EUB-8500 equipped with a probe. The system included following components: 1) digital imaging and communications in medicine (DICOM) data from dynamic CT, 2) a magnetic field generator to match the multiplanar reconstruction image on the monitor and the actual ultrasonography image, 3) the cross section with the tumor displayed as a multiplanar reconstruction image. Total twenty-five nodules of twenty-one patients underwent radiofrequency ablation monitored by Real-time Virtual Sonography. All nodules difficult to detect via conventional ultrasonography were clearly visualized in real-time. The average nodule diameter was 2.4 ± 1.6 cm, and punctures and coagulation were performed an average of 2.2 and 3 times per session. Dynamic CT after session confirmed effective coagulation of each nodule. In conclusion, this study demonstrates that the present system is capable of effectively and accurately treating tumors difficult to detect by conventional ultrasonography.

Kawasoe, Hiroaki; Eguchi, Yuichiro; Mizuta, Toshihiko; Yasutake, Tsutomu; Ozaki, Iwata; Shimonishi, Tomonori; Miyazaki, Kohji; Tamai, Tsutomu; Kato, Akira; Kudo, Sho; Fujimoto, Kazuma



Comparison of Fetal Nuchal Fold Thickness Measurements by Two- and Three-Dimensional Ultrasonography (3DXI Multislice View)  

PubMed Central

Purpose. To compare the measurements of fetal nuchal fold (NF) thickness by two-dimensional (2D) and three-dimensional (3D) ultrasonography using the three-dimensional extended imaging (3DXI). Methods. A cross-sectional study was performed with 60 healthy pregnant women with a gestational age between 16 and 20 weeks and 6 days. The 2D-NF measurements were made as the distance from the outer skull bone to the outer skin surface in the transverse axial image in the suboccipital-bregmatic plane of the head. For the 3D we employed the 3DXI multislice view software, in which 3 × 2 tomographic planes was displayed on the screen and the distance between the tomographic slices was 0.5?mm. Maximum, minimum, mean, and standard deviation were calculated for 2D and 3D ultrasonography, as well the maximum and minimum, mean, and standard deviation for the difference between both methods. The Wilcoxon signed-rank test was used to compare the two different techniques. Results. 2D-NF showed a mean of thickness of 3.52 ± 0.95?mm (1.69–7.14). The mean of 3D-NF was 3.90 ± 1.02?mm (2.13–7.72). The mean difference between the methods was 0.38?mm, with a maximum difference of 3.12?mm. Conclusion. The NF thickness measurements obtained by 3D ultrasonography were significantly larger than those detected with 2D ultrasonography.

de Freitas, Leonardo da Silva Valladao; de Bello Barros, Fernanda Silveira; Negrini, Romulo; de Silva Bussamra, Luiz Claudio; Araujo Junior, Edward; Piato, Sebastiao; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes; Aoki, Tsutomu



Preoperative Localization of Parathyroid Adenomas: A Comparison of Power and Colour Doppler Ultrasonography with Nuclear Medicine Scintigraphy  

Microsoft Academic Search

AIM: To compare power and colour Doppler ultrasonography (US) with nuclear medicine scintigraphy (NM) in the preoperative localization of parathyroid adenomas in patients with primary hyperparathyroidism (PHPT). MATERIALS AND METHODS: Thirty-one patients with biochemical evidence of PHPT underwent pre-operative US and NM for parathyroid adenoma localization. Both studies were interpreted independently without prior knowledge of the other study's findings. All

Jac D. Scheiner; Damian E. Dupuy; John M. Monchik; Richard B. Noto; John J. Cronan



Reference values for the genitalia of male dromedary before and after puberty using caliper and ultrasonography in subtropics  

Microsoft Academic Search

The aim of the present study was to characterize the dynamic changes of the testes and the pelvic genitalia in vivo in male dromedary. Eighty-one clinically healthy male dromedaries aged 1.5 to 12 years were assigned for the present study. Testicular length, breadth, and depth as well as epididymal head and tail were measured using caliper and ultrasonography. The pelvic

Derar Refaat Derar; Hasan Ali Hussein; Ahmad Ali Hussein


Iodine131 metaiodobenzylguanidine scintigraphy for localization of lesions in children with neuroblastoma: comparison with computed tomography and ultrasonography  

Microsoft Academic Search

Iodine-131 metaiodobenzylguanidine (MIBG) scintigraphy, computed tomography (CT) and ultrasonography (US) were used to localize tumour lesions in 28 children with histologically proven neuroblastoma. Overall, a total of 73 lesions were detected on imaging studies. MIBG scintigraphy, CT and US localized 63 (86%), 49 (67%) and 36 (49%) of these lesions, respectively. The findings of the three imaging techniques were concordant

S. Lastoria; S. Maurea; C. Caracò; E. Vergara; L. Maurelli; P. Indolfi; F. Casale; M. T. Tullio; M. Salvatore



D-dimer testing as an adjunct to ultrasonography in patients with clinically suspected deep vein thrombosis: prospective cohort study  

Microsoft Academic Search

Objective To investigate the efficacy of using a rapid plasma d›dimer test as an adjunct to compression ultrasound for diagnosing clinically suspected deep vein thrombosis. Design d›dimer concentrations were determined in all patients with a normal ultrasonogram at presentation. Repeat ultrasonography was performed 1 week later only in patients with abnormal d›dimer test results.

Enrico Bernardi; P. Prandoni; A. W. A. Lensing; G. Agnelli; G. Guazzaloca; G. Scannapeico; F. Piovella; F. Verlato; C. Tomasi; M. Moia; L. Scarano; A. Girolami



Comparing the Diagnosis of White Matter Injury in Premature Newborns with Serial MR Imaging and Transfontanel Ultrasonography Findings  

Microsoft Academic Search

BACKGROUND AND PURPOSE: The accurate identification of white matter injury in pre- mature neonates is important for counseling parents and for targeting these high risk neonates for appropriate rehabilitation services. The objective of this study was to compare the diagnosis of white matter injury detected by serial MR imaging and ultrasonography of a contemporary cohort of premature neonates. METHODS: Each

Steven P. Miller; Camilla Ceppi Cozzio; Ruth B. Goldstein; Donna M. Ferriero; J. Colin Partridge; Daniel B. Vigneron; A. James Barkovich


Empyema of the gallbladder detected by gallium scan and abdominal ultrasonography  

SciTech Connect

A case history of patient with a abnormal gallium uptake and sonogram in the region of the gallbladder is described. The abnormality was interpreted as empyema of the gallbladder and later proven surgically. A liver-spleen scan was normal except for slight prominence of the hilar structures. Gallium citrate Ga-67 scans done at 24 and 48 hours showed a persistent area of increased tracer localization around the gallbladder with a central clear zone in the latter scan. Ultrasonography revealed poor definition and slight thickening of the gallbladder wall. Because of the lack of specificity of gallium scans, the combination of ultrasonic imaging and gallium uptake scans appears much superior in diagnostic efficiency than either of the two alone. The sequence of performing these two examinations does not seem to be critical though it was prefered that the scintigraphy precede the sonography.

Garcia, O.M.; Kovac, A.; Plauche, W.E.



The use of ultrasonography in detection of synovitis in carpal tunnel syndrome.  


The findings of pre-operative ultrasonography of the carpal tunnel were compared with synovial histology in 50 surgically treated wrists with carpal tunnel syndrome. Eight wrists with a massive hypoechoic area (group 3) had synovitis. 28 with a minimal hypoechoic area (group 1) had no evidence of inflammation. 14 with a moderately increased hypoechoic area (group 2) consisted of three with synovitis, four with lymphocytic infiltration and seven without inflammation. Group 3 strongly indicates synovitis, in which case one should consider aetiology other than the idiopathic cause. Bilateral synovial thickening suggests carpal tunnel syndrome as the initial clinical picture of rheumatoid arthritis, and group 1 indicates idiopathic carpal tunnel syndrome provided that there are no primary causes. PMID:8501366

Nakamichi, K; Tachibana, S



B-mode and M-mode Ultrasonography of Tongue Movements during Swallowing  

Microsoft Academic Search

\\u000a Abstract\\u000a \\u000a \\u000a Objective:\\u000a   This study investigated the possibility of using Bmode and M-mode ultrasonography to differentiate between the visceral and\\u000a somatic swallowing patterns.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a Subjects and Methods:\\u000a   Tongue movements during empty swallowing by 11 volunteers with a visceral swallowing pattern were traced in B-mode and M-mode\\u000a ultrasound imaging before and after successful myofunctional therapy. Thirteen subjects with a somatic swallowing pattern\\u000a served

Steffi Galén; Paul-Georg Jost-Brinkmann



Prenatal diagnosis of truncus arteriosus using multiplanar display in 4D ultrasonography  

PubMed Central

Prenatal diagnosis of truncus arteriosus with two-dimensional (2D) sonography requires expertise in fetal echocardiography. Indeed, truncus arteriosus shares with tetralogy of Fallot and pulmonary atresia with a ventricular septal defect (VSD) the sonographic finding of a single arterial trunk overriding a VSD. The diagnosis of truncus arteriosus can be confirmed when either the main pulmonary artery or its branches are visualized arising from the truncus itself. This requires sequential examination of multiple scanning planes and a process of mental reconstruction of their spatial relationships. The advantage of multiplanar imaging in three-dimensional and four-dimensional ultrasonography is that it allows for the simultaneous visualization of three orthogonal anatomic planes, which can be very important in diagnosing cardiac abnormalities. We report, first, a case of truncus arteriosus diagnosed in utero where the multiplanar display modality provided important insight into the differential diagnosis of this conotruncal anomaly, and then, review the diagnosis of truncus arteriosus on ultrasound.

Gotsch, Francesca; Romero, Roberto; Espinoza, Jimmy; Kusanovic, Juan Pedro; Erez, Offer; Hassan, Sonia; Yeo, Lami



Preoperative staging of rectal cancer: role of 3D endorectal ultrasonography.  


Endorectal ultrasonography has become important part of preoperative staging of rectal cancer, providing adequate information for clinical decision-making in many cases. However, with the currently available ultrasonographic equipment and techniques, a good deal of relevant information may remain hidden. The advent of high-resolution three-dimensional endoluminal ultrasound, constructed from a synthesis of standard two-dimensional cross-sectional images, and of "Volume Render Mode," a technique to analyze information inside a three-dimensional volume, promises to improve the accuracy of rectal cancer staging. The anatomic structures in the pelvis, the axial and longitudinal extension of the tumor, the presence of slight or massive submucosal invasion in early rectal cancer may be imaged in greater detail. This additional information will bring an improvement for both planning and conduct of surgical procedures. PMID:23373359

Santoro, Giulio A



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

SciTech Connect

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.

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



Mediastinal Schwannoma Diagnosed by Endoscopic Ultrasonography-Guided Fine Needle Aspiration Cytology  

PubMed Central

Schwannoma is the most common neurogenic tumor that is derived from the peripheral nerve sheath. There are no specific serologic markers or characteristic imaging abnormalities associated with schwannoma. Tissue diagnosis and immunohistochemistry are required to diagnose this lesion. We describe a 65-year-old male with a finding of three mass lesions in the superior and middle mediastinum on computed tomography of the chest. The largest lesion measured 4.6 × 5 cm. The patient subsequently underwent endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) of the lesion and cytology was consistent with spindle cell neoplasm. Immunohistochemical staining of the cytologic specimen was positive for S-100 and negative for pan-cytokeratin, CD34, CD117, calcitonin, smooth muscle actin and desmin. These findings were consistent with schwannoma. This is the second reported case of a mediastinal schwannoma diagnosed by EUS-FNA.

Pakseresht, Kavous; Reddymasu, Savio C.; Oropeza-Vail, Melissa M.; Fan, Fang; Olyaee, Mojtaba



A feasibility study on bedside upper airway ultrasonography compared to waveform capnography for verifying endotracheal tube location after intubation  

PubMed Central

Background In emergency settings, verification of endotracheal tube (ETT) location is important for critically ill patients. Ignorance of oesophageal intubation can be disastrous. Many methods are used for verification of the endotracheal tube location; none are ideal. Quantitative waveform capnography is considered the standard of care for this purpose but is not always available and is expensive. Therefore, this feasibility study is conducted to compare a cheaper alternative, bedside upper airway ultrasonography to waveform capnography, for verification of endotracheal tube location after intubation. Methods This was a prospective, single-centre, observational study, conducted at the HRPB, Ipoh. It included patients who were intubated in the emergency department from 28 March 2012 to 17 August 2012. A waiver of consent had been obtained from the Medical Research Ethics Committee. Bedside upper airway ultrasonography was performed after intubation and compared to waveform capnography. Specificity, sensitivity, positive and negative predictive value and likelihood ratio are calculated. Results A sample of 107 patients were analysed, and 6 (5.6%) had oesophageal intubations. The overall accuracy of bedside upper airway ultrasonography was 98.1% (95% confidence interval (CI) 93.0% to 100.0%). The kappa value (?) was 0.85, indicating a very good agreement between the bedside upper airway ultrasonography and waveform capnography. Thus, bedside upper airway ultrasonography is in concordance with waveform capnography. The sensitivity, specificity, positive predictive value and negative predictive value of bedside upper airway ultrasonography were 98.0% (95% CI 93.0% to 99.8%), 100% (95% CI 54.1% to 100.0%), 100% (95% CI 96.3% to 100.0%) and 75.0% (95% CI 34.9% to 96.8%). The likelihood ratio of a positive test is infinite and the likelihood ratio of a negative test is 0.0198 (95% CI 0.005 to 0.0781). The mean confirmation time by ultrasound is 16.4 s. No adverse effects were recorded. Conclusions Our study shows that ultrasonography can replace waveform capnography in confirming ETT placement in centres without capnography. This can reduce incidence of unrecognised oesophageal intubation and prevent morbidity and mortality. Trial registration National Medical Research Register NMRR11100810230.



Does Contrast-Enhanced Cervical Ultrasonography Improve Preoperative Localization Results in Patients With Sporadic Primary Hyperparathyroidism?  

PubMed Central

Objective: Pre-operative localization studies are inevitable in patients with primary hyperparathyroidism (pHPT), who are eligible for focused or minimally invasive parathyroidectomy (MIP). High-resolution ultrasonography (US) in combination with planar 99mTc-Sestamibi-scintigraphy (MIBI) and additional single-photon emission computed tomography (SPECT) are the standard procedures to localize enlarged parathyroid glands. Our aim was to evaluate the practicability and significance of contrast-enhanced ultrasonography (CEUS) in patients with pHPT. Materials and Methods: All investigations were performed at the University Hospital Marburg. Totally, 25 patients with biochemical proven pHPT underwent preoperative US, MIBI/SPECT, and CEUS. For CEUS, a suspension of phospholipid-stabilized sulfur-hexafluoride (SF6) microbubbles in combination with a special 12 MHz linear US probe was used. All patients were investigated by two sonographers, who did not get to view the findings noted by the other. Finally, surgery was performed and histopathological results were obtained from 24 patients. Results: In 17 (68%) patients, US and MIBI/SPECT already raised suspicion of parathyroid lesions and all suspected lesions were reassessed by CEUS. However, no additional information was obtained using CEUS. Especially in eight patients with negative or inconsistent US and MIBI/SPECT results, CEUS did not provide additional information regarding the site of the suspected parathyroid adenoma. Overall, no side effects were observed using CEUS. Surgical cure was achieved in all patients. Conclusion: In this limited cohort of patients, no additional information could be obtained using the costly CEUS compared to results of US and MIBI/SPECT.

Karakas, Elias; Kann, Susanne; Hoffken, Helmut; Bartsch, Detlef Klaus; Celik, Ilhan; Gorg, Christian; Pfestroff, Andreas



Estimation of internal filtration flow rate in high-flux dialyzers by Doppler ultrasonography.  


Several types of dialyzer with enhanced internal filtration have been introduced for clinical application as a means of improving the efficiency of solute removal, and the enhanced internal filtration in these dialyzers has increased the convective transport of the solute besides the diffusive transport. The internal filtration flow rates (Q(IF)) of the dialyzer, however, have never been evaluated precisely. In this study, blood flow velocity in a cross-sectional plane of a dialyzer was measured by pulse Doppler ultrasonography to evaluate Q(IF). An in vitro study using bovine blood was carried out to determine the local blood flow velocity profile with a probe slider that enables the probe to move in parallel along a dialyzer. A good correlation between observed blood velocity (u(B)(0)) and blood flow rate (Q(B)(0)) at the inlet portion of the dialyzer was obtained during the in vitro study. Blood flow rate profiles along the dialyzer (Q(B)(z)) could be estimated from the product of blood velocity u(B)(z) and the total cross-sectional area of the blood flow path (S(B)) of the hollow fibers. The maximum internal filtration flow rate value (Q(IF-Max)) was estimated as Q(B)(0) - [Q(B)(z)](Min), where [Q(B)(z)](Min) is the minimum value of Q(B)(z). The Doppler ultrasonography described in this paper is a useful method for bedside monitoring of Q( IF) in several dialyzers, because it is noninvasive to the patient and produces reliable data with higher reproducibility. PMID:20938136

Mineshima, Michio



The role of thoracic ultrasonography in the diagnosis of pulmonary embolism  

PubMed Central

OBJECTIVES: The diagnosis of pulmonary embolism (PE) is still a problem especially at emergency units. The purpose of study was to determine the diagnostic accuracy of thoracic ultrasonography (TUS) in patients with PE. METHODS: In this prospective study, 50 patients with suspected PE were evaluated in Department of Pulmonary Diseases of a Training and Reasearch Hospital between January 2010 and July 2011. At the begining, TUS was performed by a chest physician, subsequently for definitive diagnosis computed tomography pulmonary angiography were performed in all cases as a reference method. Other diagnostic procedures were examination of serum d-dimer levels, echocardiography, and venous doppler ultrasonography of the legs. Both chest physician and radiologist were blinded to the results of other diagnostic method. Diagnosis of PE was suggested if at least one typical pleural-based/subpleural wedge-shaped or round hypoechoic lesion with or without pleural effusion was reported by TUS. Presence of pure pleural effusion or normal sonographic findings were accepted as negative TUS for PE. RESULTS: PE was diagnosed in 30 patients. It was shown that TUS was true positive in 27 patients and false positive in eight and true negative in 12 and false negative in three. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of TUS in diagnosis of PE for clinically suspected patients were 90%, 60%, 77.1%, 80%, and 78%, respectively. CONCLUSIONS: TUS with a high sensitivity and diagnostic accuracy, is a noninvasive, widely available, cost-effective method which can be rapidly performed. A negative TUS study cannot rule out PE with certainty, but positive TUS findings with moderate/high suspicion for PE may prove a valuable tool in diagnosis of PE at bedside especially at emergency setting, for critically ill and immobile patients, facilitating immediate treatment decision.

Comert, Sevda Sener; Caglayan, Benan; Akturk, Ulku; Fidan, Ali; K?ral, Nesrin; Parmaks?z, Elif; Salepci, Banu; Kurtulus, Betul Ayca Ozdere



An evaluation of efficacy of ultrasonography in the diagnosis of head and neck swellings  

PubMed Central

Objective The aim of this study was to evaluate the efficacy of ultrasonography in the diagnosis of swellings in the head and neck regions. Methods For this study, 70 cases with clinically obvious swellings in head and neck regions were selected randomly. The ultrasonographic features considered were shape, boundary, echo intensity, ultrasound architecture of lesion, posterior echoes and ultrasound characteristic of tissues. Intergroup comparisons were made between four different types of swellings: inflammatory; cystic; benign; and malignant. Results A comparison was made between benign and malignant neoplasms, and the criteria of boundary, echo intensity and ultrasound architecture of lesions are statistically significant as the P-value is <0.05. The comparison of inflammatory swellings and malignant neoplasms shows that criteria of boundary and ultrasound architecture of lesions are statistically significant. The comparison of cystic swellings and benign neoplasms concluded that only the criterion of ultrasound characteristics of tissues is statistically significant. The comparison of inflammatory swellings and benign neoplasms shows that the criteria of boundary and echo intensity are statistically significant. The comparison of inflammatory swellings and cystic swellings concluded that the criteria of boundary, shape, echo intensity, posterior echoes and ultrasound characteristics of tissues are statistically significant. The comparison of cystic swellings and malignant neoplasms concluded that the criteria of ultrasonography, boundary, shape, echo intensity, ultrasound architecture of lesion, posterior echoes and ultrasound characteristics of tissues are statistically significant as the P-value is <0.05. Conclusion It can be concluded that clinical diagnosis had a sensitivity and accuracy of 85.7% and ultrasonographic diagnosis had a sensitivity and accuracy of 98.5%.

Chandak, R; Degwekar, S; Bhowte, RR; Motwani, M; Banode, P; Chandak, M; Rawlani, S



Percutaneous ultrasonography-guided cutting biopsy from liver metastases of endocrine gastrointestinal tumors.  

PubMed Central

Ultrasonography-guided cutting needle biopsy of the liver was performed in 186 instances on 95 different patients with carcinoid and endocrine pancreatic tumors. In 171 cases, biopsy specimens were taken from liver metastases found on ultrasonography, and in 93% of these the obtained material was adequate for a correct diagnosis. In the 7% for which an incorrect diagnosis was made, all but one biopsy specimen contained normal liver tissue, indicating that the needle-guiding technique, and not the sampling technique, is the most critical part of the biopsy procedure. Tumor specimens were examined with silver stains and immunocytochemistry after application of monoclonal serotonin antibodies. The argyrophil silver stain of Grimelius could be applied on all specimens and had positive results in all but one case, demonstrating the neurohormonal endocrine origin of the metastases. The argentaffin reaction and/or serotonin immunoreactivity could be applied in 152 cases and had positive results in 115 of 122 (94%) of the mid-gut carcinoid tumors and negative results in 27 of 28 (96.4%) of the non-mid-gut carcinoid tumors and endocrine pancreatic tumors. Major complications occurred in 1.5%; none was lethal or required surgery. The results show that the technique used for tumor biopsy is very accurate and provides material sufficient for multiple histopathologic and immunocytochemical analyses without exposing the patients to high complication risks. It is further concluded that the staining techniques and immunocytochemical analyses applied on the biopsy specimens are valid for the prediction of the location of the primary endocrine tumor. Images Fig. 1. Figs. 3A and B.

Andersson, T; Eriksson, B; Lindgren, P G; Wilander, E; Oberg, K



'To have ... or not to have'. Should Computed Tomography and Ultrasonography be Implemented as a Routine Work-Up for Patients with Suspected Acute Appendicitis in a Regional Hospital?  

PubMed Central

INTRODUCTION Appendicitis is a common diagnosis, but is by no means a simple one to establish. This retrospective study investigated the value of medical imaging (ultrasonography and/or computed tomography [CT]) for patients with suspected appendicitis. Negative appendicectomy rate and appendiceal perforation with or without medical imaging were used as end points for this investigation. PATIENTS AND METHODS This study retrospectively reviewed all patients admitted in one district general hospital with suspected acute appendicitis. The patient cohort was identified from the Unit Registry and an International Classification of Diseases-based Review of medical records. The medical records were analysed, and the outcome of patients were followed up. RESULTS Between 12 January 2004 to 27 May 2005, 168 patients' medical records were audited. The negative appendicitis rate was 6.7% and appendiceal perforation rate was 3.2%. Among them, only 20 in-patients (12%) had medical imaging (ultrasonography and/or CT scan) after clinical assessment for suspected acute appendicitis. Medical imaging had a 70% prediction rate for acute appendicitis, 20% false-negative rate, and 10% false-positive rate. Overall, the prediction rate for appendicitis by clinical assessment supplemented by laboratory tests and medical imaging at clinician's discretion was 93.2%. CONCLUSIONS Despite studies advocating routine use of medical imaging for patients with suspected acute appendicitis, this study showed that the clinical evaluation is still paramount to the management of patients with suspected acute appendicitis before considering medical imaging.

Chiang, David T; Tan, Elaine I; Birks, David



Scapula length measurement for assessment of fetal growth and development  

Microsoft Academic Search

To determine the value of prenatal ultrasonographic scapula measurements for fetal growth and development as an adjunct to assessing in utero development, a prospective study of ultrasonography was conducted in 343 pregnant women with uneventful pregnancies with gestational ages from 16 to 41 weeks, and several biometric measurements were obtained. The relationships of scapula length with gestational age and with

Gülçin Dilmen; Nilgün Öztürk Turhan; Mete Fuad Toppare; Neslihan Seçkin; Muazzez Öztürk; Eflatun Göksin



The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center  

PubMed Central

Background This study was designed to compare the effectiveness of using auscultation, pH measurements of gastric aspirates, and ultrasonography as physical examination methods to verify nasogastric tube(NGT) placement in emergency room patients with low consciousness who require NGT insertion. Methods The study included 47 patients who were all over 18?years of age. In all patients, tube placement was verified by chest X-rays. Auscultation, pH analysis of gastric aspirates, and ultrasonography were conducted on each patient in random order. The mean patient age was 57.62?±?17.24?years, and 28 males (59.6%) and 19 females (40.4%) were included. The NGT was inserted by an emergency room resident. For pH testing, gastric aspirates were dropped onto litmus paper, and the resulting color of the paper was compared with a reference table. Ultrasonography was performed by an emergency medicine specialist, and the chest X-ray examination was interpreted by a different emergency medicine specialist who did not conduct the ultrasonography test. The results of the auscultation, gastric aspirate pH, and ultrasonography examinations were compared with the results of the chest x-ray examination. Results The sensitivity and specificity were 100% and 33.3%, respectively, for auscultation and 86.4% and 66.7%, respectively, for ultrasonography. Kappa values were the highest for auscultation at 0.484 compared to chest x-rays, followed by 0.299 for ultrasonography and 0.444 for pH analysis of the gastric aspirate. The ultrasonography has a positive predictive value of 97.4% and a negative predictive value of 25%. Conclusions Ultrasonography is useful for confirming the results of auscultation after NGT insertion among patients with low consciousness at an emergency center. When ultrasound findings suggest that the NGT placement is not gastric, additional chest X-ray should be performed.



Imaging assessment of enthesitis in spondyloarthritis.  


Enthesitis, defined as the inflammation of the origin and insertion of ligaments, tendons, aponeuroses, annulus fibrosis, and joint capsules, is a hallmark of spondyloarthritis (SpA). New imaging techniques including magnetic resonance imaging (MRI), ultrasonography, and positron emission tomography with computed tomography using 18F-fluorodeoxyglucose capable of detecting morphological and metabolic abnormalities and monitoring disease activity have improved the assessment and management of enthesitis of SpA. PMID:23192434

Taniguchi, Yoshinori; Kumon, Yoshitaka; Takata, Tomoya; Sano, Shigetoshi; Ohnishi, Takenao; Nogami, Munenobu; Ogawa, Yasuhiro; Terada, Yoshio



Accuracy of percutaneous placement of a ventriculoatrial shunt under ultrasonography guidance: a retrospective study at a single institution.  


The authors report their experience using preoperative chest radiography and intraoperative ultrasonography for percutaneous positioning of the distal end of the catheter when placing ventriculoatrial (VA) shunts in patients with hydrocephalus. The distal portion of VA shunt catheters were percutaneously placed into the internal jugular vein with the aid of intraoperative ultrasonography in 14 consecutive adults. In all cases, the technique was easy, there were no postoperative complications, and postoperative chest radiography demonstrated good positioning of the distal catheter tip. One patient presented with a shunt infection and needed a shunt replacement. The authors therefore conclude that percutaneous placement of a VA shunt under preoperative radiographic guidance and ultrasonographic monitoring is a safe, effective, and reliable technique that is simple to learn. PMID:19099376

Metellus, Philippe; Hsu, Wesley; Kharkar, Siddharth; Kapoor, Sumit; Scott, William; Rigamonti, Daniele



Accuracy of Three-Dimensional Ultrasonography in Differential Diagnosis of Septate and Bicornuate Uterus Compared with Office Hysteroscopy and Pelvic Magnetic Resonance Imaging  

Microsoft Academic Search

Study ObjectiveTo estimate the accuracy of 3-dimensional (3-D) ultrasonography in the differential diagnosis of septate and bicornuate uterus compared with office hysteroscopy and pelvic magnetic resonance imaging (MRI).

Erika Faivre; Hervé Fernandez; Xavier Deffieux; Amélie Gervaise; René Frydman; Jean Marc Levaillant


The Yield of First-Time Endoscopic Ultrasonography in Screening Individuals at a High Risk of Developing Pancreatic Cancer  

Microsoft Academic Search

OBJECTIVES:Approximately 10–15% of all pancreatic cancers (PCs) may be hereditary in origin. We investigated the use of endoscopic ultrasonography (EUS) for the screening of individuals at high risk for developing PC. In this paper the results of first-time screening with EUS are presented.METHODS:Those eligible for screening in this study were first-degree family members of affected individuals from familial pancreatic cancer

J. W. Poley; I. Kluijt; D. J. Gouma; F. Harinck; A. Wagner; C. Aalfs; C H J van Eijck; A. Cats; E. J. Kuipers; Y. Nio; P. Fockens; M. J. Bruno



Prenatal Diagnosis of Diffuse Mesangial Glomerulosclerosis by Ultrasonography: A Longitudinal Study of a Case in an Affected Family  

Microsoft Academic Search

The 4th child of an Arabian consanguineous family with 2 previous infant deaths due to diffuse mesangial glomerulosclerosis (at the ages of 1 and 44 days) and 1 healthy 3-year old child was followed up by ultrasonography from the 9th until the 35th week of gestation. Ultrasound showed enlarged hyperechogenic kidneys from the 14th week onwards, and the amniotic fluid

C. Hofstaetter; I. Neumann; T. Lennert; J. W. Dudenhausen



Localization of parathyroid enlargement: experience with technetium-99m methoxyisobutylisonitrile and thallium-201 scintigraphy, ultrasonography and computed tomography  

Microsoft Academic Search

Technetium-99m methoxyisobutylisonitrile (MIBI), like thallium-201, has recently been introduced as a myocardial perfusion agent and is now also showing very promising results in parathyroid scintigrapy. The results of 201Tl\\/99mTc-pertechnetate and 99mTc-MIBI\\/99mTc-pertechnetate subtraction scintigraphy, ultrasonography and computed tomography are presented in a series of 43 patients operated on for hyperparathyroidism. All four imaging modalities were confirmed to be reliable, scintigraphy being

Onelio Geatti; Brahm Shapiro; Pier Giuseppe Orsolon; Gianni Proto; Ugo Paolo Guerra; Francesco Antonucci; Daniele Gasparini



Community-Based, Nonprofit Organization-Sponsored Ultrasonography Screening Program for Abdominal Aortic Aneurysms Is Effective at Identifying Occult Aneurysms  

Microsoft Academic Search

Early diagnosis of abdominal aortic aneurysm (AAA), prior to rupture, is vital for optimizing patient survival. An abdominal\\u000a ultrasonography examination of an asymptomatic individual to check for the presence of an AAA, however, is not presently reimbursed\\u000a by health insurance in the United States. This article reports the results of one nonprofit, community-based screening program,\\u000a run by Aneurysm Outreach, Inc.

Toru Ogata; Sheila Arrington; P. Michael Davis; Albert D. Sam II; Larry H. Hollier; Gerard Tromp; Helena Kuivaniemi



Prostate cancer detection in a clinical urological practice by ultrasonography, digital rectal examination and prostate specific antigen  

Microsoft Academic Search

The prostate cancer detection rate from screening by digital rectal examination and tactilely guided prostate biopsy is approximately 1.7%. Among 1,807 men a detection rate of 14.6% was achieved in a clinical urological practice by physician-conducted prostate ultrasonography, digital rectal examination and determination of serum prostate specific antigen. Results are presented in 5-year increments as well as for the group

William H. Cooner; B. R. Mosley; Charles L. Rutherford; Jeff H. Beard; Harry S. Pond; William J. Terry; Todd C. Igel; Donald D. Kidd



Ultrasonography of spontaneous lesions of the genital system of three rams, and their influence on semen quality  

Microsoft Academic Search

Three young Suffolk ram lambs had lesions which rendered them reproductively unsound. One had a unilateral scrotal hernia, detected by palpation, and two had sperm granulomas which were detected by trans-scrotal ultrasonography at 18 to 20 weeks of age, before they could be detected by palpation. Changes in the lesions were monitored ultrasonographically at two-week intervals with a 7.5 MHz

N. Ahmad; G. C. W. England; D. E. Noakes



Intra-abdominal thickness by ultrasonography to predict risk factors for cardiovascular disease and its correlation with anthropometric measurements  

Microsoft Academic Search

The aim of this study was to determine if intra-abdominal thickness measured by ultrasonography (IATU) in men and women had a correlation with cardiovascular risk factors, to compare it with anthropometric measures (waist circumference [WC] and abdominal sagittal diameter [SDi]), and to find a cut-off value for IATU to predict risk factors for cardiovascular disease (CVD). In a cross-validation study,

Claudia Cozer Leite; Bernardo Leo Wajchenberg; Rosana Radominski; Daniela Matsuda; Giovanni Guido Cerri; Alfredo Halpern



Ultrasonography in the Detection of Crohn’s Disease and in the Differential Diagnosis of Inflammatory Bowel Disease  

Microsoft Academic Search

The diagnostic accuracy of abdominal ultrasonography in inflammatory bowel disease (IBD) has been evaluated in a prospective, randomized, blind study. A total of 181 patients (89 with Crohn’s disease, 57 ulcerative colitis and 35 controls) were examined. Sensitivity and specificity of diagnosis in Crohn’s disease, corrected for prevalence, were 80.8 and 79.2%, respectively, and a very similar accuracy was found

A. Pera; T. Cammarota; E. Comino; D. Caldera; V. Ponti; M. Astegiano; C. Barletti; R. Rocca; M. Cosimato; L. Bertolusso



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


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

Lim, Sok Hwan; Kim, Myung-Joon; Lee, Mi-Jung



Diagnostic value of radionuclide scanning and ultrasonography in thyroid developmental anomaly imaging.  


Thyroid is particularly prone to morphogenetic variability. Developmental failure of the thyroid gland is in 85% of cases the underlying cause of congenital hypothyroidism, diagnosed at birth with a frequency of 1:3000-1:4000 newborns. However, the incidence of less severe developmental variants of the thyroid is much higher. Determination of the aetiology of congenital hypothyroidism is crucial for predicting its severity and outcome as well as impacts dose of L-thyroxine during substitution. Thyroid imaging is necessary to establish diagnosis, and it involves mainly thyroid ultrasound examination and scintiscan. Awareness of both the advantages and limitations of sonographic and scintigraphic imaging are central to the successful interpretation of their results and reasonable recommendation of these procedures for patients with thyroid developmental anomalies of different age and clinical picture. Hence, the aim of this review is to provide the most important and up-to-date information on the place of radionuclide scanning and ultrasonography in visualization of different thyroid developmental abnormalities. PMID:21751168

Rucha?a, Marek; Szczepanek, Ewelina; Sowi?ski, Jerzy



Endoscopic ultrasonography in gastric lymphomas: appraisal on reliability in long-term follow-up.  


The reliability of endoscopic ultrasonography (EUS) in follow-up management of gastric lymphomas has not been clearly validated. We conducted a retrospective analysis on 23 patients, 12 affected by mucosa-associated lymphoid tissue (MALT) lymphoma, eight by diffuse large B-cell lymphoma, and three by high-grade lymphoma with low-grade component, all treated with a stomach-conservative approach. One hundred and twenty matched evaluations with both EUS and endoscopy with biopsy (E-Bx) were performed, according to validated guidelines and clinical judgment. At a median follow-up of 87?months ranged between 9.5 and 166?months, the analysis of progression-free survival and disease-free survival showed a strict relationship between the persistence of EUS abnormalities and the clinical outcome in patients with MALT lymphoma (p?=?0.0079; p?=?0.02) but not in patients with high-grade lymphoma. In conclusion, EUS evaluation does not seem reliable in follow-up management of high-grade lymphomas, although it could have a great clinical impact in the management of MALT lymphoma. PMID:22189677

Vetro, Calogero; Romano, Alessandra; Chiarenza, Annalisa; Conticello, Concetta; Donnarumma, Daniela; Gorgone, Ausilia; Coppolino, Francesco; Palumbo, Giuseppe Alberto; Bonanno, Giacomo; Di Raimondo, Francesco



Ultrasonography of the liver and kidneys of healthy camels (Camelus dromedarius).  


This study describes the ultrasonography of the liver and kidneys of healthy camels (Camelus dromedarius). Images of the liver were obtained from the 11th to 5th intercostal spaces (ICSs). The distance between the dorsal liver margin and the midline of the back was shortest (39.1 ± 7.4 cm) at the 11th ICS and increased cranially to 5th ICS. The size of the liver was largest at the 9th ICS and smallest at the 5th ICS. In 6 camels the right kidney was visualized from the 10th and 11th ICSs and upper right flank and in the 10th and 11th ICSs in the remaining 16 camels. In all camels, the left kidney was imaged from the caudal left flank. In 21 camels, the differentiation between the renal cortex and medulla was clearly visible in the ultrasonograms. Ultrasonographic description of the liver and kidneys provides a basic reference for diagnosing hepatic and renal disorders in camels. PMID:23729824

Tharwat, Mohamed; Al-Sobayil, Fahd; Ali, Ahmed; Buczinski, Sébastien



Contrast-enhanced ultrasonography of the rabbit VX2 tumor model: Analysis of vascular pathology  

PubMed Central

The accuracy of diagnosing tumors may be improved significantly by detecting the microvascular distribution. Indeed, contrast-enhanced ultrasonography (CEUS) has shown a distinct advantage in detecting microvasculature. This study aimed to determine the angiogenic characteristics of VX2 tumors in rabbits using CEUS. A total of 17 rabbits were injected with 0.5 ml VX2 cell suspension into the muscles of both hind legs to prepare the VX2 tumor models. At 14, 21, 28 and 35 days after tumor inoculation, CEUS was performed on the rabbits with 0.3 ml SonoVue following a local anesthesia. The pathological findings of the tumors were compared. A total of 12 rabbits survived after being inoculated with the tumor cells and developed a total of 38 tumors. The size of the tumors ranged from 1.12 to 10.85 cm. Using CEUS, all tumors demonstrated rim enhancement with some unenhanced regions. Enhancement began from the peripheral region and quickly showed internal reticular vessels. Regardless of the tumor size or the presence of necrosis, no complete enhancement of the tumors was observed. On microscopic examination, VX2 tumor cells were detected in striated muscles, immature blood capillaries and fibrosis tissues scattered in tumor nests. Immunohistochemical examination revealed that CD34+ cells appeared mainly in the muscles adjacent to vessels. In conclusion, CEUS may be an efficient method to evaluate angiogenesis and blood perfusion in VX2 tumors.




Integrating ultrasonography within the reproductive management of the collared peccary (Tayassu tajacu).  


Ultrasound imaging has been used to elucidate certain aspects of the reproductive biology of wild or endangered species. However, to our knowledge, this tool has not been used for reproductive monitoring of the collared peccary (Tayassu tajacu). In this study, real-time ultrasonography was used in 16 collared peccary females to diagnose early pregnancy status and predict gestational age. Based on the detection of an embryo, the earliest pregnancy diagnosis was made on Day 18 after mating, with the mean time needed for diagnosis being 22 days. Overall accuracies on Days 22, 26 and 28 were 56, 93, and 100%, respectively. On Days 26 and 28, all pregnancy and non-pregnancy diagnoses, respectively, were correct. The fetal measurements that best correlated with gestational age were crown-rump-length (CRL) and the length and diameter of the thorax. CRL was considered the most practical measurement because, contrary to thoracic fetometry, it could be determined when the embryo was first detected. Our findings revealed real-time ultrasound scanning to be a very accurate method for early pregnancy diagnosis and prediction of gestational age in the collared peccary. PMID:15823342

Mayor, Pedro; López-Gatius, Fernando; López-Béjar, Manel



Cross-Sectional Elastic Imaging of Arterial Wall Using Intravascular Ultrasonography  

NASA Astrophysics Data System (ADS)

There have been several studies on the imaging of the distribution of the elasticity of the arterial wall using intravascular ultrasonography (IVUS). In those studies, the elasticity is estimated only during ventricular diastole. However, the viscous characteristics of the smooth muscle in the media of the arterial wall are also included in the strain measured during diastole. Alternatively, during systole, the smooth muscle has an almost purely elastic characteristic. However, the IVUS probe moves greatly due to the arrival of the pulsatile wave at the beginning of the ejection period. Therefore, in this paper, we propose a method to compensate for the movement of the IVUS probe in order to precisely measure the regional change in thickness of the arterial wall during one cardiac cycle. Basic experiments using a silicone rubber tube, in which pulsatile flow is generated by an artificial heart, determined the two-dimensional (2-D) distribution of the regional change in thickness and the elasticity. The obtained incremental elastic modulus coincides with that determined by the static pressure-strain test. Furthermore, in an in vitro experiment performed on an extracted human iliac artery, the 2-D distribution of elasticity is obtained and compared with pathological results.

Mita, Hitoshi; Kanai, Hiroshi; Koiwa, Yoshiro; Ichiki, Masataka; Tezuka, Fumiaki



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

PubMed Central

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.

Lim, Sok Hwan; Kim, Myung-Joon



Transcranial Doppler ultrasonography in sickle cell disease: a study in Omani patients.  


Changes on Transcranial Doppler (TCD) ultrasonography have been proposed as significant predictors of cerebrovascular complications in sickle cell disease (SCD). However, consensus with regards to the TCD criteria to recognize abnormalities in cerebral vasculature is lacking. We studied the TCD characteristics of cerebral arteries among Omani patients with SCD and correlated them with cerebrovascular events. TCD was performed through the temporal and suboccipital windows using a 2 MHz probe (DWL). Thirty-three of 59 patients (56%) with SCD had neurological symptoms including stroke--12 (20%) and epilepsy--7. Fifteen patients (25%) had significant TCD abnormalities including: markedly increased velocities--11 (3 with stroke); turbulent flow--2; and reversal of flow--2. No patient had a time averaged maximum mean velocity of >200 cm/s in anterior circulation. On applying a modified definition of "abnormal TCD" to anterior and posterior circulation studies, increased TCD velocities in posterior circulation correlated with history of stroke (P < 0.05). TCD velocities in the 18 adult patients ( older than 15 y) were significantly lower than in children. Logistic regression analysis revealed abnormal TCD in the left posterior cerebral artery to be an independent predictor of stroke in this cohort (P = 0.035). PMID:23249960

Gujjar, Arunodaya R; Zacharia, Mathew; Al-Kindi, Salam; William, Ranjan; Al Lamki, Zakiya; Wali, Yasser; Bashir, Wafa; Jain, Rajeev; Al-Asmi, Abdullah; Pathare, Anil



Lung ultrasonography of pulmonary complications in preterm infants with respiratory distress syndrome  

PubMed Central

Aim. To evaluate the diagnostic possibilities of lung ultrasonography (LUS) in detecting pulmonary complications in preterm infants with respiratory distress syndrome (RDS). Material and methods. A prospective study included 120 preterm infants with clinical and radiographic signs of RDS. LUS was performed using both a transthoracic and a transabdominal approach within the first 24 h of life, and, after that, follow-up LUS examinations were performed. In 47 detected pulmonary complications of RDS (hemorrhage, pneumothorax, pneumonia, atelectasis, bronchopulmonary dysplasia), comparisons between LUS and chest X-ray (CXR) were made. Also, 90 subpleural consolidations registered during LUS examinations were analysed. Statistical analysis included MANOVA and discriminant analysis, t-test, confidence interval, and positive predictive value. Results. In 45 of 47 instances the same diagnosis of complication was detected with LUS as with CXR, indicating a high reliability of the method in premature infants with RDS. The only two false negative findings concerned partial pneumothorax. The positive predictive value of LUS was 100%. A statistically significant difference of LUS findings between the anterior and posterior lung areas was observed in both right and left hemithoraces. Conclusions. LUS enables the detection of pulmonary complications in preterm infants with RDS and has the potential to reduce the number of CXRs. The specific guidelines for its use should be provided in a more extensive study.



Prediction of Vesicoureteral Reflux in Children with First Urinary Tract Infection by Dimercaptosuccinic Acid and Ultrasonography  

PubMed Central

Objective Urinary tract infection (UTI) is one of the most common causes of febrile pediatric diseases. Also, vesicoureteral reflux (VUR) is a significant risk factor for UTI. Voiding cystourethrography (VCUG) is the method of choice for evaluation of VUR. This study was done to predict VUR by DMSA scan (technetium 99 m-labeled dimercaptosuccinic acid) and ultrasonography (US). Methods In a prospective study, all children with first time acute pyelonephritis were selected and evaluated by DMSA scan and US. Then VCUG was done with negative urine culture. All children with final diagnosis of obstructive congenital anomaly were excluded. The sensitivity, specifity, positive predictive values, negative predictive values, Confidence Interval of DMSA scan and US were calculated for prediction or exclusion of VUR. Findings Among 100 children with UTI diagnosis, VUR was detected in 39 children and 63 (31.5%) kidneys. DMSA scan was abnormal in 103 (51.5%) units, 45 units had VUR (PPV=44%), 79 units with normal DMSA scan had no VUR (NPV=81%). Of kidney units that were abnormal by DMSA or US, 51 units had VUR. PPV and NPV were 44% and 56%, respectively. Conclusion DMSA scan alone or with US cannot predict VUR (especially low grade VUR). But according to NPV, it seems that absence of VUR can be predicted. So, more studies are needed to determine the usefulness of DMSA scan and US instead of VCUG for detection of VUR.

Sorkhi, Hadi; Nooreddini, Haji-Ghorban; Amiri, Mehrangiz; Osia, Soheil; Farhadi-Niakee, Saeed



Endoscopic ultrasonography in patients with elevated carbohydrate antigen 19-9 of obscure origin  

PubMed Central

AIM: To evaluate the efficacy of endoscopic ultrasonography (EUS) in patients with elevated carbohydrate antigen (CA) 19-9 levels of obscure origin. METHODS: Patients who had visited Pusan National University Hospital because of elevated serum CA 19-9 levels, between January 2007 and December 2009, were retrospectively enrolled. EUS had been performed on all subjects, in addition to routine blood tests, endoscopy, abdominal computed tomography (CT) and other clinical exams, which had not revealed any abnormal findings suggestive of the origin of the elevated CA 19-9 levels. RESULTS: Of the 17 patients, gallbladder sludge was detected in 16 patients (94.1%) and common bile duct sludge was observed in 3 patients (17.6%). After the administration of ursodeoxycholic acid to 12 of the patients with gallbladder sludge, CA 19-9 levels normalized in 6 of the patients after a median of 4.5 mo. CONCLUSION: EUS is a useful diagnostic method for patients with elevated CA 19-9 levels of obscure origin, even if the reason for abnormal levels of this serum marker cannot be determined through prior examinations, including abdominal CT.

Cheong, Jae Hoon; Kim, Gwang Ha; Moon, Ji Yoon; Lee, Bong Eun; Ryu, Dong Yup; Kim, Dong Uk; Seo, Hyung-Il; Song, Geun Am



Are both ultrasonography and mammography necessary for cancer investigation of breast lumps in resource-limited countries?  


Objective. To reevaluate the diagnostic value of breast imaging in the diagnosis of breast cancer in areas where health resources are limited. Methods. Patients were women presenting with breast lumps in two university-affiliated tertiary hospitals, Thailand, during 2006 and 2010. Clinical data were abstracted from the breast cancer registration database and patient records. The diagnostic predictive ability of ultrasonography and mammography was obtained from logistic regression analysis and presented with areas under the receiver operating characteristics (AuROCs) curves. Results. Among 3129 breast lumps (3069 women), 854 were diagnosed with breast cancer by certified pathologists. Age and size of lumps alone already predicted cancer correctly in 77.45% (AuROC = 77.45). Additional ultrasonography increased the prediction to 96.22% (P < 0.001). Additional mammography also increased the prediction to 95.99% (P < 0.001). Performing both imaging modalities did not increase the prediction clinically (0.01%-0.24%). More accurate prediction (2.07%-2.21%) may be added by fine needle aspiration cytology (FNAC). Conclusions. Breast imaging is still valuable in settings where health resources are limited. Single breast imaging (only either ultrasonography or mammography) is adequate for cancer diagnosis. It is therefore unnecessary to perform both imaging modalities. Accuracy of the diagnosis may be improved by FNAC, if available. PMID:24066238

Chairat, Rungnapa; Puttisri, Adisorn; Pamarapa, Asani; Samintharapanya, Sahatham; Tawichasri, Chamaiporn; Patumanond, Jayanton



Prenatal Diagnosis of an Aneurysm of the Vein of Galen by Three-Dimensional Power and Color Doppler Ultrasonography  

PubMed Central

Aneurism of the vein of Galen is a complex arteriovenous malformation which is of multiply communications between of the vein of Galen and the cerebral arteries. It represents less than 1% of the cerebral arteriovenous malformations. Few cases using three-dimensional (3D) power and color Doppler ultrasound have been reported in the literature. We present a case of an aneurysm of the vein of Galen diagnosed at 25th week of pregnancy. We demonstrate the main findings of 3D power and color Doppler ultrasonography in this anomaly. A 36-year-old pregnant woman, gravida 3, para 2 was referred to our institution because of a midline cystic mass diagnosed in a previous ultrasonography undertaken at 24 weeks’ gestation. The ultrasonographic finding consisted of a male fetus with a midline cystic mass, with positive flow detection by color Doppler and ventriculomegaly due to the compressive effects of the malformation. The 3D color and power Doppler ultrasonography allowed us to reconstruct the architecture of the vascular malformation, and it showed the spatial relationships of aneurysm of the vein of Galen with the other structures of the brain. Pregnancy was interrupted at 29 weeks’ gestation because of presence of cardiomegaly. A male newborn survived for 36 hours only. The 3D ultrasound can be used as advent image technique in prenatal diagnosis of aneurysm of the vein of Galen.

Rios, Livia Teresa Moreira; Araujo, Edward; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes; Martins, Marilia da Gloria



Using ultrasonography in evaluating the intramuscular injection techniques used for administering drug treatments to schizophrenic patients in Japan.  


This study was conducted with six patients with schizophrenia, four of whom received the atypical antipsychotic risperidone long-acting injectable (RLAI), and two patients receiving the typical depot injection (TDI). The purpose of this study was to determine the location (gluteus medius or maximus; deltoid muscles) and diffusion of typical and atypical antipsychotic medications administered intramuscularly using ultrasonography. When using the standardized depth of needle insertion, in some cases, the drug was injected into the gluteus maximus instead of the gluteus medius. Similarly, in some cases the TDI was not visible in the ultrasonographic images until sixteen days after the injection. This verifies how hard the injection site becomes when microspheres of RLAI is injected as compared to other muscle areas. These results confirmed that the gluteus muscle structure was the ideal muscle for depot injection as evidenced by the injection solution being dispersed and rendered not visible immediately after intramuscular injection (IM). With the use of ultrasonography, injection sites and drug dispersions were evaluated under a direct visual guidance, suggesting that ultrasonography is a useful method for establishing evidence for determining correct insertion of IM injection, diffusion of medications, and the effective administration of IM injections. PMID:22450010

Yasuhara, Yuko; Hirai, Eri; Sakamaki, Sakiko; Tanioka, Tetsuya; Motoki, Kazushi; Takase, Kensaku; Locsin, Rozzano; Kawanishi, Chiemi; Inui, Tatsuya; Watari, Chie; Makiguchi, Kouichi



Are Both Ultrasonography and Mammography Necessary for Cancer Investigation of Breast Lumps in Resource-Limited Countries?  

PubMed Central

Objective. To reevaluate the diagnostic value of breast imaging in the diagnosis of breast cancer in areas where health resources are limited. Methods. Patients were women presenting with breast lumps in two university-affiliated tertiary hospitals, Thailand, during 2006 and 2010. Clinical data were abstracted from the breast cancer registration database and patient records. The diagnostic predictive ability of ultrasonography and mammography was obtained from logistic regression analysis and presented with areas under the receiver operating characteristics (AuROCs) curves. Results. Among 3129 breast lumps (3069 women), 854 were diagnosed with breast cancer by certified pathologists. Age and size of lumps alone already predicted cancer correctly in 77.45% (AuROC = 77.45). Additional ultrasonography increased the prediction to 96.22% (P < 0.001). Additional mammography also increased the prediction to 95.99% (P < 0.001). Performing both imaging modalities did not increase the prediction clinically (0.01%–0.24%). More accurate prediction (2.07%–2.21%) may be added by fine needle aspiration cytology (FNAC). Conclusions. Breast imaging is still valuable in settings where health resources are limited. Single breast imaging (only either ultrasonography or mammography) is adequate for cancer diagnosis. It is therefore unnecessary to perform both imaging modalities. Accuracy of the diagnosis may be improved by FNAC, if available.

Puttisri, Adisorn; Pamarapa, Asani; Samintharapanya, Sahatham; Tawichasri, Chamaiporn; Patumanond, Jayanton



Limitations of fetal ultrasonography and magnetic resonance imaging in prenatal diagnosis of congenital cerebral arteriovenous malformations with hemorrhagic onset.  


A fetus at 30 gestational weeks was observed on fetal ultrasonography to have a dilated right lateral ventricle. After delivery, the entity was diagnosed as a prenatal intracerebral hemorrhage (ICH) due to a ruptured arteriovenous malformation (AVM). Ultrasonography and MRI examinations performed before birth indicated a cerebral aneurysm in the territory of the right middle cerebral artery. However, digital subtraction angiography revealed an intracystic hemorrhage due to a ruptured cerebral AVM. Arteriovenous malformations in children are rare, difficult to diagnose, and result in permanent sequelae after delayed treatment. Patient prognosis depends on early and accurate diagnosis and intervention. Outcomes can be improved if an AVM in a child is detected at the onset of ICH for young infants in the prenatal or early postnatal periods. Early AVM diagnosis is limited to fetal ultrasonography and MRI, and special consideration through invasive examination including neonatal digital subtraction angiography is urged unless a correct and clear diagnosis is made at an early stage. Prenatal ICH due to an AVM is rare. The authors discuss their observations and findings. PMID:22725727

Eguchi, Seiichiro; Aihara, Yasuo; Yamaguchi, Kohji; Okada, Yoshikazu



Observations on the female reproductive cycles of captive Asian yellow pond turtles (Mauremys mutica) with radiography and ultrasonography.  


The annual reproductive cycle of 27 female Mauremys mutica was observed by radiography and ultrasonography from April 2006 to August 2007. Radiography was used to monitor clutch size and ultrasonography was used to monitor changes in the ovarian follicles. The follicles started to enlarge in September and became preovulatory in January. The mean maximum follicle diameter of ovulation was 18.30+/-1.44 mm, and ovulation occurred from March through August. Eggs were laid between April and August. Turtles entered latent period in early August and the maximum follicular size was at a low of 13.22+/-2.36 mm in late September. The vitellogenesis of the next reproductive cycle began in October. The 24 adult females laid 56 clutches containing a total of 227 eggs. Average clutch size was 4.05 eggs (range 1-8) and there were 2.33 clutches (range 1-4) per female. Egg shell images were first observed on the sixth or seventh day after ovulation. The oviductal period averaged 6.9 weeks (range 2-16 weeks) on the first clutch, 3.4 weeks (range 2-8 weeks) on the second, and 2.75 weeks (range 2-6 weeks) for the third. Radiography and ultrasonography are non-invasive and convenient methods to evaluate the reproductive cycle of female M. mutica. They should be applicable to other turtles and should greatly enhance knowledge of reproductive physiology. PMID:19688810

Cheng, Yuan-Yu; Chen, Ting-Yu; Yu, Pin-Huan; Chi, Chau-Hwa


Dual-energy X-ray absorptiometry versus quantitative ultrasonography in diagnosing osteoporosis in patients with refractory epilepsy and chronic antiepileptic drug use  

PubMed Central

Background: The aim of this study was to assess the feasibility of calcaneal quantitative ultrasonography (QUS) as a screening method for increased risk of osteoporosis in a unique population of people with chronic epilepsy, intellectual disability (ID), and chronic use of antiepileptic drugs. Methods: A total of 205 patients from a long-stay care facility for people with epilepsy underwent dual-energy X-ray absorptiometry (DXA) and QUS of the calcaneus. T-scores for both DXA and QUS were calculated and correlated. Results: A total of 195 patients (95.1%) were successfully measured with DXA and 204 (99.5%) with QUS. High correlations were found between DXA and QUS T-scores: r = 0.666 (QUS versus T-score total femur), r = 0.631 (QUS versus T-score femur neck) and r = 0.485 (QUS versus T-score lumbar spine). All correlations were statistically significant (p = 0.01). Conclusion: QUS showed a strong correlation with DXA and proved to be a feasible measuring method in a population with ID and epilepsy. Including osteopenia in the screening process increases the sensitivity of QUS to identify those patients at risk for the development of bone diseases.

Tan, Joost; Tan, In Yu; Verschuure, Pauline; Aldenkamp, Albert P.



Non-invasive vascular imaging: assessing tumour vascularity  

Microsoft Academic Search

.   Non-invasive assessment of vascularity is a new diagnostic approach to characterise tumours. Vascular assessment is based\\u000a on the pathophysiology of tumour angiogenesis and its diagnostic implications for tumour biology, prognosis and therapy response.\\u000a Two current techniques investigating vascular features in addition to morphology are Doppler ultrasonography and contrast-enhanced\\u000a MRI. Diagnostic differentiation has been shown to be possible with Doppler,

S. Delorme; M. V. Knopp



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


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

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



Ultrasonography in the Diagnosis of Appendicitis: Evaluation by Meta-analysis  

PubMed Central

Objective We wanted to review the usefulness of ultrasonography (US) for the diagnosis of appendicitis and to evaluate the diagnostic accuracy of US according to patients' and researchers' characteristics. Materials and Methods The relevant Korean articles published between 1985 and 2003 were included in this study if the patients had clinical symptoms of acute appendicitis. The histopathologic findings were the reference standard and the data were presented for 2×2 tables. Articles were excluded if patients had no sonographic signs of appendicitis according to graded-compression US. Two reviewers independently extracted the data on study characteristics. The Hasselblad method was used to obtain the combined estimates of sensitivity and specificity for the performance of US. Results Twenty-two articles (2,643 patients) fulfilled all inclusion criteria. The estimate of ? calculated by combining the sensitivity and specificity was 2.0054 (95% confidence interval [CI]: 1.8553, 2.1554) by a random effects model. The overall sensitivity and specificity (95% CI) were 86.7% (85.4 to 88.0), and 90.0% (88.9 to 91.2), respectively. According to the subgroup meta-analysis by patients' characteristics, the ? estimate (95% CI) of dominantly younger age, male, and highly clinical suggestive group for US was 2.2388 (1.8758 to 2.6019), 2.7131 (2.2493 to 3.1770), and 2.4582 (1.7387 to 3.1777), respectively. Also, according to subgroup meta-analysis by researchers' characteristics, the ? value (95% CI) for US done by diagnostic radiologists and gray-scale was 2.0195 (1.7942 to 2.2447) and 2.2630 (1.8444 to 2.6815). Conclusion This evidence suggests that US may be useful for the diagnosis of acute appendicitis, especially when patients are younger age, male, and highly clinical suggestive.

Yu, Seung-Hum; Park, Joong Wha; Kim, Myoung Soo; Radosevich, David M.



Endometrial microcalcifications detected by ultrasonography: clinical associations, histopathology, and potential etiology.  


Endometrial microcalcifications are uncommon, with alleged clinical implications ranging from innocuous to ominous. We reviewed the histopathologic slides from 29 patients who had endometrial echogenic foci on pelvic ultrasound and found many endometrial microcalcifications. The extent of microcalcifications in each specimen was graded on a semiquantitative scale from 0 to 3. The mean patient age was 54 years (range, 34-81 years). The specimens included endometrial biopsies, curettages, and hysterectomies. Most of the patients had presented with abnormal vaginal bleeding. Fifteen patients (51.7%) were postmenopausal, 10 (34.5%) were premenopausal, and the rest were perimenopausal. The most frequent endometrial types were atrophic (39.5%), inactive (23.3%), and proliferative (14%). Six specimens (14%) showed benign endometrial polyps. One patient had well-differentiated endometrioid carcinoma of the endometrium without myometrial invasion. Specimens from 16 patients (55.2%) had microcalcifications. The patients with calcifications were older than those without calcifications (mean age, 60 vs. 47 years, respectively; P = 0.017). The extent of microcalcifications positively correlated with the presence of endometrial polyps (P = 0.00076), postmenopausal state (P = 0.004), atrophic endometrium (P = 0.002), and hormone replacement therapy (P = 0.013). The microcalcifications were concentric or amorphous, intraglandular or stromal. They were focally associated with minute papillary epithelial projections or with degenerated endometrial glands. Follow-up was available on 26 patients (89.7%). Except for the patient with endometrioid carcinoma, none has developed uterine, adnexal, or peritoneal malignancy. In summary, endometrial microcalcifications are histologically heterogeneous and are associated with older patient age, postmenopausal state, atrophic endometrium, and endometrial polyps. Those found incidentally by means of pelvic ultrasonography, in our experience, did not portend malignancy. PMID:18156977

Truskinovsky, Alexander M; Gerscovich, Eugenio O; Duffield, Curtis R; Vogt, Philip J



Liver and biliary ultrasonography in diabetic and non-diabetic obese women.  


Liver and biliary ultrasonographic findings were studied in 217 asymptomatic obese women [mean age 35.0 +/- 8.3 years, range 15 to 57; mean body mass index (BMI, weight/height2) 40.7 +/- 6.9 kg/m2, range 30.3-71.9] from the Obesity Outpatient Clinic of the Professor Edgard Santos University Hospital. The women underwent an oral glucose tolerance test and were divided into two groups: 21 diabetic obese women plus 25 glucose intolerant (group I); and 171 non-diabetic obese women (group II). Ultrasonography (US) was performed on a Siemens Sonoline SL2 apparatus with a 3.5 MHz transducer. Plasma glucose levels and biochemical tests were determined by the enzymatic method. The frequency of liver US abnormalities was similar in both groups (52.2% of group I and 47.8% of group II). Steatosis was found in 34.8% of group I and 32.2% of group II; steatosis associated with hepatomegaly in 17.4% of group I and 10.5% of group II; and hepatomegaly in 4.1% of group I and absent in group II. Serum cholesterol, HDL-cholesterol, triglycerides, and liver function tests, including aspartate aminotransferase, alanine aminotransferase and gama-glutamiltranspeptidase levels, were similar in both groups. However, triglycerides, uric acid and gamaglutamyl transpeptidase levels were higher in the diabetic and glucose-intolerant group. The frequency of asymptomatic gallstones was higher in group II than group I (24.4% vs 11.7%, p < 0.04). It is suggested that liver and biliary US should be included in the evaluation of all obese women, even when asymptomatic. PMID:9881246

Araújo, L M; De Oliveira, D A; Nunes, D S



Interstitial brachytherapy using virtual planning and Doppler transrectal ultrasonography guidance for internal iliac lymph node metastasis.  


To expand the indications for high-dose-rate interstitial brachytherapy (HDR-ISBT) for deep-seated pelvic tumors, we investigated the usefulness of Doppler transrectal ultrasonography (TRUS) guidance and virtual planning. The patient was a 36-year-old female. She had right internal iliac lymph node oligometastasis of vaginal cancer 12 months after radical radiotherapy. The tumor could not be found by gray-scale TRUS and physical examination. Virtual planning was performed using computed tomography with template and vaginal cylinder insertion. We uploaded the images to our treatment planning software and reconstructed the contours of the clinical target volume (CTV) and right internal iliac vessel. Virtual needle applicators were plotted using the template holes for virtual planning. At the time of implantation, Doppler TRUS was used to prevent vessel injury by needle applicators. Applicators were implanted in accordance with virtual planning and Doppler TRUS could detect the right iliac vessel. The percentage of CTV covered by the prescribed dose was 99.8%. The minimum dose received by the maximally irradiated 0.1-cc volume for the right internal iliac vessel was 95% prescribed dose. Complete response was achieved, however, radiological findings showed marginal recurrence at 15 months after HDR-ISBT. Post-radiation neuropathy occurred as a late complication four months after treatment; however, the pain was well controlled by medication. We consider that virtual planning and Doppler TRUS are effective methods in cases where it is difficult to detect the tumor by physical examination and gray-scale TRUS, thereby expanding the indications for ISBT. PMID:22240939

Yoshida, Ken; Ueda, Mari; Yamazaki, Hideya; Takenaka, Tadashi; Yoshida, Mineo; Miyake, Shunsuke; Yoshida, Susumu; Koizumi, Masahiko; Ban, Chiaki; Tanaka, Eiichi



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

SciTech Connect

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.

Bakhshandeh, Mohsen [Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran (Iran, Islamic Republic of); Hashemi, Bijan, E-mail: [Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran (Iran, Islamic Republic of); Mahdavi, Seyed Rabie [Department of Medical Physics, Faculty of Medical Sciences, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of); Nikoofar, Alireza [Department of Radiation Oncology, Hafte-Tir Hospital, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of); Edraki, Hamid Reza [Department of Radiology, Panzdahe-Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran (Iran, Islamic Republic of); Kazemnejad, Anoshirvan [Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran (Iran, Islamic Republic of)



Ultrasonography of the Harderian gland in the rabbit, guinea pig, and chinchilla.  


OBJECTIVE: To evaluate the Harderian gland in rabbits, guinea pigs, and chinchillas using B-mode ultrasound and to determine normal size and changes in size and/or location in normal and diseased eyes and orbits by ultrasonographic measurements. PROCEDURE: Normal Harderian glands were evaluated ultrasonographically in 20 rabbits, 10 guinea pigs, and eight chinchillas. The Harderian gland was measured ultrasonographically in horizontal and vertical planes. Normal Harderian gland sizes were then compared with sizes in 27 rabbits, 13 guinea pigs, and three chinchillas that had exophthalmos. RESULTS: Harderian glands in normal rabbits were 0.69 ± 0.07 cm (mean value ± SD) horizontally and 1.33 ± 0.14 cm vertically. Harderian glands in normal guinea pigs were 0.58 ± 0.05 cm horizontally and 0.61 ± 0.10 vertically. In normal chinchillas, the Harderian glands were 0.53 ± 0.04 cm horizontally and 0.53 ± 0.03 cm vertically. Harderian glands were significantly larger in the vertical plane in rabbits with exophthalmos (P = 0.001) and in the horizontal plane in guinea pigs with exophthalmos (P = 0.018). Harderian glands of rabbits with exophthalmos were significantly larger in both diseased and healthy glands in both planes compared with those of normal rabbits. Guinea pigs and chinchillas with exophthalmos had larger Harderian glands bilaterally in only the vertical plane. CONCLUSIONS: Ultrasonography is a valuable diagnostic imaging technique to evaluate the Harderian gland in the rabbit, guinea pig, and chinchilla. Retrobulbar pathologic processes cause enlargement of the Harderian gland, which may be attributable to inflammation or possible obstruction of the excretory ducts. PMID:23738702

Hittmair, Katharina M; Tichy, Alexander; Nell, Barbara



Starting with ultrasonography decreases popliteal block performance time in inexperienced hands: a prospective randomized study  

PubMed Central

Background The widespread of hallux valgus surgery in a day care setting enhanced the role of regional anaesthesia in the last few years. Sciatic nerve block at popliteal fossa has been shown to provide safe and effective analgesia. Our purpose was to compare the success rate and performance time of popliteal block during resident’s training for regional anaesthesia by using nerve stimulation (NS) or combined nerve stimulation and ultrasound (NS + US). Methods 70 adult patients undergoing hallux valgus surgery were randomly assigned to receive sciatic nerve block at popliteal fossa with US+NS or NS alone with a double injection technique for peroneal and tibial branches, respectively. Two residents experienced with nerve stimulator performed the procedures after a learning phase concerning ultrasonography. A local anaesthetic solution, containing 10 mL of 0.75% ropivacaine and 10 mL of 2% lidocaine was used: 12 mL were infiltrated close the tibial nerve, and 8mL were infiltrated close the common peroneal nerve. Block success rate, sensory block onset time, block performance time were evaluated. Recourse to general anaesthesia was considered as failure. Results No differences were detected in success rate and onset time of sensory block between the two groups (P > 0.05). The time to block tibial nerve and the overall block time were significantly faster in US+NS group (P < 0.05). Conclusions Ultrasound guidance for popliteal nerve block resulted in similar success rate with a faster procedure time when compared with nerve stimulator, thus providing a possible effect on resident education and operating room efficiency.



Assessing Assessment  

Microsoft Academic Search

An assessment model, with or without using web technologies, should reflect a strategic alignment between the ob jectives one intends to achieve and the activities developed in order to fulfill them. For a same content, different levels of knowledge may be established. In a scenario where the teacher wishes his students to achieve critical thinking about the given contents, but

Philip H. DuBois; M. Moreira Silva; C. Tavares; S. Mamede



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

SciTech Connect

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.

Moschouris, Hippocrates [Tzanio General Hospital, Department of Radiology (Greece); Malagari, Katerina [University of Athens, Attikon Hospital, Second Department of Radiology (Greece); Papadaki, Marina Georgiou; Kornezos, Ioannis, E-mail:; Matsaidonis, Dimitrios [Tzanio General Hospital, Department of Radiology (Greece)



Use of ultrasonography in evaluation of new bone formation in patients treated by the method of Ilizarov.  


(Full text is available at Background: Lengthening of bones by gradually distracting bone fragments using an external apparatus by Ilizarov, is a long process with numerous complications. The greatest threats in limb lengthening are poor new bone formation as well as premature consolidation of the newly generated bone. The purpose of this study was to determine the importance of ultrasonography in evaluation of bone formation in limb lengthening. Patients and Methods: The study involved 31 patients, in whom 52 long bones were lengthened by the Ilizarov method at the University Clinic for Orthopaedic Surgery in Skopje from 2006 to 2010. The study revealed the results of ultrasonographic analysis of new bone formation at four various stages of limb lengthening. The analysis of the results of ultrasonographic examination of bones throughout the lengthening process was based on the form and dimensions of the obtained ultrasonographic parameters - indicators of new bone formation - as well as on the appearance of the cortical margin at the distraction site. Results: Tiny, solitary and confluent hypo-echogenic foci developed on sonograms approximately 2 weeks after distraction was commenced. At stage I a new cortical margin was detected in 30.77%. The number of initial small indicators significantly decreased throughout lengthening. At stage IV the solitary indicators rate was 9.51%, whereas the linear indicators rate significantly increased from 22.12% at the first stage to 54.3% at the last stage. the cortical margin was presented in all 52 bones at III and IV stage of lengthening. Discussion and Conclusions: Ultrasonography enabled an evaluation of the degree of new bone formation and it preceded the radiographic changes at the distraction site. This helped to determine the surgical lengthening and to avoid numerous complications. Key words: Limb lengthening, new bone formation, ultrasonography. PMID:22952105

Poposka, A; Atanasov, N; Dzoleva-Tolevska, R



Contrast-enhanced ultrasound (CEUS) assessment of superselective uterine fibroid embolization (SUFE): Preliminary experience  

Microsoft Academic Search

PurposeThe use of superselective uterine fibroid embolization (SUFE) requires imaging techniques that can be used to verify the success of the procedure. The purpose of our study was to analyze the potential value of pre- and post-treatment contrast-enhanced ultrasonography (CEUS) for assessing the outcome of SUFE and for posttreatment follow-up.

L. M. Sconfienza; F. Lacelli; N. Gandolfo; P. Gazzo; N. Perrone; G. Serafini



Assessment of pubertal development of boars derived from ultrasonographic determination of testicular diameter  

Technology Transfer Automated Retrieval System (TEKTRAN)

At the onset of puberty, seminiferous tubules rapidly increase in diameter occupying a greater proportion of the testis with a consequent rapid increase in testicular size. The objective of the current studies was to evaluate the utility of ultrasonography to assess testicular diameter as a basis fo...


Contrast-enhanced ultrasound assessment of tissue response to high-intensity focused ultrasound  

Microsoft Academic Search

We report the use of contrast-enhanced ultrasonography as an immediate means of assessing the clinical response to high-intensity focused ultras