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1

Transvaginal ultrasonography in the assessment of organic diseases of female urethra.  

PubMed

The current investigation aimed to check the effectiveness of transvaginal ultrasonography in the diagnosis of organic urethral diseases, comparing its results with those of conventional examinations (physical examination, voiding cystourethrography, pelvic ultrasonography, cystourethroscopy). Transvaginal ultrasonography was performed in 560 female patients with recurrent cystitis, dysuria, or palpable masses and diagnosed the following urethral diseases: 25 diverticula, seven stenoses, three carcinomas, two leiomyomas of periurethral tissue, and one incomplete duplex urethra. In our study transvaginal ultrasonography proved to be the most reliable diagnostic tool among imaging methods used. PMID:10082359

Fontana, D; Porpiglia, F; Morra, I; Destefanis, P

1999-03-01

2

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

1993-01-01

3

Measurement of cervical biometry using transvaginal ultrasonography in predicting preterm labor  

PubMed Central

Context: Preterm delivery is associated with high perinatal mortality and morbidity. Although detection of fetal fibronectin in cervical can predict preterm labor, but it is not available in lower source setting area. So, cervical length measurement by ultrasound can be used as an alternative to fetal fibronectin for predicting preterm labor. Aims: To find out the effectiveness of assessment of cervical length by endovaginal ultrasonography in predicting preterm delivery. Settings and Design: The study was conducted in the infertility clinic of Mahatma Gandhi Medical College and Research Institute, Pondicherry from January 2010 to July 2011. Materials and Methods: A total of 130 women with singleton gestation were studied with transvaginal ultrasonography (TVS) to assess the cervical changes (cervical length, dilation of internal os, presence of funneling) between 22 weeks and 24 weeks of gestation. The gestational age at delivery in women with cervical length with ?25 mm were compared with those of <25 mm. Statistical Analysis Used: Statistical analysis was done using Chi-square test. The P value is <0.001 which is statistically significant. Results: The mean cervical length in the study population was 33.16 mm. 16 women had cervical length <25 mm at mid trimesters can out of which 13 (40.62%) went for spontaneous preterm delivery. The relative risk of preterm delivery increased as the length of the cervix decreased. The P value is <0.001 which is statistically significant. A significant difference was found between multigravida at risk of preterm being 62.5% compared to primigravida which was 37.5%. Conclusions: The risk of spontaneous preterm delivery is increased in women who are found to have a short cervix by TVS during pregnancy and it is a sensitive, simple and cost effective method of assessing risk of preterm delivery. PMID:25097417

Tanvir; Ghose, Seetesh; Samal, Sunita; Armugam, Sedhilcoumari; Parida, Pallavee

2014-01-01

4

Comparison of Transvaginal Ultrasonography with Hysterosonography as a Screening Method in Patients with Abnormal Uterine Bleeding  

PubMed Central

Objective To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding. Materials and Methods We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination, endometrial cavitary lesions were classified as diffuse hyperplasia, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings. Results The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis. Conclusion TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding. PMID:15064558

Ryu, Jeong-ah; Lee, Jongmee; Kim, Sooah; Lee, Sang Hoon

2004-01-01

5

Role of Bedside Transvaginal Ultrasonography in the Diagnosis of Tubo-ovarian Abscess in the Emergency Department  

Microsoft Academic Search

Tubo-ovarian Abscess (TOA) is a complication of pelvic inflammatory disease (PID) requiring admission, i.v. antibiotics and, possibly, aspiration or surgery. The purpose of this study was to describe the role of emergency department (ED) bedside transvaginal ultrasonography (US) in the diagnosis of TOA. This was a retrospective review of non-pregnant ED patients presenting with pelvic pain who were diagnosed with

Srikar Adhikari; Michael Blaivas; Matthew Lyon

2008-01-01

6

Assessment of the Fetomaternal Circulation in Threatened Abortion by Transvaginal Color Doppler  

Microsoft Academic Search

Transvaginal color Doppler was used to investigate blood flow in the fetomaternal circulation of 60 women with threatened abortion and 90 women with normal intrauterine pregnancy. The obtained Doppler sonograms were analyzed and the resistance index (RI) was calculated in the maternal circulation, while in the fetal circulation the pulsatility index (PI) was used. There was no significant difference in

Asim Kurjak; Damir Zudenigo; Mladen Predanic; Sanja Kupesic; Biserka Funduk

1994-01-01

7

Transvaginal Endoscopic Surgery for Tubal Ectopic Pregnancy  

PubMed Central

Objective: To explore the feasibility, safety, efficacy, and cosmetic outcomes of transvaginal endoscopic salpingectomy for tubal ectopic pregnancy. Methods: From May 2009 to May 2012, we prospectively enrolled 40 patients, each of whom had been scheduled for a salpingectomy because of a tubal ectopic pregnancy, and randomized them into two groups: transvaginal endoscopic surgery and laparoscopic approach. We recorded the estimated blood loss, time of anal exhaust, postoperative pain score, length of stay, and scar assessment scale associated with transvaginal endoscopic access (n = 18) (natural orifice transluminal endoscopic surgery) and laparoscopic salpingectomy (n = 20) (control group) for tubal ectopic pregnancy. The transvaginal salpingectomy was performed with a double-channel endoscope through a vaginal puncture. A single surgeon performed the surgical procedures in patients in both groups. Results: The group that underwent the transvaginal endoscopic procedure reported lesser pain at all postoperative visits than the group that underwent the laparoscopic approach. The duration of time for transvaginal endoscopic surgery was slightly longer than that for the laparoscopic approach. However, there was no statistically significant difference between the two groups in the duration of operative time. The group that underwent transvaginal endoscopic surgery was more satisfied with the absence of an external scar than the group that underwent the laparoscopic procedure, which left a scar. The estimated blood loss, time of anal exhaust, and length of stay were the same in both groups. Conclusion: The safety and efficacy of transvaginal endoscopic salpingectomy for tubal ectopic pregnancy are equivalent to those of the laparoscopic procedure. Lesser postoperative pain and a more satisfactory cosmetic outcome were found with the transvaginal endoscopic procedure, making it the more preferred method and superior to the laparoscopic approach. PMID:24680148

Xu, Boqun; Liu, Yawen; Fan, Zhining

2014-01-01

8

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)

1999-11-15

9

Transvaginal sonographic measurement of fetal lingual width in early pregnancy.  

PubMed

Our objective was to construct a nomogram of the fetal lingual size early pregnancy and to assess the size of the tongue in abnormal fetuses. The lingual width was measured by using transvaginal ultrasonography in 80 normal fetuses at 13 and 18 weeks' gestation. In addition the tongue was measured in 22 fetuses at these gestational ages who had an abnormal karyotype or oro-facial malformations. A linear relationship was found between the lingual width and gestational age in normal fetuses. The lingual size was within the normal range in cases of trisomy 13, trisomy 21 and Turner syndrome. A small tongue was observed in fetuses with micrognathia. Correlation between lingual width and gestational age was observed in early pregnancy. The relationship between the size of the tongue and oro-facial malformation needs further evaluation. PMID:9664602

Bronshtein, M; Zimmer, E Z; Tzidony, D; Hajos, J; Jaeger, M; Blazer, S

1998-06-01

10

Clinical Examination Allied to Ultrasonography in the Assessment of New Onset Gynaecomastia: An Observational Study  

PubMed Central

Aim: New onset gynaecomastia is a relatively common presentation to breast surgical services. The main aim of clinical and radiological evaluation is to exclude the presence of concurrent breast cancer. There exists much variability in the clinical assessment of male patients presenting with new onset gynaecomastia. Materials and Methods: In the presented pilot study, all the male patients presenting with new onset gynaecomastia to our department over a period of two years were studied. Results: Fifty three patients presented with new onset gynaecomastia during the study period. Clinical examination allied with ultrasonography confirmed benign breast disease in 50 patients with only three patient requiring breast biopsy to exclude malignancy. We detail the efficacy of utilising clinical examination in conjunction with ultrasonography to evaluate new onset gynaecomastia. Conclusions: We show that clinical examination used in conjunction with ultrasonography is both highly sensitive and specific for detecting male breast cancer in patients presenting with new onset gynaecomastia. PMID:25121023

Donovan, Rosamund; Mirza, Mehboob

2014-01-01

11

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

Microsoft Academic Search

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),

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

2011-01-01

12

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. PMID:23002335

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

2012-01-01

13

Transrectal ultrasonography.  

PubMed

Transrectal ultrasonography is useful in assessing prostatic size, locally staging patients with prostatic carcinoma, and monitoring tumor response to endocrine therapy. New instrumentation provides the ability to perform needle biopsies under ultrasound guidance and potentially may be useful in the placement of radioactive seeds for treatment of localized malignancies. PMID:6719664

Spirnak, J P; Resnick, M I

1984-05-01

14

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. PMID:24106529

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

2013-01-01

15

Efficacy of Doppler Ultrasonography for Assessment of Transjugular Intrahepatic Portosystemic Shunt Patency  

SciTech Connect

Purpose: To assess the efficacy of Doppler ultrasonography (US) as a noninvasive method for monitoring patency of the transjugular intrahepatic portosystemic shunt (TIPS). Methods: Twenty-nine patients who had received TIPS for bleeding esophagogastric varices and/or refractory ascites with portal hypertension underwent Doppler US studies within 2 weeks after TIPS. Further studies were performed in 15 of them at 6 months, in 9 at 1 year, and in 4 at 2 years for a total of 57 US studies. The US findings were compared with the angiographic findings obtained at the same time. Results: In 45 of the 57 studies, shunt patency was found by Doppler US, correlating to 44 patencies and one occlusion on angiography. Doppler signal in the shunt could not be detected in 12 studies resulting in the diagnosis of shunt occlusion. This correlated with angiographic occlusion in 8 studies and patency in the remaining 4. All angiographically patent shunts that were occluded by Doppler US had various degrees of stenosis. A number of technical factors were found to be responsible for Doppler US false-positive or false-negative diagnoses, some related to the type of stent used. The Doppler US sensitivity was therefore 92%, the specificity 89%. Conclusion: Doppler US is a reliable noninvasive method to evaluate patency of TIPS.

Kimura, Masashi; Sato, Morio; Kawai, Nobuyuki; Tanaka, Kayo; Sonomura, Tetsuo; Shioyama, Kazushi; Kishi, Yasukazu; Terada, Masaki; Yamada, Ryusaku [Department of Radiology, Wakayama Medical College, 27 Banchi, 7 Bancho, Wakayama City, 640 (Japan)

1996-11-15

16

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

PubMed

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

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

2013-08-01

17

Fetal ultrasonography.  

PubMed Central

Since its introduction in the 1950s, ultrasonography in pregnancy has been helpful in determining gestational age, detecting multiple pregnancies, locating placentas, diagnosing fetal anomalies, evaluating fetal well-being, and guiding obstetricians with in utero treatment. We review current standards and controversies regarding the indications, safety, accuracy, and limitations of ultrasonography in pregnancy. Images PMID:8236969

Garmel, S H; D'Alton, M E

1993-01-01

18

A pilot study on real-time transvaginal ultrasonographic elastography of cystic ovarian lesions  

PubMed Central

Background & objectives: This study was carried out to determine the appearance of various cystic ovarian lesions on transvaginal real-time ultrasonographic elastography and to investigate its potential in the differential diagnosis of cystic ovarian lesions. Methods: Twenty six women (age range, 27-71 yr; mean age 42 ± 16 yr) with cystic ovarian masses underwent transvaginal B-mode and Doppler ultrasonography, and transvaginal real-time ultrasonographic elastography. Those having ovarian cysts with solid components underwent to biopsy or surgical excision. The elasticity colour code (pattern 1-5), and strain index of cystic ovarian lesions were analyzed and associated with histopathological diagnosis. Results: Eleven of 26 ovarian cysts (42%) (diameter range, 3.2-4.5 cm) without solid component were not colour coded with blue or colour coded with blue-red-green heterogenous mosaic pattern. Fifteen of 26 cystic ovarian lesions (58%) (diameter range, 3.5-6.5 cm) had solid components. Among these, two had colour pattern 5, their strain indexes were 3.7 and 4, and their histopathologic diagnosis were germ cell carcinoma. One had colour pattern 5, with strain index 13.6, and histopathologic diagnosis was clear cell carcinoma. Interpretation & conclusions: Transvaginal real-time ultrasonographic elastography has potential role in the differential diagnosis of cystic ovarian lesions and this technique may be useful in differentiation of the benign lesions from those of malignant. PMID:23852289

Ciledag, Nazan; Arda, Kemal; Aktas, Elif; Aribas, Bilgin Kadri

2013-01-01

19

Assessment of the subglottic region by ultrasonography for estimation of appropriate size endotracheal tube: A clinical prospective study  

PubMed Central

Background: Endotracheal intubation is important to carry out various surgical procedures. The estimation of endotracheal tube size is governed by narrowest diameter of the upper airway. The objective of the study was to assess the narrowest tracheal diameter by ultrasound for selection of the appropriate size endotracheal tube. Materials and Methods: After the approval of institution ethical committee and written informed consent, 112 patients aged 3 to 18 years of both genders with normal airways, scheduled for surgery under general anesthesia and intubation, were enrolled for this prospective clinical observational study. Preanesthetic ultrasonography of the subglottic region was performed by experienced ultrasonologist with a high-resolution linear array transducer in sniffing position for every patient and the subglottic tracheal diameter was estimated to select the appropriate-size endotracheal tube. The endotracheal tube, calculated on the basis of physical indices and by ultrasound, was statistically correlated with the appropriate size endotracheal tube used clinically for intubation. Results: The ultrasound guided selection criterion has estimated the appropriate-sized endotracheal tube better than physical indices (age or height)-based formulas. The estimated endotracheal tube size by ultrasound was significantly correlated with the clinically used endotracheal tube. Conclusion: Ultrasonography may be used for the assessment of the subglottic diameter of trachea in children to estimate the appropriate size endotracheal tube for intubation.

Gupta, Kumkum; Gupta, Prashant K.; Rastogi, Bhawna; Krishan, Atul; Jain, Manish; Garg, Gouri

2012-01-01

20

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.

1987-01-01

21

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

PubMed Central

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

Arisoy, Resul; Yayla, Murat

2012-01-01

22

dopOSCCI: a functional transcranial Doppler ultrasonography summary suite for the assessment of cerebral lateralization of cognitive function.  

PubMed

We present a description of a new software package, 'dopOSCCI', which summarises data from experimental studies where functional transcranial Doppler ultrasonography (fTCD) is used to compare hemispheric rates of blood flow in order to assess lateralization of a cognitive process. The software provides a graphical user interface to summarise analogue and digital data collected using Multi-Dop Doppler Ultrasound devices (DWL Multidop T2: manufacturer, DWL Elektronische Systeme, Singen, Germany). The unique aspects of dopOSCCI allow multi-file processing, multi-event marker processing, behavioural and multi-session summaries, image file data visualization, and tab-delimited output files which includes split-half, single-trial summaries and data quality variables. The Matlab based software is available under the GNU GPL license and can be accessed online at https://databank.ora.ox.ac.uk/general/datasets/dopOSCCI, the Oxford University DataBank. PMID:22120689

Badcock, Nicholas A; Holt, Georgina; Holden, Anneka; Bishop, Dorothy V M

2012-03-15

23

Breast cancer tumor size assessment with mammography, ultrasonography, and magnetic resonance imaging at a community based multidisciplinary breast center.  

PubMed

Paramount to staging and patient management is accurately measuring the size of invasive breast cancers. We assessed the accuracy of mammography (MG), ultrasonography (US), and magnetic resonance imaging (MRI) at our community-based hospital in which multiple radiologists and imaging machines are used in the care of our patients. We performed a retrospective analysis of a prospectively maintained database of 277 patients seen at our breast center from 2009 to 2010. We tabulated MG, US, and MRI-reported tumor sizes in 161 women with pathology-proven invasive breast cancer and compared the preoperative size measurements with final pathologic tumor size. In the 161 patients, 169 lesions were identified. Imaging using all three modalities was available in 47 patients. When compared with final pathology, MRI had a correlation of r = 0.75 to mean tumor size as compared with US (r = 0.67) and MG (r = 0.76). Mean tumor size was 1.90 cm by MG, 1.87 cm by US, 2.40 cm by MRI, and 2.19 cm by pathology. We were able to achieve an excellent correlation of pathologic tumor size to preoperative imaging. The absolute differences in size between the modalities were small. MRI, in select patients, added to the assessment of tumor size based on US and MG. PMID:22472402

Ramirez, Sarah Ines; Scholle, Max; Buckmaster, Jennifer; Paley, Robert Hunter; Kowdley, Gopal Chandru

2012-04-01

24

[Breast ultrasonography: an overview].  

PubMed

The most important roles of ultrasound in breast imaging include the diagnosis of cysts and the characterization of masses that have been incompletely assessed by mammography. Ultrasonography techniques such as harmonic and compound imaging have recently been introduced and are more efficient than conventional imaging in terms of lesion conspicuity and the characterization of breast nodule. The BI-RADS classification is an important system for describing and classifying breast lesions. With this approach, a population of benign solid breast lesions that does not require biopsy can be accurately defined. Ultrasonography should be performed as first-line examination in juvenile, in pregnant women and in patients with inflammatory syndrome. Ultrasound can detect mammographically occult breast the way they develop. PMID:17140836

Boisserie-Lacroix, M; Lebiez-Michel, N; Cavigni, P; Bentolila, J; Laumonier, H; Bouzgarrou, M; Trillaud, H

2006-12-01

25

Prognostic assessment and treatment of primary gastric lymphomas: how endoscopic ultrasonography can help in tailoring patient management.  

PubMed

Endoscopic ultrasonography (EUS) has recently gained a pivotal role in the management of gastric lymphomas, especially in the diagnostic workup. Its accuracy and reliability have overcome those of other imaging techniques, such that it represents an invaluable tool for the management of gastric lymphomas. Although this technique is operator dependent, its application in large series has proved its reliability. Thus, it has generally been considered a useful tool for providing information crucial in deciding the treatment program, especially for mucosa-associated lymphoid tissue (MALT) lymphomas, for which EUS can provide an accurate evaluation of disease extension and treatment response probability. Limited-stage disease, confined to the submucosa, has a greater probability to respond to sole Helicobacter pylori eradication. In contrast, the value of EUS in response assessment and follow-up monitoring is still debated, with discordant opinions about its reliability and clinical advantages, because normalization of the EUS findings occurs with a considerable delay compared to the histologic evaluation. In the follow-up setting, preliminary data have indicated that persistently positive EUS findings in low-grade gastric lymphoma could represent a warning for a possible relapse. However, in high-grade gastric lymphoma, such findings do not have any clinical implications. PMID:24369919

Vetro, Calogero; Chiarenza, Annalisa; Romano, Alessandra; Amico, Irene; Calafiore, Valeria; Di Raimondo, Cosimo; Coppolino, Francesco; Di Raimondo, Francesco

2014-06-01

26

Transvaginal cervical cerclage: evidence for perioperative management strategies.  

PubMed

The objective was to review the evidence supporting various perioperative technical and management strategies for transvaginal cervical cerclage. We performed MEDLINE, PubMed, EMBASE, and COCHRANE searches with the terms, cerclage, cervical cerclage, cervical insufficiency, and randomized trials, plus each technical aspect (eg, suture, amniocentesis, etc) considered. The search spanned 1966 through September 2012 and was not restricted by language. Each retrieved manuscript was carefully evaluated, and any pertinent references from the reports were also obtained and reviewed. All randomized trials covering surgical and selected perioperative, nonsurgical aspects of cerclage were included in the review. The evidence was assessed separately for history-, ultrasound-, and physical examination-indicated cerclage. Evidence levels according to the new method outlined by the US Preventive Services Task Force were assigned based on the evidence. There are no grade A high-certainty recommendations regarding technical aspects of transvaginal cervical cerclage. Grade B moderate-certainty recommendations include performing a fetal ultrasound before cerclage to ensure fetal viability, confirm gestational age, and assess fetal anatomy to rule out clinically significant structural abnormalities; administering spinal, and not general, anesthesia; performing a McDonald cerclage, with 1 stitch, placed as high as possible; and outpatient setting. Unfortunately, no other recommendations can be made regarding the other technical aspects of cerclage. PMID:23416155

Berghella, Vincenzo; Ludmir, Jack; Simonazzi, Giuliana; Owen, John

2013-09-01

27

The WHO ultrasonography protocol for assessing hepatic morbidity due to Schistosoma mansoni. Acceptance and evolution over 12 years.  

PubMed

The aim of this study is to review the worldwide acceptance of the World Health Organization (WHO) ultrasound protocol for assessing hepatosplenic morbidity due to Schistosoma mansoni since its publication in 2000. A PubMed literature research using the keywords "schistosomiasis and ultrasound," "schistosomiasis and ultrasonography," and "S. mansoni and ultrasound" from 2001 to 2012 was performed. Case reports, reviews, reports on abnormalities due to parasites other than S. mansoni, organ involvement other than the human liver, and reports where ultrasound method was not described were excluded. Six studies were retrieved from other Brazilian sources. Sixty studies on 37,424 patients from 15 countries were analyzed. The WHO protocol was applied with increasing frequency from 43.75 % in the years 2001 to 2004 to 84.61 % in 2009 to 2012. Results obtained using the pictorial image pattern approach of the protocol are reported in 38/41 studies, whereas measurements of portal branch walls were applied in 19/41 and results reported in 2/41 studies only. The practical usefulness of the pictorial approach of the WHO protocol is confirmed by its wide acceptance. This approach alone proved satisfactory in terms of reproducibility, assessment of evolution of pathology, and comparability between different settings. The measurements of portal branches, also part of the protocol, may be omitted without losing relevant information since results obtained by these measurements are nonspecific. This would save resources by reducing the time required for each examination. It is also more feasible for examiners who are not specialized in medical imaging. As with all protocols, incipient liver fibrosis is difficult to distinguish from normal ultrasound findings of the liver. The ability of this protocol to predict complications in severe cases should be further evaluated in a higher number of patients. PMID:25260691

El Scheich, Tarik; Holtfreter, Martha C; Ekamp, Hendrik; Singh, Daman D; Mota, Rodrigo; Hatz, Christoph; Richter, Joachim

2014-11-01

28

Assessment of cardiac pathology by point-of-care ultrasonography performed by a novice examiner is comparable to the gold standard  

PubMed Central

Background The aim of the study was to compare the diagnostic accuracy of point-of-care cardiac ultrasonography performed by a novice examiner against results from a specialist in cardiology with expert skills in echocardiography, with regard to the assessment of six clinically relevant cardiac conditions in a population of ward patients from the Department of Cardiology or the Department of Cardiothoracic Surgery. Methods Cardiac ultrasonography was performed by a novice examiner at the bedside and images were interpreted in a point-of-care context with dichotomous outcomes (yes/no). Six outcome categories were defined: 1) pericardial effusion (?10 mm), 2) left ventricular dilatation (?62 mm), 3) right ventricular dilatation (?42 mm or???left ventricular diameter), 4) left ventricular hypertrophy (?13 mm), 5) left ventricular failure (EF???40%), 6) aortic stenosis (maximum flow velocity ?3 m/s). The examiner was blinded to the patients’ medical history and results from previous echocardiographic examinations. Results from the interpreted point-of-care ultrasonography examination were compared with echocardiographic diagnosis made by a specialist in cardiology. Results A total of 102 medical and surgical patients were included. Assessments were made in six categories totalling 612 assessments. There was agreement between the novice examiner and the specialist in 95.6% of the cases; overall sensitivity was 0.91 and specificity was 0.97. Positive predictive value was 0.92 and negative predictive value was 0.97. Kappa statistics showed good agreement between observers (?=0.88). Conclusions This study showed that a novice examiner was able to detect common and significant heart pathology in six different categories with good accuracy using POC ultrasonography. PMID:24330752

2013-01-01

29

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

1996-01-01

30

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

Microsoft Academic Search

OBJECTIVE--To assess whether changes in the intraovarian vasculature or blood flow impedance can be used to identify potentially malignant masses. DESIGN--Open, non-comparative prospective study. SETTING--Ovarian screening clinics at King's College Hospital and the Hallam Medical Centre. SUBJECTS--50 Women selected on the basis of their medical history and the result of a previous transvaginal ultrasound scan. Thirty women (10 premenopausal (scan

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

1989-01-01

31

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

2003-01-01

32

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

E-print Network

to surgery George Condous1,4 , Emeka Okaro1 , Asma Khalid1 , Chuan Lu2 , Sabine Van Huffel2 , D Timmerman3 and Tom Bourne1 1 Early Pregnancy, Gynaecological Ultrasound and Minimal Access Surgery Unit, St George undergoing surgery for presumed ectopic pregnancy. METHODS: A prospective, observa- tional study. Women were

33

Review of ultrasonography of malignant neck nodes: greyscale, Doppler, contrast enhancement and elastography  

PubMed Central

Abstract Assessment of neck lymph nodes is essential in patients with head and neck cancers for predicting the patient’s prognosis and selecting the appropriate treatment. Ultrasonography is a useful imaging tool in the assessment of neck lymph nodes. Greyscale ultrasonography assesses the size, distribution, and internal architecture of lymph nodes. Doppler ultrasonography evaluates the intranodal vascular pattern and resistance of lymph nodes. Contrast-enhanced ultrasonography provides information on lymph node parenchymal perfusion. Elastography allows qualitative and quantitative assessment of lymph node stiffness. This article reviews the value of greyscale, Doppler and contrast-enhanced ultrasonography as well as elastography in the assessment of malignant nodes in the neck. PMID:24434158

Ying, M.; Bhatia, K.S.S.; Lee, Y.P.; Yuen, H.Y.

2013-01-01

34

Endoluminal transrectal ultrasonography: Accuracy, reliability, and validity  

Microsoft Academic Search

The significant risk of local recurrence after curative resection and the relative inaccuracy of preoperative clinical assessment justify a more sophisticated assessment for carcinoma of the rectum. Endoluminal rectal ultrasonography (EU) can directly visualize the degree of rectal wall penetration by tumor and the immediate pararectal lymph nodes. Despite several reports reporting excellent accuracy of EU compared with pathology in

Michael J. Solomon; Robin S. McLeod

1993-01-01

35

Transvaginal sonographic findings of a large intramural uterine hematoma associated with iatrogenic injury sustained at termination of pregnancy.  

PubMed

We report a case in which a patient presented with severe right lower abdominal pain associated with nausea and vomiting 3 days after termination of pregnancy. Transvaginal ultrasonography showed a large intramural mass in the anterior aspect of the lower segment of an acutely retroflexed uterus. Computed tomography and magnetic resonance imaging findings were consistent with an intramural hematoma as a result of iatrogenic injury sustained during the preceding termination of pregnancy. The patient was managed expectantly. Systematic review of the literature confirmed that this is the first report of sonographic findings associated with an intramural uterine hematoma some days after the injury sustained at termination of pregnancy. This case supports utilization of real-time ultrasound guidance during intrauterine surgery of selected cases to decrease procedure-related morbidity. PMID:17559185

Sherer, D M; Gorelick, C; Gabbur, N; Borowski, D; Serur, E; Zinn, H L; Kheyman, M; Abulafia, O

2007-07-01

36

Correlation and agreement between contrast-enhanced ultrasonography and perfusion computed tomography for assessment of liver metastases from endocrine tumors: normalization enhances correlation.  

PubMed

We studied correlation and agreement between perfusion parameters derived from contrast-enhanced ultrasonography (CEUS) and computed tomography (CT). Both techniques were performed in 16 patients with proven liver metastases from endocrine tumor. Replenishment study after ultrasound-induced destruction of microbubbles was used for CEUS quantification. CEUS-derived relative values of blood flow, blood volume and mean transit time were compared with perfusion CT-derived parameters measured in the same tumors. Significant correlation was observed between CEUS normalized values and CT absolute tumor values for blood flow (r = 0.58; p = 0.018), blood volume (r = 0.61; p = 0.012) and mean transit time (r = 0.52; p = 0.037). Correlation was not significant for non-normalized values. Agreement between CEUS normalized values and perfusion CT relative values was significant (p < 0.04). Estimated bias between CEUS and CT for relative perfusion values was -1.38 (-5.02; 2.27) for blood flow, +0.26 (-0.79; 1.31) for blood volume and +0.21 (-0.46; 0.87) for mean transit time. We conclude that normalization markedly increased correlation between CEUS- and CT-derived perfusion values and allowed agreement assessment. PMID:22475696

Lefort, Thibaud; Pilleul, Frank; Mulé, Sébastien; Bridal, S Lori; Frouin, Frédérique; Lombard-Bohas, Catherine; Walter, Thomas; Lucidarme, Olivier; Guibal, Aymeric

2012-06-01

37

Embarazo ectópico gemelar bicorial espontáneo. Diagnóstico ecográfico transvaginal  

Microsoft Academic Search

We report a case of unilateral twin tubal ectopic pregnancy in a patient without risk factors. Presurgical transvaginal sonography allowed two gestational sacs adjacent to the right ovary to be visualized. Both embryos showed cardiac activity. Laparoscopic salpingectomy was performed. These findings are extremely rare.

A. Luengo; V. Zornoza; B. Pérez-Prieto; A. Álvarez-Domínguez; V. Álvarez-Sierra

2010-01-01

38

Visualization of the Ovaries in Early Pregnancy by Transvaginal Sonography  

Microsoft Academic Search

Objective: To determine the frequency of visualization of the ovaries by transvaginal sonography (TVS) in a group of women in early pregnancy and to determine the onset of a decrease in sonographic visualization of the ovaries during this time. Methods: The study population included all patients with an intrauterine pregnancy confirmed by the presence of a yolk sac, embryo, or

Phyllis Glanc; Nicole Brofman; Anat Kornecki; Jason Abrams; Dan Farine; Shia Salem

39

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

1993-01-01

40

"Assessment of chronic sclerodermoid Graft-versus-Host Disease patients, using 20 MHz high-frequency ultrasonography and cutometer methods".  

PubMed

The development of an adverse graft-versus-host disease (GvHD) is a major complication of stem cell transplantations, which are widely used to cure increasing number of hematologic malignancies. Patients with chronic GvHD are at risk of joint contractures secondary to sclerodermatous skin changes. Several clinical scores or serologic markers have been used to assess skin sclerosis in scleroderma patients. Evaluation of sclerotic skin changes using biometric tools remains to be challenging. The purpose of this study was to illustrate and exemplify ultrasound measurement and measurement of skin elasticity of five chronic sclerodermoid GvHD patients. There is still a substantial lack of studies using objective and non-invasive methods helpful in assessment of patients with skin involvement of GvHD. Although ultrasound is not the ideal method, it is worth emphasizing that it is still useful, non-invasive, and repeatable device in monitoring patients suffering from GvHD. It should also be added, that it seems to be advisable to repeat USG examination at an interval of 3 months after the treatment. In addition, skin echogenicity may be a more sensitive parameter than skin thickness in assessment of cGvHD patients. PMID:22882597

Osmola-Ma?kowska, Agnieszka; Silny, Wojciech; Da?czak-Pazdrowska, Aleksandra; Pola?ska, Adriana; Olek-Hrab, Karolina; Sadowska-Przytocka, Anna; ?aba, Ryszard; Jenerowicz, Dorota

2013-02-01

41

Thorax, Trachea, and Lung Ultrasonography in Emergency and Critical Care Medicine: Assessment of an Objective Structured Training Concept  

PubMed Central

Background and Study objective. Focused lung ultrasound (LUS) examinations are important tools in critical care medicine. There is evidence that LUS can be used for the detection of acute thoracic lesions. However, no validated training method is available. The goal of this study was to develop and assess an objective structured clinical examination (OSCE) curriculum for focused thorax, trachea, and lung ultrasound in emergency and critical care medicine (THOLUUSE). Methods. 39 trainees underwent a one-day training course in a prospective educational study, including lectures in sonoanatomy and -pathology of the thorax, case presentations, and hands-on training. Trainees' pre- and posttest performances were assessed by multiple choice questionnaires, visual perception tests by interpretation video clips, practical performance of LUS, and identification of specific ultrasound findings. Results. Trainees postcourse scores of correct MCQ answers increased from 56 ± 4% to 82 ± 2% (mean± SD; P < 0.001); visual perception skills increased from 54 ± 5% to 78 ± 3% (P < 0.001); practical ultrasound skills improved, and correct LUS was performed in 94%. Subgroup analysis revealed that learning success was independent from the trainees' previous ultrasound experience. Conclusions. THOLUUSE significantly improves theoretical and practical skills for the diagnosis of acute thoracic lesions. We propose to implement THOLUUSE in emergency medicine training. PMID:24369503

Breitkreutz, Raoul; Dutine, Martina; Scheiermann, Patrick; Kujumdshiev, Sandy; Ackermann, Hanns; Seeger, Florian Hartmut; Walcher, Felix; Hirche, Tim Oliver

2013-01-01

42

Thorax, trachea, and lung ultrasonography in emergency and critical care medicine: assessment of an objective structured training concept.  

PubMed

Background and Study objective. Focused lung ultrasound (LUS) examinations are important tools in critical care medicine. There is evidence that LUS can be used for the detection of acute thoracic lesions. However, no validated training method is available. The goal of this study was to develop and assess an objective structured clinical examination (OSCE) curriculum for focused thorax, trachea, and lung ultrasound in emergency and critical care medicine (THOLUUSE). Methods. 39 trainees underwent a one-day training course in a prospective educational study, including lectures in sonoanatomy and -pathology of the thorax, case presentations, and hands-on training. Trainees' pre- and posttest performances were assessed by multiple choice questionnaires, visual perception tests by interpretation video clips, practical performance of LUS, and identification of specific ultrasound findings. Results. Trainees postcourse scores of correct MCQ answers increased from 56 ± 4% to 82 ± 2% (mean± SD; P < 0.001); visual perception skills increased from 54 ± 5% to 78 ± 3% (P < 0.001); practical ultrasound skills improved, and correct LUS was performed in 94%. Subgroup analysis revealed that learning success was independent from the trainees' previous ultrasound experience. Conclusions. THOLUUSE significantly improves theoretical and practical skills for the diagnosis of acute thoracic lesions. We propose to implement THOLUUSE in emergency medicine training. PMID:24369503

Breitkreutz, Raoul; Dutiné, Martina; Scheiermann, Patrick; Hempel, Dorothea; Kujumdshiev, Sandy; Ackermann, Hanns; Seeger, Florian Hartmut; Seibel, Armin; Walcher, Felix; Hirche, Tim Oliver

2013-01-01

43

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

PubMed

Acute kidney injury (AKI) is common in critically ill patients and associated with important morbidity and mortality. Although alterations in renal perfusion are thought to play a causative role in the pathogenesis of AKI, there is, to date, no reliable technique that allows the assessment of renal perfusion that is applicable in the ICU. Contrast-enhanced ultrasound (CEUS) is an ultrasound imaging technique that makes use of microbubble-based contrast agents. These microbubbles, when injected into the bloodstream, allow visualization of vascular structures and, with contrast-specific imaging modes, detection of blood flow at the capillary level. Some recent CEUS-derived approaches allow quantification of blood flow in several organs, including the kidney. Current generation ultrasound contrast agents have strong stability and safety profiles. Along with post-marketing surveillance, numerous studies report safe administration of these agents, including in critically ill patients. This review presents information on the physical principles underlying CEUS, the methods allowing blood flow quantification and the potential applications of CEUS in critical care nephrology, currently as a research tool but perhaps in the future as a way of monitoring renal perfusion. PMID:21586101

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

2011-01-01

44

Detection of congenital uterine malformation by using transvaginal three-dimensional ultrasound.  

PubMed

This study assessed the clinical application of transvaginal three-dimensional ultrasound (3D TVUS) in the diagnosis of congenital uterine malformation. A retrospective study was performed on 62 patients with congenital uterine malformation confirmed hysteroscopically and/or laparoscopically. The patients were subjected to transvaginal two-dimensional ultrasound (2D TVUS) and 3D TVUS. The accuracy rate was compared between the two methods. The accuracy rate of 3D TVUS was (98.38%, 61/62), higher than that of 2D TVUS (80.65%, 50/62). 3D TVUS coronal plane imaging could demonstrate the internal shape of the endometrial cavity and the external contour of the uterine fundus. It allowed accurate measurement on the coronary plane, and could three-dimensionally show the image of cervical tube, thereby providing information for the diagnosis of some complex uterine malformation. 3D TVUS imaging can obtain comprehensive information of the uterus malformation, and it is superior to 2D TVUS for the diagnosis of congenital uterine malformations, especially complex uterine anomaly. PMID:25318893

Yu, Li-Li; Zhang, Xuan; Zhang, Ting; Chen, Han-Rong; Wang, Ze-Hua

2014-10-01

45

Natural Orifice Translumenal Endoscopic Surgery (NOTES) Transvaginal Cholecystectomy in a Morbidly Obese Patient  

Microsoft Academic Search

Transvaginal natural orifice translumenal endoscopic surgery (NOTES) is a new diagnostic and potentially therapeutic method\\u000a of surgical endoscopy. The first case of NOTES transvaginal cholecystectomy in a morbid obese patient in the literature is\\u000a described. IRB approval was obtained at the institution for transvaginal NOTES clinical trials. A 58-year-old female patient\\u000a with cholelithiasis, hypertension, and type II diabetes, and BMI

Luis DeCarli; Ricardo Zorron; Alcides Branco; Fernando Cirme Lima; Marcos Tang; Sergio Ricardo Pioneer; Idilio Zanin Jr; Alfredo Augusto Schulte; André Vicente Bigolin; Michel Gagner

2008-01-01

46

A modified posterior pelvic exenteration technique in a woman: (a simplified method with using transvaginal way).  

PubMed

We represent a simplified surgical method for posterior pelvic exenteration in a woman by using the transvaginal way in addition to classic abdominal approach. A modified posterior pelvic exenteration technique was performed in a patient with bulky pelvic tumor. The transvaginal way was used for the deep perineal dissection when the abdominal dissection was arrested. An ultralow coloanal anastomosis was completed by using the transvaginal way. After the recovery period, the patient was discharged from hospital without any complication. The transvaginal access should be reminded in the circumstances of the abdominal dissection arrested in posterior pelvic exenteration operations in women. PMID:24082597

Yücesoy, Ali Naki; Kad?o?lu, M Burak; Gönen, Emre

2012-10-01

47

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. PMID:23925020

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

2013-01-01

48

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

PubMed

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

2012-09-01

49

The role of transvaginal sonography in the diagnosis of placenta praevia.  

PubMed

Transvaginal sonography was performed in 70 patients diagnosed to have placenta praevia by transabdominal sonography. The diagnosis was confirmed either by digital examination in theatre at term or operative finding at delivery. Forty-nine cases (70%) were correctly diagnosed to have placenta praevia by both modes of sonography. Transvaginal sonography ruled out placenta praevia in 12 cases (17%) thought to be placenta praevia by transabdominal ultrasound. Both transabdominal and transvaginal sonography demonstrated 'placental migration' in 4 cases (6%) which were no longer praevia at delivery. Five patients (7%) were erroneously believed to have placenta praevia by both sonographic techniques. Overall, the diagnostic accuracy of transvaginal sonography was 92.8% compared with 75.7% for transabdominal sonography. None of the subjects experienced any exacerbation of bleeding or other complications. The results suggest that transvaginal sonographic localization of the placenta is safe and superior to the transabdominal route. PMID:7771998

Tan, N H; Abu, M; Woo, J L; Tahir, H M

1995-02-01

50

Transvaginal repair of ureterovaginal fistula by Latzko technique.  

PubMed

Ureterovaginal fistula is an uncommon but serious sequela of unrecognized distal ureteral injury during pelvic operations. Traditionally, it is managed either by endoscopic internal ureteral stenting or by ureteral reimplantation. We report a case of ureterovaginal fistula that failed to respond to ureteral stenting. Because the patient had a history of several laparotomies and intra-abdominal abscesses, she was at high risk for complications with a transabdominal operation. Therefore, we used transvaginal Latzko partial colpocleisis and successfully resolved the ureterovaginal fistula. PMID:17404678

Chen, Shwu-Shiuang; Yang, Shwu-Huey; Yang, Jenn-Ming; Huang, Wen-Chen

2007-11-01

51

Transvaginal sonographically controlled follicle puncture for oocyte retrieval.  

PubMed

Transvaginal sonographically guided follicle aspiration under local anesthesia was performed on more than 100 patients and compared favorably with the other techniques that have been proposed to retrieve oocytes for in vitro fertilization. Sonography employs a sector scanner placed on the abdomen, and the needle is introduced through the posterior fornix of the vagina into the cul-de-sac and the ovary. In case of a high ovary, a transvaginal-transvesical variation may be used. The method is not painful and is easy to learn and perform. The sole adverse incidents have involved inadvertent venous puncture with no sequelae. The number and quality of recovered oocytes are good, and five normal children conceived after this method of retrieval were recently born. The technique permits substantial simplification of egg recovery for in vitro fertilization, which can now be performed in an outpatient setting without the risk and expense of laparoscopy and general anesthesia or the discomfort of transabdominal-transvesical ultrasound-guided aspiration. PMID:3932103

Dellenbach, P; Nisand, I; Moreau, L; Feger, B; Plumere, C; Gerlinger, P

1985-11-01

52

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.

1991-05-01

53

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

PubMed Central

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

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

2013-01-01

54

Fundamentals of diagnostic ultrasonography.  

PubMed

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

1990-01-01

55

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

PubMed

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

2013-04-01

56

Ovarian torsion diagnosed by ultrasonography.  

PubMed

We have reported the ultrasonographic findings in a 9-year-old girl with torsion of a normal ovary. In this and six previously reported cases ultrasonography has shown hypoechoic, solid, intrapelvic masses sometimes containing small cysts. Liquid may be present in the pelvic cul-de-sac, and in one instance an anechoic halo surrounded an infarcted ovary. A second case, a seemingly false-positive ultrasonic diagnosis of ovarian enlargement, illustrated a possible pitfall. Ultrasonography can aid in earlier diagnosis of ovarian torsion, which may permit more ovaries to be salvaged. PMID:3906912

Bowen, A

1985-11-01

57

Transvaginal Cystocele Repair by Purse-String Technique Reinforced with Three Simple Sutures: Surgical Technique and Results  

PubMed Central

Purpose Different techniques for cystocele repair including the conventional anterior colporrhaphy and mesh technique are known. Our goal was to evaluate the anatomical success and safety of our method of transvaginal anterior vaginal wall repair by the purse-string technique reinforced with three simple additional sutures in the repair of cystocele over a 4-year follow-up period. Methods This was a retrospective review of 69 consecutive patients (grades 2 to 4) who underwent the above operations between 2001 and 2011, including their success rates as assessed by use of the Baden-Walker halfway classification system. Results Of the patients, 62 patients (98%) were completely cured of cystocele and 1 patient showed grade 2 cystocele recurrence that required no further treatment. Two patients with grade 4 cystocele were completely cured. There was no vaginal erosion related to the cystocele repair. Conclusions Transvaginal anterior colporrhaphy by a purse-string technique reinforced with simple additive sutures appears to be a simple, safe, and easily performed approach in cystocele repair. There is no need for other material for reinforcement, even in high-grade cystocele, which is an advantage of our technique. PMID:23094221

Song, Ho-Sook; Choo, Gwoan Youb; Jin, Long-Hu; Yoon, Sang-Min

2012-01-01

58

TRANSVAGINAL SONOGRAPHIC CERVICAL LENGTH FOR THE PREDICTION OF SPONTANEOUS PRETERM BIRTH IN TWIN PREGNANCIES: A SYSTEMATIC REVIEW AND METAANALYSIS  

PubMed Central

Objective To assess the accuracy of transvaginal sonographic cervical length (CL) in predicting spontaneous preterm birth in women with twin pregnancies. Study design Systematic review and metaanalysis of predictive test accuracy. Results Twenty-one studies (16 in asymptomatic women and 5 in symptomatic women) with a total of 3523 women met the inclusion criteria. Among asymptomatic women, a CL ?20 mm 20-24 weeks’ gestation was the most accurate in predicting preterm birth <32 and <34 weeks’ gestation (pooled sensitivities, specificities, and positive and negative likelihood ratios of 39% and 29%, 96% and 97%, 10.1 and 9.0, and 0.64 and 0.74, respectively). A CL ?25 mm 20-24 weeks’ gestation had a pooled positive likelihood ratio of 9.6 to predict preterm birth <28 weeks’ gestation. The predictive accuracy of CL for preterm birth was low in symptomatic women. Conclusion Transvaginal sonographic CL 20-24 weeks’ gestation is a good predictor of spontaneous preterm birth in asymptomatic women with twin pregnancies. PMID:20576253

CONDE-AGUDELO, Agustin; ROMERO, Roberto; HASSAN, Sonia S.; YEO, Lami

2011-01-01

59

[Ultrasonography for carpal tunnel syndrome].  

PubMed

Ultrasonography in cases of carpal tunnel syndrome is described with respect to the following aspects: (1) imaging technique; (2) image characteristics; (3) detection of pathophysiology; (4) diagnosis of idiopathic cases; (5) screening of local pathologies (space-occupying lesions, tenosynovitis, and bone and joint abnormalities), incomplete release, and anatomic variations; and (6) role in facilitating minimally-invasive surgery. PMID:24607945

Nakamichi, Kenichi

2014-03-01

60

[Evaluation of carotid stenosis by using carotid ultrasonography].  

PubMed

Carotid stenosis is observed in several diseases such as atherosclerosis, moyamoya disease, and aortitis. Carotid stenosis can be assessed using computed tomography (CT), magnetic resonance angiography (MRA), ultrasonography, or cerebral angiography. Carotid ultrasonography is superior to other modalities because it is a noninvasive, repeatable, and easy method that does not involve much cost. The intima-media complex thickness (IMT) can be easily measured using carotid ultrasonography. The incidence of cerebral and cardiovascular events increases with increase in the thickness of the IMT. The percentage of stenosis was expressed using the NASCET, ECST, or area methods. The NASCET criterion of 70% stenosis for performing carotid endarterectomy for symptomatic carotid stenosis corresponded to 85% ECST stenosis, 90% area stenosis, and 200 cm/sec of peak systolic velocity. Carotid ultrasonography provides information on not only carotid stenosis but also unstable plaques such as ulcer, hypoechoic plaque, thin fibrous cap, and mobile plaque. In patients with moyamoya disease, carotid ultrasonography often reveals that the diameter of the internal carotid artery (ICA) is greatly reduced at the proximal portion above the bulbus (resembling a champagne bottle neck) and is less than 50% that of the common carotid artery (champagne bottle neck sign); the diameter of the ICA is smaller than that of the external carotid artery (diameter reversal sign). In patients with aortitis, IMT thickness is frequently observed at the common carotid artery (Macaroni sign) but not at the ICA. PMID:21139180

Seike, Nahoko; Ito, Michiko; Yasaka, Masahiro

2010-12-01

61

Current situation of transvaginal mesh repair for pelvic organ prolapse.  

PubMed

SURGICAL mesh is a metallic or polymeric screen intended to be implanted to reinforce soft tissue or bone where weakness exists. Surgical mesh has been used since the 1950s to repair abdominal hernias. In the 1970s, gynecologists began using surgical mesh products to indicate the repair of pelvic organ prolapse (POP), and in the 1990s, gynecologists began using surgical mesh for POP. Then the U.S. Food and Drug Administration (FDA) approved the first surgical mesh product specifically for use in POP. Surgical mesh materials can be divided into several categories. Most surgical mesh devices cleared for POP procedures are composed of non-absorbable synthetic polypropylene. Mesh can be placed in the anterior vaginal wall to aid in the correction of cystocele (anterior repair), in the posterior vaginal wall to aid in correction of rectocele (posterior repair), or attached to the top of the vagina to correct uterine prolapse or vaginal apical prolapse (apical repair). Over the past decades, surgical mesh products for transvaginal POP repair became incorporated into "kits" that included tools to aid in the delivery and insertion of the mesh. Surgical mesh kits continue to evolve, adding new insertion tools, tissue fixation anchors, surgical techniques, and ab- sorbable and biological materials. This procedure has been performed popularly. It was also performed increased in China. But this new technique met some trouble recently and let shake in urogynecology. PMID:25264889

Zhu, Lan; Zhang, Lei

2014-09-29

62

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.

1984-01-01

63

Three-dimensional Endoluminal Ultrasonography  

Microsoft Academic Search

\\u000a Endoanal ultrasonography (EAUS) is important in patients with fecal incontinence (FI) to differentiate between incontinent\\u000a patients with intact anal sphincters and those with sphincter lesions (defects, scarring, thinning, thickening, and atrophy).\\u000a High-resolution multiplanar reconstructions and rendering techniques further enhance the accuracy of EAUS. Ultrasonographic\\u000a findings may lead to appropriate therapy (sphincteroplasty, graciloplasty, injection of bulking agents, sacral nerve stimulation),\\u000a and

Giulio Aniello Santoro; Giuseppe Di Falco

64

Thyroid Ultrasonography: Pitfalls and Techniques  

PubMed Central

Thyroid ultrasonography (US) plays a key role in the diagnosis and management of thyroid-related diseases. The aim of this article was to illustrate various pitfalls that can occur in utilizing thyroid US and techniques to prevent them. In this article, we present cases demonstrating the common pitfalls associated with US equipment, performance, normal thyroid structures, misinterpretations, and surrounding structures. Knowledge of these areas is essential to avoid misdiagnosis or improper disease management. PMID:24642650

Choi, Seon Hyeong; Kim, Eun-Kyung; Kim, Soo Jin

2014-01-01

65

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. PMID:21943467

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

2011-01-01

66

Managing chronic pelvic pain following reconstructive pelvic surgery with transvaginal mesh.  

PubMed

In 2001, the US Food and Drug Administration (FDA) approved the first transvaginal mesh kit to treat pelvic organ prolapse (POP). Since the introduction of vaginal mesh kits, some vaginal meshes have been associated with chronic pelvic pain after reconstructive pelvic floor surgery. Pelvic pain results in between 0 % and 30 % of patients following transvaginal mesh placement. Common causes of chronic pelvic pain include pelvic floor muscle spasm, pudendal neuralgia, and infection. Paucity of data exists on the effective management of chronic pelvic pain after pelvic reconstructive surgery with mesh. We outline the management of chronic pelvic pain after transvaginal mesh placement for reconstructive pelvic floor repair based on our clinical experience and adaptation of data used in other aspects of managing chronic pelvic pain conditions. PMID:24217793

Gyang, Anthony N; Feranec, Jessica B; Patel, Rakesh C; Lamvu, Georgine M

2014-03-01

67

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. PMID:22065797

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

2011-01-01

68

How safe is diagnostic ultrasonography?  

PubMed Central

Health care workers and patients alike are concerned about the safety of diagnostic ultrasonography in clinical practice. Evidence published to date on the immediate and possible long-term biologic effects of exposure to ultrasound in diagnostic procedures is reviewed in this paper. No harmful effect in the human fetus, child or adult following the diagnostic use of pulsed ultrasound has been reported. However, the question of long-term biologic effects cannot yet be answered. Continued vigilance and further research are required. PMID:6378349

Brown, B S

1984-01-01

69

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

PubMed

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

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

2014-05-01

70

Cranial Ultrasonography in Maple Syrup Urine Disease  

Microsoft Academic Search

Summary: We performed serial cranial ultrasonography in four newborns affected by maple syrup urine disease. Symmetric increase of echogenicity of periventricular white matter, basal ganglia (mainly pallidi), and thalami was detected in the acute stage. The degree of ultrasonography abnormalities paralleled the clinical course of the disease. Maple syrup urine disease is a rare inborn error of branched-chain amino acid

Giuseppe Fariello; Carlo Dionisi-Vici; Cinzia Orazi; Saverio Malena; Andrea Bartuli; Paolo Schingo; Enza Carnevale; Isora Saponara; Gaetano Sabetta

71

Gray scale ultrasonography of calcified liver metastases.  

PubMed

Three cases of calcified liver metastases demonstrating acoustical shadowing on gray scale ultrasonography are reported. Ultrasonography may show calcified liver masses that are not readily apparent on plain film radiographs. The discovery of calcified liver metastases by ultrasound can suggest a primary site of malignancy. PMID:409227

Katragadda, C S; Goldstein, H M; Green, B

1977-10-01

72

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

1997-01-01

73

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

2000-01-01

74

Transvaginal Management of Cesarean Scar Section Diverticulum: A Novel Surgical Treatment  

PubMed Central

Background The aim of this study was to investigate the clinical value of transvaginal management of cesarean section scar diverticulum. Material/Methods We evaluated 64 patients receiving transvaginal management of previous cesarean scar defect (PCSD). Results The PCSD was successfully treated by transvaginal surgery, without evident complications. The mean operation time was 33.6±4.1 min, blood loss was 37.9±16.8 ml, and the mean hospital stay after surgery was 6±2.9 days. Symptoms related to the prolonged menstruation in 53 patients were improved after surgery, vaginal bleeding time was reduced by an average of 7.3±2.8 days, and a significant difference was noted between the mean pre- and post-operative duration of menstruation (P<0.01). Of 11 patients with guttate between menstrual periods, guttate was absent in 9 patients and improved in 2. Clinical improvement was observed in 85.9% (55/64). Conclusions Transvaginal intervention is feasible and safe for the management of PCSD. PMID:25104647

Chen, Yuqing; Chang, Yajie; Yao, Shuzhong

2014-01-01

75

Transvaginal emergence of a broken cup marker ring 21 years after total hip arthroplasty.  

PubMed

Broken cups, wires, and cable systems have the potential to cause complications, and they can migrate into joints, abdominal and thoracic organs. We describe a case of migration and transvaginal emergence of a marker wire from a polyethylene cup. PMID:19679442

Krocker, Doerte; Perka, Carsten

2010-06-01

76

Laparoscopy and Laparoscopic Ultrasonography for Staging Pancreatic Cancer: Critical Appraisal  

Microsoft Academic Search

.   A pilot study was designed to elucidate the role of staging laparoscopy for determining resectability in patients with pancreatic\\u000a cancer. The additional value of laparoscopic contact ultrasonography (LCU) was also evaluated with specific regard to its\\u000a ability to detect hepatic metastases and assess vascular infiltration of the portomesenteric trunk. A consecutive sample of\\u000a 50 patients referred for operation of

A. Pietrabissa; D. Caramella; G. Di Candio; A. Carobbi; U. Boggi; G. Rossi; F. Mosca

1999-01-01

77

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

PubMed Central

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

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

2014-01-01

78

Trans-vaginal total pelvic floor repair using customized prolene mesh: A safe and cost-effective approach for high-grade pelvic organ prolapse  

PubMed Central

Aims: To assess safety, efficacy, and cost-effectiveness of trans-vaginal total pelvic floor repair with customized prolene mesh in patients with high-grade pelvic organ prolapse. Materials and Methods: A total of 32 patients, who underwent trans-vaginal total pelvic floor repair using a customized prolene mesh from January 2007 to June 2010 for grade III and IV pelvic organ prolapse, were analyzed retrospectively. Prolapse was graded using Pelvic Organ Prolapse Quantification system of International Continence Society. Patients were evaluated for symptoms associated with prolapse pre- and postoperatively. Results: Of the 32 patients, 18 were grade IV uterine prolapse, 10 were grade III uterine prolapse, and 4 were grade IV vault prolapse. Twenty-eight patients underwent vaginal hysterectomy at the time of repair. All the patients had associated anterior and posterior prolapse of varying degree. Follow-up ranged from 6 to 42 months. All patients had symptomatic relief after surgery. There were no intraoperative rectal or bladder injuries. Early complications were perineal pain (30), de novo urgency (4), vaginal discharge (3), vaginal wall hematoma (2), and failure to void (2). Two patients had vaginal erosion of mesh. Conclusions: Trans-vaginal total pelvic floor repair using a customized prolene mesh is safe and effective treatment for comprehensive repair of high-grade pelvic organ prolapse. The use of this custom-made prolene mesh makes the procedure very cost-effective and affordable. The reduction in cost is about 25-30 times with the use of this mesh when compared with commercially available variety. PMID:22557712

Chaturvedi, Samit; Bansal, Rajesh; Ranjan, Priyadarshi; Ansari, M. S.; Kapoor, Deepa; Kapoor, Rakesh

2012-01-01

79

A case of simultaneous transvaginal NOTES gastrectomy and vaginal hysterectomy in a patient with gastric submucosal tumor and uterine prolapse.  

PubMed

A 5-cm gastric submucosal tumor was incidentally found through abdominal CT as a preoperative work-up for hysterectomy in a 62-year-old woman with uterine prolapse. NOTES using a flexible gastrointestinal endoscope via the transvaginal route was indicated to accomplish concomitant partial gastrectomy and hysterectomy. Perigastric dissection was performed, followed by stapled partial gastrectomy using transvaginal NOTES technique with two transabdominal ports. The specimen was delivered transvaginally by enlarging the initial vaginal entry site. Vaginal hysterectomy was then accomplished by utilizing the enlarged vaginal wound. The patient showed rapid and uneventful postoperative recovery without any narcotic need. No complication was noted, her cosmetic result was satisfactory, and there was complete resolution of preoperative gynecological symptoms. Female patients with concomitant gastrointestinal and gynecological conditions requiring large specimen retrieval would potentially be suitable candidates for the transvaginal NOTES approach. PMID:23095293

Hirota, Masashi; Nakajima, Kiyokazu; Hara, Johji; Takahashi, Tsuyoshi; Yamasaki, Makoto; Tsutsui, Tateki; Kobayashi, Eiji; Kurokawa, Yukinori; Miyata, Hiroshi; Takiguchi, Shuji; Mori, Masaki; Doki, Yuichiro

2012-11-01

80

[3D ultrasonography diagnostics of the eye and orbit].  

PubMed

3D ultrasonography eye and orbit improve local topography of the eye and orbital space. 3D ultrasonography doesn't supply ultrasonography examination A and B mode. 3D ultrasonography is appropriate for diagnostics of vitreoretional proliferations, tumour diagnostics and therapy (surgical, laser, Ruthenium plate implantation), druses of the optic nerve and for education of young physicians in sonography too. PMID:18988472

Cmelo, Jozef

2008-09-01

81

Transvaginal pelvic organ prolapse repair of anterior enterocele following cystectomy in females.  

PubMed

This study aims to highlight pelvic organ prolapse (POP) in females following radical cystectomy and to describe our experiences with their management. This is a retrospective case series of five women who had symptomatic POP following radical cystectomy and ileal conduit urinary diversion. All patients presented with a midline anterior enterocele with atrophic ulcerated vaginal skin. One patient presented with small bowel evisceration and required an emergency surgical repair. The average time for presentation was 10.6 +/- 6.5 months after cystectomy. In all cases, repair was done via a transvaginal approach. Three patients underwent fascial repair, one colpocleisis, and one bilateral iliococcygeal repair. In three cases, we had to use mesh for reinforcement. Two patients underwent ancillary procedures because of POP recurrence. Surgical repair of POP in women following radical cystectomy is challenging especially if vaginal length is to be maintained. Transvaginal repair is feasible and using synthetic mesh may be necessary. PMID:19089305

Stav, Kobi; Dwyer, Peter L; Rosamilia, Anna; Lim, Yik N; Alcalay, Meny

2009-04-01

82

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. PMID:22474622

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

2010-01-01

83

Bedside ultrasonography: Applications in critical care: Part I  

PubMed Central

There is increasing interest in the use of ultrasound to assess and guide the management of critically ill patients. The ability to carry out quick examinations by the bedside to answer specific clinical queries as well as repeatability are clear advantages in an acute care setting. In addition, delays associated with transfer of patients out of the Intensive Care Unit (ICU) and exposure to ionizing radiation may also be avoided. Ultrasonographic imaging looks set to evolve and complement clinical examination of acutely ill patients, offering quick answers by the bedside. In this two-part narrative review, we describe the applications of ultrasonography with a special focus on the management of the critically ill. Part I explores the utility of echocardiography in the ICU, with emphasis on its usefulness in the management of hemodynamically unstable patients. We also discuss lung ultrasonography - a vastly underutilized technology for several years, until intensivists began to realize its usefulness, and obvious advantages over chest radiography. Ultrasonography is rapidly emerging as an important tool in the hands of intensive care physicians. PMID:24914259

Chacko, Jose; Brar, Gagan

2014-01-01

84

Diagnostic accuracy of sonohysterography, transvaginal sonography, and hysterosalpingography in patients with uterine cavity diseases  

Microsoft Academic Search

Objective: To evaluate the diagnostic accuracy of sonohysterography (SHG) in uterine cavity diseases in infertile patients, comparing its results with those of hysterosalpingography (HSG) and transvaginal sonography (TVS). Hysteroscopy was the gold standard.Design: Descriptive, prospective study.Setting: A tertiary university referral center.Patient(s): Sixty-five infertile women 19 to 43 years of age.Intervention(s): Patients underwent SHG, conventional TVS, HSG, and hysteroscopy.Main Outcome Measure(s):

Sérgio Reis Soares; Marcos Messala Batista Barbosa dos Reis; Aroldo Fernando Camargos

2000-01-01

85

Transvaginal 3-d power Doppler ultrasound evaluation of the fetal brain at 10-13 weeks' gestation.  

PubMed

The objective of this study was to measure the fetal brain volume (FBV) and vascularization and blood flow using transvaginal 3-D power Doppler (3DPD) ultrasound late in the first trimester of pregnancy. 3DPD ultrasound examinations with the VOCAL imaging analysis program were performed on 36 normal fetuses from 10-13 weeks' gestation. FBV and 3DPD indices related to the fetal brain vascularization (vascularization index [VI], flow index [FI] and vascularization flow index [VFI]) were calculated in each fetus. Intra- and interclass correlation coefficients and intra- and interobserver agreements of measurements were assessed. FBV was curvilinearly correlated well with the gestational age (R2 = 0.861, p < 0.0001). All 3-D power Doppler indices (VI, FI and VFI) showed no change at 10-13 weeks' gestation. FBV and all 3-D power Doppler indices (VI, FI and VFI) showed a correlation > 0.82, with good intra- and interobserver agreement. Our findings suggest that 3-D ultrasound is a superior means of evaluating the FBV in utero, and that 3-D power Doppler ultrasound histogram analysis may provide new information on the assessment of fetal brain perfusion. PMID:22261516

Hata, Toshiyuki; Tanaka, Hirokazu; Noguchi, Junko

2012-03-01

86

Transvaginal Laparoscopic Appendectomy Simultaneously with Vaginal Hysterectomy: Initial Experience of 10 Cases  

PubMed Central

Background Natural orifice transluminal endoscopic surgery (NOTES) involves the introduction of instruments through a natural orifice into the peritoneal cavity to perform surgical interventions. The vagina is the most widely used approach to NOTES. We report the utilization of the vaginal opening at the time of vaginal hysterectomy as a natural orifice for laparoscopic appendectomy. Material/Methods We reviewed cases of 10 patients with chronic appendicitis who underwent transvaginal laparoscopic appendectomy simultaneously with vaginal hysterectomy. A laparoscopic approach was established after removal of the uterus, and the appendix was removed transvaginally. Among the 10 cases, 5 were conducted under gasless laparoscopy by using a simple abdominal wall-lifting instrument. Results All procedures were performed successfully without intraoperative or major postoperative complications. The appendectomy portion of the procedure took approximately 21 minutes to 34 minutes. All patients were discharged less than 4 days after surgery, without external scars. Conclusions Transvaginal appendectomy with rigid laparoscopic instruments following vaginal hysterectomy appears to be a feasible and safe modification of established techniques, with acceptable outcomes. PMID:25300522

Tian, Yu; Wu, Shuo-Dong; Chen, Ying-Han; Wang, Dan-Bo

2014-01-01

87

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

PubMed

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

Leanza, V; Intagliata, E; Leanza, G; Cannizzaro, M A; Zanghì, G; Vecchio, R

2013-01-01

88

Transvaginal laparoscopic appendectomy simultaneously with vaginal hysterectomy: initial experience of 10 cases.  

PubMed

Background Natural orifice transluminal endoscopic surgery (NOTES) involves the introduction of instruments through a natural orifice into the peritoneal cavity to perform surgical interventions. The vagina is the most widely used approach to NOTES. We report the utilization of the vaginal opening at the time of vaginal hysterectomy as a natural orifice for laparoscopic appendectomy. Material and Methods We reviewed cases of 10 patients with chronic appendicitis who underwent transvaginal laparoscopic appendectomy simultaneously with vaginal hysterectomy. A laparoscopic approach was established after removal of the uterus, and the appendix was removed transvaginally. Among the 10 cases, 5 were conducted under gasless laparoscopy by using a simple abdominal wall-lifting instrument. Results All procedures were performed successfully without intraoperative or major postoperative complications. The appendectomy portion of the procedure took approximately 21 minutes to 34 minutes. All patients were discharged less than 4 days after surgery, without external scars. Conclusions Transvaginal appendectomy with rigid laparoscopic instruments following vaginal hysterectomy appears to be a feasible and safe modification of established techniques, with acceptable outcomes. PMID:25300522

Tian, Yu; Wu, Shuo-Dong; Chen, Ying-Han; Wang, Dan-Bo

2014-01-01

89

Recto-sigmoid endoscopic-ultrasonography in the staging of deep infiltrating endometriosis  

PubMed Central

Recto-sigmoid endoscopic ultrasonography (RS-EUS) has first been used in the staging of pelvic deep infiltrating endometriosis in the early 1990's. Since then, although publications have been sparse, RS-EUS is routinely used for this indication in few centers. In this paper, we focus on technical aspects and operating method of rectal and sigmoid endo-sonography, and describe the most characteristic echographic presentations of endometriosis of the lower digestive tract. Through a literature review, results obtained with different types of endo-rectal probes, either flexible endoscopic, or blind rigid, are presented and compared with those of other close imaging techniques: magnetic resonance imaging and the more recent trans-vaginal sonography. As well as these two latter techniques, RS-EUS appears as an interesting method in the staging of pelvic deep infiltrating endometriosis particularly to evaluate rectal and sigmoid infiltrations. However, more prospective studies are required, to correctly define respective indications for each exam, in the light of recent advancements in treating this frequent disease.

Roseau, Gilles

2014-01-01

90

Recto-sigmoid endoscopic-ultrasonography in the staging of deep infiltrating endometriosis.  

PubMed

Recto-sigmoid endoscopic ultrasonography (RS-EUS) has first been used in the staging of pelvic deep infiltrating endometriosis in the early 1990's. Since then, although publications have been sparse, RS-EUS is routinely used for this indication in few centers. In this paper, we focus on technical aspects and operating method of rectal and sigmoid endo-sonography, and describe the most characteristic echographic presentations of endometriosis of the lower digestive tract. Through a literature review, results obtained with different types of endo-rectal probes, either flexible endoscopic, or blind rigid, are presented and compared with those of other close imaging techniques: magnetic resonance imaging and the more recent trans-vaginal sonography. As well as these two latter techniques, RS-EUS appears as an interesting method in the staging of pelvic deep infiltrating endometriosis particularly to evaluate rectal and sigmoid infiltrations. However, more prospective studies are required, to correctly define respective indications for each exam, in the light of recent advancements in treating this frequent disease. PMID:25400866

Roseau, Gilles

2014-11-16

91

[The progesterone test and transvaginal sonography as methods for the early discovery and screening of endometrial cancer in women in the postmenopause from some risk groups].  

PubMed

We wanted to assess the effect of tamoxifen treated women with breast cancer, as well as to examine patients with diabetes blood hypertension, and obesity. The influence of Tamoxifen was searched over the endometrium in patients treated with it for 3 years. In this research work is assessed the effect of this medicament from this risk group. The second risk group were the women with high blood pressure, obesity and diabetes mellitus. We used transvaginal sonography and the progesterone test to find endometrial pathology and especially endometrial cancer in asymptomatic women-measuring the depth of the endometrium, and using abrasio probatoria separata in order to find endometrial cancer. With these tests we found polyps, hyperplasia, and early endometrial cancer. We wanted with progesteron test and vaginal sonography in these risk groups to find endometrial pathology and especially early endometrial cancer in asymptomatic women. PMID:10730382

Ivanov, S; Ivanov, S

1999-01-01

92

Role of high frequency ultrasonography in the evaluation of palpable breast masses in Chinese women: alternative to mammography?  

PubMed

We prospectively assessed the accuracy of high resolution breast ultrasonography in the diagnosis of palpable breast masses in comparison to clinical palpation and x-ray mammography. Four hundred and eight Chinese women with palpable breast lumps had clinical assessment followed by ultrasonography of the breast, mammography (for women over 35 years), and fine needle aspiration cytology. Excisional biopsy or surgery was performed for suggestive lesions. The clinical, mammographic and ultrasound diagnoses were compared with the final pathologic diagnosis. In the determination of whether a lesion was malignant, the sensitivity, specificity, and positive predictive values were 97%, 97%, and 85%, respectively, for ultrasonography; 92%, 94%, and 84%, respectively, for mammography; and 88%, 92%, and 67%, respectively, for clinical evaluation. The specificity for combined clinical palpation and ultrasonography was higher (99%) than that for combined clinical palpation and mammography (96%). Addition of ultrasonography to combined clinical palpation and mammography increased specificity. Mammography in addition to combined clinical palpation and ultrasonography did not significantly improve the sensitivity, specificity, or positive predictive value. This limited usefulness raises the question as to whether it should be eliminated in the workup of a palpable mass in the average Chinese patient. Its main advantage is the detection of extended foci of carcinoma in situ related to a palpable mass, which often is undetected by ultrasonography. PMID:8866446

Yang, W T; Mok, C O; King, W; Tang, A; Metreweli, C

1996-09-01

93

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

PubMed Central

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 any kind of fracture and randomly assigned them to low intensity pulsed ultrasonography or to a control group. Two reviewers independently agreed on eligibility; three reviewers independently assessed methodological quality and extracted outcome data. All outcomes were included and meta-analyses done when possible. Results 13 randomised trials, of which five assessed outcomes of importance to patients, were included. Moderate quality evidence from one trial found no effect of low intensity pulsed ultrasonography on functional recovery from conservatively managed fresh clavicle fractures; whereas low quality evidence from three trials suggests benefit in non-operatively managed fresh fractures (faster radiographic healing time mean 36.9%, 95% confidence interval 25.6% to 46.0%). A single trial provided moderate quality evidence suggesting no effect of low intensity pulsed ultrasonography on return to function among non-operatively treated stress fractures. Three trials provided very low quality evidence for accelerated functional improvement after distraction osteogenesis. One trial provided low quality evidence for a benefit of low intensity pulsed ultrasonography in accelerating healing of established non-unions managed with bone graft. Four trials provided low quality evidence for acceleration of healing of operatively managed fresh fractures. Conclusion Evidence for the effect of low intensity pulsed ultrasonography on healing of fractures is moderate to very low in quality and provides conflicting results. Although overall results are promising, establishing the role of low intensity pulsed ultrasonography in the management of fractures requires large, blinded trials, directly addressing patient important outcomes such as return to function. PMID:19251751

2009-01-01

94

Ultrasonography in diagnosing chronic pancreatitis: New aspects  

PubMed Central

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

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

2013-01-01

95

Sources of error in emergency ultrasonography  

PubMed Central

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

2013-01-01

96

Ultrasonography of the rumen of dairy cows  

PubMed Central

Background This study describes the ultrasonographic findings of the rumen in 45 healthy dairy cows. Results The cows were scanned on both sides using a 5.0 MHz transducer. The dorsal visible margin of the rumen ran parallel to the lung from cranioventral to caudodorsal. It was furthest from the dorsal midline at the 9th intercostal space (48.3?±?9.24 cm) and closest at the 12th intercostal space (22.4?±?3.27 cm). The longitudinal groove, which could be clearly identified at all examination sites because it appeared as a triangular notch, formed the ventral margin of the dorsal sac of the rumen. The dorsal sac of the rumen was largest at the caudal flank (40.3?±?6.33 cm), where it was adjacent to the abdominal wall. The ventral sac of the rumen extended across the ventral midline into the right hemiabdomen and its ventral margin had a largely horizontal craniocaudal course. The height of the ventral sac of the rumen exceeded that of the dorsal sac at all examination sites; the maximum height was measured at the 12th intercostal space (62.6?±?9.53 cm). The dorsal gas cap, characterised ultrasonographically by typical reverberation artifacts, was visible in all cows from the 12th intercostal space to the caudal flank. It was largest at the 12th intercostal space (20.5?±?7.03 cm). The transition from the gas cap to the fibre mat was marked by the abrupt cessation of the reverberation artifacts. It was not possible to differentiate a fibre mat and a ventral fluid phase. The rumen could be imaged from the right side in 21 cows (47%). Conclusions Ultrasonography is well suited for the detailed examination of the rumen of cows. The reference values obtained from this study add to the diagnostic tools that are available for the assessment of bovine patients. PMID:23497545

2013-01-01

97

Evaluation for transvaginal and transgastric NOTES cholecystectomy in human and animal natural orifice translumenal endoscopic surgery  

Microsoft Academic Search

Background\\/purpose  Natural orifice translumenal endoscopic surgery (NOTES) is a novel concept using an endoscope via a translumenal access for\\u000a abdominal surgery. This study was designed to evaluate the feasibility and technical aspects of NOTES cholecystectomy from\\u000a our experience on humans and animals.\\u000a \\u000a \\u000a \\u000a Methods  NOTES cholecystectomies were performed in 12 animal experiments, including 8 pigs (6 by transgastric and 2 by transvaginal\\u000a accesses)

Maki Sugimoto; Hideki Yasuda; Keiji Koda; Masato Suzuki; Masato Yamazaki; Tohru Tezuka; Chihiro Kosugi; Ryota Higuchi; Yoshihisa Watayo; Yohsuke Yagawa; Shuichiro Uemura; Hironori Tsuchiya; Atsushi Hirano; Shoki Ro

2009-01-01

98

Transvaginal specimen extraction following totally laparoscopic subtotal gastrectomy in early gastric cancer  

Microsoft Academic Search

Background  Although natural orifice extraction is now widely performed, there have been no reports of this procedure following subtotal\\u000a gastrectomy for gastric cancer. This report describes trans-vaginal specimen extraction in four patients with early gastric\\u000a cancer.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The clinical data of four patients with early gastric cancer were reviewed. Totally laparoscopic subtotal gastrectomy and\\u000a D1 + ? lymph node dissection was performed using five

Sang-Ho Jeong; Young-Joon Lee; Won Jun Choi; Won Young Paik; Chi-Young Jeong; Soon-Tae Park; Sang-Kyung Choi; Soon-Chan Hong; Eun-Jung Jung; Young-tae Joo; Woo-Song Ha

2011-01-01

99

Duplex ultrasonography in portal vein thrombosis  

Microsoft Academic Search

Duplex ultrasonography (US) was performed in 23 patients with portal vein thrombosis. In 7 children and 16 adults, duplex US demonstrated intraluminal thrombi (4 cases), thrombus and periportal collaterals (2 cases), and cavernomatous transformation of the portal vein (17 cases). Real-time US is a suitable means of demonstrating the anatomy of the portal venous system; pulsed Doppler provided information on

Z. Harkányi; M. Temesi; G. Varga; V. Weszelits

1989-01-01

100

Cerebrovascular ultrasonography: Technique and common pitfalls  

PubMed Central

Although the clinical features in some patients with cerebrovascular ischemia may be ill defined, majority of the patients present with focal neurological deficits caused by an arterial occlusion, and the clinical presentations are usually referable to the involved arterial territory. Therefore, vascular imaging constitutes an important component of the diagnostic workup. Cervical duplex ultrasonography of carotid and vertebral arteries is employed to evaluate the extracranial vasculature while transcranial Doppler provides important information about intracranial hemodynamic changes in cerebrovascular ischemia. These two components of cerebrovascular ultrasonography are fast and reproducible, and can be performed at the bedside. They provide real-time information about the status of cervico-cranial arterial patency and various hemodynamic alterations, including collateral flow. The information obtained from cerebrovascular ultrasonography is useful for diagnostic as well as prognostic purposes. Furthermore, it can be used to monitor cerebral blood flow for extended periods and aid in decision making for various interventions. The hemodynamic information obtained from cerebrovascular ultrasonography helps in determining the underlying mechanisms of brain ischemia, and is complementary to the clinical examination and other imaging modalities.We describe the technique of performing cervical duplex sonography, diagnostic criteria for arterial stenosis, characterizing plaque morphology, measuring intima–media thickness and various pitfalls while performing the test. PMID:23661981

Bathala, Lokesh; Mehndiratta, Man Mohan; Sharma, Vijay K.

2013-01-01

101

Transabdominal Ultrasonography of the Small Bowel  

PubMed Central

In the era of double balloon enteroscopy, capsule endoscopy, CT, and MRI enterography is transabdominal ultrasonography (TUS) underestimated method for evaluation of small bowel pathology. As often initial imagine method in abdominal complaints, nowadays has TUS much better diagnostic potential than two decades ago. High-resolution ultrasound probes with harmonic imaging significantly improve resolution of bowel wall in real time, with possibility to asses bowel peristalsis. Color flow doppler enables evaluation of intramural bowel vascularisation, pulse wave doppler helps to quantificate flow in coeliac and superior mesenteric arteries. Small intestine contrast ultrasonography with oral contrast fluid, as well as contrast enhanced ultrasonography with intravenous microbubble contrast also improves small bowel imaging. We present a review of small intestine pathology that should be detected during ultrasound examinations, discuss technical requirements, advantages and limitations of TUS, typical ultrasound signs of Crohn's disease, ileus, celiac disease, intussusception, infectious enteritis, tumours, ischemic and haemorrhagic conditions of small bowel. In the hands of experienced investigator, despite some significant limitations(obesity, meteorism), is transabdominal ultrasonography reliable, noninvasive and inexpensive alternative method to computerised tomography (CT) and magnetic resonance imaging (MRI) in small bowel examination. PMID:24348544

Trnovsky, Peter; Kopacova, Marcela

2013-01-01

102

The significance of ultrasonography in diagnosing and follow-up of cystic cystitis in children.  

PubMed

Cystic cystitis is a separate form of urinary bladder inflammation, detected by cystoscopy in children with recurrent urinary infections. Cystoscopy is an invasive method, so the aim of this investigation was to determine the ultrasonographic characteristics of cystic cystitis and to assess the reliability of ultrasound in relation to cystoscopy in diagnosing cystic cystitis. The study included 115 girls with repeated urinary infections. Cystoscopy and ultrasonography was performed in all. According to the cystoscopic finding the subjects were divided into 4 groups. Lateral and posterior urinary bladder wall thickness was measured during ultrasonography. A statistically significant difference was found between all 4 groups, the method demonstrated a high degree of sensitivity (0.97) and specificity (0.91). Percentile calculations were determined for wall thickness. Ultrasonography can replace endoscopy in diagnosis and follow-up of cystic cystitis in children, with at least 50% fullness of the urinary bladder as a prerequisite. PMID:16848151

Vrljicak, Kristina; Milosevi?, Danko; Batini?, Danica; Kniewald, Hrvoje; Nizi?, Ljiljana

2006-06-01

103

Ultrasonography survey and thyroid cancer in the Fukushima Prefecture.  

PubMed

Thyroid cancer is one of the major health concerns after the accident in the Fukushima Dai-ichi nuclear power station (NPS). Currently, ultrasonography surveys are being performed for persons residing in the Fukushima Prefecture at the time of the accident with an age of up to 18 years. Here, the expected thyroid cancer prevalence in the Fukushima Prefecture is assessed based on an ultrasonography survey of Ukrainians, who were exposed at an age of up to 18 years to (131)I released during the Chernobyl NPS accident, and on differences in equipment and study protocol in the two surveys. Radiation risk of thyroid cancer incidence among survivors of the atomic bombings of Hiroshima and Nagasaki and preliminary estimates of thyroid dose due to the Fukushima accident were used for the prediction of baseline and radiation-related thyroid cancer risks. We estimate a prevalence of thyroid cancer of 0.027 % (95 % CI 0.010 %; 0.050 %) for the first screening campaign in the Fukushima Prefecture. Compared with the incidence rate in Japan in 2007, the ultrasonography survey is predicted to increase baseline thyroid cancer incidence by a factor of 7.4 (95 % CI 0.95; 17.3). Under the condition of continued screening, thyroid cancer during the first fifty years after the accident is predicted to be detected for about 2 % of the screened population. The prediction of radiation-related thyroid cancer in the most exposed fraction (a few ten thousand persons) of the screened population of the Fukushima Prefecture has a large uncertainty with the best estimates of the average risk of 0.1-0.3 %, depending on average dose. PMID:24398917

Jacob, Peter; Kaiser, Jan Christian; Ulanovsky, Alexander

2014-05-01

104

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

PubMed Central

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

Uysal, Fatma; Sad?k, Salih; Guler, Ahmet; T?nar, Sivekar; Task?n, Omur

2014-01-01

105

Necrotising fasciitis after hysterectomy and concomitant transvaginal mesh repair in a patient with pelvic organ prolapse.  

PubMed

Necrotising fasciitis is a severe form of soft tissue infection. Herein, we present an unreported complication of the transvaginal repair of a pelvic organ prolapse (POP) with trocar-guided polypropylene mesh and a concomitant hysterectomy. A 61-year-old Caucasian female who had been using an intrauterine device (IUD) for 30 years presented with a stage 3 pelvic organ prolapse. A genital ultrasound examination confirmed the presence of an IUD, but found no endometrial abnormalities. The surgical management was limited to a transvaginal hysterectomy and simultaneous anterior vaginal wall repair augmented with trocar-guided mesh. A morphological examination of the removed uterus confirmed the presence of the intrauterine device and additionally found endometrial cancer (T1N0M0), which was not revealed during the preoperative ultrasound. Within 6 days of the surgery, she developed anaerobic bilateral necrotising fasciitis on both thighs. Non-clostridial streptococci were identified in the wound. After 18 days of intensive care, the patient died of fatal coagulopathy. PMID:23389641

Pushkar, Dmitry Y; Vasilchenko, Mikhail I; Kasyan, George R

2013-10-01

106

Accuracy of transvaginal ultrasound in diagnosing endometrial pathology in women with post-menopausal bleeding on tamoxifen  

Microsoft Academic Search

The incidence of endometrial pathology is increased in women with tamoxifen-induced post- menopausal bleeding (PMB). The aim of this study was to determine the accuracy of transvaginal ultrasound (TVS) in diagnosing endometrial pathology in symptomatic women taking tamoxifen, using endometrial thickness measurements (5 mm and 10 mm cut-offs) and morphological changes within the uterine cavity to define abnormality. The sensitivity

J Weaver; JMM CHUGO; T J CLARK

2005-01-01

107

Risk factors for mesh erosion after transvaginal surgery using polypropylene (Atrium) or composite polypropylene\\/polyglactin 910 (Vypro II) mesh  

Microsoft Academic Search

The objective of this study was to identify the risk factors associated with the occurrence of mesh erosion (ME) during the first 6 post-operative months in patients having undergone transvaginal repair of pelvic organ prolapse (POP) with Atrium or Vypro II mesh. We retrospectively reviewed the records of 198 consecutive patients who underwent vaginal reconstructive surgery reinforced either by Atrium

Chahin Achtari; Richard Hiscock; Barry A. O’Reilly; Lore Schierlitz; Peter L. Dwyer

2005-01-01

108

Transvaginal Radio Frequency Treatment of the Endopelvic Fascia: A Prospective Evaluation for the Treatment of Genuine Stress Urinary Incontinence  

Microsoft Academic Search

PurposeWe evaluate the safety and efficacy of a new treatment modality for genuine stress urinary incontinence which was a transvaginal radio frequency applicator to deliver radio frequency energy to the endopelvic fascia. The purported mechanism of effect for this therapy is shrinkage of the collagenated tissue which composes the endopelvic fascia that supports the bladder neck and proximal urethra, thus

ROGER R. DMOCHOWSKI; MARK AVON; JAMES ROSS; JAY M. COOPER; RICHARD KAPLAN; BEVERLY LOVE; NEERAJ KOHLI; DAVID ALBALA; BRUCE SHINGLETON

2003-01-01

109

First trimester fetal heart rate measurements by transvaginal ultrasound combined with pulsed Doppler: an evaluation of 1331 cases  

Microsoft Academic Search

The aim of this study is to present the cardiac activity measurements obtained from 1331 embryos and first trimester fetuses in whom the crown-rump length (CRL) measurements were between 2 and 60 mm, and to correlate the pattern of changes according to growth in body length, with an objective and reliable technique; transvaginal ultrasound combined with pulsed Doppler. Sonographic examinations

Elif Gül Yapar; Eyüp Ekici; Oya Gökmen

1995-01-01

110

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. PMID:23213271

Sato, Takahiro; Yamazaki, Katsu

2012-01-01

111

[Chest ultrasonography in pediatric critical care practice].  

PubMed

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

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

2013-12-01

112

Prone view ultrasonography for pancreatic tail neoplasms.  

PubMed

Ultrasonography was performed in the prone and supine positions in six patients with neoplasms in the tail of the pancreas. The masses were either not apparent (three cases) or less well visualized on the supine scans. The value and indications of the prone position in the ultrasonic evaluation of masses in this portion of the pancreas are documented. Prone scanning is particularly useful when malignant ascites interferes with pancreatic visualization in the supine position. PMID:98000

Goldstein, H M; Katragadda, C S

1978-08-01

113

Endoscopic ultrasonography-guided tumor ablation.  

PubMed

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

2012-04-01

114

Hysteroscopic Assessment of Menopausal Breast-Cancer Patients Taking Tamoxifen; There is a Bias from the Mode of Endometrial Sampling in Estimating Endometrial Morbidity?  

Microsoft Academic Search

The aim of this study is to evaluate the accuracy of hysteroscopy in detecting tamoxifen-associated endometrial morbidity.\\u000a Ninety-eight menopausal breast cancer patients taking tamoxifen underwent hysteroscopy because of an endometrial thickness\\u000a above 4?mm measured by Transvaginal Ultrasonography. Thirty-one women recorded uterine bleeding while 67 were asymptomatic.\\u000a Hysteroscopies with operative facilities were performed, mainly in out-patient setting. Hysteroscopic findings were matched

Giancarlo Garuti; Francesco Grossi; Fulvia Cellani; Giovanna Centinaio; Monica Colonnelli; Massimo Luerti

2002-01-01

115

Interobserver agreement on the interpretation of automated whole breast ultrasonography  

PubMed Central

Purpose: The purpose of this study was to prospectively evaluate the interobserver agreement on lesion characterization and the final assessment of automated whole breast ultrasonography (ABUS) images. Methods: Between March and August 2012, 172 women underwent bilateral ABUS before biopsy guided by handheld ultrasonography (HHUS) and mammography. A total of 206 breast lesions were confirmed histopathologically by biopsy. Three-dimensional volume data from ABUS scans were analyzed by two radiologists without the knowledge of HHUS results or patient clinical information. The two readers described the type, shape, orientation, margin, echogenicity, posterior acoustic features, and categorization of the final assessment of detected breast lesions. Kappa statistics were used to analyze the described characteristics of the breast lesions detected by both of the two readers. Results: Of the 206 histopathologically confirmed lesions, reader 1 detected 166 lesions and reader 2 detected 150 lesions. A total of 145 lesions were detected by both readers using ABUS images. There was substantial agreement on shape (?=0.707), and moderate agreement on type, margin, mass orientation, echogenicity, and posterior acoustic features (?=0.592, 0.438, 0.472, 0.524, and 0.541, respectively). Breast Imaging Reporting and Data System final assessment values yielded a kappa value of 0.3971 when category subdivisions 4A, 4B, and 4C were included. With respect to the C2, C3, C4, and C5 categories, the interobserver agreement was moderate (?=0.505). Conclusion: ABUS is a promising diagnostic tool with a good interobserver agreement, comparable to that of HHUS. PMID:25036754

2014-01-01

116

Transvaginal ultrasound  

MedlinePLUS

... ovary, ultrasound imaging of pelvic structures. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive ... cell neoplasms, sex-cord stromal tumors. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive ...

117

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

PubMed Central

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

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

2014-01-01

118

Contrast-enhanced endoscopic ultrasonography: advance and current status  

PubMed Central

Endoscopic ultrasonography (EUS) technology has undergone a great deal of progress along with the color and power Doppler imaging, three-dimensional imaging, electronic scanning, tissue harmonic imaging, and elastography, and one of the most important developments is the ability to acquire contrast-enhanced images. The blood flow in small vessels and the parenchymal microvasculature of the target lesion can be observed non-invasively by contrast-enhanced EUS (CE-EUS). Through a hemodynamic analysis, CE-EUS permits the diagnosis of various gastrointestinal diseases and differential diagnoses between benign and malignant tumors. Recently, mechanical innovations and the development of contrast agents have increased the use of CE-EUS in the diagnostic field, as well as for the assessment of the efficacy of therapeutic agents. The advances in and the current status of CE-EUS are discussed in this review. PMID:25038805

2014-01-01

119

Suspected acute cholecystitis. Comparison of hepatobiliary scintigraphy versus ultrasonography  

SciTech Connect

One hundred ninety-five patients with suspected acute cholecystitis (AC) underwent both hepatobiliary scintigraphy (HBS) and static gray-scale ultrasonography (US) to assess the relative value of each imaging modality in this clinical setting. HBS was performed after the intravenous injection of 5 mCi /sup 99m/Tc iprofenin. Abnormal HBS indicative of AC visualized the common bile duct, but not the gallbladder, within 1 to 4 hours after tracer administration. Abnormal US indicative of AC demonstrated cholelithiasis and/or gallbladder wall edema. In this series, HBS surpassed US in sensitivity (98.3% versus 81.4%), specificity (90.2% versus 60.2%), predictive value of an abnormal test (91.4% versus 51.6%), and predictive value of a normal test (100% versus 92%), HBS should be the procedure of choice for the rapid detection of AC.

Freitas, J.E.; Mirkes, S.H.; Fink-Bennett, D.M.; Bree, R.L.

1982-08-01

120

Solitary cold thyroid nodule: cost-ineffectiveness of ultrasonography  

SciTech Connect

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

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

1984-09-01

121

Miliary Tuberculosis Following Transrectal Ultrasonography (TRUS)-Guided Prostate Biopsy  

PubMed Central

Miliary tuberculosis (TB) after transrectal ultrasonography (TRUS)-guided prostate biopsy is an extremely rare complication. A 75-year-old patient who presented with high fever and cough following TRUS-guided prostate biopsy for his high serum prostate-specific antigen (PSA) level (13.104 ng/ml) was diagnosed with miliary TB after clinical, laboratory, and radiological assessments. Histopathological examination of the prostate revealed TB with acid-fast bacilli. He was treated with chemotherapy for 9 months. The patient is now symptom-free, and his post-treatment PSA level was 5.023 ng/ml. This case is reported to acknowledge the possibility that miliary TB can occur as a complication of prostate biopsy if the patient suffers from prostate TB. PMID:21755022

Sano, Taichi; Takimoto, Keita

2011-01-01

122

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. PMID:7994719

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

1994-01-01

123

[Carpal tunnel syndrome. The contribution of ultrasonography].  

PubMed

Carpal tunnel syndrome is the most frequent mononeuropathy. Its incidence is huge and the ensuing community health problems are therefore the cause of much concern. Such a situation has made it necessary to develop a key point in the management of the illness, that is, to find flexible, sensitive, specific and cost-effective diagnostic procedures. Today tools of proven worth are now available, especially electrophysiology, and quite recently we also have ultrasonography. Both of these techniques allow us to confirm and characterise neuropathies due to entrapment and indeed a large number of papers dealing with ultrasound imaging have been published in the literature over the last few years. It therefore comes as no surprise that many renowned authors have acknowledged the usefulness of this technique. Here, we review the pathophysiological and diagnostic aspects of carpal tunnel syndrome, with greater emphasis on how ultrasonography has contributed to the morphological evaluation of the entrapped nerve. This method has proved itself to have significant advantages not only due to its being readily available, inexpensive, fast and painless, but also, and above all, because of its high capacity to detect neural and perineural alterations. A critical review of the literature supports this thesis and shows its incorporation into routine daily evaluation to be highly recommendable. PMID:25354508

Pardal-Fernandez, J M

2014-11-16

124

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

2010-01-01

125

Potential and Limitations of Echocontrast-Enhanced Ultrasonography in Acute Stroke Patients A Pilot Study  

Microsoft Academic Search

Background and Purpose—Ultrasonography (US) is a well-established method used to assess the brain-supplying arteries in the acute stroke setting. However, several technical and anatomic limitations are known to reduce its diagnostic accuracy and confidence level. Echocontrast agents (ECA) are known to improve the signal-to-noise ratio by enhancing the intensity of the reflecting Doppler signal. We undertook this prospective study to

Darius G. Nabavi; Dirk W. Droste; Vendel Kemeny; Gernot Schulte-Altedorneburg; Sepp Weber; E. Bernd Ringelstein

126

Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis  

Microsoft Academic Search

Purpose  To evaluate the diagnostic accuracy of ultrasonography of optic nerve sheath diameter (ONSD) for assessment of intracranial\\u000a hypertension.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Systematic review without language restriction based on electronic databases, with manual review of literature and conference\\u000a proceedings until July 2010. Studies were eligible if they compared ultrasonography of ONSD with intracranial pressure (ICP)\\u000a monitoring. Data were extracted independently by three authors. Random-effects

Julie Dubourg; Etienne Javouhey; Thomas Geeraerts; Mahmoud Messerer; Behrouz Kassai

127

Usefulness of endoscopic ultrasonography in hepatology  

PubMed Central

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

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

2011-01-01

128

Fatty meal ultrasonography in chronic acalculous cholecystitis  

PubMed Central

Chronic acalculous cholecystits typically presents with biliary symptoms, normal blood tests and unremarkable ultrasound, computerized tomography and magnetic resonance cholangiopancreatography. However, cholescintigraphy may show reduced gallbladder ejection fraction (GBEF). There are no reports on using ultrasound to measure GBEF in adults. Twenty-eight patients with the above presentation underwent ultrasound before and after ingestion of a standardized fatty meal. Consequently, GBEF was calculated. Seven patients had reduced GBEFs (<38%). Two of these patients underwent cholecystectomy and both were found to have chronic gallbladder inflammation. Three patients with normal GBEFs underwent cholecystectomy and were also found to have chronic gallbladder inflammation. There may be a role for fatty meal ultrasonography in the diagnosis of chronic acalculous cholecystitis, but it should be used more widely in this patient cohort for its role to be established. It ideally needs to performed alongside cholescintigraphy for the comparison of accuracy. PMID:25409675

Donen, Anna; Kantor, Robin

2014-01-01

129

The benefits and limitations of using ultrasonography to supplement anatomical understanding.  

PubMed

Anatomical understanding is critical to medical education. With reduced teaching time and limited cadaver availability, it is important to investigate how best to utilize in vivo imaging to supplement anatomical understanding and better prepare medical graduates for the proliferation of point-of-care imaging in the future. To investigate whether using short sessions of in vivo imaging using ultrasonography could benefit students' anatomical knowledge and clinical application, we conducted a 2-hour session on abdominal anatomy using ultrasonography in small groups of five to six students, for both first- and second-year student cohorts. Individual feedback was collected to assess student perceptions. To measure retention and understanding, a short examination containing ultrasound images and questions and performance of a clinical skill (gastrointestinal' tract examination) were assessed. Ultrasonography sessions were highly valued by the students, with 90% of the students reporting their understanding was improved, and over 70% reporting increased confidence in their anatomical knowledge. However, the assessments showed no appreciable impact on skills or understanding related to abdominal anatomy and examination. We conclude that the risk associated with limited exposure increasing confidence without increasing skills remains real and that in vivo imaging is not effective when used as a short adjunct teaching tool. The widespread use of ultrasonography means finding the best way to incorporate ultrasound into medical education remains important. To this end, we are currently implementing an extended program including echocardiography and multiple anatomical sessions that will determine if frequency and repetition of use can positively impact on student performance and understanding. PMID:23109325

Sweetman, Greg M; Crawford, Gail; Hird, Kathryn; Fear, Mark W

2013-01-01

130

Diagnosis of pancreatic tumors by endoscopic ultrasonography  

PubMed Central

Pancreatic tumors are highly diverse, as they can be solid or cystic, and benign or malignant. Since their imaging features overlap considerably, it is often difficult to characterize these tumors. In addition, small pancreatic tumors, especially those less than 2 cm in diameter, are difficult to detect and diagnose. For characterizing pancreatic tumors and detecting small pancreatic tumors, endoscopic ultrasonography (EUS) is the most sensitive of the imaging procedures currently available. This technique also provides good results in terms of the preoperative staging of pancreatic tumors. EUS-guided fine needle aspiration (EUS-FNA) has also proved to be a safe and useful method for tissue sampling of pancreatic tumors. Despite these advantages, however, it is still difficult to differentiate between benign and malignant, solid or cystic pancreatic tumors, malignant neoplasms, and chronic pancreatitis using EUS, even when EUS-FNA is performed. Recently, contrast-enhanced EUS with Doppler mode (CE-EUS) employing ultrasound contrast agents, which indicate vascularization in pancreatic lesions, has been found to be useful in the differential diagnosis of pancreatic tumors, especially small pancreatic tumors. However, Doppler ultrasonography with contrast-enhancement has several limitations, including blooming artifacts, poor spatial resolution, and low sensitivity to slow flow. Consequently, an echoendoscope was developed recently that has a broad-band transducer and an imaging mode that was designed specifically for contrast-enhanced harmonic EUS (CEH-EUS) with a second-generation ultrasound contrast agent. The CEH-EUS technique is expected to improve the differential diagnosis of pancreatic disease in the future. This review describes the EUS appearances of common solid and cystic pancreatic masses, the diagnostic accuracy of EUS-FNA, and the relative efficacies and advantages of CE-EUS and CEH-EUS along with their relative advantages and their complementary roles in clinical practice. PMID:21160578

Sakamoto, Hiroki; Kitano, Masayuki; Kamata, Ken; El-Masry, Muhammad; Kudo, Masatoshi

2010-01-01

131

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

1998-01-01

132

A phenomenological study to explore the experiences of Ugandan women that have undergone transvaginal ultrasound  

PubMed Central

Introduction Transvaginal ultrasound (TVUS) is an important examination of the female pelvis that involves the transducer being inserted into the vagina to obtain more detailed images of the pelvic organs. Unfortunately, this examination has received mixed experiences from the women who have undergone it. This study set out to explore the lived experiences of Ugandan women who have undergone TVUS. Methods It was a phenomenological exploratory study involving 20 women in Uganda that had previously undergone TVUS. Data were collected using in-depth individual interviews. The responses from the women were audio-recorded and later transcribed. Thematic analysis was used to interpret and make meaning of the data collected. Results Analysis of data revealed mostly negative experiences of the women who were included in this study. Key words from the participating women that illustrated the negative experiences included: fear, vulnerability, guilt, anxiety and embarrassment. It was also observed that these initial negative experiences are likely to reduce the women's acceptability and compliance to TVUS even when it is needed for better clinical management. Data were categorised into the following three thematic areas: (1) broken communication, (2) anxiety and discomfort and (3) cultural influence. Conclusion Women in this study portrayed negative experiences of undergoing TVUS. Key suggestions like informed consent are recommended to improve compliance of the women to this type of procedure.

Mubuuke, Aloysius Gonzaga

2014-01-01

133

Comparison of Outcome and Side Effects Between Conventional and Transvaginal Laparoscopic Cholecystectomy: A Meta-analysis.  

PubMed

Transvaginal laparoscopic cholecystectomy (TVC) is becoming an attractive alternative to conventional laparoscopic cholecystectomy (CLC). We conducted a meta-analysis study to compare the outcome and side effects between TVC and CLC. Clinical studies on TVC with CLC as control were identified by searching PubMed and EMBASE (from 2007 to December 2013). Nine studies were identified for meta-analysis. Our results showed that TVC required much longer operative time [MD, 30.82; 95% confidence interval (CI), 13.00-48.65; P=0.0007] and had significantly lower pain score on postoperative day 1 as compared with CLC (MD, -1.77; 95% CI, -2.91 to -0.63; P=0.002). No statistical difference in days of hospital stay (MD, -1.60; 95% CI, -4.73 to 1.54; P=0.32) and number of complications was found between the 2 groups (risk ratio, 0.52; 95% CI, 0.25-1.10; P=0.09). Safety of TVC is similar as CLC. In conclusion, TVC patients have significantly less postoperative pain but need much longer operative time. PMID:25084449

Xu, Jian; Xu, Liang; Li, Lintao; Zha, Siluo; Hu, Zhiqian

2014-10-01

134

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

PubMed

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

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

2014-09-01

135

Co-registered spectral photoacoustic tomography and ultrasonography of breast cancer  

NASA Astrophysics Data System (ADS)

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

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

2014-03-01

136

Ultrasonography of the optic nerve in neurocritically ill patients.  

PubMed

The rapid diagnosis of intracranial hypertension is urgently needed for therapeutic reasons in various clinical settings. This can rarely be achieved without invasive procedures such as intracranial pressure (ICP) monitoring or neuroimaging. The optic nerve is surrounded by cerebrospinal fluid (CSF) and dura mater, which forms the optic nerve sheath (ONS). Because of the connection with the intracranial subarachnoid space, ONS diameter (ONSD) is influenced by CSF pressure variations. Bedside ultrasonographic measurement of ONSD has been proposed as a non-invasive and reliable means to detect raised ICP in neurocritically ill patients. In several studies, it proves to have a good correlation with the direct measurement of ICP and a low interobserver variability. However, no general consensus exists over the upper normal ONSD limit. We performed a review of the literature on the use of the ultrasonography of the optic nerve in the evaluation of patients with suspected intracranial hypertension. The aim of this review is to describe the technique and to assess the validity of this diagnostic method. PMID:21463263

Moretti, R; Pizzi, B

2011-07-01

137

NOTES cholecystectomy: matched-pair analysis comparing the transvaginal hybrid and conventional laparoscopic techniques in a series of 216 patients  

Microsoft Academic Search

Background  Natural orifice transluminal endoscopic surgery (NOTES) is currently a very important topic for both gastroenterologists and\\u000a surgeons. We have developed a technique of transvaginal hybrid NOTES cholecystectomy (TVC) that leaves no visible scar and\\u000a is applicable to daily use. This technique is compared to the conventional laparoscopic cholecystectomy (CLC) in a matched-pair\\u000a analysis.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  From June 2007 until February 2009, 108

Carsten Zornig; Linn Siemssen; Alice Emmermann; Margrit Alm; Hans A. von Waldenfels; Conrad Felixmüller; Hamid Mofid

2011-01-01

138

Is Sonographic Assessment of the Cervix Necessary and Helpful?  

PubMed Central

Transvaginal sonography of the cervix has emerged as a useful window onto preterm parturition. Cervical sonography allows measurements of cervical length which can aid clinicians in identifying women at risk for preterm birth. The use of transvaginal assessments of cervical length can assist in the triage of patients with possible preterm labor. Recent studies also support the use of cervical length measurements as a means of determining appropriate candidates for cerclage placement and progesterone supplementation to reduce the risk of premature birth, further highlighting the importance of this modality in modern obstetric management. PMID:22343248

Larma, Joel D.; Iams, Jay D.

2012-01-01

139

Endoscopic ultrasonography in the diagnosis and staging of pancreatic adenocarcinoma. Results of a prospective study with comparison to ultrasonography and CT scan.  

PubMed

Endoscopic ultrasonography (EUS) was compared to ultrasonography (US) and CT scan (CT) in order to evaluate its role in the diagnosis and the locoregional spread assessment of pancreatic cancer. Sixty-four patients suspected of pancreatic cancer were studied prospectively, and the results of imaging techniques were compared to histology and surgical exploration. There were 49 cases of pancreatic adenocarcinoma, 11 of pancreatitis, 2 of common bile duct carcinoma, 1 lymphoma and 1 hepatocellular carcinoma with peripancreatic metastatic lymph nodes. EUS was significantly more accurate (91%) than CT (66%) and US (64%) for diagnosis of pancreatic cancer. EUS was able to image all 7 cancers less than 25 mm in diameter, US and CT only one. There were 4 false positives with EUS which were all cases of pseudotumorous pancreatitis. For detecting lymph node involvement, EUS was significantly more sensitive (62%) and accurate (74%) than US (8% and 37%) and CT (19% and 42%), respectively. Invaded lymph nodes adjacent to large tumors and micrometastatic involvement were responsible for this lack of sensitivity. EUS was significantly more sensitive (100%) than CT (71%) and US (17%) for detecting venous involvement. The specificity of EUS was lower (67%) because of duodenal bulb stenosis and large tumors. In conclusion, this prospective and comparative study confirms that EUS is an accurate tool for diagnosis and locoregional spread assessment of pancreatic cancer when performed in a reference center. EUS is of particular interest for small tumours. However, EUS does not enable differentiation of pseudotumorous pancreatitis from adenocarcinoma. PMID:8491130

Palazzo, L; Roseau, G; Gayet, B; Vilgrain, V; Belghiti, J; Fékéte, F; Paolaggi, J A

1993-02-01

140

[What about transvaginal mesh repair of pelvic organ prolapse? Review of the literature since the HAS (French Health Authorities) report].  

PubMed

The French Health Authorities' (HAS) report of November 2006 concluded that the use of mesh at the time of transvaginal repair of pelvic organ prolapse (POP) should be limited to clinical research. This review intends to analyse and comment the recent data on this topic. A review on PubMed, on a personal database and actualisation until May 2008 has been performed choosing French or English language series concerning prolapse surgery with mesh disposed by the vaginal route. It includes six randomised controlled trials comparing transvaginal repair of POP with or without mesh: four about cystocele, one about rectocele and one about apical prolapse. Both surgical techniques and recurrence criteria are poorly standardised. The four randomised trials focusing on cystocele repair support the anatomical superiority of techniques using mesh, with similar functional results with or without mesh reinforcement. In the other indications, the results remain unclear or controversial. According to the randomised trials, the complications rate, except mesh exposure, is similar with and without mesh. However there are some specific complications when using mesh, such as mesh infection, mesh exposure or shrinkage and visceral extrusion. We recommend using vaginal reinforcement mesh with specific care in selected patients and we suggest some guidelines to be proposed for consensus at concerned French scientific societies. PMID:18996650

Savary, D; Fatton, B; Velemir, L; Amblard, J; Jacquetin, B

2009-02-01

141

Laparoscopy and laparoscopic ultrasonography for staging pancreatic cancer: critical appraisal.  

PubMed

A pilot study was designed to elucidate the role of staging laparoscopy for determining resectability in patients with pancreatic cancer. The additional value of laparoscopic contact ultrasonography (LCU) was also evaluated with specific regard to its ability to detect hepatic metastases and assess vascular infiltration of the portomesenteric trunk. A consecutive sample of 50 patients referred for operation of a suspected pancreatic cancer were submitted to preoperative contrast-enhanced high-resolution computed tomography (CT) and staging laparoscopy combined with LCU at a university hospital. For those progressing to exploratory laparotomy, the intraoperative findings relating to tumor diffusion and vascular infiltration were compared to CT, laparoscopic, and LCU data. Analytical description of the laparoscopic findings is given. Row data of predicted versus observed vascular infiltration were tabulated for CT and LCU. The sensitivity, specificity, and overall accuracy of each diagnostic test were calculated for comparative analysis. Laparoscopy alone prevented unnecessary laparotomy in 20% of cases. A complete procedure could not be achieved in 28% of patients. Three false-negative staging results occurred. LCU identified small (benign) hepatic nodules not seen by CT in 8% of patients. Sensitivity, specificity, and overall accuracy for assessing vascular infiltration were 82%, 53%, and 69% for CT and 94%, 80%, and 87% for LCU. Laparoscopy was confirmed to be safe and effective for staging pancreatic cancer. Because of its unique capabilities to detect even small peritoneal tumor deposits a quick exploration immediately before laparotomy is advised in all patients. The additional benefit of a more extensive procedure is not supported by our results. Although LCU appears to define the vascular involvement more accurately than conventional CT, the limitation of getting clinically useful ultrasound data in all the patients suggests its adoption in only a selected population. PMID:10512938

Pietrabissa, A; Caramella, D; Di Candio, G; Carobbi, A; Boggi, U; Rossi, G; Mosca, F

1999-10-01

142

Obstruction following anti-incontinence procedures: diagnosis and treatment with transvaginal urethrolysis.  

PubMed

We reviewed the charts of 41 patients who underwent transvaginal urethrolysis and resuspension of the bladder neck by the Raz technique for urethral obstruction with or without stress urinary incontinence following anti-incontinence surgery. We sought to evaluate the effectiveness of the procedure as well as to determine any factors that had an effect on the outcome of surgery. Patients were evaluated for obstruction and stress urinary incontinence by history, physical examination, video urodynamics (or multichannel urodynamics plus cystogram and voiding cystourethrography) and cystoscopy. All patients reported normal emptying before the procedure that caused obstruction. Several variables were evaluated for individual predictive values for outcome, including type of surgery causing obstruction, number of previous anti-incontinence procedures, urodynamic evidence of obstruction (high pressure, low flow), instability, concomitant stress urinary incontinence and total urinary retention, which were evaluated by the Fisher exact test, and the amount of post-void residual, bladder capacity, maximum detrusor pressure, maximum urinary flow and interval since surgery causing obstruction, which were evaluated by logistic regression analysis. Mean patient age was 59 years (range 26 to 86 years) and mean followup was 21 months. A total of 19 patients (46%) suffered from concurrent stress urinary incontinence, 23 (56%) had urodynamic evidence of obstruction (high pressure/low flow) and 6 (15%) had only radiographic or endoscopic evidence with a deviated or kinked urethra. Postoperatively, 29 patients (71%) voided normally without significant residuals. Eight patients (20%) remain on self-catheterization and 1 has persistent stress urinary incontinence. When individual variables were evaluated to determine the predictive values with respect to outcome of urethrolysis, only the preoperative post-void residual was statistically significant (the greater the post-void residual, the more likely was failure, p = 0.021). The presence or strength of the detrusor contraction preoperatively and pressure-flow analysis did not predict outcome. Of the patients with stress urinary incontinence 15 (79%) were cured and 3 (16%) were significantly improved with rare stress urinary incontinence not requiring protection. Overall, 33 patients (80%) had some benefit from surgery. Patients who emptied normally before and anti-incontinence procedure that causes obstruction or impaired emptying should not be excluded from urethrolysis based on low detrusor pressures or pressure-flow analysis alone. Simultaneous radiographic imaging and endoscopy may help to select certain patients with obstruction. PMID:8201698

Nitti, V W; Raz, S

1994-07-01

143

Red flags in bedside ultrasonography for surgical cases.  

PubMed

Bedside ultrasonography is highly accurate in evaluating hypotension, even if performed by nonradiologist. Here we report three cases presenting with hypotension to the trauma room. In the first case, limited bedside ultrasonography demonstrated dilatation of the inferior vena cava and loss of respiratory variation in diameter. In further evaluation, dilated aortic root, massive pericardial effusion, collapse of right heart chambers, and a dissection flap at the anterior wall of base of ascending aorta were detected. With these findings, the patient was sent to the operation room with a diagnosis of DeBakey type 2 aortic dissection in approximately 15 min. In the second case, bedside ultrasonography demonstrated absence of pleural movements and comet tail artifacts on the right lung region of the patient. Together with deterioration of the vital signs, the patient was diagnosed as right-sided pneumothorax and underwent the tube thoracostomy. In the third case, bedside ultrasonography revealed the presence of free fluid in Morrison's pouch and splenorenal space in a hypotensive patient with a blunt abdominal trauma. He was consulted with general surgery department and was sent to the operation room without further diagnostic evaluation. In these cases, we emphasized the key role of bedside ultrasonography in hypotensive patients. PMID:24265896

Unlüer, Erden Erol; Karagöz, Arif

2013-06-01

144

[The application of digestive endoscopic ultrasonography in the gallbladder pathology].  

PubMed

A WELL DEFINED PATHOLOGY: Bilary lithiasis and vesicular parietal abnormalities constitute the totality of the gallbladder pathology. The surgical experience and widely current use of digestive imaging, notably ultrasonography, have contributed to enlightening our knowledge of this pathology. POTENTIAL DIAGNOSTIC PROBLEMS: There is no particular problem in the diagnosis of gallbladder lithiasis and its treatment is currently codified. However the discovery of thickened gallbladder wall or polyps increases the fear of gallbladder cancer. A FUNDAMENTAL ROLE FOR ENDOSCOPIC ULTRASONOGRAPHY: Within the framework of screening for cancer, endoscopic ultrasonography, the performance of which in gallbladder pathology has rarely been studied, appears promising. Other than its role in the control of the extension of gallbladder cancers, it provides reliable characterisation of most of the polyps. Hence its place today is unavoidable in the therapeutic decision trees of such affections. PMID:15509055

Roseau, Gilles

2004-08-28

145

Excursion-volume relation of the right hemidiaphragm measured by ultrasonography and respiratory airflow measurements.  

PubMed Central

BACKGROUND--Although real time ultrasonography has been used in the last decade to record diaphragmatic motion, the relation between diaphragmatic excursion and different inspired volumes (VT) has not been assessed by ultrasound. METHODS--Ten normal subjects were studied in the supine posture. Diaphragmatic excursion and VT were assessed simultaneously by M mode ultrasonography and respiratory airflow measurements at different inspired volumes. Ultrasound recordings of the movement of the right hemidiaphragm were carried out in the longitudinal plane subcostally. The transducer was held in a fixed position by a frame, built especially to eliminate any artefactual movement caused by outward motion of the anterior abdominal wall on inspiration. RESULTS--Mean (SD) maximal diaphragmatic excursion recorded was 6.0 (0.7) cm. Inspired volumes ranged from 15(5%) to 87(10%) of the subjects' inspiratory capacity. A linear relation between diaphragmatic excursion and VT was found in all subjects (r = 0.976-0.995). The regression line had a slope of 1.66 (0.24) cm/l. This slope had no correlation with either the height (r = 0.007) or weight (r = 0.143) of the subjects. In five subjects in whom diaphragmatic excursion could be recorded at volumes near total lung capacity, the relation between diaphragmatic excursion and VT became alinear at very high lung volumes. CONCLUSIONS--The relation between diaphragmatic excursion and VT was linear between 15(5%) and 87(10%) of inspiratory capacity. Ultrasonography of the diaphragm is a simple technique that could be applied in the clinical investigation of patients with suspected abnormalities of diaphragmatic movement. Images PMID:7940428

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

1994-01-01

146

Diagnostic utility of cholescintigraphy and ultrasonography in acute cholecystitis  

SciTech Connect

When faced with a patient with possible acute cholecystitis, technetium-99m-HIDA scintigraphy should be the primary diagnostic procedure performed. If scintigraphy reveals a normal gallbladder, acute cholecystitis is excluded. If the scintigram fails to visualize the gallbladder, ultrasonography is deemed advisable to exclude potential false-positive scintigrams and confirm the presence of cholelithiasis.

Zeman, R.K.; Burrell, M.I.; Cahow, C.E.; Caride, V.

1981-04-01

147

Ultrasonography of periportal fibrosis in schistosomiasis mansoni in Brazil  

Microsoft Academic Search

In patients with hepatosplenic schistosomiasis, characteristic thickening of the walls of the portal vein in the hilus and its central and peripheral branches is observed. In an area of high prevalence of the disease in Brazil, 424 individuals older than 5 years have been examined by abdominal ultrasonography and 146 presented fibrosis, classified as central in 31 (21%), peripheral in

Rogério Gerspacher-Lara; Rogério A. Pinto-Silva; Abdunnabi A. M. Rayes; Sandra C. Drummond; JoséRoberto Lambertucci

1997-01-01

148

Subepithelial masses of the gastrointestinal tract evaluated by endoscopic ultrasonography  

Microsoft Academic Search

Objectives: To diagnose and characterize subepithelial lesions of the gastrointestinal (GI) tract using endoscopic ultrasonography (EUS) and search for markers of malignancy in stromal cell tumors. Methods: Fifty-four patients with suspected subepithelial lesions at endoscopy were examined using miniature ultrasound probes, integrated ultrasound endoscopes, or both. Surgical treatment was considered if a solid lesion had a maximum diameter of at

Lars B. Nesje; Ole D. Laerum; Knut Svanes; Svein Ødegaard

2002-01-01

149

Effectiveness of Vardenafil versus Papaverine in Penile Doppler Ultrasonography  

Microsoft Academic Search

Purpose: To evaluate erectile dysfunction, penile color Doppler ultrasound is currently considered the best method. But intracavernous injection is invasive and has adverse effects, such as prolonged erection and risk of priapism. In our study we want to evaluate whether vardenafil can be used instead of papaverine in penile Dopp-ler ultrasonography. Materials and Methods: A total of 24 patients with

Arslan Ardicoglu; Ercan Kocakoc; Ugur Oktay Tuygun; Zulkif Bozgeyik; Irfan Orhan

2005-01-01

150

Impact of bedside right upper quadrant ultrasonography on radiology imaging  

Microsoft Academic Search

Many Emergency Departments (ED) use emergency ultrasonography of the right upper quadrant (RUQ) to capture images of the gallbladder in patients with suspected gallstones. It is unclear what impact this practice has on additional imaging performed by radiology. Patients were enrolled 24 h a day by ED residents and attending physicians who have completed an educational program in limited RUQ ultrasound.

Romolo J. Gaspari; Eitan Dickman; David Blehar

2006-01-01

151

Ultrasonography of chronic tendon injuries in the groin  

Microsoft Academic Search

Ultrasonography was used in the diagnosis of 36 pa tients with chronic groin pain localized to the tendons of the rectus abdominis, rectus femoris, adductor mus cles, hamstring muscles, and the gluteal muscles. Ab normal findings, such as focal sonolucent areas and discontinuity of tendon fibers, that are indicative of nonhealed partial ruptures were found in 28 patients. These findings

Peter Kälebo; Jon Karlsson; Leif Sward; Lars Peterson

1992-01-01

152

Use of contrast-enhanced ultrasonography to characterize adrenal gland tumors in dogs.  

PubMed

Objective-To describe the contrast-enhanced ultrasonographic characteristics and vascular patterns of adrenal gland tumors in dogs and determine whether those features are indicative of malignancy or histologic type of tumor. Animals-14 dogs with 16 adrenal gland lesions (10 carcinomas [8 dogs], 3 adenomas [3 dogs], and 3 pheochromocytomas [3 dogs]). Procedures-Unsedated dogs with adrenal gland lesions underwent B-mode ultrasonography and contrast-enhanced ultrasonography ? 48 hours before adrenalectomy; contrast-enhanced ultrasonographic examinations were video-recorded. Macroscopic evaluation of the adrenal gland lesions and histologic examination of removed adrenal gland tissues were subsequently performed. Surgical and histopathologic findings and the ultrasonographic and contrast-enhanced ultrasonographic characteristics were recorded for the various tumor types. Time-intensity curves were generated from the contrast-enhanced ultrasonographic recordings and used to calculate regional blood volume (value proportional to area under the curve) and mean transit time (time the lesion began to enhance to the half-peak intensity). Results-In adrenal gland carcinomas, tortuous feeding vessels were noticeable during the arterial and venous phases of contrast enhancement. Heterogeneity of contrast enhancement was evident only in malignant tumors. Compared with adenomas, adrenal gland carcinomas and pheochromocytomas had significantly less regional blood volume. Mean transit times were significantly shorter in adrenal gland carcinomas and pheochromocytomas than in adenomas. Conclusions and Clinical Relevance-For dogs, evaluation of the vascular pattern and contrast-enhancement characteristics of adrenal gland tumors by means of contrast-enhanced ultrasonography may be useful in assessment of malignancy and tumor type. PMID:25255177

Pey, Pascaline; Rossi, Federica; Vignoli, Massimo; Duchateau, Luc; Marescaux, Laurent; Saunders, Jimmy H

2014-10-01

153

Correlation between Ultrasonography Findings and Electrodiagnostic Severity in Carpal Tunnel Syndrome: 3D Ultrasonography  

PubMed Central

Background and Purpose To determine the correlation between the cross-sectional area (CSA) of the median nerve measured at the wrist using three-dimensional (3D) ultrasonography (US) and the electrophysiological severity of carpal tunnel syndrome (CTS). Methods We prospectively examined 102 wrists of 51 patients with clinical CTS, which were classified into 3 groups according to the electrodiagnostic (EDX) findings. Median nerve CSAs were measured using 3D US at the carpal tunnel inlet and at the level of maximal swelling. Results Ten wrists were negative for CTS. Of the 92 CTS-positive wrists, 23, 30, and 39 were classified as having mild, moderate, and severe CTS, respectively. The median nerve CSA differed significantly between the severe- and moderate-CTS groups (p=0.0007 at the carpal tunnel inlet and p<0.0001 at the maximal swelling site). There was a correlation between median nerve CSA and EDX parameters among those wrists with severe and mild CTS (p<0.0001 at both sites). Conclusions The median nerve CSA as measured by 3D US could provide additional information about the severity of CTS, as indicated by the strong correlation with standard EDX findings. PMID:25324885

Kwon, Hee Kyu; Kang, Hyo Jung; Byun, Chan Woo; Kang, Chang Ho; Pyun, Sung Bum

2014-01-01

154

Transvaginal needle suspension with LeFort colpocleisis for stress incontinence and advanced uterovaginal prolapse in a high-risk patient.  

PubMed

Surgical therapy in high-risk patients with advanced symptomatic pelvic floor defects sometimes mandates a compromise in the extent of proposed and desired repairs in favor of procedures that can be performed more rapidly. An 80-year-old woman with disabling genuine stress urinary incontinence and stage IV uterovaginal prolapse who was unable to retain a pessary was at high surgical risk due to ischemic heart disease. Uterovaginal prolapse was treated by LeFort partial colpocleisis, and stress urinary incontinence by transvaginal needle suspension with symptomatic cure and without significant perioperative morbidity. Operating time was 29 minutes and estimated blood loss was 50 ml. The patient was discharged on the second postoperative day with adequate spontaneous voiding and without urinary retention. A combination of partial colpocleisis with transvaginal needle suspension worked well in this case and may represent an effective and rapid surgical option for similar women. PMID:9564074

Pelosi, M A; Pelosi, M A

1998-05-01

155

The Current Role of Carotid Duplex Ultrasonography in the Management of Carotid Atherosclerosis: Foundations and Advances  

PubMed Central

The management of atherosclerotic carotid occlusive disease for stroke prevention has entered a time of dramatic change. Improvements in medical management have begun to challenge traditional interventional approaches to asymptomatic carotid stenosis. Simultaneously, carotid artery stenting (CAS) has emerged as an alternative to carotid endarterectomy (CE). Finally, multiple factors beyond degree of stenosis and symptom status now mitigate clinical decision making. These factors include brain perfusion, plaque morphology, and patency of intracranial collaterals (circle of Willis). With all of these changes, it seems prudent to review the role of carotid duplex ultrasonography in the management of atherosclerotic carotid occlusive disease for stroke prevention. Carotid duplex ultrasonography (CDU) for initial and serial imaging of the carotid bifurcation remains an essential component in the management of carotid bifurcation disease. However, correlative axial imaging modalities (computer tomographic angiography (CTA) and contrast-enhanced magnetic resonance angiography (CE-MRA)) increasingly aid in the assessment of individual stroke risk and are important in treatment decisions. The purpose of this paper is twofold: (1) to discuss foundations and advances in CDU and (2) to evaluate the current role of CDU, in light of other imaging modalities, in the clinical management of carotid atherosclerosis. PMID:22489269

Byrnes, Kelly R.; Ross, Charles B.

2012-01-01

156

Treatment of Endometriosis with Transvaginal Ultrasound-Guided Drainage under GnRH Analogues and Recombinant Interleukin2 Left in the Cysts  

Microsoft Academic Search

Background: To analyze the therapeutic results of one dose of 3 million IU of recombinant interleukin-2 (rIL-2) left intracyst (group I) versus two doses with a 1-month interval (group II) after transvaginal ultrasound (US)-guided drainage of endometriomas under the effect of GnRH analogues. Methods: Prospective and randomized clinical trial (helped by a random number table) at a University Hospital. Twenty-four

Pedro Acién; Gloria Pérez-Albert; Francisco J. Quereda; Marisa Sánchez-Ferrer; Ana García-Almela; Irene Velasco

2005-01-01

157

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

1998-01-01

158

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

PubMed

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

Beltrán, L M; García-Casasola, G

2014-04-01

159

Comparison of radionuclide imaging and ultrasonography of the liver  

SciTech Connect

Radionuclide liver scans and gray scale ultrasonography of the liver were compared in 456 patients with various abnormalities including normal variants, jaundice, abscesses, and metastatic diseases. In general the better resolution of sonography detected smaller and deeper focal lesions than nuclide scans, but nuclide studies were more informative in hepatocellular disorders. Nuclide studies frequently demonstrated lesions that could be further delineated by sonography as either cystic or solid. This ability was of particular significance in isolated liver lesions found during metastatic surveys.

Elyaderani, M.K.; Gabriele, O.F.

1983-01-01

160

Comparison of radionuclide imaging and ultrasonography of the liver  

SciTech Connect

Radionuclide liver scans and gray scale ultrasonography of the liver were compared in 456 patients with various abnormalities including normal variants, jaundice, abscesses, and metastatic diseases. In general the better resolution of sonography detected smaller and deeper focal lesions than nuclide scans, but nuclide studies were more informative in heptatocellular disorders. Nuclide studies frequently demonstrated lesions that could be further delineated by sonography as either cystic or solid. This ability was of particular significance in isolated liver lesions found during metastatic surveys.

Elyaderani, M.K.; Gabriele, O.F.

1983-01-01

161

Endoscopic ultrasonography in the management of pancreatic cancer  

NASA Astrophysics Data System (ADS)

Pancreatic cancer diagnosis and management has been enhanced with the application of endoscopic ultrasound. The close proximity of the pancreas to the stomach and duodenum permits detailed imaging with intraluminal ultrasonography and staging of pancreatic tumors. EUS directed fine needle aspiration and injection may be successfully employed with patients with pancreatic cancer. Expandable metal stents can palliate patients with obstruction of the pancreaticobiliary tract as well as the gastroduodenum. The efficacy of EUS in the management of pancreatic cancer is critically reviewed.

Trowers, Eugene A.

2001-05-01

162

Bedside Ultrasonography In Detection Of Post Procedure Pneumothorax  

PubMed Central

Background Bedside ultrasonography in the diagnosis of pneumothorax has been well described in emergency and trauma medicine literature. Its role in detection of iatrogenic pneumothoraces has not been studied. We describe the performance of bedside ultrasonography in detection of procedure related pneumothoraces and highlight some limitations. Methods 185 patients underwent thoracentesis (n=60), transbronchial biopsy (n=48), CT-guided lung biopsy (n=76), and CT-guided cryoablation of a lung mass (n=1). Bedside transthoracic ultrasound examination and post-procedure chest radiograph were performed in all patients. Patients in whom pleural surface was not well imaged with ultrasound were said to have a limited exam. Chest x-ray was the standard for diagnosing pneumothorax. Results Chest x-ray detected pneumothorax in 8/185 patients (4.0%). Ultrasound diagnosed pneumothorax in seven of these patients. Sensitivity, specificity and diagnostic accuracy were 88%, 97% and 97%, respectively. Limited quality ultrasound examinations due to pre-existing lung disease was seen in 43/185 patients. The positive and negative likelihood ratios for patients with adequate scans were 55 and 0.17, respectively. Likelihood ratio for patients with limited quality scan was 1.08. Conclusions Bedside chest ultrasonography, in the presence of good quality scan, is a valuable tool in the evaluation of post procedure pneumothorax. Patients with preexisting lung disease in whom the quality of ultrasound examination is limited should be studied with a chest x-ray. PMID:23716522

Shostak, Eugene; Brylka, Douglas; Krepp, Joseph; Pua, Bradley; Sanders, Abraham

2014-01-01

163

Transcranial Doppler ultrasonography in intensive care.  

PubMed

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

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

2008-01-01

164

Validity of ultrasonography to diagnosing pneumothorax: a critical appraisal of two meta-analyses.  

PubMed

Clinical questionCan ultrasonography be used in lieu of chest radiography to diagnose pneumothorax?Articles chosen1. Ding W, Shen Y, Yang J, et al. Diagnosis of pneumothorax by radiography and ultrasonography: a meta-analysis. Chest 2011;140:859-66. [Epub 2011 May 5]2. Alrajhi K, Woo MY, Vaillancourt C. Test characteristics of ultrasonography for the detection of pneumothorax: a systematic review and meta-analysis. Chest 2012;141:703-8. PMID:25155473

Azad, Aftab; Al Juma, Saad; Bhatti, Junaid A; Dankoff, Jerrald

2014-08-01

165

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. PMID:21401932

2011-01-01

166

Age determination using ultrasonography in young football players  

PubMed Central

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

Karami, Mehdi; Moshirfatemi, Alireza; Daneshvar, Pooya

2014-01-01

167

[Ultrasonography of the brain in children with craniocerebral trauma].  

PubMed

The authors examined 275 children with acute craniocerebral trauma (CCT). Various types of intracranial hemorrhages and contusions of the brain were differentiated by means of ultrasonography (USG). Analysis of complex examination of children with CCT allows the conclusion that USG is a highly informative diagnostic method, particularly in infancy, which makes it possible to visualize the craniocerebral injuries and study them continuously during treatment. Intraoperative USG was conducted in older children with suspected intracranial hematoma, which allowed the pathological process to be clearly located. PMID:1659075

Gaevy?, O V; Artarian, A A; Korolev, A G

1991-01-01

168

Ultrasonography reveals nail thickening in patients with chronic plaque psoriasis.  

PubMed

Nail psoriasis is usually investigated and diagnosed by clinical examination. Ultrasonography is a non-invasive imaging technique for studying soft tissue involvement. The objective of this study was to estimate nail involvement in patients with chronic plaque psoriasis by ultrasonography. Prevalence, clinical type and severity of nail involvement according to nail psoriasis and severity index (NAPSI) were investigated in 138 patients with psoriasis. The thickness of the plate and bed of the fingernails was measured in 54 patients with psoriasis, 46 healthy controls and 37 patients with chronic eczema, using an ultrasonographic system equipped with a frequency transducer of 18 MHz. The prevalence of nail psoriasis was 73 % (102 out of 138). Onycholysis and thickening of the nail plate were the most common clinical type affecting 56 and 50 % of patients, respectively; splinter haemorrhages was the less common involving 10 % of patients. The mean NAPSI score was 18.4 ± 17.5 (SD; range 0-107). The thickness of fingernail plate and bed was significantly higher in patients with psoriasis with nail disease compared to healthy controls and patients with chronic eczema (p < 0.001). There was a linear correlation between NAPSI and plate and bed nail thickness (r = 0.52 and r = 0.38, p = 0.001). Increased nail plate and bed thickness was observed also in patients with psoriasis without clinically apparent nail involvement. In conclusion, thickening of the nail is a common feature of nail psoriasis also in patients without clinically apparent nail involvement. PMID:23011659

Gisondi, P; Idolazzi, L; Girolomoni, G

2012-11-01

169

Estimation and visualization of longitudinal muscle motion using ultrasonography: a feasibility study.  

PubMed

Ultrasonography is a convenient and widely used technique to look into the longitudinal muscle motion as it is radiation-free and real-time. The motion of localized parts of the muscle, disclosed by ultrasonography, spatially reflects contraction activities of the corresponding muscles. However, little attention was paid to the estimation of longitudinal muscle motion, especially towards estimation of dense deformation field at different depths under the skin. Yet fewer studies on the visualization of such muscle motion or further clinical applications were reported in the literature. A primal-dual algorithm was used to estimate the motion of gastrocnemius muscle (GM) in longitudinal direction in this study. To provide insights into the rules of longitudinal muscle motion, we proposed a novel framework including motion estimation, visualization and quantitative analysis to interpret synchronous activities of collaborating muscles with spatial details. The proposed methods were evaluated on ultrasound image sequences, captured at a rate of 25 frames per second from eight healthy subjects. In order to estimate and visualize the GM motion in longitudinal direction, each subject was asked to perform isometric plantar flexion twice. Preliminary results show that the proposed visualization methods provide both spatial and temporal details and they are helpful to study muscle contractions. One of the proposed quantitative measures was also tested on a patient with unilateral limb dysfunction caused by cerebral infarction. The measure revealed distinct patterns between the normal and the dysfunctional lower limb. The proposed framework and its associated quantitative measures could potentially be used to complement electromyography (EMG) and torque signals in functional assessment of skeletal muscles. PMID:24206676

Li, Jizhou; Zhou, Yongjin; Ivanov, Kamen; Zheng, Yong-Ping

2014-03-01

170

Randomised controlled trial of ultrasonography in diagnosis of acute appendicitis, incorporating the Alvarado score  

Microsoft Academic Search

Objectives To determine whether diagnosis by graded compression ultrasonography improves clinical outcomes for patients with suspected appendicitis. Design A randomised controlled trial comparing clinical diagnosis (control) with a diagnostic protocol incorporating ultrasonography and the Alvarado score (intervention group). Setting Single tertiary referral centre. Participants 302 patients (age 5›82 years) referred to the surgical service with suspected appendicitis. 160 patients were

Charles D Douglas; Neil E Macpherson; Patricia M Davidson; Jonathon S Gani; Callaghan NSW

2000-01-01

171

Ultrasonography-Assisted Arthroscopic Proximal Iliotibial Band Release and Trochanteric Bursectomy  

PubMed Central

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

Weinrauch, Patrick; Kermeci, Sharon

2013-01-01

172

Conventional and color Doppler transvaginal sonography of pelvic masses: a comparison of relative histologic specificities.  

PubMed

The relative specificity of CDS versus conventional TVS was assessed in 96 women with surgically excised and pathologically examined pelvic masses. In general, CDS was more specific than TVS in 43% of cases, both were equally specific in 41%, neither was more specific in 10%, and TVS was more specific than CDS in 6%. In particular, CDS seemed to be most specific in detecting ovarian malignancies, ovarian torsion, and ectopic pregnancy. The positive and negative predictive values of CDS were higher in postmenopausal women than in premenopausal women. The use of CDS as an adjunct to TVS is supported by the data from this study. PMID:8301708

Fleischer, A C; Cullinan, J A; Kepple, D M; Williams, L L

1993-12-01

173

Contrast-enhanced ultrasonography for the determination of Crohn's disease activity - preliminary experience  

PubMed Central

Summary Background Contrast-enhanced ultrasound (CEUS) is a recent non-invasive modality, which may partially replace currently used techniques (endoscopy, CT enterography and MR enterography) in the diagnostics and assessment of Crohn’s disease (CD). The aim of the study was to analyze early experience in the use of CEUS for the measurement of activity and staging of CD. Material/Methods Eleven patients previously diagnosed with CD were included in the study. They underwent contrast-enhanced ultrasonography (SonoVue, Bracco), low-dose CT enterography (LDCTE), assessment of laboratory markers of inflammation and clinical CD activity index (CDAI). Contrast enhancement was evaluated using a semi-quantitative method and a quantitative method that included measurement of peak enhancement (PE), enhancement curve rise time (RT) and wash-in-rate (WiR). Results Ileal wall thickening was observed in all patients. Semi-quantitative method was used to observe CD activity in CEUS in 10 cases that perfectly matched LDCTE findings. There was a moderate positive correlation between PE and CDAI (r=0.65, p<0.001). There was no significant relationship between perfusion parameters and laboratory markers of inflammation. Conclusions CEUS is a promising modality for non-invasive assessment of pathologic ileal vascularization in the course of Crohn’s disease. Intensity of enhancement in CEUS reflects activity of the disease detected in LDCTE and correlates with CDAI. PMID:24723988

Bialecki, Marcin; Bialecka, Agnieszka; Laskowska, Katarzyna; Klopocka, Maria; Liebert, Ariel; Lemanowicz, Adam; Serafin, Zbigniew

2014-01-01

174

Ultrasonography of normal and abnormal appendix in children  

PubMed Central

Appendicitis is the most common acute surgical emergency of childhood. Since the original report by Puylaert in 1986, the use of ultrasonography in the diagnosis of appendicitis has been the subject of considerable study. Among the reported diagnostic criteria, the maximal outer diameter (MOD) of the appendix is accepted as the one of the most reliable criteria used to differentiate between a normal appendix and acute appendicitis. However, MOD measurement is subject to inaccuracies because luminal distention by non-compressible, non-inflammatory material such as fecal material, or increased maximal mural thickness due to reactive mucosal lymphoid hyperplasia, or a medical cause due to a generalized gastrointestinal disease, such as Crohn’s disease, can cause the measurement to exceed the upper limits of normality. The aim of this article is to introduce the spectrum of ultrasonographic findings in the normal and abnormal appendix and eventually to reduce unnecessary surgery in children. PMID:21532869

Park, Noh Hyuck; Oh, Hwa Eun; Park, Hee Jin; Park, Ji Yeon

2011-01-01

175

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. PMID:22254164

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

2011-01-01

176

Intraductal papillary and mucinous tumors of the pancreas: accuracy of preoperative computed tomography, endoscopic retrograde pancreatography and endoscopic ultrasonography, and long-term outcome in a large surgical series  

Microsoft Academic Search

Background: Few data are available on the accuracy of preoperative imaging or on long-term outcome after surgery for intraductal papillary and mucinous tumors of the pancreas. The aims of this study were to assess the following: (1) the accuracy of preoperative computed tomography, endoscopic retrograde pancreatography, and endoscopic ultrasonography for determination of tumor invasion and pancreatic extension as compared with

Christophe Cellier; Emmanuel Cuillerier; Laurent Palazzo; Fabienne Rickaert; Jean-Francois Flejou; Bertrand Napoleon; Daniel Van Gansbeke; Natacha Bely; Philippe Ponsot; Christian Partensky; Paul-Henri Cugnenc; Jean-Philippe Barbier; Jacques Devière; Michel Cremer

1998-01-01

177

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

2000-01-01

178

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. PMID:23560151

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

2013-01-01

179

Comparative evaluation of the mandibular distraction zone using ultrasonography and conventional radiography.  

PubMed

The purpose of this study was to determine the efficacy of ultrasonography (USG) for the evaluation of bone formation in the mandibular distraction wound and to compare this with radiographic evaluation, which is currently the standard modality. Twenty-two patients underwent mandibular distraction (30 sides) with a variety of distraction devices. The wounds were assessed with plain radiographs and USG at established time intervals. Estimates of bone formation using a semiquantitative bone fill score were made for radiographs and USG. USG bone fill scores were correlated with radiography scores. At week 4 the difference between the scores was statistically significant (P=0.01); at all other time points, USG and radiography scores were comparable. At week 4, USG scores were significantly higher than the corresponding radiography scores, indicating that USG is an earlier indicator of calcification in the distraction zone as compared to radiography. USG evaluation of the distraction osteogenesis (DO) zone has many inherent advantages over conventional methods. The results of this study indicate that USG is an accurate non-invasive technique that may prove to be useful in assessing the mandibular DO regenerate in patients. PMID:24393569

Issar, Y; Sahoo, N K; Sinha, R; Satija, L; Chattopadhyay, P K

2014-05-01

180

Current practice of lung ultrasonography (LUS) in the diagnosis of pneumothorax: a survey of physician sonographers in Germany  

PubMed Central

Background The purpose of this study was to survey the current practice of the use of lung ultrasonography (LUS) in the diagnosis of pneumothorax. Methods Physician sonographers, accredited for diagnostic ultrasonography in surgery, anaesthesia and medicine were studied. Questions addressed the frequency of exposure to patients with suspected pneumothorax, frequency of LUS use, preferences regarding technical aspects of LUS examination, assessment of diagnostic accuracy of LUS and involvement in teaching. Results Of the respondents, 55.1% used LUS ‘always’ or ‘frequently’ for suspected pneumothorax. Also, 35.5% of physicians rated LUS as ‘always reliable’ in ruling out pneumothorax, and 21.3% of respondents rated LUS as ‘always reliable’ in ruling in pneumothorax. The mode of performing LUS for pneumothorax was highly variable. Statistically significant differences were found regarding the likelihood of LUS usage, the combined use of M-Mode and B-mode scanning and the confidence to exclude pneumothorax based on LUS findings for physicians with frequent exposure to pneumothorax cases. Conclusions Physicians' use of LUS in the diagnosis of pneumothorax is modest. Confidence in diagnostic accuracy is not comprehensive. Further research is required to establish the most efficient way of performing LUS in this scenario to achieve the highest possible diagnostic accuracy and reliable documentation of examination results.

2014-01-01

181

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. PMID:20445795

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

2010-01-01

182

Diagnosis of Gallbladder Diseases by Contrast-Enhanced Phase-Inversion Harmonic Ultrasonography  

Microsoft Academic Search

We evaluated the usefulness of contrast-enhanced ultrasonography(US) for detecting and differentiating gallbladder lesions. Contrast-enhanced coded phase-inversion harmonic US was performed on 90 patients with gallbladder abnormalities. After administering Levovist®, we observed the gallbladders in real time. Contrast-enhanced coded phase-inversion harmonic ultrasonography was compared with B-mode US and contrast-enhanced computer tomography (CT) with regard to the sensitivity and specificity in depicting

Tatsuo Inoue; Masayuki Kitano; Masatoshi Kudo; Hiroki Sakamoto; Toshihiko Kawasaki; Chikao Yasuda; Kiyoshi Maekawa

2007-01-01

183

Intraoperative ultrasonography versus cholangiography during laparoscopic cholecystectomy: a prospective comparative study  

Microsoft Academic Search

Background:The purpose of this study was to compare the functional utility of intraoperative ultrasonography (IOUS) and cholangiography (IOC) during a laparoscopic cholecystectomy for the treatment of gallstone disease.Study Design:A prospective study comparing IOUS and IOC was carried out in 65 patients. Intraoperative ultrasonography was conducted first using a 7.5-MHz linear array probe. After IOUS, IOC was then conducted in all

Tetsuya Ohtani; Chihiro Kawai; Yoshio Shirai; Kazutake Kawakami; Keisuke Yoshida; Katsuyoshi Hatakeyama

1997-01-01

184

An experience of emergency ultrasonography in children in a sub-Saharan setting  

PubMed Central

Emergency ultrasonography is an appealing imaging modality in paediatric emergencies, given its non?invasive nature and potential as an adjunct to physical examination in a setting where rapid decisions need to be made. This review of a case series describes the applications, versatility, and limitations of emergency physician led ultrasonography in a paediatric resuscitation room in a sub?Saharan African setting. PMID:16627831

Ahmad, S; Kampondeni, S; Molyneux, E

2006-01-01

185

Sex detection of the bovine fetus using linear array real-time ultrasonography  

E-print Network

SEX DETECTION OF THE BOVINE FETUS USING LINEAR ARRAY REAL-TINE ULTRASONOGRAPHY A Thesis DONALD W I DEMAN I JR Submitted to the Office of Graduate Studies of Texas A&M University in partial fulfillment of the requirements for the degree... of MASTER OF SCIENCE May 1990 Major Subject: Veterinary Physiology SEX DETECTION OF THE BOVINE FETUS USING LINEAR ARRAY REAL-TIME ULTRASONOGRAPHY A Thesis by Donald Wideman, Jr. Approved as to style and content by: Duane C. raemer (Chair...

Wideman, Donald

2012-06-07

186

Percutaneous Liver Biopsies Guided with Ultrasonography: A Case Series  

PubMed Central

Background Although liver biopsy is an easy procedure for hospitalized patients and outpatients, some complications may occur. Objectives To evaluate the efficiency, complications, safety and clinicopathological utility of ultrasonographic-guided percutaneous liver biopsy in diffuse liver disease. Patients and Methods In our retrospective study, we evaluated ultrasound-assisted needle biopsies that were performed in outpatients from October 2006 to July 2010. The liver biopsies were performed following one-night fasting using the tru-cut biopsy gun (18-20 gauge) after marking the best seen and hypovascular part of the liver, distant enough from the adjacent organs. Results A total of 1018 patients were referred to our radiology department. Most of the patients had hepatitis B (60.6%). The biopsy specimens were recorded and sent to our pathology department for histopathological examination. Conclusion According to the results of our series, percutaneous liver biopsy using the tru-cut biopsy gun guided by ultrasonography can be performed safely. We resolve that routine ultrasound of the puncture site is a quick, effective and safe procedure. The complication rate is very low. The US-assisted percutaneous liver biopsy should be used for all cases. PMID:24348609

Cakmakci, Emin; Caliskan, Kosti Can; Tabakci, Omer Naci; Tahtabasi, Mehmet; Karpat, Zeki

2013-01-01

187

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

2012-02-01

188

Lesions of biliary hamartoms can be diagnosed by ultrasonography, computed tomography and magnetic resonance imaging  

PubMed Central

Aims: This study is to compare the value of ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of biliary hamartomas. Methods: From 2003 to 2013, 15 cases of liver biopsies were found to have biliary hamartomas, including 3 cases excluded from this study. The remaining 12 patients were 7 women and 5 men aged from 28 to 66 years (mean age, 53 years). Ultrasonography examinations were performed by two different scanners using 3.5- to 5.0-MHz convex array transducers. Eight patients were examined by plain and contrast CT including 2 cases with Sensation Cardiac 64 and 6 cases with Somatom definition dual source CT. MRI was performed by a 3 T system using an eight-channel phased-array torso coil. Using pathology slides, lesions were classified into class 1 (predominantly solid), class 2 (intermediate, mixed solid and cystic), and class 3 (predominantly cystic). Results: Patients with biliary hamartomas have distributed lesions. Ultrasonography can be used to diagnose biliary hamartomas, with occasional mistakes. CT is effective in the diagnosis of biliary hamartomas. MRI is capable of diagnosing biliary hamartomas. Histopathological examination provides a direct means to classify the degrees of lesions caused by biliary hamartomas. Conclusions: Biliary hamartomas showed characteristic features on imaging findings by ultrasonography, CT, and MRI. Although abdominal ultrasonography could detect suspected biliary hamartomas, the best choice for further diagnosis is MRI examination instead of CT. In addition, follow-up ultrasonography examinations are necessary.

Liu, Shaoling; Zhao, Bin; Ma, Jincai; Li, Jichang; Li, Xin

2014-01-01

189

[Analysis of blood flow in hepatic tumors by color Doppler ultrasonography].  

PubMed

We evaluated the diagnostic significance of blood flow pattern and velocity in hepatic tumors detected by color doppler ultrasonography. Fifty seven patients with hepatocellular carcinoma (HCC) and 12 patients with hepatic hemangioma (HEM) were studied with ultrasonographic apparatus equipped with color doppler system (Toshiba SSA-270A, 3.75MHz sector scanner). Furthermore 12 patients with HCC were studied repeatedly after transcatheter arterial embolization (TAE) and/or percutaneous ethanol injection (PEI). Blood flow was measurable in 2 of 12 patients with HEM (17%). Pulsatile flow with low speed (7 cm/sec) and low amplitude was detected in one patient, and continuous flow with low speed (5 cm/sec) in the other. Blood flow was measurable in 43 of 57 patients with HCC (75%). The detection rate of blood flow in HCC was significantly higher than in HEM. Pulsatile flow was detectable in 42 of 43 patients (98%). Average maximum velocity of pulsatile flow was over 40cm/sec. Analysis of blood flow after treatment provided us useful information on the effect of treatment. In conclusion, analysis of blood flow in hepatic tumors on US with color doppler system may provide useful information on differential diagnosis between HCC and HEM, the assessment of the therapeutic effect of TAE or PEI, whether additional treatment is required or not, and when it should be done if required. PMID:8145366

Oguma, M; Kawano, M; Monma, T

1994-03-01

190

The role of ultrasonography in the diagnosis of the musculo-skeletal problems of haemophilia.  

PubMed

Recurrent haemarthrosis is the final cause of haemophilic arthrosic disease in haemophilia patients. Therefore, it is essential to diagnose it early, both clinically and by imaging. In addition, haemophilia patients experience chronic synovitis, joint degeneration, muscle haematoma and pseudotumours. The objective of this article is to highlight the value of ultrasounds in the diagnosis and control of the evolution of musculo-skeletal problems in haemophilia patients. To this end, we have performed a literature search in the PubMed, Web of Science(®) (WOS) and SciVerse bases, using the following keywords: hemophilia or haemophilia and ultrasonography (US), ultrasound, echography and sonography. The search was limited to studies published in English between the years 1991 and 2011, finding a total of 221 references. After reviewing the title or abstract for evidence of the use of US for the diagnosis of musculo-skeletal lesions in haemophilia, we selected 24 of these references. We added data collected from our experience to the most important data found in the references. Our main conclusion is that US is highly valuable for the diagnosis of musculo-skeletal diseases in haemophilia. It is a fast, effective, safe, available, comparative, real-time technique that can help us confirm the clinical examination. It is particularly important in acute haemarthrosis, as it can be used to objectively identify the presence of blood in the joints, measure its size, pinpoint its location, assess its evolution and confirm its complete disappearance. PMID:22044728

Querol, F; Rodriguez-Merchan, E C

2012-05-01

191

Staging of gastric cancer with endoscopic ultrasonography and endoscopic mucosal resection.  

PubMed

Since it was found that the gastrointestinal wall is visualized as a five-layered structure corresponding to the histological layers of the wall, endoscopic ultrasonography (EUS) has become recognized clinically as the most accurate method for diagnosing and assessing the local staging of gastric cancer. However, some problems have remained, including how to differentiate between cancer invasion and ulcer fibrosis, how to detect microinvasion, and how to recognize malignant lymph nodes. Using the pattern analysis for depressed-type gastric cancer, it is usually possible to distinguish between cancer invasion and ulcer fibrosis, except in cases of microinvasion into ulcer fibrosis or inadequate scanning. However, the sensitivity of EUS for evaluating metastatic lymph nodes is still problematic. Endoscopic mucosal resection (EMR) for early gastric cancer has been widely accepted as a standard treatment in Japan due to its minimal invasiveness. According to our data, the overall rate of radical resection was 68.3% (168 of 246), and 31.7% of the remaining patients additionally received laser treatment, surgery, or heater-probe treatment. There were no deaths owing to gastric cancer. Some lesions in which there was microinvasion of the submucosa were incorrectly diagnosed by EUS. It may be possible to solve this problem using three-dimensional EUS (3D-EUS) in the near future. PMID:9765088

Kida, M; Tanabe, S; Watanabe, M; Kokutou, M; Kondou, I; Yamada, Y; Sakaguchi, T; Saigenji, K

1998-08-01

192

The impact of the prenatal ultrasonography on birth of babies with Korean pediatric surgical index diseases  

PubMed Central

Purpose The purpose of this study is to examine the impact of prenatal ultrasonography (US) on the birth of babies with diseases listed on the Korean pediatric surgery index diseases (IDs). Methods Depending the ease of diagnosis using prenatal US, [diagnostic facility if prenatal US] IDs were divided into easily diagnosed (ED), not easily diagnosed (NED) and detected with difficulty (DD) groups. Five-year data were obtained for the total live birth number (TBN) from the Korean Statistical Information Service, and the actual birth number of IDs (ABNID) from the Korean Health Insurance Review and Assessment Service. The certified incidences of IDs (I) were obtained from a prestigious textbook of pediatric surgery. The estimated abortion rate (AR) of fetus in each group was obtained using the following formula: AR (%) = [1 - (ABNID)/(TBN × I)] × 100. Results The AR with all IDs was 38 to 77%. The AR was 78 to 93% for ED group, 38 to 66% for NED group and 0% for DD group. Conclusion In spite of high survival rates after treatment, the AR of each group depends on the ease of diagnosis using prenatal US in Korea. A recommendatory policy for the fetus with IDs should be urgently established after general consensus within the related medical societies. PMID:22066101

Shin, Jae Ho

2011-01-01

193

Comparison of Long-term Clinical Outcomes according to the Change in the Rectocele Depth between Transanal and Transvaginal Repairs for a Symptomatic Rectocele  

PubMed Central

Purpose This study was aimed to compare the results of a transanal repair with those of a transvaginal levatorplasty and to determine the long-term clinical outcomes according to the change in the depth of the rectocele after the procedure. Methods Of 50 women who underwent a rectocele repair from March 2005 to February 2007, 26 women (group A) received a transanal repair, and 24 (group B) received a transvaginal repair with or without levatorplasty. At 12 months after the procedures, 45 (group A/B, 22/23 women) among the 50 women completed physiologic studies, including anal manometry and defecography, and clinical-outcome measurements. The variations of the clinical outcomes with changes in the depth of the rectocele were also evaluated in 42 women (group A/B, 20/22) at the median follow-up of 50 months. Results On the defecographic findings, the postoperative depth of the rectocele decreased significantly in both groups (group A vs. B, 1.91 ± 0.20 vs. 2.25 ± 0.46, P = 0.040). At 12 months after surgery, 17 women in each group (group A/B, 77/75%) reported improvement of their symptoms. However, only 11 and 13 women (group A/B, 55/59%) of groups A and B, respectively, maintained their improvement at the median follow-up of 50 months. Better results were reported in patients with a greater change in the depth of their rectocele (?4 cm) after the procedure (P = 0.001) Conclusion In both procedures, clinical outcomes might become progressively worse as the length of the follow-up is increased. PMID:22816057

Yu, Sang Hwa; Lee, Jeong Eun; Lee, Dong Keun

2012-01-01

194

Integration of three-dimensional ultrasonography in the prenatal diagnosis of amniotic band syndrome: A case report  

PubMed Central

Amniotic band syndrome is a rare disorder which is thought to be caused by early rupture of the amniotic membrane. The extent of the disease may vary from minor digital amputations to severe lethal anomalies. For many years in routine clinical practice, this syndrome has been diagnosed with two-dimensional ultrasonography. Evolving imaging techniques by means of three-dimensional ultrasonography gives the chance of early and accurate diagnosis of this devastating anomaly. By integrating three-dimensional ultrasonography to the suspected findings diagnosed in the two-dimensional ultrasonography allows us to predict possible outcomes and provides convenience in counselling. Herein we present a case of amniotic band syndrome diagnosed at 19 weeks of gestation with three-dimensional ultrasonography and pregnancy was terminated in the 20th week. Using three-dimensional ultrasonography in certain suspected foetal anomalies may provide the early diagnosis and more accurate knowledge about extent of the disease. PMID:24790518

Turgal, Mert; Ozyuncu, Ozgur; Yaz?c?oglu, Asl?han; Onderoglu, Lutfu Sabri

2014-01-01

195

Integration of three-dimensional ultrasonography in the prenatal diagnosis of amniotic band syndrome: A case report.  

PubMed

Amniotic band syndrome is a rare disorder which is thought to be caused by early rupture of the amniotic membrane. The extent of the disease may vary from minor digital amputations to severe lethal anomalies. For many years in routine clinical practice, this syndrome has been diagnosed with two-dimensional ultrasonography. Evolving imaging techniques by means of three-dimensional ultrasonography gives the chance of early and accurate diagnosis of this devastating anomaly. By integrating three-dimensional ultrasonography to the suspected findings diagnosed in the two-dimensional ultrasonography allows us to predict possible outcomes and provides convenience in counselling. Herein we present a case of amniotic band syndrome diagnosed at 19 weeks of gestation with three-dimensional ultrasonography and pregnancy was terminated in the 20th week. Using three-dimensional ultrasonography in certain suspected foetal anomalies may provide the early diagnosis and more accurate knowledge about extent of the disease. PMID:24790518

Tur?al, Mert; Ozyüncü, Ozgür; Yaz?c?o?lu, Asl?han; Ondero?lu, Lütfü Sabri

2014-01-01

196

Harmonic ultrasonography for the detection of microlithiasis in the gallbladder  

PubMed Central

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

2014-01-01

197

[Ultrasonography for traction injuries of the brachial plexus].  

PubMed

Results of preoperative ultrasonography (US) were compared with the subsequently offered operative findings retrospectively on 35 ventral rami of the cervical nerves (11 C5, 11 C6 and 13 C7) in 12 patients injured in motorcycle accidents in order to examine the usefulness of US in the diagnosis of nerve injury. The findings of a US-scanned ramus consisted of shape, internal echo pattern, regularity of border, and ratio of the diameter of an injured nerve to that of the corresponding nerve on the intact side (I/C). An intact ventral ramus was shown as a hypoechoic tubular structure with many parallel fine linear internal echoes, a regular border, and I/C ranging from 1.0 to 1.2. Categories such as I/C and shape improved the accuracy of differential diagnosis of severe nerve injuries. Avulsion of the ganglion was observed as a winding or tadpole-shaped remarkably enlarged (2.3 < or = I/C < or = 5.0) mass lesion, intraforaminal lesion as a thick (1.5 < or = I/C < or = 3.2) structure with an irregular shape and border close to the transverse process, and pseudocontinuity as irregular internal echoes. It was difficult to discriminate a lesion with continuity and localized scar formation around the nerve from normal fasciculi. These results strongly suggest that the application of improved US diagnosis to cervical nerve injury should make it much easier to select the best treatment for the patient, in that we can detect preoperatively those injuries to which nerve transplantation is not applicable. PMID:8539106

Hayamizu, K; Naito, K; Ito, K

1995-10-01

198

[Application of ultrasonography in diagnosis and treatment of acute inflammation of soft tissues in maxillofacial region and neck].  

PubMed

We investigated the value of ultrasonography (USG) and ultrasound-guided aspirations in diagnosis and treatment of acute inflammation of soft tissues in maxillofacial region and neck. We performed 174 USG in 136 patients (73 with abscesses and phlegmons, 27 with acute lymphadenitis, 16 with inflamed cysts, 12 with parotitis, 3 with sialolithiasis and 5 with diseases, simulated acute inflammation). Ultrasound-guided aspirations performed in 35 patients. We considered USG to be useful diagnostic tool in acute inflammation of soft tissues in maxillofacial region and neck. USG allowed to determine localization and stage of inflammation, discriminate it from non-inflammatory diseases and improve assessment of its dynamics. Ultrasound-guided aspirations was a valuable tool for diagnostic and treatment purposes in inflamed cysts. PMID:21983614

Iaremenko, A I; Petrov, N L; Matina, V N; Kirillov, A L

2011-01-01

199

The role of transcranial Doppler ultrasonography in the diagnosis and management of vasospasm after aneurysmal subarachnoid hemorrhage.  

PubMed

Transcranial Doppler ultrasonography (TCD) is a tool employed by the neurosurgeon and neurointensivist in the management of vasospasm in the intensive care unit after aneurysmal subarachnoid hemorrhage. A review of the current indications, monitoring parameters, indices, and relevance of modern TCD technology is provided, as well as algorithms for the use of TCD ultrasonography in the management of patients with subarachnoid hemorrhage. Other current uses of TCD ultrasonography are also discussed in the setting of neurocritical care. PMID:20380971

Marshall, Scott A; Nyquist, Paul; Ziai, Wendy C

2010-04-01

200

The pattern and significance of the calcifications of papillary thyroid microcarcinoma presented in preoperative neck ultrasonography  

PubMed Central

Purpose To analyze the incidence and patterns of calcification of papillary thyroid microcarcinoma (PTMC) on neck ultrasonography (NUS) and assess the clinical implications of calcification, especially for neck node metastasis. Methods The clinical data of 379 patients with PTMC who underwent thyroidectomy between January and December 2011 were retrospectively analyzed. PTMC lesions were classified into four subgroups according to their calcification patterns on preoperative NUS: microcalcification, macrocalcification, rim calcification, and noncalcification. The clinicopathologic characteristics were compared between the patients with and without calcification, and among the four subgroups. Results Calcifications were detected on NUS in 203 patients (53.5%) and central neck node metastasis was observed in 119 patients (31.3%). Calcification was associated with larger tumor size (0.68 cm vs. 0.54 cm), higher rate of lymph node metastasis (38.6% vs. 23.2%) and higher lymph node ratio (0.11 vs. 0.06) compared to noncalcification (All P < 0.05). In addition, the extent of calcification correlated with lesion size (0.67 cm vs. 0.69 cm vs. 0.85 cm). Further, the likelihood of lymph node metastasis also correlated with the extent of calcification in the order of non-, micro- and macrocalcification (23.3%, 36.8%, and 44.1%, respectively). The calcification rate was higher in patients with lymph node metastasis than those without it (65.5% vs.47.7%) (All P < 0.05). Conclusion PTMC patients positive for calcification on NUS had a higher rate of lymph node metastasis, and a higher lymph node ratio compared to noncalcification patients. Calcification patterns should be assessed carefully in patients with PTMC by preoperative NUS. PMID:24761419

Oh, Eun Mee; Chung, Yoo Seung; Song, Won Jong

2014-01-01

201

Characterization of solid focal pancreatic lesions using endoscopic ultrasonography with real-time elastography.  

PubMed

OBJECTIVES. The aim of this study was to evaluate the diagnostic potential of strain assessment in solid focal pancreatic lesions using real-time elastography in combination with endoscopic ultrasonography (EUS). MATERIAL AND METHODS. Forty-eight solid focal pancreatic lesions in 39 patients were included prospectively over a 3-year period and studied by EUS with real-time elastography (EUS-RTE). Lesions previously described as cystic by CT were not included. Distribution patterns of tissue strain were assessed using strain ratio (SR) measurements, continuous visual analog scale (VAS), and a visual categorical score (VCS), based on color coding of relative strain. Final diagnosis was based on histopathology, fine-needle aspiration cytology, and/or follow-up for ?6 months. RESULTS. The 48 lesions included 11 adenocarcinomas, 7 malignant neuroendocrine tumors (NETs), 11 benign or indeterminate NETs, 8 focal pancreatic lesions, 2 microcystic adenomas, and 9 other benign lesions. Malignant lesions had significantly higher median SR (7.05 vs. 1.56) and VAS scores (93.0 vs. 63.5) than benign lesions. A receiver operation characteristic curve analysis showed sensitivity of 67% and specificity of 71%, when using SR = 4.4 as a cut-off for malignancy. The highest SR values were found in two benign microcystic adenomas. CONCLUSIONS. EUS-RTE with SR measurements and VAS evaluation demonstrated a significant strain difference between benign and malignant lesions. However, the variation within the entities was substantial and some benign lesions presented with low strain. Benign lesions were generally characterized by a strain similar to reference tissue, whereas malignant lesions were harder. The recorded strain pattern in individual lesions must be interpreted with caution. PMID:24713038

Havre, Roald Flesland; Ødegaard, Svein; Gilja, Odd Helge; Nesje, Lars Birger

2014-06-01

202

Preoperative imaging of liver metastases. Comparison of angiography, CT scan, and ultrasonography.  

PubMed Central

Thirty-one patients with mostly colorectal cancer metastases to the liver had preoperative selective/superselective angiograms (24 cases), computed tomography (CT) [26 cases, mostly enhanced by contrast administered by a peripheral vein (9), the common hepatic artery (9), or the portal vein (5)], and ultrasonography (26 cases). Intraoperative ultrasonography and palpation and examination of the resected specimens revealed 113 tumors. CT detected almost half of the masses smaller than 1 cm, and ultrasonography and angiography about one-third of lesions 1-2 cm in size. Ultrasonography was less powerful for examination of the posterior segment of the liver. CT and ultrasonography placed the tumors into subsegments more accurately than did angiography. Almost 40% of the preoperative plans had to be changed: in two-thirds by extended resections and in one-third by a change from curative to palliative intent. Most changes were due to extrahepatic tumor growth, often within areas screened before surgery. The use of all three imaging modalities for liver metastases is recommended for preoperative planning. PMID:3901943

Gunvén, P; Makuuchi, M; Takayasu, K; Moriyama, N; Yamasaki, S; Hasegawa, H

1985-01-01

203

Papillary Thyroid Carcinoma with Honeycomb-Like Multiple Small Cysts: Characteristic Features on Ultrasonography  

PubMed Central

Background Thyroid nodules with cystic content or mixed sponge-like aspect on ultrasonography and a concordant cytology are strongly predictive of benignity. Objectives We present 8 patients with honeycomb-like papillary thyroid carcinoma with multiple small cysts on ultrasonography. Methods The patients were 6 women and 2 men aged between 30 and 57 years. The tumors of these patients showed honeycomb-like multiple small cysts that were aggregated in some area of the thyroid gland on ultrasonography. Histopathological examination indicated a well-differentiated type of papillary thyroid carcinoma with multiple small cysts and a small solid lesion. The cysts were lined with papillary carcinoma cells, and normal thyroid tissue lay between the cysts. Results There is a peculiar type of papillary thyroid carcinoma that histopathologically shows honeycomb-like multiple small cysts in the thyroid gland. Ultrasonography can be used to identify characteristic features of honeycomb-like multiple small cysts in the thyroid gland in such patients. Conclusions One should be aware of this peculiar type of papillary thyroid carcinoma with honeycomb-like multiple small cysts on ultrasonography, although thyroid nodules with cystic lesions are generally regarded as benign in clinical management. PMID:24783058

Kobayashi, Kaoru; Hirokawa, Mitsuyoshi; Yabuta, Tomonori; Fukushima, Mitsuhiro; Kihara, Minoru; Takamura, Yuuki; Ito, Yasuhiro; Miya, Akihiro; Amino, Nobuyuki; Miyauchi, Akira

2013-01-01

204

Imaging of the malignant peripheral nerve sheath tumour with emphasis ?n ultrasonography: correlation with MRI.  

PubMed

Malignant peripheral nerve sheath tumours affect 0.001 % of the population. The epithelioid subtype accounts for only 5 % of them. We herein present a patient with a palpable mass on the left calf, which was investigated by ultrasonography, ultrasonographically guided fine-needle biopsy and MRI. Ultrasonography estimated the size of the tumour and evaluated its echotexture. Doppler technique detected characteristic corkscrew-type blood vessel entering in the upper pole of the mass. T1-weighted, fat-suppression and gadolinium-enhanced MRI sequences confirmed ultrasonographic findings. In conclusion, although final diagnosis was established by biopsy, ultrasonography and MRI proved complementary in the characterization of the lesion and planning of surgery. PMID:25177396

Rafailidis, Vasileios; Kaziani, Theodora; Theocharides, Costas; Papanikolaou, Athanasios; Rafailidis, Dimitrios

2014-09-01

205

Randomised controlled trial of ultrasonography in diagnosis of acute appendicitis, incorporating the Alvarado score  

PubMed Central

Objectives To determine whether diagnosis by graded compression ultrasonography improves clinical outcomes for patients with suspected appendicitis. Design A randomised controlled trial comparing clinical diagnosis (control) with a diagnostic protocol incorporating ultrasonography and the Alvarado score (intervention group). Setting Single tertiary referral centre. Participants 302 patients (age 5-82 years) referred to the surgical service with suspected appendicitis. 160 patients were randomised to the intervention group, of whom 129 underwent ultrasonography. Ultrasonography was omitted for patients with extreme Alvarado scores (1-3, 9, or 10) unless requested by the admitting surgical team. Main outcome measures Time to operation, duration of hospital stay, and adverse outcomes, including non-therapeutic operations and delayed treatment in association with perforation. Results Sensitivity and specificity of ultrasonography were measured at 94.7% and 88.9%, respectively. Patients in the intervention group who underwent therapeutic operation had a significantly shorter mean time to operation than patients in the control group (7.0 v 10.2 hours, P=0.016). There were no differences between groups in mean duration of hospital stay (53.4 v 54.5 hours, P=0.84), proportion of patients undergoing a non-therapeutic operation (9% v 11%, P=0.59) or delayed treatment in association with perforation (3% v 1%, P=0.45). Conclusion Graded compression ultrasonography is an accurate procedure that leads to the prompt diagnosis and early treatment of many cases of appendicitis, although it does not prevent adverse outcomes or reduce length of hospital stay. PMID:11030676

Douglas, Charles D; Macpherson, Neil E; Davidson, Patricia M; Gani, Jonathon S

2000-01-01

206

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

PubMed Central

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

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

2014-01-01

207

Renal Tract Ultrasonography for Routine Surveillance in Spinal Cord Injury Patients  

PubMed Central

Objectives: To report the efficacy of a urinary tract surveillance regime based on annual renal tract ultrasound without routine use of urodynamic testing (UDS) in our population of spinal cord injury (SCI) patients managed with clean intermittent catheterization (CIC). Methods: Data was gathered retrospectively from the records of 48 SCI patients (40 males and 8 females). After establishing a safe system with initial urodynamics, renal ultrasonography was done annually for surveillance. UDS was repeated only when patients presented with new symptoms. The primary endpoint was the report of ultrasound findings at last follow-up. Findings of dilatation, calculi, scarring, and reflux were noted. Results: Mean follow-up was 6.8 years. By final follow-up, pelvicaliectasis was present in 4 (8%) subjects. Mild-moderate hydronephrosis was present in 3 (6%) subjects: 1 stable and 2 (4%) new compared to initial assessment. No severe cases of hydronephrosis were noted. Six (13%) subjects had renal/ureteral calculi. No new cases of renal cortical scarring or thinning were noted. One (2%) subject had high-grade reflux on UDS secondary to a double J stent. Conclusions: Data relating to the efficacy of sequential surveillance studies in SCI patients are scarce, thus there is great variability in urologic surveillance methods worldwide. Upper tract abnormalities detected in our patients were early consequences of acute obstruction rather than late manifestations of detrusor changes and could not have been prevented with more regular urodyamic testing. These results suggest that annual ultrasound monitoring without routine urodynamic testing is an effective surveillance strategy in SCI patients managed with CIC. PMID:23678286

2013-01-01

208

Hepatic perfusion parameters of contrast-enhanced ultrasonography correlate with the severity of chronic liver disease.  

PubMed

In the study described here, we introduced a new ratio acquired with contrast-enhanced ultrasonography (CEUS): a liver parenchyma blood supply ratio that differentiates arterial and portal phases. Our purpose was to determine whether this ratio and other liver parenchyma perfusion parameters acquired with CEUS can be correlated with the severity of chronic liver disease. Twelve patients with non-cirrhotic chronic liver disease, 35 patients with cirrhosis (child class A: n = 10; child class B: n = 13; child class C: n = 12) and 21 healthy volunteers were examined by CEUS. Time-intensity curves were drawn for regions of interest located in liver parenchyma and right kidney cortex using QLAB quantification software. The arterial and portal phases were differentiated by the time to the maximum enhancement of right kidney and liver parenchyma perfusion data acquired from the time-intensity curves: the intensity of liver parenchyma perfused by hepatic arterial flow (Iap), the intensity of total perfusion of liver parenchyma (Ipeak), the intensity of liver parenchyma perfused by portal venous flow (Ipp) and the ratio of portal perfusion to total perfusion of liver parenchyma expressed by the parameters Ipp/Ipeak, Ipeak, Ipp and Ipp/Ipeak significantly decreased in patients with cirrhosis and in patients with non-cirrhotic chronic liver disease, whereas Iap increased. The parameters Ipp, Ipeak, Ipp/Ipeak and Iap correlated with the severity of chronic liver disease (r = -0.938, p < 0.001; r = -0.790, p < 0.001; r = -0.931 p < 0.001; r = 0.31, p < 0.05). The diagnostic accuracy rates for cirrhosis expressed as areas under receiver operating characteristic curves were 0.93 for Ipeak, 0.98 for Ipp, 0.98 for Ipp/Ipeak, and 0.69 for Iap. Liver parenchyma perfusion parameters obtained by CEUS were correlated with the severity of chronic liver disease and have the potential to assess cirrhosis non-invasively. PMID:25218453

Liu, Dong; Qian, Linxue; Wang, Jinrui; Hu, Xiangdong; Qiu, Lanyan

2014-11-01

209

Hemodynamics in the portal vein evaluated by pulse wave Doppler ultrasonography in patients with chronic hepatitis C treated with interferon  

PubMed Central

AIM: To employ pulse wave Doppler ultrasonography to evaluate the changes in portal blood flow velocity in patients with chronic hepatitis C (CHC) receiving interferon (IFN) treatment. METHODS: The subjects in this study were 14 patients (13 men and 1 woman) with CHC who received IFN treatment. Portal blood flow velocity was measured in the vessels at the porta hepatis at four time points: before IFN administration (pre-IFN), 2 wk after the start of administration (wk 2), 24 wk after the start of administration (wk 24, i.e., the end of IFN administration), and 24 wk after the end of administration (wk 48). RESULTS: The patients with CHC in whom IFN treatment resulted in complete elimination or effective elimination of viruses showed a significant increase in portal blood flow velocity at the end of IFN treatment compared with that before IFN treatment. In contrast, when IFN was ineffective, no significant increase in portal blood flow velocity was observed at wk 24 or 48 compared with the pre-IFN value. In addition, the patients with CHC in whom IFN was ineffective showed significantly lower portal blood flow velocity values than control subjects at all measurement time points. CONCLUSION: Pulse wave Doppler ultrasonography is a noninvasive and easily performed method for evaluating the effects of IFN treatment in patients with CHC. This technique is useful for measuring portal blood flow velocity before and 24 wk after IFN administration in order to evaluate the changes over time, thus assessing the effectiveness of IFN treatment. PMID:15637752

Nakanishi, Shigeo; Shiraki, Katsuya; Yamamoto, Kouji; Koyama, Mutsumi; Kimura, Noboru; Nakano, Takeshi

2005-01-01

210

Learning curve of endorectal ultrasonography in preoperative staging of rectal carcinoma  

PubMed Central

Accurate preoperative staging of rectal carcinoma is essential for optimal treatment. This study was designed to evaluate the accuracy and learning curve of endorectal ultrasonography (ERUS) in the preoperative staging of rectal carcinoma. We retrospectively analyzed the records of patients with rectal carcinoma who underwent preoperative ERUS followed by curative surgery at the Shanxi Province Tumor Hospital between January, 2007 and March, 2010. The patients were divided into three groups, namely A, B and C, depending on whether the examination was performed between January and December, 2007, between January and December, 2008 or between January, 2009 and March, 2010, respectively. Five physicians with no prior experience in ERUS performed the examinations. We compared the ERUS staging with the pathological findings using the tumor-node-metastasis (TNM) classification. The accuracy of ERUS in T and N staging after each additional consecutive 20 patients was calculated for physicians D, E and F. A total of 319 patients underwent ERUS prior to surgery. There were 38 patients in group A, 135 in group B and 146 in group C. Two of the five physicians performed only 47 of the 319 examinations, whereas the remaining 272 patients were examined by physicians D (n=162), E (n=64) and F (n=46). The overall accuracy in assessing the extent of rectal wall invasion (T) was 67%, with 16% of the cases overstaged and 17% understaged and the accuracy in assessing nodal involvement (N) was 66%, with 11% of the cases overstaged and 23% understaged. The total T and N staging accuracy of physicians D, E and F was 75 and 72%; 59 and 59%; and 50 and 52%, respectively. For physicians D, E and F, the accuracy of T and N staging after each additional 20 patients was calculated and the curve of the accuracy reached a plateau after physician D completed 80 cases. Therefore, ERUS is a valuable tool for assessing the depth of tumor invasion and it appears that after ~80 cases a physician may be considered able to apply it efficiently.

LIU, ZUO-LIANG; ZHOU, TONG; LIANG, XIAO-BO; MA, JUN-JIE; ZHANG, GUANG-JUN

2014-01-01

211

Transvaginal photoacoustic imaging probe and system based on a multiport fiber-optic beamsplitter and a real time imager for ovarian cancer detection  

NASA Astrophysics Data System (ADS)

This paper presents a real-time transvaginal photoacoustic imaging probe for imaging human ovaries in vivo. The probe consists of a high-throughput (up to 80%) fiber-optic 1 x 19 beamsplitters, a commercial array ultrasound transducer, and a fiber protective sheath. The beamsplitter has a 940-micron core diameter input fiber and 240-micron core diameter output fibers numbering 36. The 36 small-core output fibers surround the ultrasound transducer and delivers light to the tissue during imaging. A protective sheath, modeled in the form of the transducer using a 3-D printer, encloses the transducer with array of fibers. A real-time image acquisition system collects and processes the photoacoustic RF signals from the transducer, and displays the images formed on a monitor in real time. Additionally, the system is capable of coregistered pulse-echo ultrasound imaging. In this way, we obtain both morphological and functional information from the ovarian tissue. Photoacousitc images of malignant human ovaries taken ex vivo with the probe revealed blood vascular and networks that was distinguishable from normal ovaries, making the probe potential useful for characterizing ovarian tissue.

Kumavor, Patrick D.; Alqasemi, Umar; Tavakoli, Behnoosh; Li, Hai; Yang, Yi; Zhu, Quing

2013-03-01

212

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

2000-01-01

213

Clinical utility of adrenal ultrasonography in the diagnosis of congenital adrenal hyperplasia  

Microsoft Academic Search

Rapid, accurate diagnosis of congenital adrenal hyperplasia (CAH) is essential in the neonate with ambiguous genitalia, life-threatening salt loss, or both. We aimed to determine the accuracy of adrenal ultrasonography in the diagnosis of CAH in a retrospective analysis of 52 children with ambiguous genitalia or salt-losing crises. Adrenal ultrasounds were interpreted as follows: “normal” if the adrenals were normal

Ibrahim Al-Alwan; Oscar Navarro; Denis Daneman; Alan Daneman

1999-01-01

214

Clinical examination versus ultrasonography in detecting developmental dysplasia of the hip  

PubMed Central

Although hip ultrasonography is gaining acceptance as the most effective method for the early diagnosis of developmental dysplasia of the hip, there is still some controversy regarding the use of ultrasonography as a screening method. The purpose of this study was to investigate prospectively the capacity of clinical examination findings and associated risk factors to detect developmental dysplasia of the hip defined ultrasonographically in infants. A total of 3,541 infants underwent clinical examination and hip ultrasonography. Measured against ultrasonography as a standard, the sensitivity and specificity of clinical examination were 97% and 13.68%, respectively. Graf type IIb or more severe developmental dysplasia was found in 167 infants (208 hips), at an overall frequency of 4.71%. Graf type IIa physiological immaturity was encountered in 838 hips, and of these, 15 hips (1.78%) developed Graf type IIb dysplasia and underwent treatment. Patient characteristics that were found to be significant risk factors were swaddling use, female gender, breech delivery and positive family history. Given its low specificity, our findings suggest that clinical examination does not reliably detect ultrasonographically defined developmental dysplasia of the hip in infants being screened for this disease. PMID:17333184

Atalar, H.; Yavuz, O. Y.; Sayli, U.

2007-01-01

215

Dynamic imaging of the pancreas using real-time endoscopic ultrasonography with secretin stimulation  

Microsoft Academic Search

Background: Obstructive disorders of the pancreas, including strictures, stones, sphincter of Oddi dysfunction, and pancreas divisum, are diagnostic and therapeutic challenges. Conventional extracorporeal ultrasound with secretin stimulation has been used as a noninvasive study to detect obstruction and predict outcome of therapy. Inconsistent results have been obtained because of the inherent limitations of standard ultrasonography. The aim of this study

Marc F. Catalano; Sandeep Lahoti; Eduardo Alcocer; Joseph E. Geenen; Walter J. Hogan

1998-01-01

216

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

2011-01-01

217

Striated pattern on scrotal ultrasonography: A marker for Non-hodgkins lymphoma of testis  

PubMed Central

We present a case of 52 year old man who presented with bilateral painless testicular swelling. On evaluation with high resolution ultrasonography of the scrotum, typical “striated pattern” which is highly suggestive of Non Hodgkins lymphoma of the testis was seen. The patient underwent bilateral inguinal orchidectomy and the histopathological examination confirmed the diagnosis of Non Hodgkins lymphoma. PMID:24497696

Bhat, Suresh; Sachin, Joseph; Ramaprasad; Job, Suma

2014-01-01

218

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: kablakziembicka@op.pl; 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)

2007-09-15

219

Diagnostic Accuracy and Reliability of Ultrasonography for the Detection of Fatty Liver: A Meta-Analysis  

PubMed Central

Ultrasonography is a widely accessible imaging technique for the detection of fatty liver, but the reported accuracy and reliability have been inconsistent across studies. We aimed to perform a systematic review and meta-analysis of the diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver. We used MEDLINE and Embase from October 1967 to March 2010. Studies that provided cross-tabulations of ultrasonography versus histology or standard imaging techniques, or that provided reliability data for ultra-sonography, were included. Study variables were independently abstracted by three reviewers and double checked by one reviewer. Forty-nine (4720 participants) studies were included for the meta-analysis of diagnostic accuracy. The overall sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of ultrasound for the detection of moderate-severe fatty liver, compared to histology (gold standard), were 84.8% (95% confidence interval: 79.5-88.9), 93.6% (87.2-97.0), 13.3 (6.4-27.6), and 0.16 (0.12-0.22), respectively. The area under the summary receiving operating characteristics curve was 0.93 (0.91-0.95). Reliability of ultrasound for the detection of fatty liver showed kappa statistics ranging from 0.54 to 0.92 for intrarater reliability and from 0.44 to 1.00 for interrater reliability. Sensitivity and specificity of ultrasound was similar to that of other imaging techniques (i.e., computed tomography or magnetic resonance imaging). Statistical heterogeneity was present even after stratification for multiple clinically relevant characteristics. Conclusion Ultrasonography allows for reliable and accurate detection of moderate-severe fatty liver, compared to histology. Because of its low cost, safety, and accessibility, ultrasound is likely the imaging technique of choice for screening for fatty liver in clinical and population settings. PMID:21618575

Bonekamp, Susanne; Kamel, Ihab; Brancati, Frederick L.; Guallar, Eliseo; Clark, Jeanne M.

2014-01-01

220

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.

1987-02-01

221

Time-Intensity Curve Parameters in Rectal Cancer Measured Using Endorectal Ultrasonography with Sterile Coupling Gels Filling the Rectum: Correlations with Tumor Angiogenesis and Clinicopathological Features  

PubMed Central

The primary aim of this study was to investigate the relationship between contrast-enhanced ultrasonography (CEUS) imaging parameters and clinicopathological features of rectal carcinoma and assess their potential as new radiological prognostic predictors. A total of 66 rectal carcinoma patients were analyzed with the time-intensity curve of CEUS. The parameter arrival time (AT), time to peak enhancement (TTP), wash-in time (WIT), enhanced intensity (EI), and ascending slope (AS) were measured. Microvessel density (MVD) was evaluated by immunohistochemical staining of surgical specimens. All findings were analysed prospectively and correlated with tumor staging, histological grading, and MVD. The mean values of AT, TTP, WIT, EI, and AS value of the rectal carcinoma were 10.84 ± 3.28?s, 20.61 ± 5.52?s, 9.78 ± 2.83?s, 28.68 ± 4.67?dB, and 3.20 ± 1.10, respectively. A positive linear correlation was found between the EI and MVD in rectal carcinoma (r = 0.295, P = 0.016), and there was a significant difference for EI among histological grading (r = ?0.264, P = 0.007). EI decreased as T stage increased with a trend of association noted (P = 0.096). EI of contrast enhanced endorectal ultrasonography provides noninvasive biomarker of tumor angiogenesis in rectal cancer. CEUS data have the potential to predict patient prognosis. PMID:24900973

Wang, Yong; Wang, Yi-Xiang J.; Cui, Ning-Yi; Zou, Shuang-Mei; Zhou, Chun-Wu; Jiang, Yu-Xin

2014-01-01

222

Effects of Noradrenaline and Adenosine Triphosphate on the Degree on Contrast Enhancement in a Rabbit Model of Atherosclerosis during Contrast-Enhanced Ultrasonography.  

PubMed

The aim of the study is to assess the effects of vasoactive agents on the degree of contrast enhancement in experimental atherosclerotic plaque during contrast-enhanced ultrasonography (CEUS). Abdominal aortic atherosclerosis was induced in 25 New Zealand white rabbits by a combination of cholesterol-rich diet and balloon endothelial denudation. Standard ultrasonography and CEUS were performed at baseline and during intravenous infusion of noradrenaline or adenosine triphosphate (ATP). The degree of contrast enhancement of the plaque after injection of contrast material was quantified by calculating the enhanced intensity in the plaque. The infusion of noradrenaline induced significant increase in systolic blood pressure (84 ± 13 mm Hg vs. 112 ± 20 mm Hg, p = 0.011) and significant decrease in the enhanced intensity in the plaque (7.52 ± 1.32 dB vs. 5.88 ± 1.33 dB, p < 0.001) during CEUS. The infusion of ATP resulted in the significant decrease in systolic blood pressure (80 ± 13 mm Hg vs. 65 ± 11 mm Hg, p = 0.005) and increase in the enhanced intensity in the plaque (7.52 ± 1.32 dB vs. 8.84 ± 1.55 dB, p < 0.001) during CEUS. The degree of contrast enhancement within an experimental atherosclerotic plaque during CEUS can be influenced by vasoactive agents and hemodynamic status. PMID:25218451

Sun, Jie; Deng, You-Bin; Liu, Kun; Wang, Yu-Bo

2014-11-01

223

Advanced Clinical Usefulness of Ultrasonography for Diseases in Oral and Maxillofacial Regions  

PubMed Central

Various kinds of diseases may be found in the oral and maxillofacial regions and various modalities may be applied for their diagnosis, including intra-oral radiography, panoramic radiography, ultrasonography, computed tomography, magnetic resonance imaging, and nuclear medicine methods such as positron emission tomography. Of these modalities, ultrasound imaging is easy to use for the detection of noninvasive and soft tissue-related diseases. Doppler ultrasound images taken in the B-mode can provide vascular information associated with the morphology of soft tissues. Thus, ultrasound imaging plays an important role in confirming the diagnosis of many kinds of diseases in such oral and maxillofacial regions as the tongue, lymph nodes, salivary glands, and masticatory muscles. In the present article, we introduce three new applications of ultrasonography: guided fine-needle aspiration, measurement of tongue cancer thickness, and diagnosis of metastasis to cervical lymph nodes. PMID:20445749

Wakasugi-Sato, Nao; Kodama, Masaaki; Matsuo, Kou; Yamamoto, Noriaki; Oda, Masafumi; Ishikawa, Ayataka; Tanaka, Tatsurou; Seta, Yuji; Habu, Manabu; Kokuryo, Shinya; Ichimiya, Hisashi; Miyamoto, Ikuya; Kito, Shinji; Matsumoto-Takeda, Shinobu; Wakasugi, Tetsuro; Yamashita, Yoshihiro; Yoshioka, Izumi; Takahashi, Tetsu; Tominaga, Kazuhiro; Morimoto, Yasuhiro

2010-01-01

224

Advanced clinical usefulness of ultrasonography for diseases in oral and maxillofacial regions.  

PubMed

Various kinds of diseases may be found in the oral and maxillofacial regions and various modalities may be applied for their diagnosis, including intra-oral radiography, panoramic radiography, ultrasonography, computed tomography, magnetic resonance imaging, and nuclear medicine methods such as positron emission tomography. Of these modalities, ultrasound imaging is easy to use for the detection of noninvasive and soft tissue-related diseases. Doppler ultrasound images taken in the B-mode can provide vascular information associated with the morphology of soft tissues. Thus, ultrasound imaging plays an important role in confirming the diagnosis of many kinds of diseases in such oral and maxillofacial regions as the tongue, lymph nodes, salivary glands, and masticatory muscles. In the present article, we introduce three new applications of ultrasonography: guided fine-needle aspiration, measurement of tongue cancer thickness, and diagnosis of metastasis to cervical lymph nodes. PMID:20445749

Wakasugi-Sato, Nao; Kodama, Masaaki; Matsuo, Kou; Yamamoto, Noriaki; Oda, Masafumi; Ishikawa, Ayataka; Tanaka, Tatsurou; Seta, Yuji; Habu, Manabu; Kokuryo, Shinya; Ichimiya, Hisashi; Miyamoto, Ikuya; Kito, Shinji; Matsumoto-Takeda, Shinobu; Wakasugi, Tetsuro; Yamashita, Yoshihiro; Yoshioka, Izumi; Takahashi, Tetsu; Tominaga, Kazuhiro; Morimoto, Yasuhiro

2010-01-01

225

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))

1990-09-15

226

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. PMID:24143321

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

2013-01-01

227

Diagnostic Value of Ultrasonography and Magnetic Resonance Imaging in Ulnar Neuropathy at the Elbow  

PubMed Central

Aim. To evaluate the diagnostic value of ultrasonography and magnetic resonance imaging (MRI) in patients with ulnar neuropathy at the elbow (UNE). Methods. We prospectively performed electrodiagnostic, ultrasonographic, and MRI studies in UNE patients and healthy controls. Three cross-sectional area (CSA) measurements of the ulnar nerve at multiple levels along the arm and maximum CSA(-max) were recorded. Results. The ulnar nerve CSA measurements were different between the UNE severity grades (P < 0.05). CSA-max had the greatest sensitivity (93%) and specificity (68%). Moreover, CSA-max ?10?mm2 defined the severe UNE cases (sensitivity/specificity: 82%/72%). In MRI, ulnar nerve hyperintensity had the greatest sensitivity (90%) and specificity (80%). Conclusion. Ultrasonography using CSA-max is sensitive and specific in UNE diagnosis and discriminating the severe UNE cases. Furthermore, MRI particularly targeting at increased signal of the ulnar nerve can be a useful diagnostic test of UNE. PMID:22888452

Ayromlou, Hormoz; Tarzamni, Mohammad K.; Daghighi, Mohammad Hossein; Pezeshki, Mohammad Zakaria; Yazdchi, Mohammad; Sadeghi-Hokmabadi, Elyar; Sharifipour, Ehsan; Ghabili, Kamyar

2012-01-01

228

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. PMID:22511435

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

2012-01-01

229

Patient satisfaction and quality of care at four diagnostic imaging procedures: mammography, double-contrast barium enema, abdominal ultrasonography and vaginal ultrasonography.  

PubMed

The objective of this study was to measure patient satisfaction and to investigate the practical implications of monitoring the quality of care at four radiology procedures. A survey was conducted immediately after the examinations in eight radiology departments: 550 patients attending for mammography, 110 for double-contrast barium enema (DCBE), 97 for abdominal ultrasonography and 90 for vaginal ultrasonography. Outcome measures were seven questionnaire scales: pain, emotional distress, information received, staff's punctuality and technical ability, facilities, and general satisfaction. Response rate was 87 %. Multivariate regression analysis showed significant differences between procedures on all scales (p < 0.001). Differences considered to be of practical importance, i. e. >/= 7 scale points, were detected on five of the scales. Mammography and DCBE caused the most pain, and vaginal US and DCBE caused the most distress. The US procedures entailed dissatisfaction with information about the procedures. The DCBE patients recorded dissatisfaction with the staff's lack of punctuality, and these and the mammography patients recorded dissatisfaction with the facilities. The findings indicate a potential for improving patients' experiences. Several aspects of care, i. e. pain management, attention to the patient's emotional concerns, explanation of procedures, punctuality and quality of the facilities, can be improved. PMID:10460397

Loken, K; Steine, S; Laerum, E

1999-01-01

230

The relationship between inferior vena cava diameter measured by bedside ultrasonography and central venous pressure value  

PubMed Central

Objective: We aimed to present inferior vena cava (IVC) diameter as a guiding method for detection of relationship between IVC diameter measured noninvasively with the help of ultrasonography (USG) and central venous pressure (CVP) and evaluation of patient's intravascular volume status. Methods: Patients over the age of 18, to whom a central venous catheter was inserted to their subclavian vein or internal jugular vein were included in our study. IVC diameter measurements were recorded in millimeters following measurement by the same clinician with the help of USG both at the end-inspiratory and end-expiratory phase. CVP measurements were viewed on the monitor by means of piezoelectric transducer and recorded in mmHg. SPSS 18.0 package program was used for statistical analysis of data. Results: Forty five patients were included in the study. The patients had the diagnosis of malignancy (35.6%), sepsis (13.3%), pneumonia, asthma, chronic obstructive pulmonary disease (11.1%). 11 patients (24.4%) required mechanical ventilation while 34 (75.6%) patients had spontaneous respiration. In patients with spontaneous respiration, a significant relationship was found between IVC diameters measured by ultrasonography at the end of expiratory and inspiratory phases and measured CVP values at the same phases (for expiratory p = 0.002, for inspiratory p= 0.001). There was no statistically significant association between IVC diameters measured by ultrasonography at the end of expiration and inspiration and measured CVP values at the same phases in mechanically ventilated patients. Conclusions: IVC diameter measured by bedside ultrasonography can be used for determination of the intravascular volume status of the patients with spontaneous respiration. PMID:24772133

Citilcioglu, Serenat; Sebe, Ahmet; Oguzhan Ay, Mehmet; Icme, Ferhat; Avci, Akkan; Gulen, Muge; Sahan, Mustafa; Satar, Salim

2014-01-01

231

Comparison of digital radiography, ultrasonography, and positive contrast vaginourethrography for determining reproductive status of female cats.  

PubMed

It is not always possible to identify female cats that have undergone previous ovariohysterectomy based on physical examination alone. An easy, cost-effective method for screening female cats for reproductive status would be helpful for avoiding unnecessary exploratory laparotomies. The purpose of this prospective study was to compare diagnostic sensitivities of digital radiography, ultrasonography, and positive contrast vaginourethrography for determining reproductive status in female cats. Sixty-seven recently euthanized female cats of unknown medical history and reproductive status were randomly selected and included in the study. Digital abdominal radiography, digital abdominal radiography with compression, abdominal ultrasonography, and positive contrast vaginourethrography were performed in sequence by a board-certified veterinary radiologist and a second-year radiology resident. Immediately following diagnostic imaging procedures, necropsy was performed. Ultrasonography of the uterus had the highest sensitivity (86%) for determining reproductive status of all the imaging modalities tested. The specificity was 88%, and the positive predictive value and negative predictive value were 96% and 68%, respectively. The calculated sensitivities and specificities of other modalities were as follows: digital radiographs (28%, 100%), digital compression radiographs (58%, 100%), and vaginourethrography (32%, 100%). Based on McNemar's test statistic, there was a significant difference in the sensitivity of ultrasound compared to digital radiographs (P ? 0.05), compression radiographs (P ? 0.05), and vaginourethrogram (P ? 0.05). Findings from the current study indicated that ultrasonography is a sensitive diagnostic test for determining reproductive status in female cats. Although more readily available in private practice and shelters, digital radiography and vaginourethrography are not reliable predictors of reproductive status. PMID:24372970

Woodland, Meghan; Pack, LeeAnn; Rist, Paul; Crane, Bronwyn

2014-01-01

232

Role of transcranial Doppler ultrasonography in evaluation of patients with cerebrovascular disease  

Microsoft Academic Search

Transcranial Doppler ultrasonography (TCD) is the only noninvasive examination method that enables the reliable evaluation\\u000a of blood flow from the basal intracerebral vessels, adding physiologic information to the anatomic images. TCD is relatively\\u000a inexpensive, can be performed at bedside, and allows monitoring in acute emergency settings and for prolonged periods with\\u000a a high temporal resolution, making it ideal for studying

Vijay K. Sharma; Georgios Tsivgoulis; Annabelle Y. Lao; Andrei V. Alexandrov

2007-01-01

233

The role of optic nerve ultrasonography in the diagnosis of elevated intracranial pressure  

Microsoft Academic Search

Objective: To evaluate the convenience and utility of optic nerve ultrasonography (ONUS) in the evaluation of emergency patients with elevated intracranial pressure (EICP) due to traumatic or non-traumatic causes.Methods: This study was conducted between May 2005 and December 2005 in the emergency department of Meram Faculty of Medicine, Selcuk University. Patients with traumatic or non-traumatic EICP were included in the

Abdullah Sadik Girisgin; Erdal Kalkan; Sedat Kocak; Basar Cander; Mehmet Gul; Mustafa Semiz

2007-01-01

234

Standardized grey scale ultrasonography in Graves' disease: correlation to autoimmune activity  

Microsoft Academic Search

Objective: Graves' disease leads to thyroid enlargement and to reduction of tissue echogenicity. Our purpose was to correlate grey scale ultrasonography of the thyroid gland with clinical and laboratory findings in patients with Graves' disease. Design: Fifty-three patients with Graves'disease were included in our study, 100 euthyroid volunteers served as control group. Free thyroxine (FT4), TSH and TRAb (TSH receptor

Uwe Schiemann; Reinhold Gellner; Britta Riemann; Gabriela Schierbaum; Josef Menzel; Wolfram Domschke; Karin Hengst

1999-01-01

235

Current status of magnetic resonance imaging (MRI) and ultrasonography fusion software platforms for guidance of prostate biopsies.  

PubMed

Prostate MRI is currently the best diagnostic imaging method for detecting PCa. Magnetic resonance imaging (MRI)/ultrasonography (US) fusion allows the sensitivity and specificity of MRI to be combined with the real-time capabilities of transrectal ultrasonography (TRUS). Multiple approaches and techniques exist for MRI/US fusion and include direct 'in bore' MRI biopsies, cognitive fusion, and MRI/US fusion via software-based image coregistration platforms. PMID:24298917

Logan, Jennifer K; Rais-Bahrami, Soroush; Turkbey, Baris; Gomella, Andrew; Amalou, Hayet; Choyke, Peter L; Wood, Bradford J; Pinto, Peter A

2014-11-01

236

Intervention on the left main coronary artery. Importance of periprocedural and follow-up intravascular ultrasonography guidance  

PubMed Central

Periprocedural intravascular ultrasonography guidance for left main coronary artery stenting is well established. However, the role of this tool is also important at follow-up interventions. We present a case of a patient with previous history of left main coronary artery angioplasty. During a recent attempt to treat tight stenosis in the left anterior descending coronary artery, it was not possible to advance the stent into the left main coronary artery. Intravascular ultrasonography explained the difficulties encountered. PMID:25061462

Chmielak, Zbigniew; Pregowski, Jerzy; Rewicki, Marek; Karcz, Maciej

2014-01-01

237

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: ftercan@yahoo.com; 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)

2008-05-15

238

Contrast-enhanced ultrasonography follow-up after radiofrequency ablation in normal rabbit kidney  

PubMed Central

Introduction The aim of this study was to evaluate the diagnostic performance of SonoVue-enhanced ultrasonography in the follow-up of rabbit kidney lesions induced by percutaneous radiofrequency ablation. Material and methods New Zealand rabbits (28) underwent percutaneous radiofrequency ablation (RFA) to generate renal lesions. Lesions were evaluated by conventional 2D ultrasound and contrast-enhanced ultrasonography (CEUS) at 1 day, 1 week, 1 month and 3 months after RFA, and the results were compared to gross pathology. Results One day and 1 week after RFA, renal lesions were wedge-shaped in the gross dissection cross-sectional profiles. Conventional ultrasound could not indicate the extent of the lesions; however, CEUS could exactly delineate the lesion shape and size. At 1 and 3 months, lesions were observed as hyperechogenic areas on conventional ultrasound, and as small perfusion defects on CEUS. The differences in the lesion measurements obtained by CEUS and in pathological specimens were not statistically significant (p > 0.05). Conclusions The conclusion could be deduced from the study that SonoVue-enhanced ultrasonography was effective for the follow-up of normal rabbit kidney percutaneous radiofrequency ablation. PMID:24049518

Wu, Rong; Xu, Fan-hua; Yao, Ming-hua; Xie, Juan

2013-01-01

239

Verifying complete obliteration of carotid artery-cavernous sinus fistula: role of color Doppler ultrasonography.  

PubMed

The purpose of this study was to evaluate the role of color Doppler ultrasonography in verifying obliteration of carotid artery-cavernous sinus fistula before and after therapeutic embolization or gamma knife radiosurgery. Before treatment, carotid artery-cavernous sinus fistula showed the following data on color Doppler ultrasonography: (1) increased blood flow in the common carotid artery (220 to 1264 ml/min with mean+/-SD of 728+/-378 ml/min); internal carotid artery (435 to 1097 ml/min with mean+/-SD of 834+/-216 ml/min) in fistulas of the direct type; and external carotid artery (85 to 257 ml/min with mean+/-SD of 170+/-75 ml/min) in fistulas of the indirect type in comparison to the contralateral side; (2) reverse pulsatile flow or spiculated wave form with turbulent flow in the engorged superior ophthalmic vein on the lesion side in all patients. All of the above abnormal hemodynamic changes became normal in six patients immediately after first embolization, in two patients with balloon embolization combined with subsequent direct embolization by direct puncture through the superior orbital fissure or internal carotid artery embolization, and in five patients after gamma knife radiosurgery at 4, 4, 8, 9, and 9 months, respectively. Color Doppler ultrasonography might be a good modality in long-term follow-up of carotid artery-cavernous sinus fistula after gamma knife radiosurgery and embolization. PMID:9586700

Chiou, H J; Chou, Y H; Guo, W Y; Teng, M M; Hsu, C C; Tiu, C M; Lirng, J F; Luo, C B; Shiau, C Y; Pan, D H

1998-05-01

240

Changes in cerebral hemodynamics assessed by transcranial Doppler ultrasonography in children after head injury  

Microsoft Academic Search

Introduction. Head injury is an important factor in children's morbidity and mortality. Arterial vasospasm and probably resulting from this, delayed ischemic deficit are important sequels of head trauma with detrimental effects on outcome. These problems have already been well studied in adults, but not in children. The noninvasiveness and ease in use of transcranial Doppler ultrasound technique (TCD) make it

Marek Mandera; Dawid Larysz; Maciej Wojtacha

2002-01-01

241

Ultrasonographic reference values for assessing normal radial nerve ultrasonography in the normal population  

PubMed Central

High-resolution ultrasound has been used recently to characterize median and ulnar nerves, but is seldom used to characterize radial nerves. The radial nerve is more frequently involved in entrapment syndromes than the ulnar and median nerves. However, the reference standard for normal radial nerves has not been established. Thus, this study measured the cross-sectional areas of radial nerves of 200 healthy male or female volunteers, aged 18 to 75, using high-resolution ultrasound. The results showed that mean cross-sectional areas of radial nerves at 4 cm upon the lateral epicondyle of the humerus and mid-humerus (midpoint between the elbow crease and axilla) were 5.14 ± 1.24 and 5.08 ± 1.23 mm2, respectively. The age and the dominant side did not affect the results, but the above-mentioned cross-sectional areas were larger in males (5.31 ± 1.25 and 5.19 ± 1.23 mm2) than in females (4.93 ± 1.21 and 4.93 ± 1.23 mm2, respectively). In addition, the cross-sectional areas of radial nerves were positively correlated with height and weight (r = 0.38, 0.36, respectively, both P < 0.05). These data provide basic clinical data for the use of high-resolution ultrasound for the future diagnosis, treatment, and prognostic evaluation of peripheral neuropathies.

Chen, Jun; Wu, Shan; Ren, Jun

2014-01-01

242

Correlation of Glottal Closure Using Concurrent Ultrasonography and Nasolaryngoscopy in Children: A Novel Approach to Evaluate Glottal Status  

PubMed Central

Objectives Endoscopic procedures to assess aerodigestive symptoms by evaluating glottal motion are not practical in neonates because of small nares, respiratory difficulties, or additional stress. Our objective was to determine the temporal correlation between concurrent nasolaryngoscopy (NLS) and ultrasonography (USG) evaluation of glottal motion. Methods Simultaneous USG of the glottis was performed in 10 subjects (5 males, 5 females, age = 4.5 months to 7.1 years) that underwent diagnostic flexible outpatient NLS. The USG transducer was placed on the anterior neck at the level of the vocal cords. The video signals from NLS and USG were integrated and synchronized into real-time cine loops of 1-min duration. Results Frame-by-frame evaluation of 10,800 frames identifying glottal opening and closure time was compared between the two modalities by three observers and the timing of glottal closure was marked. Two investigators, blinded to NLS images, identified ultrasonographically determined glottal closure with 99% and 100% accuracy, and the mean probability of missing a closure frame was 0.007 (95% CI = 0.0008–0.024). Conclusions Temporal characteristics of glottal motion can be quantified by USG with perfect reliability and safety. This method can be useful in measuring the presence and the duration of laryngeal adduction. PMID:16786412

Jadcherla, Sudarshan R.; Gupta, Alankar; Stoner, Erin; Coley, Brian D.; Wiet, Gregory J.; Shaker, Reza

2014-01-01

243

Muscle ultrasonography for detecting fasciculations in frontotemporal dementia.  

PubMed

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

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

2014-12-01

244

Automatic detection and measurement of femur length from fetal ultrasonography  

NASA Astrophysics Data System (ADS)

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

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

2010-03-01

245

Endoscopic ultrasonography for pancreatic cancer: current and future perspectives  

PubMed Central

A suspected pancreatic lesion can be a difficult challenge for the clinician. In the last years we have witnessed tumultuous technological improvements of the radiological and nuclear medicine imaging. Taking this into account, we will try to delineate the new role of endoscopic ultrasound (EUS) in pancreatic imaging and to place it in a shareable diagnostic and staging algorithm of pancreatic cancer (PC). To date the most accurate imaging techniques for the PC remain contrast-enhanced computed tomography (CT) and EUS. The latter has the highest accuracy in detecting small lesions, in assessing tumor size and lymph nodes involvement, but helical CT or an up-to-date magnetic resonance imaging (MRI) must be the first choice in patients with a suspected pancreatic lesion. After this first step there is place for EUS as a second diagnostic level in several cases: negative results on CT/MRI scans and persistent strong clinical suspicion of PC, doubtful results on CT/MRI scans or need for cyto-histological confirmation. In the near future there will be great opportunities for the development of diagnostic and therapeutic EUS and pancreatic pathology could be the best testing bench. PMID:23730519

Brizzi, Rosario Francesco; Pellicano, Rinaldo

2013-01-01

246

Chromatin and cytoplasmic characteristics of equine oocytes recovered by transvaginal ultrasound-guided follicle aspiration are influenced by the developmental stage of their follicle of origin.  

PubMed

Dynamic follicular changes occur during the equine estrus cycle, but little is known about their impact on the properties of recovered oocytes. The aim of this study was to characterize the cytoplasmic and chromatin status of equine oocytes in relation to the time of recovery during the follicle wave. Transvaginal ultrasound-guided follicle aspiration was performed two times in relation to the follicle wave: estrus-subordinate, from the subordinate follicles of mares in estrus, 24 hours after human chorionic gonadotropin stimulation of a dominant preovulatory follicle, and new-wave, from the follicles of the subsequent induced follicular wave, at the time of dominant follicle divergence (largest follicle 23 mm diameter). A total of 1011 follicles were aspirated. The oocyte recovery rate in the new-wave group was significantly lower than that for the estrus-subordinate group (12% vs. 26%, respectively); this was associated with a significantly higher proportion of oocytes with compact cumuli (44% vs. 27%, respectively). Estradiol concentrations were markedly higher in follicular fluid from new-wave follicles (885.6 ± 123.2 ng/mL vs. 54.3 ± 18.9 ng/mL, for estrus-subordinate; P < 0.001), indicating greater viability. Aspiration group did not affect glucose-6-phosphate dehydrogenase activity in recovered oocytes. Fibrillar (more juvenile) chromatin was more prevalent in new-wave oocytes, whereas estrus-subordinate oocytes showed more condensed chromatin or resumption of meiosis (P < 0.05). Mitochondrial activity was higher in oocytes with expanded cumuli in the new-wave group, but not in the estrus-subordinate group. In conclusion, our results clearly showed that the time of aspiration in relation to the follicle wave is associated with significant differences in follicle status and oocyte characteristics: new-wave oocytes were from a more viable follicle population and had more juvenile chromatin and cytoplasmic characteristics, whereas estrus-subordinate oocytes were from a more atretic follicle population and exhibited signs of atresia-related acquisition of meiotic and cytoplasmic competence. These findings will help in effective scheduling of oocyte recovery for equine-assisted reproduction techniques. PMID:23623162

Vernunft, Andreas; Alm, Hannelore; Tuchscherer, Armin; Kanitz, Wilhelm; Hinrichs, Katrin; Torner, Helmut

2013-07-01

247

Diagnostic sensitivity and interobserver agreement of radiography and ultrasonography for detecting trochlear ridge osteochondrosis lesions in the equine stifle.  

PubMed

Osteochondrosis lesions commonly occur on the femoral trochlear ridges in horses and radiography and ultrasonography are routinely used to diagnose these lesions. However, poor correlation has been found between radiographic and arthroscopic findings of affected trochlear ridges. Interobserver agreement for ultrasonographic diagnoses and correlation between ultrasonographic and arthroscopic findings have not been previously described. Objectives of this study were to describe diagnostic sensitivity and interobserver agreement of radiography and ultrasonography for detecting and grading osteochondrosis lesions of the equine trochlear ridges, using arthroscopy as the reference standard. Twenty-two horses were sampled. Two observers independently recorded radiographic and ultrasonographic findings without knowledge of arthroscopic findings. Imaging findings were compared between observers and with arthroscopic findings. Agreement between observers was moderate to excellent (? 0.48-0.86) for detecting lesions using radiography and good to excellent (? 0.74-0.87) for grading lesions using radiography. Agreement between observers was good to excellent (? 0.78-0.94) for detecting lesions using ultrasonography and very good to excellent (? 0.86-0.93) for grading lesions using ultrasonography. Diagnostic sensitivity was 84-88% for radiography and 100% for ultrasonography. Diagnostic specificity was 89-100% for radiography and 60-82% for ultrasonography. Agreement between radiography and arthroscopy was good (? 0.64-0.78). Agreement between ultrasonography and arthroscopy was very good to excellent (? 0.81-0.87). Findings from this study support ultrasound as a preferred method for predicting presence and severity of osteochondrosis lesions involving the femoral trochlear ridges in horses. PMID:23278908

Beccati, Francesca; Chalmers, Heather J; Dante, Sara; Lotto, Eleonora; Pepe, Marco

2013-01-01

248

Contribution of subcutaneous abdominal fat on ultrasonography to carotid atherosclerosis in patients with type 2 diabetes mellitus  

PubMed Central

Background Whereas visceral abdominal adipose tissue (VAT) is associated with cardiometabolic risk, there is debate regarding the role of subcutaneous abdominal adipose tissue (SAT). The aim of this study was to investigate the relationships of subcutaneous and visceral abdominal fat with carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM). Methods A total of 234 patients (men 131, women 103, mean age: 53 years) with T2DM were enrolled. Carotid intima-media thickness (CIMT), abdominal subcutaneous fat thickness (SFT) and visceral fat thickness (VFT) were assessed by high-resolution B-mode ultrasonography (US). Results Compared to women, men had significantly higher VFT and lower SFT (p?=?0.002, p?=?0.04, respectively). In partial correlation coefficient analyses between CIMT and abdominal fat thickness after adjustment for body mass index (BMI), SFT showed a negative correlation with CIMT in men (r?=?-0.27, p?=?0.03). VFT was not correlated with CIMT in either men or women. In women, SFT was not correlated with CIMT (r?=?-0.01, p?=?0.93). VFT/SFT ratio was not correlated with CIMT in either men or women. In multivariate regression analyses adjusted for BMI and other CVD risk factors, SFT but not VFT was independently inversely associated with CIMT in men but not in women (p?assessed by US was inversely associated with carotid atherosclerosis in patients with T2DM, particularly men. Further research into the different roles of the two types of abdominal adipose tissue in both men and women is warranted. PMID:24678948

2014-01-01

249

Low-intensity pulsed ultrasonography versus electrical stimulation for fracture healing: a systematic review and network meta-analysis  

PubMed Central

Background To best inform evidence-based patient care, it is often desirable to compare competing therapies. We performed a network meta-analysis to indirectly compare low intensity pulsed ultrasonography (LIPUS) with electrical stimulation (ESTIM) for fracture healing. Methods We searched the reference lists of recent reviews evaluating LIPUS and ESTIM that included studies published up to 2011 from 4 electronic databases. We updated the searches of all electronic databases up to April 2012. Eligible trials were those that included patients with a fresh fracture or an existing delayed union or nonunion who were randomized to LIPUS or ESTIM as well as a control group. Two pairs of reviewers, independently and in duplicate, screened titles and abstracts, reviewed the full text of potentially eligible articles, extracted data and assessed study quality. We used standard and network meta-analytic techniques to synthesize the data. Results Of the 27 eligible trials, 15 provided data for our analyses. In patients with a fresh fracture, there was a suggested benefit of LIPUS at 6 months (risk ratio [RR] 1.17, 95% confidence interval [CI] 0.97–1.41). In patients with an existing nonunion or delayed union, ESTIM had a suggested benefit over standard care on union rates at 3 months (RR 2.05, 95% CI 0.99–4.24). We found very low-quality evidence suggesting a potential benefit of LIPUS versus ESTIM in improving union rates at 6 months (RR 0.76, 95% CI 0.58–1.01) in fresh fracture populations. Conclusion To support our findings direct comparative trials with safeguards against bias assessing outcomes important to patients, such as functional recovery, are required. PMID:24869616

Ebrahim, Shanil; Mollon, Brent; Bance, Sheena; Busse, Jason W.; Bhandari, Mohit

2014-01-01

250

Imaging techniques for the pre-surgical diagnosis of adnexal tumours.  

PubMed

A correct diagnosis of any adnexal mass is essential to triage women to appropriate treatment pathways. Several imaging techniques are available that may be used to provide an assessment of a mass before treatment, such as transvaginal ultrasonography, magnetic resonance imaging, computed tomography, and positron emission tomography combined with computed tomography. In this chapter, we focus in depth on the role of transvaginal ultrasonography, as current evidence suggests it is the most appropriate initial imaging investigation to identify and characterise any mass if present in women suspected of having adnexal pathology. Subjective assessment by an experienced ultrasound examiner is the optimal approach to diagnose masses, followed by risk models and rules developed by the International Ovarian Tumor Analysis study. A group of tumours has proven difficult to classify with transvaginal ultrasound, and remain a diagnostic challenge for which accurate second-stage tests would be of value. Some studies suggest that magnetic resonance imaging (MRI), compared with other imaging modalities, may play a role in the assessment of this cohort of 'difficult to classify' adnexal masses. These studies, however, did not report quality of transvaginal ultrasonography (i.e. experience level of the examiner) and lacked uniformity in describing the criteria used to define such 'difficult' masses. On the basis of standardised terminology developed by the International Ovarian Tumor Analysis study to describe adnexal masses, as well as prediction models and rules developed in the course of the study, we propose new criteria that we can use to clearly define complex or 'difficult to classify' adnexal masses to focus the role for second-line imaging tests, such as conventional magnetic resonance imaging combined with dynamic contrast-enhanced or diffusion-weighted sequences on masses where further tests other than ultrasonography would be of value. PMID:24780415

Kaijser, Jeroen; Vandecaveye, Vincent; Deroose, Christophe M; Rockall, Andrea; Thomassin-Naggara, Isabelle; Bourne, Tom; Timmerman, Dirk

2014-07-01

251

[Varicose vein recurrence after surgery of the sapheno-femoral junction: color Doppler ultrasonography study].  

PubMed

The aim of this study was to evaluate the accuracy and sensitivity of colour Doppler ultrasonography for the diagnosis of postoperative recurrent varicose veins in patients submitted to surgical ligation of the saphenofemoral junction with a view to classifying the recurrences according to the causes. We studied 401 lower limbs in the orthostatic position with colour Doppler ultrasonography in 318 patients (64 M and 254 F) presenting postoperative varicose vein recurrence during the follow-up (12-60 months). We evaluated the type of reflux at the inguinal level under the Valsalva manoeuvre and divided them into 5 types. We observed an incomplete crossectomy (type 1) in 23.2% of the cases; an incontinent saphenofemoral junction, intact and in an anatomical site in 12.5% (type 2); a major tributary (double saphena) originating from the common femoral vein near to the crossectomy site in 10.2% (type 3); neovascularization in 9.7% (type 4) and the presence of a number of major tributaries from the veins of the perineal and pudendal region or from the abdominal parietal veins in 44.4% (type 5). In all cases it was possible to note and classify the type of recurrence. Colour Doppler ultrasonography is an accurate, reliable tool for the diagnosis and classification of postoperative varicose vein recurrences in patients submitted to surgical obliteration of the saphenofemoral junction. It is decisive in the preoperative evaluation and follow-up of patients. In our experience, more than one half of the cases of recurrence were not due to an error of surgical technique. PMID:14725231

Roscitano, Giuseppe; Mirenda, Francesco; Mandolfino, Tommaso; De Caridi, Giovanni; Stilo, Francesco; Benedetto, Filippo; Spinelli, Francesco

2003-01-01

252

Fibromatosis Associated with Silicone Breast Implant: Ultrasonography and MR Imaging Findings.  

PubMed

Desmoid type fibromatosis is an uncommon benign disease entity of which its etiology is currently unknown. It constitutes 0.3% of all solid neoplasms, but it is rarely seen in the breast and even more scarcely reported to develop in association with breast implant. We present ultrasonography and magnetic resonance imaging findings of a 29-year-old female patient with fibromatosis after breast implant surgery. Knowledge of imaging findings of breast fibromatosis associated with implant will be helpful for accurate diagnosis and appropriate management. PMID:25251931

Shim, Hyun Seok; Kim, Seon-Jeong; Kim, Ok Hwa; Jung, Hyun Kyung; Kim, Suk Jung; Kim, Woogyeong; Kim, Woon Won

2014-11-01

253

Characterization of primary hepatic carcinosarcoma by contrast-enhanced ultrasonography: A case report  

PubMed Central

Primary hepatic carcinosarcoma is a rare tumor and is comprised of a mixture of carcinomatous and sarcomatous elements. We present a case of primary carcinosarcoma of the liver in a 59-year-old woman, which was confirmed by pathology following surgical resection. Using contrast-enhanced ultrasonography, the tumor showed peripheral nodular hyperenhancement in the arterial phase with two feeding arterial vessels and a large internal non-enhancing portion in the center. The peripheral nodular portion of the tumor showed hypoenhancement in the later phase. PMID:24587642

Liu, Li-Ping; Yu, Xiao-Ling; Liang, Ping; Dong, Bao-Wei

2014-01-01

254

Sciatic hernia clinically mimicking obturator hernia, missed by ultrasonography: case report.  

PubMed

Sciatic hernia is a rare pelvic floor hernia that occurs through the greater or lesser sciatic foramen. Sciatic hernias often present as pelvic pain, particularly in women, and diagnosis can be difficult. Sciatic hernia is one of the rarest forms of internal hernia, which can present as signs and symptoms of small bowel obstruction, swelling in the respective gluteal region or pelvic pain. Transabdominal and transgluteal operative approaches, including laparoscopic repair, have been reported. We present a case of left-sided sciatic hernia with incarcerated small bowel as its contents. The hernia was missed by ultrasonography and plain abdominal radiography, but the clinical features were suggestive of an obturator hernia. PMID:21935810

Rather, Shiraz Ahmad; Dar, Tanveer Iqbal; Malik, Aijaz Ahmad; Parray, Fazal Q; Ahmad, Mukhtar; Asrar, Syed

2011-05-01

255

Musculoskeletal Ultrasonography  

Microsoft Academic Search

\\u000a Musculoskeletal ultrasound (US) applications continue to show considerable expansion mainly because of technical improvements\\u000a (development of high-frequency broadband transducers, refined focusing, and sensitive colour and power Doppler technology)\\u000a and the growing interest of musculoskeletal radiologists. Its low cost, non-invasivity, and possibility to perform the examination\\u000a directly, e.g., in sport fields, are additional qualities appreciated by the patients. Up to-date, high-level

Eugene Mcblally; Stefano Bianchi

256

Vascular Waveform Analysis of Flap-Feeding Vessels Using Color Doppler Ultrasonography  

PubMed Central

We performed vascular waveform analysis of flap-feeding vessels using color Doppler ultrasonography and evaluated the blood flow in the flaps prior to surgery. Vascular waveform analysis was performed in 19 patients. The analyzed parameters included the vascular diameter, flow volume, flow velocity, resistance index, pulsatility index, and acceleration time. The arterial waveform was classified into 5 types based on the partially modified blood flow waveform classification reported by Hirai et al.; in particular, D-1a, D-1b, and D-2 were considered as normal waveforms. They were 4 patients which observed abnormal vascular waveform among 19 patients (D-4?:?1, D-3?:?1, and Poor detect?:?2). The case which presented D-4 waveform changed the surgical procedure, and a favorable outcome was achieved. Muscle flap of the case which presented D-3 waveform was partially necrosed. The case which detected blood flow poorly was judged to be the vascular obstruction of the internal thoracic artery. In the evaluation of blood flow in flaps using color Doppler ultrasonography, determination of not only basic blood flow information, such as the vascular distribution and diameter and flow velocity, but also the flow volume, vascular resistance, and arterial waveform is essential to elucidate the hemodynamics of the flap. PMID:24804093

Onishi, Kiyoshi

2014-01-01

257

The value of high-frequency and color Doppler ultrasonography in diagnosing congenital muscular torticollis  

PubMed Central

Background Congenital muscular torticollis (CMT) is a relatively common neck deformity in infancy. The aim of our research was to determine the value of high-frequency and color Doppler ultrasonography in diagnosing CMT. Methods Patients with a clinical suspicion of CMT underwent an ultrasound examination before diagnosis, and the sonographic characteristics were analyzed and compared with the clinical findings. Results The sensitivity and specificity of an ultrasound diagnosis for CMT was 95.83% and 83.33%, respectively. The patients were divided into 2 groups based on the stage of the disease: the early-stage group (age <1 year) and the late-stage group(age ?1 year). Differences existed between the two groups with respect to sonographic findings and clinical characteristics. The sonographic characteristics of the early-stage group included local thickening of the sternocleidomastoid muscle (SCM), weak or uneven echoes, and blood flow signals around or inside most of the lesions. The sonographic characteristics of the late-stage group included diffusely hyperechoic, or cord-like hyperechoic signals inside the muscle layer without significant blood flow signals. Conclusions Different stage of CMT patients had different sonographic characteristics. High-frequency and color Doppler ultrasonography can serve as adjunct confirmation tool for the diagnosis of CMT. PMID:23102117

2012-01-01

258

Contrast-enhanced endoscopic ultrasonography improves the preoperative localization of insulinomas.  

PubMed

We report a case in which endoscopic ultrasonography (EUS), intraductal ultrasonography (IDUS) and contrast-enhanced EUS using Levovist helped to localize insulinoma correctly. A 74-year-old woman complained of symptomatic fasting hypoglycemia with relatively high concentration of serum insulin level. Dynamic contrast-enhanced computed tomography revealed a small tumor of 8 mm diameter in the pancreatic head. Insulin secretion was strongly stimulated by calcium injection into the gastroduodenal artery. To clarify the precise localization, we performed EUS, IDUS and contrast-enhanced EUS. The tumor was enhanced clearly by Levovist, and the distance from the main pancreatic duct was more than 3 mm. Therefore, a preoperative decision could be made to use the enucleation method for resection of the tumor. The surgeon could enucleate the tumor in a brief operation according to the preoperative diagnosis, and serum glucose levels returned to normal range after the operation. Contrast-enhanced EUS using Levovist was shown to be a useful diagnostic method for precise localization of small insulinoma. PMID:12402985

Kasono, Keizo; Hyodo, Takafumi; Suminaga, Yoshihisa; Sugiura, Yasuko; Namai, Kazuyuki; Ikoma, Aki; Tamemoto, Hiroyuki; Imawari, Michio; Kawakami, Masanobu; Ishikawa, San-e

2002-08-01

259

Follow-up of low risk patients with papillary thyroid cancer: role of neck ultrasonography in detecting lymph node metastases.  

PubMed

Persistent or recurrent disease is rare in low risk patients with papillary thyroid cancer, and follow-up of these patients is a matter of debate. Neck ultrasonography (US), serum thyroglobulin (Tg), and whole body scan (WBS) after T(4) withdrawal were performed in 456 patients, followed up to 5 yr. At the end of the first year, 335 patients were Tg negative, and 121 were Tg positive; 65 of 96 patients with Tg levels between 1 and 10 ng/ml became spontaneously Tg negative after 2 yr. During follow-up, WBS discovered node metastases in 13 subjects, and US discovered node metastases in 38 subjects (31 Tg positive and 7 Tg negative). WBS did not add any information, because all WBS-positive patients were also US and Tg positive. Fifty percent of metastases were less than 1 cm and not palpable. Finally, the negative predictive value of both negative Tg and US at first follow-up was 98.8%. We suggest a first follow-up based upon US assessment and stimulated (after T(4) withdrawal or recombinant human TSH) serum Tg determination; subsequently, 1) US should not be mandatory at each examination in initially Tg- and US-negative subjects, but is strongly suggested in all other cases; 2) Tg determination should be repeated 1 yr later, after exogenous or endogenous TSH stimulation only in initially Tg-positive patients without any other evidence of residual disease; and 3) Tg measurement during therapy should be sufficient in all other cases. PMID:15240622

Torlontano, Massimo; Attard, Marco; Crocetti, Umberto; Tumino, Salvatore; Bruno, Rocco; Costante, Giuseppe; D'Azzò, Girolamo; Meringolo, Domenico; Ferretti, Elisabetta; Sacco, Rosario; Arturi, Franco; Filetti, Sebastiano

2004-07-01

260

Shear rate specific blood viscosity and shear stress of carotid artery duplex ultrasonography in patients with lacunar infarction  

PubMed Central

Background This study describes a new method for determining site-specific vascular shear stress using dynamic measures of shear rate and blood viscosity (BV) in the carotid arteries, and examines characteristics of carotid arterial shear stress among patients with lacunar infarction. Methods Vascular shear stress measurements were conducted in 37 patients (17 lacunar infarction patients and 20 control subjects) using duplex ultrasonography. Vessel wall diameters and velocities were measured in each arterial segment at peak-systolic (PS) and end-diastolic (ED) phases, for calculation of PS/ED shear rates. PS/ED shear stresses [dyne/cm2] were determined with PS/ED shear rates and shear-rate dependent BV values. For comparison, both values of hematocrit-derived BV and BV measurements at 300 s-1 were used for calculation of shear stress. Results All cardiovascular disease (CVD) risk factors including BV values were similar between the two groups. In both common carotid arteries, PS and ED shear stresses were significantly lower in the patients with lacunar infarction than in controls in multivariate models that included age, sex, and other major CVD risk factors. PS and ED shear stresses using the shear rate specific BV were 4.5% lower and 7.3% higher than those using the two other BVs, respectively. Conclusion Lacunar infarction was associated with reduced carotid arterial shear stress. The use of estimated BV for calculating carotid arterial shear stress provides more accurate assessment of the hemodynamic contribution of shear stress than previous models that have arbitrarily assigned a constant value to this dynamic flow property. PMID:23597083

2013-01-01

261

Effect of Ultrasonography-Guided Botulinum Toxin Type A Injection in Holmes' Tremor Secondary to Pontine Hemorrhage: Case Report  

PubMed Central

Holmes' tremor is a low-frequency rest and intentional tremor secondary to various insults, including cerebral ischemia, hemorrhage, trauma, or neoplasm. Pharmacologic treatment is usually unsuccessful, and some cases require surgical intervention. We report a rare case of Holmes' tremor secondary to left pontine hemorrhage in a 29-year-old Asian male patient who developed 1.6-Hz postural and rest tremor of the right hand. He responded markedly to ultrasonography-guided botulinum toxin type A injection. To our knowledge, this is the first report of Homes' tremor treated with ultrasonography-guided botulinum toxin type A injection with favorable results. PMID:25379500

Ahn, So-Yeon; Kim, Dong-A; Park, Youn-Ok

2014-01-01

262

Incidentally diagnosed Takayasu arteritis on thyroid ultrasonography showing prominent collateral vessels of thyroidal arteries and common carotid artery occlusion  

PubMed Central

We report a case of middle-aged woman incidentally diagnosed with Takayasu arteritis during the ultrasonography of a thyroid gland nodule. Prominent collaterals of the thyroidal arteries and a thin common carotid artery with mural thickening and deficient intraluminal flow signals were initially depicted on the ultrasonography with color Doppler. Subsequent magnetic resonance angiography and computed tomography aortography confirmed the diagnosis with the imaging features of a bilateral long segment common carotid artery occlusion and segmental stenosis of the left subclavian artery in addition to the suggestive physical findings. PMID:25038813

2014-01-01

263

Prenatal Diagnosis of Treacher-Collins Syndrome Using Three-Dimensional Ultrasonography and Differential Diagnosis with Other Acrofacial Dysostosis Syndromes  

PubMed Central

Treacher-Collins syndrome (TCS) is a rare dominant autosomal anomaly resulting from malformation or disruption of the development of the first and second branchial arches. It is characterized by micrognathia, malar hypoplasia, and malformations of the eyes and ears. The prenatal diagnosis using two-dimensional ultrasonography (2DUS) is characterized by identification of facial malformations together with polyhydramnios. Three-dimensional ultrasonography (3DUS) has the capacity to spatially display these facial malformations, thus making it easy for the parents to understand them. We present a case of TCS diagnosed in the 33rd week using 3DUS, with postnatal confirmation using cranial computed tomography and anatomopathological analysis. PMID:23653874

Pereira, Daniela Cardoso; Bussamra, Luiz Claudio Silva; Drummond, Carolina Leite; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes; Aldrighi, Jose Mendes

2013-01-01

264

Prenatal diagnosis of treacher-collins syndrome using three-dimensional ultrasonography and differential diagnosis with other acrofacial dysostosis syndromes.  

PubMed

Treacher-Collins syndrome (TCS) is a rare dominant autosomal anomaly resulting from malformation or disruption of the development of the first and second branchial arches. It is characterized by micrognathia, malar hypoplasia, and malformations of the eyes and ears. The prenatal diagnosis using two-dimensional ultrasonography (2DUS) is characterized by identification of facial malformations together with polyhydramnios. Three-dimensional ultrasonography (3DUS) has the capacity to spatially display these facial malformations, thus making it easy for the parents to understand them. We present a case of TCS diagnosed in the 33rd week using 3DUS, with postnatal confirmation using cranial computed tomography and anatomopathological analysis. PMID:23653874

Pereira, Daniela Cardoso; Bussamra, Luiz Claudio Silva; Araujo Júnior, Edward; Drummond, Carolina Leite; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes; Aldrighi, José Mendes

2013-01-01

265

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

2012-01-01

266

Early Detection of Atrophy of Foot Muscles in Chinese Patients of Type 2 Diabetes Mellitus by High-Frequency Ultrasonography  

PubMed Central

The aim of this study was to evaluate the diagnostic value of high-frequency ultrasonography in detecting atrophy of foot muscles in Chinese patients of type 2 diabetes mellitus (T2DM). Chinese patients of T2DM with (n = 56) or without (n = 50) diabetic peripheral neuropathy (DPN) and the control subjects (n = 50) were enrolled. The nondominant foot of all subjects was examined with high-frequency ultrasonography. The transverse diameter, thickness, and cross-sectional area of the extensor digitorum brevis muscle (EDB) and the thickness of the muscles of the first interstitium (MILs) were measured. The results showed that the ultrasonographic transverse diameter, thickness, and cross-sectional area of EDB and the thickness of MILs in patients of T2DM with DPN were significantly smaller than those in patients of T2DM without DPN (all P < 0.01) and those in the control subjects (all P < 0.01). The transverse diameter and cross-sectional area of the EDB and thickness of MILs in patients of T2DM without DPN were significantly smaller than those of the control subjects (all P < 0.01). In conclusion, the atrophy of foot muscle in Chinese T2DM patients can be detected by high-frequency ultrasonography. Notably, ultrasonography may detect early atrophy of foot muscles in patients without DPN. PMID:25165725

Wang, Xiaohui; Chen, Liang; Liu, Weiwei; Su, Benli; Zhang, Yuhong

2014-01-01

267

Ultrasonography shows increased cross-sectional area of the median nerve in patients with arthritis and carpal tunnel syndrome  

Microsoft Academic Search

Objectives. To examine whether patients with arthritic diseases and carpal tunnel syndrome (CTS) have increased cross- sectional areas of the median nerves measured by ultrasonography (US). Enlarged cross-sectional areas have previously been found in non-arthritic patients with idiopathic CTS. Methods. During 1 yr, all 12 patients with rheumatoid arthritis (RA) or other arthritic diseases hospitalized in our department for surgery

H. B. Hammer; I. A. H. Hovden; E. A. Haavardsholm; T. K. Kvien

2005-01-01

268

'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. PMID:18201492

Chiang, David T; Tan, Elaine I; Birks, David

2008-01-01

269

Transcervical Ultrasonography Is Feasible to Visualize and Evaluate Base of Tongue Cancers  

PubMed Central

Background Base of tongue (BOT) is a difficult subsite to examine clinically and radiographically. Yet, anatomic delineation of the primary tumor site, its extension to adjacent sites or across midline, and endophytic vs. exophytic extent are important characteristics for staging and treatment planning. We hypothesized that ultrasound could be used to visualize and describe BOT tumors. Methods Transcervical ultrasound was performed using a standardized protocol in cases and controls. Cases had suspected or confirmed BOT malignancy. Controls were healthy individuals without known malignancy. Results 100% of BOT tumors were visualized. On ultrasound BOT tumors were hypoechoic (90.9%) with irregular margins (95.5%). Ultrasound could be used to characterize adjacent site involvement, midline extent, and endophytic extent, and visualize the lingual artery. No tumors were suspected for controls. Conclusions Ultrasonography can be used to transcervically visualize BOT tumors and provides clinically relevant characteristics that may not otherwise be appreciable. PMID:24498138

Blanco, Ray Gervacio F.; Califano, Joseph; Messing, Barbara; Richmon, Jeremy; Liu, Jia; Quon, Harry; Neuner, Geoffrey; Saunders, John; Ha, Patrick K.; Sheth, Sheila; Gillison, Maura; Fakhry, Carole

2014-01-01

270

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.

1981-08-01

271

Contrast Agent Ultrasonography before and after HIFU Treatment of Parathyroid Glands  

NASA Astrophysics Data System (ADS)

OBJECTIVES: To observe changes in the parathyroid tissue treated by extracorporeal HIFU. MATERIAL AND METHODS: 5 patients were treated for primary hyperparathyroidism by thermally ablating enlarged parathyroid glands using an external HIFU applicator. The treated glands were visualized with B-Mode and contrast enhanced ultrasonography (CEUS) before, 1 week and 4 weeks post HIFU. Serum iPTH, calcium, and phosphorus levels were monitored before and after the treatment. RESULTS: The initial results showed a correlation between contrast agent uptake of treated parathyroid tissue, the reduction of volume of the gland and the decrease of iPTH levels. CONCLUSIONS These results show it is possible to use CEUS to monitor the thermal ablation of parathyroid glands.

Kovatcheva, Roussanka; Arnaud, Françoise; Lacoste, François

2010-03-01

272

Fusion imaging of real-time ultrasonography with CT or MRI for hepatic intervention  

PubMed Central

With the technical development of ultrasonography (US), electromagnetic tracking-based fusion imaging of real-time US and computed tomography/magnetic resonance (CT/MR) images has been used for percutaneous hepatic intervention such as biopsy and radiofrequency ablation (RFA). Because of the fusion imaging technique, the fused CT or MR images show the same plane and move synchronously while performing real-time US. With this information, fusion imaging can enhance lesion detectability and reduce the false positive detection of focal hepatic lesions with poor sonographic conspicuity. Three-dimensional US can also be fused with realtime US for the percutaneous RFA of liver tumors requiring overlapping ablation. When fusion imaging is not sufficient for identifying small focal hepatic lesions, contrast-enhanced US can be added to fusion imaging. PMID:25036756

2014-01-01

273

Imaging of transplanted islets by positron emission tomography, magnetic resonance imaging, and ultrasonography  

PubMed Central

While islet transplantation is considered a useful therapeutic option for severe diabetes mellitus (DM), the outcome of this treatment remains unsatisfactory. This is largely due to the damage and loss of islets in the early transplant stage. Thus, it is important to monitor the condition of the transplanted islets, so that a treatment can be selected to rescue the islets from damage if needed. Recently, numerous trials have been performed to investigate the efficacy of different imaging modalities for visualizing transplanted islets. Positron emission tomography (PET) and magnetic resonance imaging (MRI) are the most commonly used imaging modalities for this purpose. Some groups, including ours, have also tried to visualize transplanted islets by ultrasonography (US). In this review article, we discuss the recent progress in islet imaging. PMID:24231367

Sakata, Naoaki; Yoshimatsu, Gumpei; Tsuchiya, Haruyuki; Aoki, Takeshi; Mizuma, Masamichi; Motoi, Fuyuhiko; Katayose, Yu; Kodama, Tetsuya; Egawa, Shinichi; Unno, Michiaki

2013-01-01

274

Diagnosis of the cavo-hepato-atrial pathway in Budd-Chiari syndrome by ultrasonography  

PubMed Central

The aim of this study was to investigate the ultrasonic features of the cavo-hepato-atrial pathway in Budd-Chiari syndrome (BCS), by which blood is drained from the occluded inferior vena cava (IVC) to the right atrium via hepatic veins. Ultrasonograms from 11 patients with BCS with cavo-hepato-atrial pathways were retrospectively studied. Doppler ultrasound was used to observe the direction of the flow and measure the velocity of the blood-draining vessels. Blood flow in the draining vessels and the collaterals was shown as blue, red or bicolored depending on whether the flow direction was away from the transducer, towards the transducer or both. For measurement, the Doppler angle between the axis of the Doppler beam and that of the vein examined was always <60°. Ultrasonography was performed 1–2 weeks prior to digital subtraction angiography (DSA). All patients were confirmed by DSA. Membranous and segmental occlusions of IVCs were observed in seven and four cases, respectively. Blood flow from the IVC reversed to the hepatic/accessory hepatic vein, continued through the dilated intrahepatic collaterals, onward to the other hepatic vein and finally to the right atrium. The majority of the inlets (8/11) of hepatic veins above the occlusion were narrow compared with the dilated distant parts of the lumens. Accelerated blood flow in the inlets was detected in all patients regardless of the luminal diameter. In conclusion, the results from the present study suggest that the unusual cavo-hepato-atrial pathway can be diagnosed reliably by ultrasonography, which may be useful for clinical management. PMID:25120601

GAI, YONG-HAO; CAI, SHI-FENG; FAN, HUI-LI; LIU, QING-WEI

2014-01-01

275

Ultrasonography of Median Nerve and Electrophysiologic Severity in Carpal Tunnel Syndrome  

PubMed Central

Objective To investigate the correlation of the ultrasonographic wrist-to-forearm median nerve area ratio (WFR) and cross sectional area of median nerve at the wrist (CSA-W) to the electrophysiologic severity in patients with carpal tunnel syndrome (CTS). Method One hundred and ten wrists electrophysiologically graded as mild, moderate, and severe CTS and 38 healthy controls underwent ultrasonography of median nerve at the distal wrist crease and mid-forearm. WFR and CSA-W were analyzed according to the severity of CTS. Results WFR was 1.12±0.14, 1.91±0.33, 2.27±0.47 and 3.02±0.97 and the CSAs-W was 7.23±1.67 mm2, 13.51±3.72 mm2, 14.67±2.93 mm2, and 18.74±6.01 mm2 in controls, mild (n=28), moderate (n=46), and severe (n=36) CTS, respectively. CSA-W displayed significant differences between the control and the mild CTS, moderate CTS and severe CTS groups. However, there was no significant difference between mild CTS and moderate CTS groups. WFR revealed significant difference between all groups. The sensitivity and specificity of the WFR in grading the severity of CTS were higher than those of the CSA-W. Conclusion Ultrasonography is a useful complementary tool for the evaluation of CTS. Both WFR and CSA-W are highly correlated with severity grade of CTS. However, WFR is superior to CSA-W for diagnosis and grading of the severity of CTS. PMID:22506238

Kang, Seok; Kim, Ki Hoon; Yun, Hyung Seok

2012-01-01

276

The role of optic nerve ultrasonography in the diagnosis of elevated intracranial pressure  

PubMed Central

Objective To evaluate the convenience and utility of optic nerve ultrasonography (ONUS) in the evaluation of emergency patients with elevated intracranial pressure (EICP) due to traumatic or non?traumatic causes. Methods This study was conducted between May 2005 and December 2005 in the emergency department of Meram Faculty of Medicine, Selcuk University. Patients with traumatic or non?traumatic EICP were included in the study. Among these, 28 patients with EICP determined on cranial computed tomography (CCT) and a control group of 26 patients with no disease had the vertical and horizontal diameters of the optic nerves (ONs) of both eyes measured by ultrasonography (US). The measurements were done by wetting the closed eyelids and using a 7.5?MHz linear probe. Results Horizontal and vertical diameters of both ONs of the 54 patients were measured and the averages calculated. The mean (SD) ON diameter for the group suspected of having EICP was found to be 6.4 (0.7)?mm, and that for the control group to be 4.6 (0.3)?mm. In the statistical analysis carried out between these two groups (t test), the difference was found to be significant at p<0.001. Conclusions In detection and follow?up of EICP cases, such as cerebrovascular accident and trauma, ONUS is a practical, risk?free, inexpensive, convenient and, if performed by experts, reliable method. As a result, although CCT may be more useful in diagnosis, ONUS may be more efficient in detecting EICP. In those cases where CCT and other conventional imaging methods are not available, ONUS can facilitate the diagnosis and help in treatment. PMID:17384377

Girisgin, Abdullah Sadik; Kalkan, Erdal; Kocak, Sedat; Cander, Basar; Gul, Mehmet; Semiz, Mustafa

2007-01-01

277

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%. PMID:21493877

Chandak, R; Degwekar, S; Bhowte, RR; Motwani, M; Banode, P; Chandak, M; Rawlani, S

2011-01-01

278

Reasons for disclosure of gender to pregnant women during prenatal ultrasonography  

PubMed Central

Background The objective of this study was to determine the proportion of women who want to know fetal gender on antenatal ultrasonography and the reasons behind this. Methods A descriptive, cross-sectional study was carried out between March 10, 2012 and September 10, 2012 at two tertiary care hospitals (Dow University Hospital, Ojha Campus, and Lady Dufferin Hospital) in Karachi. In total, 223 pregnant women who attended the antenatal clinic and gave their consent were included in the study. Information was collected on a predesigned questionnaire. Results Of the 223 pregnant women, 109 (49.1%) were younger than 25 years. The majority (216, 96.9%) were Muslim, 164 (73.4%) were educated to different levels, 121 (54.3%) spoke Urdu, and 66 (29.6%) were primigravidas. Thirty-four (15.2%) women had a preference for a male child, 24 (10.8%) had a female preference, and 165 (74%) had no preference. Seventy (31.4%) women were interested to know the fetal gender. The association between education and gender preference was found to be statistically significant (P = 0.004) and also that between age and gender preference (P = 0.05), but no relationship was found between gender preference and gender of previous babies (P = 0.317 for males and P = 0.451 for females). Association of ethnicity was also not statistically significant (P = 0.102). Conclusion This study revealed that 31.4% of women were interested in disclosure of gender on prenatal ultrasonography and only15.2% women had a preference for a male child. PMID:24363561

Shukar-ud-din, Shazia; Ubaid, Fareeha; Shahani, Erum; Saleh, Farah

2013-01-01

279

Contrast-enhanced ultrasonography parameters in neural network diagnosis of liver tumors  

PubMed Central

AIM: To study the role of time-intensity curve (TIC) analysis parameters in a complex system of neural networks designed to classify liver tumors. METHODS: We prospectively included 112 patients with hepatocellular carcinoma (HCC) (n = 41), hypervascular (n = 20) and hypovascular (n = 12) liver metastases, hepatic hemangiomas (n = 16) or focal fatty changes (n = 23) who underwent contrast-enhanced ultrasonography in the Research Center of Gastroenterology and Hepatology, Craiova, Romania. We recorded full length movies of all contrast uptake phases and post-processed them offline by selecting two areas of interest (one for the tumor and one for the healthy surrounding parenchyma) and consecutive TIC analysis. The difference in maximum intensities, the time to reaching them and the aspect of the late/portal phase, as quantified by the neural network and a ratio between median intensities of the central and peripheral areas were analyzed by a feed forward back propagation multi-layer neural network which was trained to classify data into five distinct classes, corresponding to each type of liver lesion. RESULTS: The neural network had 94.45% training accuracy (95% CI: 89.31%-97.21%) and 87.12% testing accuracy (95% CI: 86.83%-93.17%). The automatic classification process registered 93.2% sensitivity, 89.7% specificity, 94.42% positive predictive value and 87.57% negative predictive value. The artificial neural networks (ANN) incorrectly classified as hemangyomas three HCC cases and two hypervascular metastases, while in turn misclassifying four liver hemangyomas as HCC (one case) and hypervascular metastases (three cases). Comparatively, human interpretation of TICs showed 94.1% sensitivity, 90.7% specificity, 95.11% positive predictive value and 88.89% negative predictive value. The accuracy and specificity of the ANN diagnosis system was similar to that of human interpretation of the TICs (P = 0.225 and P = 0.451, respectively). Hepatocellular carcinoma cases showed contrast uptake during the arterial phase followed by wash-out in the portal and first seconds of the late phases. For the hypovascular metastases did not show significant contrast uptake during the arterial phase, which resulted in negative differences between the maximum intensities. We registered wash-out in the late phase for most of the hypervascular metastases. Liver hemangiomas had contrast uptake in the arterial phase without agent wash-out in the portal-late phases. The focal fatty changes did not show any differences from surrounding liver parenchyma, resulting in similar TIC patterns and extracted parameters. CONCLUSION: Neural network analysis of contrast-enhanced ultrasonography - obtained TICs seems a promising field of development for future techniques, providing fast and reliable diagnostic aid for the clinician. PMID:22969209

Streba, Costin Teodor; Ionescu, Mihaela; Gheonea, Dan Ionut; Sandulescu, Larisa; Ciurea, Tudorel; Saftoiu, Adrian; Vere, Cristin Constantin; Rogoveanu, Ion

2012-01-01

280

Vasoconstriction in horses caused by endophyte-infected tall fescue seed is detected with Doppler ultrasonography.  

PubMed

The hypotheses that endophyte (Neotyphodium coenophialum)-infected tall fescue (TF) seed causes vasoconstriction in horses in vivo and that ground seed would cause more pronounced vasoconstriction than whole seed were tested. Ten horses each received 1 of 3 treatments: endophyte-free ground (E-G; n = 4 horses) seed, endophyte-positive whole (E+W; n = 3) seed, or endophyte-positive ground (E+G; n = 3) seed. There were two 14-d periods, P1 and P2. During P1, animals were adapted to a concentrate (0.2% BW, as fed, twice daily) and alfalfa cubes. During P2, the seed was mixed into the concentrate portion of the diet and alfalfa cubes were offered ad libitum. Fescue seed was fed in increasing amounts ranging from 0.02% BW on d 1 (averaging 76 ug/kg ergovaline + ergovalinine) to 0.22% BW on d 11 to 14 (averaging 713 ug/kg ergovaline + ergovalinine). The distal palmar artery of the left foreleg of each horse was scanned via Doppler ultrasonography for 4 d during each period, with 5 replicate scans performed on each scanning day. The measurements taken at each scan included artery luminal diameter, area, and circumference, peak systolic velocity, end diastolic velocity and blood flow variables. Animal temperature, heart rate, and respiration rate and ambient temperature and humidity were also recorded. Blood samples were taken on each scanning day to measure inflammatory cytokine mRNA abundances, and blood samples were collected on d 0, 4, 8, and 14 of P2 to measure prolactin concentrations. Consumption of E+G TF seed caused decreased artery lumen diameter (P = 0.0033), area (P = 0.0406), and circumference (P = 0.0480) compared with E-G seed, and E+W seed produced an intermediate response. Blood flow volume was reduced (P < 0.05) during P2 in horses receiving E+G seed compared with horses receiving E-G seed. Other ultrasound variables were not different (P > 0.05) among treatment groups, and neither were cytokine mRNA or prolactin concentrations. Treatment did not alter (P > 0.05) animal temperature, heart rate, or respiration rate, and neither ambient temperature nor relative humidity was consistently correlated with any response variable measured. Taken together, these data confirm that consumption of E+G fescue seed caused vasoconstriction in horses, which could be readily measured by Doppler ultrasonography. Use of Doppler ultrasound to monitor the diameter of the palmar artery of horses grazing endophyte-infected (E+) fescue pastures may provide a convenient and satisfactory biomarker to determine premonitory signs of fescue toxicosis. PMID:23449860

McDowell, K J; Moore, E S; Parks, A G; Bush, L P; Horohov, D W; Lawrence, L M

2013-04-01

281

Usefulness of Real-Time 4D Ultrasonography during Radiofrequency Ablation in a Case of Hepatocellular Carcinoma  

PubMed Central

We report a case of hepatocellular carcinoma (HCC) with chronic hepatitis C virus infection successfully treated with percutaneous radiofrequency ablation (RFA) under live four-dimensional (4D) echo guidance. A 65-year-old Japanese man had a HCC nodule in the liver S5 region 2.0 cm in diameter. We performed real-time 4D ultrasonography during RFA therapy with a LeVeen needle electrode. The echo guidance facilitated an accurate approach for the needle puncture. The guidance was also useful for confirming whether an adequate safety margin for the nodule had been obtained. Thus real-time 4D ultrasonography echo technique appears to provide safe guidance of RFA needles via accurate targeting of HCC nodules, thereby allowing real-time visualization when combined with echo contrast. Furthermore the position of the needle in a still image was confirmed in every area using a multiview procedure. PMID:21526141

Hotta, Naoki; Yamada, Seigo; Murase, Kenichi; Masuko, Kazuo

2011-01-01

282

Robot-assisted laparoscopic radical prostatectomy after fluoroquinolone resistant Escherichia coli sepsis following a transrectal ultrasonography-guided prostate biopsy  

PubMed Central

The incidence of febrile urinary tract infection after transrectal ultrasonography-guided prostate biopsy has been reported to range from 0.1% to 7%, with Escherichia coli being the most common organism identified. The conventional wisdom is to recommend an interval of more than 4 to 6 weeks after the transrectal prostate biopsy before treating patients with radical prostatectomy. This allows time for resolution of the biopsy-induced inflammation, which might complicate the surgical planes for dissection. We present a 58-year-old man with an elevated prostate-specific antigen, who developed near-fatal sepsis following transrectal ultrasonography-guided prostate biopsy despite quinolone prophylaxis. The patient underwent a robot-assisted laparoscopic radical prostatectomy 31 days after the prostate biopsy. PMID:21806895

Park, Seung Chol; Lee, Jea Whan; Rim, Joung Sik

2011-01-01

283

Informed choice for users of health services: views on ultrasonography leaflets of women in early pregnancy, midwives, and ultrasonographers.  

PubMed

With the aim of promoting the informed choice of pregnant women, staff and pregnant women at two urban hospitals were offered leaflets summarising the best available evidence about the effectiveness of routine ultrasonography in early pregnancy. Ultrasonographers doubted the credibility of the evidence and were concerned that the leaflets would raise women's anxiety, reduce uptake of scans, disrupt hospital organisation, and reinforce media messages about the poor safety record of ultrasonography. Midwives thought that the leaflets would inform women, help them to talk about their care with health professionals, and help them to get better care. Women were shocked at some of the contents but thought that it was appropriate to include both advantages and disadvantages of routine scanning in the leaflet. This case study highlights the resistance of some health professionals to evidence based health care; underlying conflicts with the principle of professional autonomy; concern that informed choice may create anxiety; and professional and organisational barriers to allowing informed choice. PMID:8939120

Oliver, S; Rajan, L; Turner, H; Oakley, A; Entwistle, V; Watt, I; Sheldon, T A; Rosser, J

1996-11-16

284

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

PubMed Central

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

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

2014-01-01

285

volume measurements of gastric antrum by 3-D ultrasonography and flow measurements through the pylorus by duplex technique  

Microsoft Academic Search

We present a method for estimating volumes of abdominal organs using 3-D ultrasonography.In vitro validation experiments demonstrated excellent agreement between estimated and true volumes.In vivo estimations after ingestion of 500 ml meat soup showed greater antral filling and poorer emptying of the gallbladder in patients\\u000a with functional dyspepsia (FD) than in healthy controls. Abnormal antral filling was associated with dyspeptic

Arnold Berstad; Trygve Hausken; Odd Helge Gilja; Nils Thune; Knut Matre; Svein Ødegaard

1994-01-01

286

Comparision between transrectal ultrasonography and computed tomography with rectal inflation of gas in preoperative staging of lower rectal cancer  

Microsoft Academic Search

.   Computed tomography with rectal air insufflation was compared with transrectal ultrasonography (TRUS) in 63 patients. The\\u000a CT protocol involved pre- and postcontrast scans with 5 mm slice thickness following air insufflation in IV antiperistaltic\\u000a agent. Of the patients, 79 % were scanned in the prone position. Results of the preoperative examinations were compared with\\u000a the histological findings. The CT

M. F. Osti; F. Scattoni Padovan; C. Pirolli; S. Sbarbati; V. Tombolini; C. Meli; R. Maurizi Enrici

1997-01-01

287

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. PMID:22529858

de Freitas, Leonardo da Silva Valladão; de Bello Barros, Fernanda Silveira; Negrini, Rômulo; de Silva Bussamra, Luiz Cláudio; Araujo Júnior, Edward; Piato, Sebastião; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes; Aoki, Tsutomu

2012-01-01

288

The Role of Colour Doppler Ultrasonography in the Diagnosis of Fascial Space Infections - A Cross Sectional Study  

PubMed Central

Aims and Objectives: (1) To evaluate the role of ultrasonography with colour Doppler in the diagnosis of fascial space infections, (2) To determine the nature, size and extent of the odontogenic infections which involve the primary and secondary fascial spaces of the maxilla and the mandible (3) To evaluate the sensitivity of ultrasonography in determining whether the inflammatory process is in a stage of cellulitis or abscess and to thus determine the appropriate time for a surgical intervention during the course of the infection and to correlate the clinical and radiographic findings with the ultrasonographic findings and (4) to determine the treatment plan. Methodology: Thirty four patients with odontogenic infections which involved the superficial and the deep fascial spaces of the head and neck were subjected to ultrasonographic examinations over the suspected area in the transverse and axial directions to determine the stage of the infection, its anatomic location and the treatment plan. Results: Ultrasonography showed 95.7% sensitivity and 100% specificity as compared to the clinical and radiographic diagnoses and it proved to be an effective investigation modality in the diagnosis of fascial space infections. PMID:23814756

Nisha V., Aarthi; J., Parthiban; N., Santana; A.G, Giridhar; Devi B.K., Yashoda; Reddy S., Sujatha; N., Rakesh

2013-01-01

289

Prenatal diagnosis of an aneurysm of the vein of galen by three-dimensional power and color Doppler ultrasonography.  

PubMed

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. PMID:22675269

Rios, Livia Teresa Moreira; Araujo Júnior, Edward; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes; Martins, Marília da Glória

2012-01-01

290

[Ultrasonography and computed tomography in ophthalmological practice: comparative value during exploration of the eye and orbit (author's transl)].  

PubMed

Ultrasonography is a completely harmless method of examining the eye and the orbit and uses light, inexpensive equipment, within the reach of any ophthalmologist, to provide excellent information concerning the eye and is also well adapted to orbital examination. Cephalic computed tomography, which uses ionizing radiation, is especially efficient in orbital investigations, but this kind of examination is only required in about 10% of cases. It requires expensive, cumbersome equipment and highly specialised staff; frequent use of this method, as well as the injection of contrast products, can be risky. The reader will find 3 tables that summarize briefly the comparative possibilities of ultrasonography and computed tomography in bulbar and orbital investigations and for biometry. A 4th table underlines the suitability of one method or the other in terms of the symptomatology. Consultation of this table could be a time-saver: the ophthalmologist would always begin with the method most likely to give the best information and not waste time doing both. As far as the globe and the orbit are concerned, ultrasonography is normally sufficient. When this method seems problematical or gives insufficient information, the investigation can easily be completed with a computed tomography. Using this method, therefore we can go some way towards limiting the irradiation of the crystalline lens (sometimes unjustified) and towards saving time and money within the Health Service. PMID:7299066

Toufic, N; Ilic, B

1981-01-01

291

In vivo measurement of human rectus femoris architecture by ultrasonography: validity and applicability.  

PubMed

The architectural feature of the rectus femoris (RF) has been scarcely investigated despite its substantial contribution to knee extension torque and large plasticity in the muscularity. This study aimed to examine the reproducibility and validity of ultrasound measurements of RF architecture and interrelationships among the architectural parameters. After confirming the measurement accuracy of an examiner (measurement errors <1%), in vivo and cadaveric measurements of fascicle lengths and pennation angles of RF were performed. Day-to-day reproducibility of measurements was investigated in vivo including muscle thickness measurement. Validity of measurements was investigated by comparing the values between direct and ultrasound measurements for the cadaver. The intraclass correlation coefficients were 0·984, 0·960 and 0·932, and root mean square difference between measured values on 2 days was 0·8 mm, 3·1 mm and 1·4° for muscle thickness, fascicle length and pennation angle, respectively. The validity of measurements was similar or better than those of previous reports on other muscles. We also confirmed a positive correlation between the muscle thickness and the pennation angle as has been shown in other muscles. The current results warrant the use of B-mode ultrasonography for examining the architectural characteristics of RF in vivo. PMID:23692615

Ema, Ryoichi; Wakahara, Taku; Mogi, Yasuyoshi; Miyamoto, Naokazu; Komatsu, Toshihiko; Kanehisa, Hiroaki; Kawakami, Yasuo

2013-07-01

292

Pelvic ultrasonography in premenarcheal girls: relation to puberty and sex hormone concentrations.  

PubMed Central

Real time ultrasonography of the pelvic organs was performed on 114 normal premenarcheal girls aged between 2 years and 13 years 11 months. Values were obtained for total uterine length, anteroposterior diameters of the corpus and cervix, corpus/cervix ratio, and uterine and ovarian volumes and the resultant data were grouped according to age. It was concluded that there is no change in uterine size until approximately 7 years of age. Then the uterus begins to enlarge, both in prepubertal girls, in whom this is an age related function, and in pubertal girls, whose uterine growth is influenced not only by age but also by size and, independently of these two factors, by oestradiol concentrations. The onset of a modification in uterine morphology with a greater enlargement of the corpus than the cervix is also seen at age 7 years. Ovarian maturation begins in the very first years of life and, even in pubertal girls, seems to be influenced by age only and not by hormonal stimuli. PMID:3883910

Salardi, S; Orsini, L F; Cacciari, E; Bovicelli, L; Tassoni, P; Reggiani, A

1985-01-01

293

Is endoscopic ultrasonography still the modality of choice in preoperative staging of gastric cancer?  

PubMed Central

The treatment option for gastric cancer is usually based on preoperative staging by imaging modalities. Endoscopic ultrasonography (EUS) and computed tomography (CT) have been used as the diagnostic modality of choice in preoperative staging of gastric cancer. Magnetic resonance imaging (MRI) has been employed in several studies, and (18F) 2-Fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) has emerged as a new promising imaging modality. The purpose of this article is to provide summarized information on preoperative staging using EUS, multi-detector row CT (MDCT), MRI and PET for gastric cancer. In T staging, both EUS and MDCT show high accuracy. MRI seemed to have better performance, but the number of MRI studies is limited. FDG-PET is not able to properly evaluate the depth of invasion. In N staging, the diagnostic accuracy of EUS, MDCT and MRI is not sufficient. In preoperative M staging, MDCT and FDG-PET showed similar diagnostic accuracies. FDG-PET/CT fusion could be expected to show better performance in the future. Physicians should keep in mind that each diagnostic modality has advantages and limitations and choose an appropriate diagnostic strategy tailored for each patient. PMID:25320515

Hwang, Sung Wook; Lee, Dong Ho

2014-01-01

294

Evaluation of aging on muscle blood flow in conscious healthy dogs by duplex Doppler ultrasonography.  

PubMed

According to a study conducted on a population of 9,248 subjects, cardiac diseases are the second most prevalent cause of death in the dog. During the last decades, a common scenario has been the increase on life expectancy of dogs. The exact relationship between the negative modifications of cardiovascular function and the development of specific cardiovascular diseases is difficult to ascertain, and also, the effect of age per se on vascular impedance is important. It may result in limited cardiovascular reserve under conditions of increase demand in senescent animals. To evaluate the effect of age on the peripheral vasculature specifically, the objective of this study was to compare parameters of the regional blood flow as well as compliance and resistance indexes in the femoral arterial system of younger and older conscious healthy dogs by duplex Doppler ultrasonography. The data were collected from 16 mixed-breed dogs divided into two groups: young and old healthy dogs. In all dogs Doppler spectra blood flow patterns of the femoral artery were triphasic. Significant differences were not found between the parameters measured for young and old groups. Despite this, the average value of femoral flow volume in the older group was approximately 50% lower than the younger group. This finding could play an important role in limiting exercise response with age. In order to validate these speculations, further studies should be performed in aged dogs. PMID:20354784

Nogueira, Rodrigo Bernardes; Muzzi, Ruthnéa A Lázaro

2010-04-01

295

Ultrasonography with color Doppler and power Doppler in the diagnosis of periapical lesions  

PubMed Central

Aim: To evaluate the efficacy of ultrasonography (USG) with color Doppler and power Doppler applications over conventional radiography in the diagnosis of periapical lesions. Materials and Methods: Thirty patients having inflammatory periapical lesions of the maxillary or mandibular anterior teeth and requiring endodontic surgery were selected for inclusion in this study. All patients consented to participate in the study. We used conventional periapical radiographs as well as USG with color Doppler and power Doppler for the diagnosis of these lesions. Their diagnostic performances were compared against histopathologic examination. All data were compared and statistically analyzed. Results: USG examination with color Doppler and power Doppler identified 29 (19 cysts and 10 granulomas) of 30 periapical lesions accurately, with a sensitivity of 100% for cysts and 90.91% for granulomas and a specificity of 90.91% for cysts and 100% for granulomas. In comparison, conventional intraoral radiography identified only 21 lesions (sensitivity of 78.9% for cysts and 45.4% for granulomas and specificity of 45.4% for cysts and 78.9% for granulomas). There was definite correlation between the echotexture of the lesions and the histopathological features except in one case. Conclusions: USG imaging with color Doppler and power Doppler is superior to conventional intraoral radiographic methods for diagnosing the nature of periapical lesions in the anterior jaws. This study reveals the potential of USG examination in the study of other jaw lesions. PMID:22223940

Goel, Sumit; Nagendrareddy, Suma Gundareddy; Raju, Manthena Srinivasa; Krishnojirao, Dayashankara Rao Jingade; Rastogi, Rajul; Mohan, Ravi Prakash Sasankoti; Gupta, Swati

2011-01-01

296

Diagnostic sensitivity of subjective and quantitative laryngeal ultrasonography for recurrent laryngeal neuropathy in horses.  

PubMed

Recurrent laryngeal neuropathy (RLN) is the most common cause of laryngeal hemiplegia in horses and causes neurogenic atrophy of the intrinsic laryngeal muscles, including the cricoarytenoideus lateralis muscle. Recurrent laryngeal neuropathy results in paresis to paralysis of the vocal fold and arytenoid cartilage, which limits performance through respiratory compromise. Ultrasound has previously been reported to be a useful diagnostic technique in horses with RLN. In this report, the diagnostic sensitivity of subjective and quantitative laryngeal ultrasonography was evaluated in 154 horses presented for poor performance due to suspected upper airway disease. Ultrasonographic parameters recorded were: cricoarytenoideus lateralis echogenicity (subjective and quantitative), cricoarytenoideus lateralis thickness, vocal fold movement, and arytenoid cartilage movement. Ultrasonographic parameters were then compared with laryngeal grades based on resting and exercising upper airway endoscopy. Subjectively increased left cricoarytenoideus lateralis echogenicity yielded a sensitivity of 94.59% and specificity of 94.54% for detecting RLN, based on the reference standard of exercising laryngeal endoscopy. Quantitative left cricoarytenoideus lateralis echogenicity values differed among resting laryngeal grades I-IV. Findings from this study support previously published findings and the utility of subjective and quantitative laryngeal ultrasound as diagnostic tools for horses with poor performance. PMID:22985286

Chalmers, Heather J; Yeager, Amy E; Cheetham, Jonathan; Ducharme, Norm

2012-01-01

297

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

SciTech Connect

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

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

1985-08-01

298

Intraoperative ultrasonography with a surgeon-manipulated microtransducer during robotic radical prostatectomy.  

PubMed

Intraoperative transrectal ultrasonography during laparoscopic radical prostatectomy has been reported to lead to a reduction in surgical margin rates. However, the use of a surgeon-controlled ultrasound probe that allows for precise manipulation and direct interpretation of the image by a console surgeon has yet to be studied. The aim of the present study was to show initial feasibility using the microtransducer with 9-mm scan length controlled by the console surgeon during robot-assisted radical prostatectomy in 10 patients. The transducer is designed as a drop-in probe with a flexible cord for insertion through a laparoscopic port, and is controlled by a robotic arm with the ultrasonographic image shown as a console Tile-pro display. Intraoperative localization of the biopsy-proven cancerous hypoechoic lesion was feasible in four out of four cases. The microtransducer facilitated identification of the bladder neck as well as the appropriate level of neurovascular bundle release. Negative surgical margin was achieved in all 10 cases (100%), even though five of 10 patients (50%) had extraprostatic (pT3) disease. Recovery of erectile function and continence was encouraging. In conclusion, intraoperative ultrasound navigation using a drop-type microtransducer is a novel technique that could enhance the incremental value of the standard information. PMID:24446651

Shoji, Sunao; Aron, Monish; de Castro Abreu, Andre Luis; Leslie, Scott; Ahmadi, Hamed; Desai, Mihir M; Gill, Inderbir S; Ukimura, Osamu

2014-07-01

299

Contrast-enhanced color Doppler ultrasonography increases diagnostic accuracy for soft tissue tumors.  

PubMed

Resolution of ultrasonography (US) has undergone marked development. Additionally, a new-generation contrast medium (Sonazoid) used for US is newly available. Contrast-enhanced US has been widely used for evaluating several types of cancer. In the present study, we evaluated the ability of color Doppler US (CDUS) and Sonazoid to differentiate between benign and malignant soft tissue tumors. A total of 180 patients (87 male, 93 female) were enrolled in the present study. The patient ages ranged from 1 to 91 years (mean 58.1±20.0 years). The maximum size, depth, tumor margins, shape, echogenicity and textural pattern were measured on gray-scale images. CDUS was used to evaluate the intratumoral blood flow with and without Sonazoid. Peak systolic flow velocity (Vp), mean flow velocity (Vm), resistivity index (RI) and pulsatility index (PI) of each detected intratumoral artery were automatically calculated with power Doppler US (PDUS). The present study included 118 benign and 62 malignant tumors. Statistical significances were found in size, depth, tumor margin and textural pattern but not in shape or echogenicity on gray-scale images. Before Sonazoid injection, CDUS findings showed 55% sensitivity, 77% specificity and 69% accuracy, whereas contrast-enhanced CDUS showed 87% sensitivity, 68% specificity and 74% accuracy. There were no statistically significant differences between malignant and benign tumors regarding the mean Vp, Vm, RI and PI values determined on PDUS. In conclusion, contrast-enhanced CDUS proved to be a reliable diagnostic tool for detecting malignant potential in soft tissue tumors. PMID:25109621

Oebisu, Naoto; Hoshi, Manabu; Ieguchi, Makoto; Takada, Jun; Iwai, Tadashi; Ohsawa, Masahiko; Nakamura, Hiroaki

2014-10-01

300

Hepatic schwannoma: Imaging findings on CT, MRI and contrast-enhanced ultrasonography  

PubMed Central

A primary benign schwannoma of the liver is extremely rare and is difficult to preoperatively discriminate from a malignant tumor. We compared the imaging and pathological findings, and examined the possibility of preoperatively diagnosing a benign liver schwannoma. A 72-year-old woman was admitted to our hospital because of a 4.6-cm mass in the liver. A malignant tumor was suspected, and a right hepatectomy was performed. After this, the diagnosis of a primary benign schwannoma of the liver was made through pathological examination. Contrast-enhanced ultrasonography (CEUS) with Sonazoid showed minute blood flows into the septum and solid areas of the tumor in the vascular phase; most likely due to increased arterial flow associated with infiltration of chronic inflammatory cells. In the postvascular phase, CEUS showed contrast defect of cystic areas and delayed enhancement of solid areas; most likely due to aggregation of siderophores. Because discriminating between a benign and malignant schwannoma of the liver is difficult, surgery is generally recommended. However, the two key findings from CEUS may be useful in discriminating ancient schwannoma by recognizing the hemorrhage involved in the secondary degeneration and aggregation of siderophores. PMID:23002371

Ota, Yu; Aso, Kazunobu; Watanabe, Kenji; Einama, Takahiro; Imai, Koji; Karasaki, Hidenori; Sudo, Ryuji; Tamaki, Yosui; Okada, Mituyoshi; Tokusashi, Yosihiko; Kono, Toru; Miyokawa, Naoyuki; Haneda, Masakazu; Taniguchi, Masahiko; Furukawa, Hiroyuki

2012-01-01

301

Endoscopic ultrasonography in gastric lymphomas: appraisal on reliability in long-term follow-up.  

PubMed

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

2012-12-01

302

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. PMID:24142662

Lim, Sok Hwan; Kim, Myung-Joon

2013-01-01

303

The Development of a Flexible Measuring System for Muscle Volume Using Ultrasonography  

NASA Astrophysics Data System (ADS)

Quantification of muscle volume can be used as a means for the estimation of muscle strength. Its measuring process does not need the subject's muscular contractions so it is completely safe and particularly suited for elderly people. Therefore, we have developed a flexible measuring system for muscle volume using ultrasonography. In this system, an ultrasound probe is installed on a link mechanism which continuously scans fragmental images along the human body surface. These images are then measured and composed into a wide area cross-sectional image based on the spatial compounding method. The flexibility of the link mechanism enables the operator to measure the images under any body postures and body site. The spatial compounding method significantly reduces speckle and artifact noises from the composed cross-sectional image so that the operator can observe the individual muscles, such as Rectus femoris, Vastus intermedius, and so on, in detail. We conducted the experiments in order to examine the advantages of this system we have developed. The experimental results showed a high accuracy of the measuring position which was calculated using the link mechanism and presented the noise reduction effect based on the spatial compounding method. Finally, we confirmed high correlations between the MRI images and the ones of the developed system to verify the validity of the system.

Fukumoto, Kiyotaka; Fukuda, Osamu; Tsubai, Masayoshi; Muraki, Satoshi

304

Application of real-time ultrasonography for the detection of tarsal vein thrombosis in cattle.  

PubMed

The clinical and ultrasonographic features of the thrombosis of three tarsal veins in a six-year-old dairy cow are described. Thrombosis and metastatic abscessation developed on the left tarsus six days after the amputation of the lateral claw of the left hindlimb. Originally, the cow suffered from a severe purulent arthritis of the distal interphalangeal joint and a retroarticular abscess, caused by interdigital necrobacillosis. By means of real-time ultrasonography, using a 7.5 MHz transducer, a marked subcutaneous oedema, a subcutaneous abscess, and a thrombosis of the ramus cranialis and ramus caudalis of the vena saphena lateralis reaching the confluence into the vena saphena lateralis and a thrombosis of the ramus caudalis of the vena saphena medialis could be identified. The thrombosed veins were not compressible, were oval and had an increased diameter of up to 9 x 12 mm. Intraluminal masses were visualised as hypoechoic structures and the veins distal to the thrombosis were distended up to 10 x 13 mm. The differential diagnosis and pathogenesis of the thrombosis and the abscessation are discussed, and the clinical course and the sonographic observations of the thrombosis during a six week period are described. PMID:8629321

Kofler, J; Buchner, A; Sendlhofer, A

1996-01-13

305

Current status and future applications of contrast-enhanced endoscopic ultrasonography  

PubMed Central

Endoscopic ultrasonography (EUS) is currently an integral investigation of many gastrointestinal disorders. It has been shown to have a higher efficacy than conventional computed tomography in detection and characterization of small lesions especially in the pancreas. Much effort has been put to further improve the sensitivity, specificity and overall accuracy of EUS. One of the major advances is the utilization of contrast agents for better delineation of the vascularity and tissue perfusion of the target lesion. This article describes the basic principles of ultrasound contrast agents and the different modalities used in contrast-enhanced EUS (CE-EUS) including contrast-enhanced Doppler EUS (CED-EUS) and contrast-enhanced harmonic EUS (CEH-EUS). In addition, the current applications of contrast enhanced EUS in different gastrointestinal conditions were discussed. Furthermore, the future development of hybrid approaches combining CE-EUS with other imaging modalities and the potential therapeutic aspect of using it as a vector for drug delivery were also discussed. PMID:24748919

Yip, Hon Chi; Teoh, Anthony Yuen Bun; Chong, Charing Ching Ning; Lau, James Yun Wong

2014-01-01

306

Hepatic schwannoma: imaging findings on CT, MRI and contrast-enhanced ultrasonography.  

PubMed

A primary benign schwannoma of the liver is extremely rare and is difficult to preoperatively discriminate from a malignant tumor. We compared the imaging and pathological findings, and examined the possibility of preoperatively diagnosing a benign liver schwannoma. A 72-year-old woman was admitted to our hospital because of a 4.6-cm mass in the liver. A malignant tumor was suspected, and a right hepatectomy was performed. After this, the diagnosis of a primary benign schwannoma of the liver was made through pathological examination. Contrast-enhanced ultrasonography (CEUS) with Sonazoid showed minute blood flows into the septum and solid areas of the tumor in the vascular phase; most likely due to increased arterial flow associated with infiltration of chronic inflammatory cells. In the postvascular phase, CEUS showed contrast defect of cystic areas and delayed enhancement of solid areas; most likely due to aggregation of siderophores. Because discriminating between a benign and malignant schwannoma of the liver is difficult, surgery is generally recommended. However, the two key findings from CEUS may be useful in discriminating ancient schwannoma by recognizing the hemorrhage involved in the secondary degeneration and aggregation of siderophores. PMID:23002371

Ota, Yu; Aso, Kazunobu; Watanabe, Kenji; Einama, Takahiro; Imai, Koji; Karasaki, Hidenori; Sudo, Ryuji; Tamaki, Yosui; Okada, Mituyoshi; Tokusashi, Yosihiko; Kono, Toru; Miyokawa, Naoyuki; Haneda, Masakazu; Taniguchi, Masahiko; Furukawa, Hiroyuki

2012-09-21

307

Severity assessment in trauma patient.  

PubMed

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

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

2013-01-01

308

Assessment of cervical length and the relationship between short cervix and preterm birth.  

PubMed

Premature effacement of the cervix, or short cervix, in the midtrimester of pregnancy currently represents the strongest predictor of spontaneous preterm birth. Numerous studies have examined the relationship between short cervix and preterm birth, and although differences in sensitivity and predictive value exist, the overwhelming consensus indicates that the risk of preterm birth increases with decreasing cervical length. Cutoff values for cervical length range from less than 25 mm to less than 15 mm depending on patient characteristics and gestational age. Importantly, short cervix is more sensitive for predicting earlier forms of prematurity (at <32 weeks) than later forms of prematurity (>32 weeks). Cervical length measured at 18 to 24 weeks' gestation appears to be the most valuable measurement. Cervical length assessments can be performed by digital examination, a cervical measurement device, transabdominal ultrasound, or transvaginal ultrasound. Transvaginal ultrasound is the most reliable method to evaluate cervical length, but it is not available in all locations. Current clinical practice standards do not recommend universal screening for cervical length; however, results of randomized controlled clinical trials provide evidence to support expanded screening programs by individual practitioners. PMID:22776243

Slager, Joan; Lynne, Sandra

2012-07-01

309

Transcranial Doppler Ultrasonography in Beta-thalassemia Major Patients Without and With Thrombocytosis  

PubMed Central

Background Beta-thalassemia is a type of anemia in which the patients may require splenectomy and this can lead to thrombocytosis with increased risk of stroke. Transcranial Doppler ultrasound is a method for determining cerebral vessel stenosis. Objectives The aim of this study was to investigate whether the risk of a future stroke secondary to cerebral artery stenosis can be predicted with the use of transcranial Doppler ultrasound in beta-thalassemia major patients. Patients and Methods This study included 54 beta-thalassemia major patients divided into 2 groups; group A consisted of 28 patients who have thrombocytosis secondary to a previous splenectomy and group B comprised of 26 patients who did not have a splenectomy with normal platelet count, as well as a control group of 30 healthy individuals. Results Transcranial Doppler ultrasound of the cerebral vessels were performed in all participants, and the results for each group were compared with the controls. In addition, patients were evaluated for evidence of high flow velocity in the cerebral vessels that met the clinically significant criteria of ? 50% stenosis. Transcranial Doppler ultrasound velocity criteria for > 50% stenosis, indicating a risk of stroke, were not documented in any patients but increase in cerebral blood velocities in many arteries in group A and in some arteries in group B were revealed. Conclusion Following splenectomy, thrombocytosis can predispose the patients to an increase in cerebral blood velocities more than respected with anemia. But by transcranial doppler ultrasonography no evidence of significant stenosis were found in intracerebral arteries to conclude that the beta-thalassemia major patients were more prone to the development of stroke secondary to this abnormality. PMID:23984004

Shariat, Abdolhamid; Nazeri, Masoume; Abolhasani Foroughi, Amin; Karimi, Mehran

2013-01-01

310

Conventional papillary thyroid carcinoma: effects of cystic changes visible on ultrasonography on disease prognosis  

PubMed Central

Purpose To investigate the characteristics of papillary thyroid carcinoma (PTC) with cystic changes visible on ultrasonography (US). Methods This study included 553 PTCs in 553 patients between January 2003 and August 2004. One radiologist with 10 years of experience in thyroid imaging retrospectively reviewed the preoperative US images. Two different groups were formed according to two different reference points (group 1, 25%; group 2, 50%) of the cystic component. Patients between the groups were compared according to their clinicopathologic characteristics. Disease-free survival (DFS) was estimated. Cox’s multivariate proportional hazards regression model was used to identify the effect of variable factors on the recurrence risk. Results Fifty-six patients (10.1%) were confirmed to have tumor recurrence within the follow-up period. Thirty-five patients had regional metastasis, one had distant metastasis, eight had multiple site metastases, and 12 had biochemical recurrence. PTC patients with a ? 50% or PTC patients with a ? 25% cystic component did not have a statistically significant longer DFS than those with a >50% (hazard ratio [HR], 1.118; 95% confidence interval [CI], 0.255 to 4.910; P=0.883) or those with a >25% cystic component (HR, 0.569; 95% CI, 0.164 to 1.976; P=0.375), respectively. Moreover, independent predictors of recurrence were pathologic size, male gender, and lymph node metastasis, not a >50% or >25% cystic component. Conclusion The proportion of the cystic component in PTCs did not affect DFS. PMID:25212970

2014-01-01

311

Performance of lung ultrasonography in children with community-acquired pneumonia  

PubMed Central

Background There are few prospective evaluations of point-of-care ultrasonography (US) for the diagnosis of pediatric community-acquired pneumonia (CAP). In particular, there are very few data concerning the efficiency of US in comparison with that of chest radiography (CR) in defining different kinds of lung alterations in the various pulmonary sections. The aim of this study was to bridge this gap in order to increase our knowledge of the performance of US in diagnosing CAP in childhood. Methods A total of 103 children (56 males, 54.4%; mean age ± standard deviation 5.6?±?4.6 years) admitted to hospital with a clinical diagnosis of suspected CAP were prospectively enrolled and underwent CR (evaluated by an independent expert radiologist) and lung US (performed by a resident in paediatrics with limited experience in US). The performance of US in diagnosing CAP (i.e. its sensitivity, specificity, and positive and negative predictive values) was compared with that of CR. Results A total of 48 patients had radiographically confirmed CAP. The sensitivity, specificity, and positive and negative predictive values of US in comparison with CR were respectively 97.9%, 94.5%, 94.0% and 98.1%. US identified a significantly higher number of cases of pleural effusion, but the concordance of the two methods in identifying the type of CAP was poor. Conclusion US can be considered a useful means of diagnosing CAP in children admitted to an Emergency Department with a lower respiratory tract infection, although its usefulness in identifying the type of lung involvement requires further evaluation. PMID:24742171

2014-01-01

312

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. PMID:23253617

2012-01-01

313

Vertebral level of Tuffier's line measured by ultrasonography in parturients in the lateral decubitus position  

PubMed Central

Background It is known that Tuffier's line intersects the spine at the L4 spinous process or at the L4-L5 intervertebral space. Full term parturient women undergo various physical changes. Therefore, determining the vertebral level with Tuffier's line based on palpation inevitably is not very accurate. The aim of this study was to use ultrasound to verify the difference between vertebral levels for the palpated Tuffier's line in parturient and non-parturient women in the lateral decubitus position. Methods We consecutively enrolled 40 parturient women at 37-41 weeks of gestation and 40 non-parturient women scheduled for regional anesthesia. In the left lateral position, the location of the vertebra was identified using ultrasonography. We marked every intervertebral space from L5 to L2 vertebra, divided each spinous process into two equal parts, and numbered the spaces sequentially from 1 to 9. We drew a Tuffier's line by palpating, recorded the vertebral level that this line intersected. Results The mean value of an arbitrary number of vertebral level of Tuffier's line was 6.4 ± 0.9 in the non-pregnant group and this represents L4-lower vertebral level. In the pregnant group, the mean value was 3.0 ± 1.0 which represents L3-lower vertebral level. There was a significant difference between the two groups (P < 0.05). Conclusions We compared using an available ultrasound technique the vertebral levels intersected by the palpated Tuffier's line between parturient and non-parturient women and found that the vertebral levels were more cephalad in the parturient women compared to the non-parturient women. PMID:25302094

Kim, Se Hee; Han, Jong In; Baik, Hee Jung; Park, Hahck Soo; Lee, Guie Yong; Kim, Jong Hak

2014-01-01

314

Prevalence of vertebral artery origin stenosis and occlusion in outpatient extracranial ultrasonography  

PubMed Central

Background and purpose Most data on the prevalence of vertebral artery origin (VAo) disease is derived from hospital-based studies of patients with posterior circulation strokes and TIA. The prevalence of VAo disease in patients without posterior circulation symptoms or asymptomatic patients is poorly characterized. Our objective was to examine the prevalence of VAo stenosis and occlusion in consecutive patients, presenting for extracranial ultrasonography to an outpatient laboratory. Methods We retrospectively identified 2490 consecutive extracranial duplex studies performed in an ambulatory neurovascular ultrasound laboratory. All studies were reviewed for the presence of >50% VAo stenosis, defined as a PSV > 114 cm/s, and VA occlusion. We also reviewed the prevalence of >50% carotid stenosis, defined as a PSV > 120 cm/s, in the same population, to draw comparisons with VAo stenosis prevalence. Results We identified right VAo stenosis in 52/1955 (2.7%) and occlusion in 74/1955 (3.9%) and left-sided VAo stenosis in 45/1973 (2.5%) and occlusion in 64/1973 (3.6%). The prevalence of having any (either right or left) VAo stenosis or occlusion was 8.2% and 1.4% had bilateral VAo stenosis or occlusion. Right carotid stenosis and occlusion was found in 236/2399 (9.8%) and 53/2399 (2.2%) and left carotid stenosis and occlusion in 236/2397 (9.8%) and 45/2397 (1.9%), respectively. Any carotid disease, either right or left, was present in 18.9% and 4.7% had bilateral carotid disease. Conclusion Although less prevalent than cervical carotid disease, we found that approximately 8% of patients who presented to an ambulatory ultrasound laboratory had >50% VAo disease.

Koch, Sebastian; Bustillo, Antonio J; Campo, Bertha; Campo, Nelly; Campo-Bustillo, Iszet; McClendon, Mark S; Katsnelson, Michael; Romano, Jose G

2014-01-01

315

Morphometric analysis of fetal development of Cavia porcellus (Linnaeus, 1758) by ultrasonography--pilot study.  

PubMed

Measurements on the growth process and placental development of the embryo and fetuses of Cavia porcellus were carried out using ultrasonography. Embryo, fetus, and placenta were monitored from Day 15 after mating day to the end of gestation. Based on linear and quadratic regressions, the following morphometric analysis showed a good indicator of the gestational age: placental diameter, biparietal diameter, renal length, and crown rump. The embryonic cardiac beat was first detected at an average of 22.5 days. The placental diameter showed constant increase from beginning of gestation then remained to term and presented a quadratic correlation with gestational age (r(2) = 0.89). Mean placental diameter at the end of pregnancy was 3.5 ± 0.23 cm. By Day 30, it was possible to measure biparietal diameter, which followed a linear pattern of increase up to the end of gestation (r(2) = 0.95). Mean biparietal diameter in the end of pregnancy was 1.94 ± 0.03 cm. Kidneys were firstly observed on Day 35 as hyperechoic structures without the distinction of medullar and cortical layers, thus the regression model equation between kidney length and gestational age presents a quadratic relationship (r(2) = 0.7). The crown rump presented a simple linear growth, starting from 15 days of gestation, displaying a high correlation with the gestational age (r(2) = 0.9). The offspring were born after an average gestation of 61.3 days. In this study, we conclude that biparietal diameter, placental diameter, and crown rump are adequate predictive parameters of gestational age in guinea pigs because they present high correlation index. PMID:24560548

Santos, Juliana; Fonseca, Erika; van Melis, Juliano; Miglino, Maria Angélica

2014-04-15

316

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: bhashemi@modares.ac.ir [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)

2012-05-01

317

Values of endoscopic ultrasonography for diagnosis and treatment of duodenal protruding lesions*  

PubMed Central

Objective: The diagnoses of patients with duodenal protruding lesions are difficult when using conventional examinations such as computed tomography (CT) and conventional endoscope etc. Thus, we investigated the clinical value of endoscopic ultrasonography (EUS) with miniature ultrasonic probes on the diagnosis and treatment of duodenal protruding lesions. Methods: Patients with duodenal protruding lesions who were indicated for EUS were examined by EUS with 12~15 MHz miniature ultrasonic probes and double-cavity electronic endoscope. According to diagnosis of EUS, those patients were indicated for biopsy and treatment received biopsy, endoscopic resection or surgical excision. The postoperative histological results were compared with the preoperative diagnosis of EUS. Those patients without endoscopic resection or surgical excision were periodically followed up with EUS. Results: A total of 169 patients with duodenal protruding lesions were examined by EUS, of which 40 were diagnosed with cysts, 36 with inflammatory protruding or polyp, 25 with Brunner’s gland adenoma, 19 with ectopic pancreas, 17 with gastrointestinal stromal tumor, 12 with extrinsic compression, 12 with minor papilla, 6 with lipoma, 1 with adenocarcinoma and 1 with lymphoma. After EUS examinations, 75 patients received biopsy, endoscopic resection or surgical excision respectively. The postoperative histological results of 70 patients were completely consistent with the preoperative diagnosis of EUS, with 93.33% diagnostic accuracy. The results of follow-up with EUS indicated that duodenal cyst, Brunner’s gland adenoma, ectopic pancreas, gastrointestinal stromal tumor and lipoma remained unchanged within 1~3 years. No related complications occurred among all patients that received EUS examinations. Conclusion: EUS is an effective and reliable diagnostic method for duodenal protruding lesions. PMID:18381809

Xu, Guo-qiang; Wu, Yi-qun; Wang, Li-jun; Chen, Hong-tan

2008-01-01

318

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

PubMed

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

2013-10-01

319

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

PubMed Central

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

2011-01-01

320

EFFECT OF TRANSFUSION THERAPY ON TRANSCRANIAL DOPPLER ULTRASONOGRAPHY VELOCITIES IN CHILDREN WITH SICKLE CELL DISEASE  

PubMed Central

Background Children with sickle cell disease and abnormal transcranial Doppler (TCD) ultrasonography have a high risk of stroke, but this risk is greatly reduced when chronic transfusion therapy is administered. The change in TCD velocities during chronic transfusion therapy and rate and frequency of normalization of TCD findings have not been studied extensively. Procedures Using data from children with sickle cell disease enrolled as potential subjects in the Optimizing Primary Stroke Prevention in Sickle Cell Anemia (STOP 2) trial, we characterized the change in TCD velocities on transfusion therapy and identified predictors of developing a normal TCD. Results Among 88 children with serial TCD data after starting transfusions for abnormal TCD 46 (52%) converted to normal TCD after a mean of 4.3 months (median 3.0; range 0.85-14.3 months) of transfusions. TCD studies remained abnormal in 19/88 (21.6%) after a mean of 2.4 years of transfusion. The median TCD velocity was lowered by 38 cm/s within three months of initiating transfusions, followed by a more gradual decline then stabilization of velocities, although with significant individual variation. Factors associated with conversion to normal TCD included lower initial TCD velocity, younger age, and higher pre-transfusion hemoglobin level during transfusion therapy. Conclusion Younger children with higher pre-transfusion hemoglobin levels and lower abnormal TCD velocities are most likely to have rapid normalization of TCD on transfusions. Long-term follow-up of children with persistently abnormal exams or worsening velocities on transfusion is needed to determine if these children are at higher risk of stroke. PMID:21370410

Kwiatkowski, Janet L.; Yim, Eunsil; Miller, Scott; Adams, Robert J.

2011-01-01

321

The Osteoporosis Self-Assessment Tool versus alternative tests for selecting postmenopausal women for bone mineral density assessment: a comparative systematic review of accuracy  

Microsoft Academic Search

Summary  We performed a systematic review of studies comparing the Osteoporosis Self-Assessment Tool (OST) and other tests used to\\u000a select women for bone mineral density (BMD) assessment. In comparative meta-analyses, we found that the accuracy of OST was\\u000a similar to other tests that are based on information from the medical history. By contrast, assessment by quantitative ultrasonography\\u000a at the heel was

B. Rud; J. Hilden; L. Hyldstrup; A. Hróbjartsson

2009-01-01

322

Low Rates of Additional Cancer Detection by Magnetic Resonance Imaging in Newly Diagnosed Breast Cancer Patients Who Undergo Preoperative Mammography and Ultrasonography  

PubMed Central

Purpose We evaluated the efficacy of breast magnetic resonance imaging (MRI) for detecting additional malignancies in breast cancer patients newly diagnosed by breast ultrasonography and mammography. Methods We retrospectively reviewed the records of 1,038 breast cancer patients who underwent preoperative mammography, bilateral breast ultrasonography, and subsequent breast MRI between August 2007 and December 2010 at single institution in Korea. MRI-detected additional lesions were defined as those lesions detected by breast MRI that were previously undetected by mammography and ultrasonography and which would otherwise have not been identified. Results Among the 1,038 cases, 228 additional lesions (22.0%) and 30 additional malignancies (2.9%) were detected by breast MRI. Of these 228 lesions, 109 were suspected to be malignant (Breast Imaging-Reporting and Data System category 4 or 5) on breast MRI and second-look ultrasonography and 30 were pathologically confirmed to be malignant (13.2%). Of these 30 lesions, 21 were ipsilateral to the main lesion and nine were contralateral. Fourteen lesions were in situ carcinomas and 16 were invasive carcinomas. The positive predictive value of breast MRI was 27.5% (30/109). No clinicopathological factors were significantly associated with additional malignant foci. Conclusion Breast MRI was useful in detecting additional malignancy in a small number of patients who underwent ultrasonography and mammography. PMID:25013439

Kim, Jisun; Han, Wonshik; Moon, Hyeong-Gon; Ahn, Soo Kyung; Shin, Hee-Chul; You, Jee-Man; Chang, Jung Min; Cho, Nariya; Moon, Woo Kyung; Park, In-Ae

2014-01-01

323

[Diagnosis of ductal carcinoma in situ with interruption of the anterior border of the mammary gland by ultrasonography-a case report].  

PubMed

We report a case of ductal carcinoma in situ( DCIS) with interruption of the anterior border of the mammary gland by ultrasonography. The patient was a 41-year-old woman. The patient was identified by a focal asymmetric density on her left breast by screening mammography. Ultrasonography showed an ill-defined low echoic mass, 25 mm in diameter, in the A area of her left breast. The tumor had features consistent with the interruption of the anterior border of the mammary gland. Therefore, she was diagnosed with invasive ductal carcinoma of the breast. We performed a modified radical mastectomy with sentinel lymph node biopsy. A resected specimen led to a diagnosis of DCIS positive for estrogen receptor and progesterone receptor, and negative for HER2/neu protein expression. After surgery, she was administered tamoxifen. One year and 6 months after the operation, she is well without metastases. Ultrasonography is generally useful to differentiate between a DCIS lesion or an invasive ductal carcinoma lesion. However, in this case, we could not diagnose the tumor as DCIS by ultrasonography because the tumor was interrupted by the anterior border of the mammary gland. This case suggests that we should be cautious when diagnosing low echoic tumors with interruption of the anterior border of the mammary gland by ultrasonography. PMID:24394112

Sakurai, Kenichi; Fujisaki, Shigeru; Maeda, Tetsuyo; Nagashima, Saki; Hara, Yukiko; Tomita, Ryouichi; Suzuki, Shuhei; Enomoto, Katsuhisa; Amano, Sadao

2013-11-01

324

Anal inspection and digital rectal examination compared to anorectal physiology tests and endoanal ultrasonography in evaluating fecal incontinence  

Microsoft Academic Search

Background  Anal inspection and digital rectal examination are routinely performed in fecal incontinent patients but it is not clear to\\u000a what extent they contribute to the diagnostic work-up. We examined if and how findings of anal inspection and rectal examination\\u000a are associated with anorectal function tests and endoanal ultrasonography.\\u000a \\u000a \\u000a \\u000a Methods  A cohort of fecal incontinent patients (n=312, 90% females; mean age 59)

Annette C. Dobben; Maaike P. Terra; Marije Deutekom; Michael F. Gerhards; A. Bart Bijnen; Richelle J. F. Felt-Bersma; Lucas W. M. Janssen; Patrick M. M. Bossuyt; Jaap Stoker

2007-01-01

325

Transcranial doppler ultrasonography in acute ischemic stroke predicts stroke subtype and clinical outcome: a study in Omani population  

Microsoft Academic Search

Background  Transcranial Doppler ultrasonography (TCD) is being increasingly used for its ability to provide cerebral hemodynamic information\\u000a in stroke. Few studies have explored its association with cerebral arteriographic changes and stroke subtype. This study explored\\u000a the relation of TCD changes in acute stroke with stroke subtypes, MR cerebral arteriography and clinical outcome in Omani\\u000a population.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Adult patients presenting with acute ischemic

Arunodaya R. Gujjar; Ranjan William; P. C. Jacob; Rajeev Jain; Abdullah R. Al-Asmi

2011-01-01

326

[Clinical significance of detection time and site of early gestational sac by ultrasonography].  

PubMed

Ultrasonography was used to determine not only the shape but also the appearance time and site of GS before the formation of the embryo. These factors were analysed for their clinical significance in association with early GS. The following results were obtained. 1. GS with diameters of 2 < or = approximately < or = 4 mm (abr. EGS) were found at 17-25 postovulatory days (gestational age: GA 4w2d-5w3d) in the ovulation presumed group. EGS was detected at GA 4w2d-7w5d in the normal menstrual group and 17.6% of cases were detected at GA 6w or later. 2. 95.3% of EGS were found in the upper 2/3 of the uterine cavity, while only 4.6% were found in the lower 1/3. This difference in incidence was significant. When EGS was found in the lower uterine segment at GA 6w or later, the abortion rate was very high. 3. In cases where gestation continued to term, there was no difference between the ovulation presumed and normal menstrual groups in terms of various fetal conditions. When normal menstrual group cases where EGS was detected at GA 6w or later were compared with the members of the ovulation presumed group, gestation duration was prolonged in the former. From the above mentioned findings, it can be concluded that even in the early stage of gestation, there can be individual growth differences and that in cases with normal menstrual cycles, gestation can take place much later than the expected date of ovulation, and further that the diagnosis of intrauterine gestation should be postponed until the end of GA 6w. Many blighted ova are detected in cases where GS is found at GA 6w or later, but when gestation is carried to term, no fetal growth abnormalities are found. The ideal nidation site is the endometrium near the fundus and when nidation takes place in the lower segment, the incidence of abortion or placenta previa is very high. PMID:8126381

Kinoshita, K

1994-02-01

327

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

PubMed Central

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

2014-01-01

328

Multimodal Perfluorocarbon Nanoemulsions for 19F MRI, Ultrasonography, and Catalysis of MRgFUS-Mediated Drug Delivery  

NASA Astrophysics Data System (ADS)

Perfluorocarbon nanoemulsions can target lipophilic therapeutic agents to solid tumors and simultaneously provide for monitoring nanocarrier biodistribution via ultrasonography and/or 19F MRI. In the first generation of block copolymer stabilized perfluorocarbon nanoemulsions, perfluoropentane (PFP) was used as the droplet forming compound. Although manifesting excellent therapeutic and ultrasound imaging properties, PFP nanoemulsions were unstable at storage, difficult to handle, and underwent droplet-to-bubble transition upon injection that was hard to control. To solve the above problems, perfluoro-15-crown-5-ether (PFCE) was used as a core forming compound in the second generation of block copolymer stabilized perfluorocarbon nanoemulsions. In the present paper, acoustic, imaging, and therapeutic properties of unloaded and paclitaxel (PTX) loaded PFCE nanoemulsions are reported. The size of paclitaxel-loaded PFCE nanodroplets (300 nm to 500 nm depending on emulsification conditions) favors their passive accumulation in tumor tissue. PFCE nanodroplets manifest both ultrasound and 19F MR contrast properties, which allows the use of multimodal imaging to monitor nanodroplet biodistribution. Ultrasonography and 19F MRI produced consistent results on nanodroplet biodistribution. Sonication with 1-MHz therapeutic ultrasound triggered reversible droplet-to-bubble transition in PFCE nanoemulsions. Microbubbles formed by acoustic vaporization underwent stable cavitation. In a pilot study on ultrasound-mediated therapy of a large breast cancer tumor, paclitaxel-loaded PFCE nanoemulsions combined with 1-MHz ultrasound (MI?1.75) showed excellent therapeutic properties. Anticipated mechanisms of the observed effects are discussed.

Rapoport, N.; Nam, K.-H.; Christensen, D. A.; Kennedy, A. M.; Parker, D. L.; Payne, A. H.; Todd, N.; Shea, J. E.; Scaife, C. L.

2011-09-01

329

Radiofrequency Ablation Combined with Chemoembolization for Intermediate-Sized (3-5 cm) Hepatocellular Carcinomas Under Dual Guidance of Biplane Fluoroscopy and Ultrasonography  

PubMed Central

Objective To assess the technical feasibility and local efficacy of percutaneous radiofrequency ablation (RFA) combined with transcatheter arterial chemoembolization (TACE) for an intermediate-sized (3-5 cm in diameter) hepatocellular carcinoma (HCC) under the dual guidance of biplane fluoroscopy and ultrasonography (US). Materials and Methods Patients with intermediate-sized HCCs were treated with percutaneous RFA combined with TACE. RFA was performed under the dual guidance of biplane fluoroscopy and US within 14 days after TACE. We evaluated the rate of major complications on immediate post-RFA CT images. Primary technique effectiveness rate was determined on one month follow-up CT images. The cumulative rate of local tumor progression was estimated with the use of Kaplan-Meier method. Results Twenty-one consecutive patients with 21 HCCs (mean size: 3.6 cm; range: 3-4.5 cm) were included. After TACE (mean: 6.7 d; range: 1-14 d), 20 (95.2%) of 21 HCCs were visible on fluoroscopy and were ablated under dual guidance of biplane fluoroscopy and US. The other HCC that was poorly visible by fluoroscopy was ablated under US guidance alone. Major complications were observed in only one patient (pneumothorax). Primary technique effectiveness was achieved for all 21 HCCs in a single RFA session. Cumulative rates of local tumor progression were estimated as 9.5% and 19.0% at one and three years, respectively. Conclusion RFA combined with TACE under dual guidance of biplane fluoroscopy and US is technically feasible and effective for intermediate-sized HCC treatment. PMID:23483753

Min, Ji Hye; Cha, Dong Ik; Jeon, Yong Hwan; Shin, Sung Wook; Cho, Sung Ki; Rhim, Hyunchul; Lim, Hyo K.

2013-01-01

330

Comparison between subjective and objective assessments of the cervix before induction of labour.  

PubMed

The aim of the study was to compare the pre-induction cervical assessment by Bishop's score with the transvaginal ultrasound cervical length as predictors of the induction-delivery interval (IDI) and the success of induction. This prospective study included 104 women with singleton pregnancies who were booked for induction of labour at term over a period of 3 years. Transvaginal ultrasound measurement of the cervical length and Bishop's Score were performed by different operators. Data were collected on parity, gestational age, methods of induction, Bishop's score, ultrasound cervical length measurements, IDI and mode of delivery. A total of 87 women (83.7%) delivered vaginally and 17 (16.3%) delivered by caesarean section. Linear regression models demonstrated that ultrasound cervical length was a better indicator of IDI than Bishop's score. The adjusted R2 for the regression including ultrasound cervical length was 0.87 compared with a value of 0.67 for the model including Bishop's score. Although logistic regression analysis confirmed that cervical effacement was the best component of Bishop's score to predict the mode of delivery, ultrasound cervical length assessment provided better prediction. Receiver operating characteristic curve showed that the optimised cut-off value for prediction of vaginal delivery was < or =3.4 cm for the cervical length and >5 for the Bishop's score. At those optimised cut-off values the cervical length predicted vaginal delivery with sensitivity of 62.1% (95% CI [51%, 72.3%]) and specificity of 100% (95% CI [80.5%, 100%]) while the Bishop's score predicted vaginal delivery with a sensitivity of 23% (95% CI [14.6%, 33.2%]) and specificity of 88.2% (95% CI [63.5%, 98.5%]). Further analysis showed that ultrasound cervical length has a higher sensitivity in prediction of vaginal delivery in multiparous than nulliparous women (85.1% compared with 35%) at a cut-off value of < or =3.4 cm. On the other hand, it has a higher sensitivity in nulliparous comparable with multiparous women (85.3% compared with 30%) in prediction of IDI at a cut-off value of >3.5 cm. In conclusion, transvaginal ultrasound cervical length assessment is better than Bishop's score in predicting the IDI and the success of induction of labour. PMID:17000497

Elghorori, M R M; Hassan, I; Dartey, W; Abdel-Aziz, E; Bradley, M

2006-08-01

331

Liver function assessment in workers exposed to vinyl chloride  

Microsoft Academic Search

Objective: To investigate liver function in vinyl chloride workers and assess its relation with current\\/past occupational exposure\\u000a to vinyl chloride monomer (VCM). Methods: A medical examination including the execution of liver function tests (LFTs) and liver ultrasonography was executed in a\\u000a group of 757 workers with a long-standing service in the production of VCM\\/polyvinylchloride (PVC). Cumulative and maximum\\u000a VCM exposures

Marco Maroni; Anna Clara Fanetti

2006-01-01

332

Continuous fetal heart rate monitoring during late gestation in cattle by means of Doppler ultrasonography: Reference values obtained by computer-assisted analysis  

Microsoft Academic Search

Continuous fetal heart rate (FHR) monitoring using transabdominal Doppler ultrasonography can be assumed to provide information about the viability of the bovine fetus during late gestation, as has been found in humans. To be able to recognize unfavourable fetal conditions, first the normal ranges of FHR parameters in cattle should be established. Therefore, in this study we aimed to determine

Simone Breukelman; Edu J. H. Mulder; Riek van Oord; Herman Jonker; Bert C van der Weijden; Marcel A. M. Taverne

2006-01-01

333

Endoscopic ultrasonography-guided trucut biopsy for the preoperative diagnosis of peripancreatic Castleman's disease: a case report.  

PubMed

Castleman's disease (CD) of the pancreas/peripancreas is extremely rare. The recently introduced, endoscopic ultrasonography (EUS)-guided trucut biopsy (TCB) is a useful diagnostic modality for obtaining tissue samples from peripancreatic lesions. However, its role in diagnosing CD remains unknown. We report a case of localized, peripancreatic, hyaline-vascular CD biopsied using EUS. The pathology results were initially interpreted as an extranodal, marginal-zone B-cell lymphoma. However, polymerase chain reaction (PCR) study for the IgH gene rearrangement revealed a polyclonal pattern. We also reviewed the relevant literature. To our knowledge, this is the first illustrated report on EUS-TCB findings of CD with its pathology results of EUS-TCB mimicked a B-cell lymphoma. PMID:18395917

Rhee, Kyoung-Hoon; Lee, Sang-Soo; Huh, Joo-Ryung

2008-04-01

334

Estimation of blood flow in the carotid artery and intraorbital ophthalmic artery by color pulse Doppler ultrasonography.  

PubMed

Blood flow velocity was estimated in the orbital part of the ophthalmic artery and in the carotid artery, by way of pulse Doppler ultrasonography. The equipment was a Toshiba SSA-270A machine. The material comprised 12 glaucoma patients (20 eyes, all with open angles) under satisfactory IOP control, mean age 52 years, and 28 healthy controls (mean age 40 years; 54 eyes). Systolic flow velocities of 46 cm/sec and 103 cm/sec, in the ophthalmic and carotid artery respectively, were found in the normal subjects. With mean values of 42 and 116 cm/sec in the glaucoma group there was no significant difference between groups. The same applied to the average flow velocities. A considerable interindividual variation was found. PMID:1332397

Tane, S; Hashimoto, T

1992-01-01

335

[Usefulness of Doppler-color ultrasonography and identification of resistance indexes as early indicators of testicular infarction secondary to orchiepididymitis].  

PubMed

The testicular infarction can be a rare complication of the orchiepididymitis. The ultrasonography appearance of the partial infarctions creates confusion with expansive intratesticular processes. We present three cases of focal testicular infarction associated with orchiepididymitis, stressing the usefulness of the Color doppler sonography for detecting the avascular nature o these lesions. The determination of de indeces of resistance (IR) in the doppler spectrum of intratesticular arteries showed a highly increased vascular resistance in respect of the healthy testicle. In patients with grave orchiepididymitis vein drainage can be affected due to compressive edema or to thrombosis, causing the raising of the resistance indeces. Acknowledging the avascular resistance of the focal post-orchiepididymitis infarction we can prevent unnecessary orchiectomy. PMID:10746375

López Milena, G; Medina Benítez, A; Ortega Herrera, R; Rabaza Espigares, J; Romero Manjón, M I; Hernández Abad, M J

2000-01-01

336

Clinician performed resuscitative ultrasonography for the initial evaluation and resuscitation of trauma  

PubMed Central

Background Traumatic injury is a leading cause of morbidity and mortality in developed countries worldwide. Recent studies suggest that many deaths are preventable if injuries are recognized and treated in an expeditious manner – the so called 'golden hour' of trauma. Ultrasound revolutionized the care of the trauma patient with the introduction of the FAST (Focused Assessment with Sonography for Trauma) examination; a rapid assessment of the hemodynamically unstable patient to identify the presence of peritoneal and/or pericardial fluid. Since that time the use of ultrasound has expanded to include a rapid assessment of almost every facet of the trauma patient. As a result, ultrasound is not only viewed as a diagnostic test, but actually as an extension of the physical exam. Methods A review of the medical literature was performed and articles pertaining to ultrasound-assisted assessment of the trauma patient were obtained. The literature selected was based on the preference and clinical expertise of authors. Discussion In this review we explore the benefits and pitfalls of applying resuscitative ultrasound to every aspect of the initial assessment of the critically injured trauma patient. PMID:19660123

Gillman, Lawrence M; Ball, Chad G; Panebianco, Nova; Al-Kadi, Azzam; Kirkpatrick, Andrew W

2009-01-01

337

Evaluation of the clinical impact of endoscopic ultrasonography in gastrointestinal disease  

Microsoft Academic Search

Background: Outcome studies evaluating the impact of endosonography on patient management are lacking. We conducted a prospective study to assess the overall clinical effectiveness of endosonography as perceived by the requesting physician.Methods: Physicians requesting endosonography were asked to fill out a questionnaire listing clinical diagnosis, diagnostic certainty, and future management plans. After the procedure, the requesting physicians were asked about

Irshad H. Jafri; John R. Saltzman; Jay M. Colby; Peter E. Krims

1996-01-01

338

NOTES transvaginal cholecystectomy: preliminary clinical application  

Microsoft Academic Search

Background  Natural orifice translumenal endoscopic surgery (NOTES) is an emerging concept in the recent literature that could lead to\\u000a potential benefits in clinical applications. Restricted to animal experiments, however, human procedures have not yet been\\u000a published. Because of the technical and ethical challenges involved in perforation and closure of a healthy organ—as is also\\u000a seen in operating via the transgastric route—and

R. Zorron; L. C. Maggioni; L. Pombo; A. L. Oliveira; G. L. Carvalho; M. Filgueiras

2008-01-01

339

Transvaginal perineal body repair for low rectocele.  

PubMed

We describe our technique of low rectocele repair which is based on the approximation and lifting of the laterally displaced perineal bodies (PBs) using the Tissue Fixation System, a 7-mm-wide tensioned macropore polypropylene sling. In low rectocele, the PB between the rectum and vagina is thinned and laterally displaced but still attached to the deep transverse perineal (DTP) muscle. Our technique is described with the aid of a video. The vagina and rectum are dissected off the laterally displaced PBs. The DTP attachment of each PB to the descending ramus is identified per rectum. A tunnel is created in the DTP on both sides to insert the polypropylene mesh attached to an anchor. The loop of tape between the anchors is shortened via the one-way system at the base of the anchor to elevate the inferolaterally displaced PBs to a more medial position. This is infiltrated by collagen over time, creating a "neo-central tendon." The musculofascial layer of the rectum, the vagina, and superficial layers of the PBs are approximated. Our cure rate for low rectocele repair was in excess of 90 %, even with an early version of this procedure. Our method differs from rectocele repair with large mesh in that it precisely mimics the damaged structure and uses only very short thin strips of tape to approximate and reinforce PBs weakened by birth injury and age. PMID:23417773

Petros, P; Inoue, H

2013-08-01

340

The clinical contribution of integrated laboratory and ambulatory anorectal physiology assessment in faecal incontinence.  

PubMed

To determine the clinical value of anorectal physiology testing, we have assessed 73 patients with neurogenic incontinence (median age 55 years, 60 female) and 115 controls (median age 48 years, 81 female). All the faecally incontinent patients displayed abnormal anal mucosal electrosensitivity and prolonged pudendal nerve latencies. Rectal compliance was poor in 14% of patients with neurogenic incontinence. Twenty-seven sphincter injuries were identified by endoanal ultrasonography in patients with neurogenic incontinence. Anal sphincter electromyographic abnormalities were demonstrated in all the incontinent patients. Anal pressures were lower in the incontinent group. Frequent, abnormal internal sphincter relaxations were observed in patients with incontinence during ambulatory assessment. These tests provide objective evidence of injury but do not frequently affect clinical decision making. Endoanal ultrasonography and ambulatory assessment provided clinical information of the mechanism of incontinence in 60% of patients. PMID:8409687

Farouk, R; Bartolo, D C

1993-07-01

341

Ultrasonography as an aid in the diagnosis and management of surgical diseases of the pelvis: special emphasis on the genitourinary system.  

PubMed

Technological advances, particularly the advent of the gray scale technique, has greatly extended the application and usefulness of this modality to clinical diagnoses and surgery. The ultrasonic beam uniquely provides anatomical profiles in the transverse (cross-sectional) and sagittal (longitudinal) planes of the body. Intra-rectal and intra-vaginal ultrasonic probes have provided unique definition of both the normal and pathologic anatomy of the pelvic organs. The present report is drawn from a continuing experience with ultrasonography of the genitourinary system with an update of current technological advances. Ultrasonography has proven especially valuable in the following clinical applications: 1) Early diagnosis of cancer (especially of the prostate); 2) Accurate staging of cancer of the bladder and prostate; 3) Monitoring of the response of the pathologic process to therapy. PMID:1015892

Boyce, W H; McKinney, W M; Resnick, M I; Willard, J W

1976-10-01

342

Endoscopic Retrograde Cholangiopancreatography, Intraductal Ultrasonography, and Magnetic Resonance Cholangiopancreatography in Bile Duct Strictures: A Prospective Comparison of Imaging Diagnostics with Histopathological Correlation  

Microsoft Academic Search

OBJECTIVES:A variety of imaging techniques are available to diagnose bile duct strictures; the most effective imaging technique, however, has not been established yet. In the present study, we compared the impact of endoscopic retrograde cholangiopancreatography (ERCP), intraductal ultrasonography (IDUS), and magnetic resonance cholangiopancreatography (MRCP) with regard to diagnosing bile duct strictures.METHODS:We prospectively examined 33 patients with jaundice due to bile

Dirk Domagk; Johannes Wessling; Peter Reimer; Lars Hertel; Christopher Poremba; Norbert Senninger; Achim Heinecke; Wolfram Domschke; Josef Menzel

2004-01-01

343

Endobronchial ultrasonography with a guide-sheath and virtual bronchoscopy navigation aids management of peripheral pulmonary nodules.  

PubMed

Occasionally, we have difficulty in diagnosing small peripheral pulmonary nodules. However, efforts have been made to resolve this problem. For instance, computed-tomography (CT), positron emission tomography (PET), flexible bronchoscopy examination (BF), and video-assisted thoracic surgery (VATS) have been performed to investigate such nodules. We have used endobronchial ultrasonography with a guide-sheath (EBUS-GS) for BF examination, and recently applied the virtual reality technique "virtual bronchoscopy (VB)". Here, we present a case in which a combined technique with VB and EBUS-GS was useful. The patient was a 54-year-old man with a persistent cough and chest pain. Small nodules were seen in the bilateral lungs on the chest CT taken at the local hospital. A slight increase in the CEA level (6.1 ng/ml; normal level < 5.0 ng/ml) was shown as well as an uptake in the latter term on PET. As a result, he was referred to our hospital for a detailed work-up. We applied VB to confirm the location of the tumor, which allowed us to approach the lesion easily. Furthermore, we precisely localized the lesion using EBUS-GS. Then a biopsy was performed, which demonstrated bronchiolitis obliterans organizing pneumonia (BOOP). As seen in this case, combining VB and EBUS-GS seems beneficial for diagnosing peripheral pulmonary nodules. PMID:17760269

Okimasa, Seiji; Yoshioka, Shinkichiro; Shibata, Satoshi; Awaya, Yoshikazu; Nagao, Yukiyasu; Murakami, Isao; Shigeto, Eriko; Asahara, Toshimasa

2007-06-01

344

Evaluation of hemodynamics in esophageal varices. Value of endoscopic color Doppler ultrasonography with a galactose-based contrast agent.  

PubMed

Endoscopic color Doppler ultrasonography (ECDUS) is a useful modality for obtaining color flow images of esophageal varices. Levovist is a microbubble echo-enhancing agent, which improves Doppler ultrasound examination. In this paper, we compared vessel images detected with pre-contrast with those detected by enhanced ECDUS using Levovist in 62 patients with esophageal varices. Color flow images of esophageal varices and paraesophageal veins by pre-contrast ECDUS were obtained in 62 (100%) of the 62 patients. Vessel images of perforating veins were obtained in 48 (77.4%) of the 62 patients with pre-contrast ECDUS. The perforating veins were classified into three types according to the flow direction. Type 1 showed in-flow from the paraesophageal veins to the esophageal varices, Type 2 showed out-flow from the esophageal varices to the paraesophageal veins, and Type 3 was a mixed type showing both in-flow and out-flow. After Levovist contrast, color flow images detected with pre-contrast ECDUS were improved in all patients. Color flow images of perforating veins were obtained in 60 (96.8%) of the 62 patients by enhanced ECDUS using Levovist. Pre-contrast-diagnosed Type 2 patterns had been re-diagnosed as Type 3 in five patients, and three cases with Type 1 had been relabeled as Type 3 pattern using Levovist. The use of Levovist contrast can improve the diagnostic quality of ECDUS examinations of esophageal variceal patients, yielding a much clearer picture of the hemodynamics. PMID:12644039

Sato, Takahiro; Yamazaki, Katsu; Toyota, Jouji; Karino, Yoshiyasu; Ohmura, Takumi; Suga, Toshihiro

2003-01-01

345

[Ultrasonography of the whole abdomen in non-Hodgkin's lymphoma of the small intestine in children. Apropos of 9 cases].  

PubMed

The value of ultrasonic tomography exploration of the abdomen in non-Hodgkin's lymphoma of the small intestine is illustrated by findings in 9 children. Performed as the initial examination for an abdominal mass (sometimes after a straight radiograph), a positive diagnosis was established by ultrasonography in all cases. Moreover, extensions of the lesion were identified in the liver in two cases, in the two kidneys in four cases, and retroperitoneal adenopathies detected in one case. Ultrasonic findings in the case of intestinal localizations were a hypoechogenic mass with a hyperechogenic zone or a gaseous acoustic shadow in its center. Kidney, liver, and retroperitoneal lesions were seen as hypoechogenic nodules. In one case, there was an increase in echogenicity of both kidneys, these being more echogenic than the liver. This atypical appearance is emphasized as it does not appear to have been reported previously in the published literature. Results of ultrasonic and conventional radiological examinations are compared, and ultrasonic differential diagnosis discussed. PMID:7153959

Hamdouch, M; Sbihi, A H; Barahioui, M; Outarahout, O; Benjelloun, H

1982-11-01

346

Transcranial Doppler Ultrasonography (TCD) in Infants with Sickle Cell Anemia: Baseline Data from the BABY HUG Trial  

PubMed Central

Background Transcranial Doppler ultrasonography (TCD) is used to predict stroke risk in children with sickle cell anemia (SCA), but has not been adequately studied in children under age 2 years. Procedure TCD was performed on infants with SCA enrolled in the BABY HUG trial. Subjects were 7–17 months of age (mean 12.6 months). TCD examinations were successfully performed in 94% of subjects (n=192). Results No patient had an abnormal TCD as defined in the older child (time averaged maximum mean velocity ? 200cm/sec) and only 4 subjects (2%) had velocities in the conditional range (170–199cm/sec). TCD velocities were inversely related to hemoglobin concentration and directly related to increasing age. Conclusion Determination of whether the TCD values in this very young cohort of infants with SCA can be used to predict stroke risk later in childhood will require analysis of exit TCD’s and long-term follow-up, which is ongoing. (ClinicalTrials.gov number, NCT00006400) PMID:19813252

Pavlakis, Steven G.; Rees, Renee C.; Huang, Xiangke; Brown, R. Clark; Casella, James F.; Iyer, Rathi V.; Kalpatthi, Ram; Luden, Judy; Miller, Scott T.; Rogers, Zora R.; Thornburg, Courtney D.; Wang, Winfred C.; Adams, Robert J.

2009-01-01

347

The diagnostic utility of endobronchial ultrasonography with a guide sheath and tomosynthesis images for ground glass opacity pulmonary lesions  

PubMed Central

Background With the widespread use of computed tomography (CT), the frequency of discovering ground glass opacity (GGO) pulmonary lesions has increased. There have been some reports on surgery or transthoracic needle aspiration (TTNA) for diagnostic sampling of GGOs but none on transbronchial biopsy (TBB). The purpose of this study was to evaluate the diagnostic utility of chest tomosynthesis images and TBB through endobronchial ultrasonography with a guide sheath (EBUS-GS) for GGO. Methods This study included 40 patients (19 men, 21 women; age 66.9±8.7 years, mean ± standard deviation, SD). The mean lesion diameter was 22±10 mm (mean ± SD). Chest tomosynthesis images served as maps prior to bronchoscopic sampling using radial EBUS probe with a guide sheath kit. Results The overall diagnostic yield of EBUS-GS-guided TBB was 65.0% (26 of 40 lesions). In a multivariate analysis, diagnostic yield of lesions with EBUS images (79.2%, 19 of 24 cases) was significantly higher than those lesions without EBUS images detected (43.8%, 7 of 16 cases) (P=0.017). Detectability on chest tomosynthesis was not a significant contributing factor. Only one complication was observed: pneumothorax that did not require chest tube drainage. Conclusions TBB through EBUS-GS can be considered as one of the diagnostic methods for GGO. Further technological development is required to identify the location of the target GGO lesion more precisely. PMID:24409350

Sasada, Shinji; Chavez, Christine; Tsuchida, Takaaki

2013-01-01

348

Peripheral nerve sheath tumors. Benign or malignant? The role of MRI and ultrasonography in a case report.  

PubMed

A 31-year-old male patient admitted to another hospital for investigation of a localized painful hump in the medial surface of his left leg. The clinical examination revealed a painful palpable lump in the medial surface of left thigh that was initially thought to be a hematoma due to a history of recent trauma. However, an ultrasound was requested to exclude deep venous thrombosis (DVT). The US examination revealed a heterogeneous, fusiform lesion with elongated proximal and distal projections in close proximity to superficial femoral artery and vein and could not definitely exclude the DVT hypothesis. In a second ultrasound examination performed in our department, a neurogenic origin of the lesion was proposed. A consequent MRI examination confirmed the presence of a fusiform tumor in the anatomic path of the saphenous nerve. This was further confirmed intraoperatively, and pathologically was diagnosed as a malignant peripheral nerve sheath tumor (MPNST). In this present study the role of ultrasonography, the correlation between MRI and ultrasonographic findings are discussed and a review of the literature is presented. PMID:22913746

Chatzistefanou, Alexandros; Mantatzis, Michalis; Deftereos, Savas; Mintzopoulou, Paraskevi; Prassopoulos, Panos

2014-01-01

349

The role of ultrasonography in the diagnosis of rheumatoid arthritis and peripheral spondyloarthropathies  

PubMed Central

Summary In recent years a dynamic development of ultrasound technology has been observed. Consequently, ultrasound is increasingly being utilized in rheumatology. With the introduction of high-frequency (up to 18 MHz) linear probes, sensitive Doppler techniques, harmonic imaging options and cross beams, ultrasound is used in the initial diagnosis of rheumatic diseases, monitoring of the effectiveness of treatment and confirmation of remission. Ultrasound cannot identify specific rheumatic diseases, but it does allow for an evaluation of the type of pathology, including an assessment of disease progression and its location. These irregularities include: synovial pathologies, effusion, tendon, cartilage and bone lesions, tendon and ligament pathology at the site of their insertion (enthesopathies). This publication discusses the wide spectrum of changes in peripheral joints and entheses observed on ultrasound. Special consideration is given to the ultrasound, which besides an MRI is a leading diagnostic tool in the diagnosis of early stages of the disease and monitoring of disease progression. PMID:24688619

Sudol-Szopinska, Iwona; Zaniewicz-Kaniewska, Katarzyna; Saied, Fadhil; Kunisz, Wojciech; Smorawinska, Patrycja; Wlodkowska-Korytkowska, Monika

2014-01-01

350

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

PubMed

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

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

2011-01-01

351

Misoprostol Abortion: Ultrasonography versus Beta-hCG Testing for Verification of Effectiveness  

PubMed Central

Background and Objective: Miscarriage is a common complication of early pregnancy with medical and psychological consequences. Dilation and Curettage are considered as two standard caring ways for early pregnancy failure. Alternatively misoprostol has been used as a single agent for termination of early pregnancy. Aim of the present study was to compare the usefulness of serum ?-hCG measurement and ultrasound examination to predict complete abortion after medical induction. Methods: There were one hundred and thirty three patients experiencing missed abortion or blighted ovum. Ultrasound examination and serum ?-hCG test were performed before treatment and during follow-up in all these patients. Results: Treatment was successful without any need for surgical intervention in 92.4% of the cases. Both methods could verify the complete abortion among all the patients at the end of the study (4th week). Kappa agreement coefficient for the two methods of diagnosis was 0.327 (P < 0.5). Conclusion: Based on our results, ?- hCG is as effective as ultrasound in confirming a successful medically induced abortion in early pregnancy, but it should be used as supplements to clinical assessments. PMID:24550955

Behnamfar, Fariba; Mahdian, Mehrdad; Rahimi, Fereshteh; Samimi, Mansoureh

2013-01-01

352

Clinical, ultrasonography and haematology of aglepristone-induced mid-gestation pregnancy terminations in rabbits.  

PubMed

Aglepristone is a safe abortifacient in cats, dogs and rabbits. Although no serious side effects have been reported, there is no information available about the effects of the medicine on haematological parameters. For the first time clinical and ultrasonographic features and haematological profiles were evaluated in rabbits treated with aglepristone 15 and 16 days after mating. Ten healthy 10-14 month-old New Zealand White female rabbits were mated with fertile bucks and pregnancies were con?rmed by ultrasound 15 days later. Of these, 5 does were treated with aglepristone (test group, n = 5) whilst the remaining five (control group, n = 5) were treated with a saline solution (0.9% NaCl). The treatment dose was 10 mg/kg body weight, administered subcutaneously once daily on two consecutive days (day 15 and 16 post mating). Ultrasonographic, clinical and haematological assessments were performed daily. Aglepristone treatment induced embryonic fluid resorptions without foetal death in mid-gestation terminations. Following ultrasonographic and haematological examinations, it was established that aglepristone is a safe abortifacient in rabbits. PMID:23718772

Özalp, Gözde R; Temizel, Ethem M; Özocak-Batmaz, Elçin

2013-01-01

353

Skin thickness on bony prominences measured by ultrasonography in patients with spinal cord injury  

PubMed Central

Objective The detailed assessment of soft tissues over bony prominences and identification of methods of predicting pressure sores would improve the quality of care for patients with spinal cord injury (SCI). Comparing skin thicknesses on bony prominences in patients with SCI to those in healthy individuals will represent, to our knowledge, the first study aimed at determining whether differences in skin thicknesses between these groups can be detected by ultrasound. Design In both patients and controls, skin thicknesses on the sites at risk for pressure ulcers – sacrum, greater trochanter, and ischium – were evaluated using high-frequency ultrasound. The waist was also evaluated by the same method for control as it was considered to be a pressure-free region. Participants Thirty-two patients with complete thoracic SCI and 34 able-bodied individuals. Results The skin was significantly thinner over the sacrum and ischial tuberosity in individuals with SCI compared with healthy individuals. No significant differences were observed in skin thicknesses over the greater trochanter or the waist between the two groups. Conclusions Protecting skin integrity in patients with paraplegia is challenging due to many contributing factors, such as prolonged pressure, frictional/shearing forces, and poor nutrition. Thinning of the skin can increase the risk of soft tissue damage, leading to pressure ulcers. The significant differences in skin thickness at the sacrum and ischium provide the basis for establishing the early signs of pressure damage. Measuring skin thickness by ultrasound is a reliable non-invasive method that could be a promising tool for predicting pressure ulcers. PMID:23809593

Yalcin, Elif; Akyuz, Mufit; Onder, Burcu; Unalan, Halil; Degirmenci, Ibrahim

2013-01-01

354

Computer-aided detection system for masses in automated whole breast ultrasonography: development and evaluation of the effectiveness  

PubMed Central

Purpose: The aim of this study was to evaluate the performance of a proposed computer-aided detection (CAD) system in automated breast ultrasonography (ABUS). Methods: Eighty-nine two-dimensional images (20 cysts, 42 benign lesions, and 27 malignant lesions) were obtained from 47 patients who underwent ABUS (ACUSON S2000). After boundary detection and removal, we detected mass candidates by using the proposed adjusted Otsu's threshold; the threshold was adaptive to the variations of pixel intensities in an image. Then, the detected candidates were segmented. Features of the segmented objects were extracted and used for training/testing in the classification. In our study, a support vector machine classifier was adopted. Eighteen features were used to determine whether the candidates were true lesions or not. A five-fold cross validation was repeated 20 times for the performance evaluation. The sensitivity and the false positive rate per image were calculated, and the classification accuracy was evaluated for each feature. Results: In the classification step, the sensitivity of the proposed CAD system was 82.67% (SD, 0.02%). The false positive rate was 0.26 per image. In the detection/segmentation step, the sensitivities for benign and malignant mass detection were 90.47% (38/42) and 92.59% (25/27), respectively. In the five-fold cross-validation, the standard deviation of pixel intensities for the mass candidates was the most frequently selected feature, followed by the vertical position of the centroids. In the univariate analysis, each feature had 50% or higher accuracy. Conclusion: The proposed CAD system can be used for lesion detection in ABUS and may be useful in improving the screening efficiency. PMID:24936503

2014-01-01

355

A new endoscopic ultrasonography image processing method to evaluate the prognosis for pancreatic cancer treated with interstitial brachytherapy  

PubMed Central

AIM: To develop a fuzzy classification method to score the texture features of pancreatic cancer in endoscopic ultrasonography (EUS) images and evaluate its utility in making prognosis judgments for patients with unresectable pancreatic cancer treated by EUS-guided interstitial brachytherapy. METHODS: EUS images from our retrospective database were analyzed. The regions of interest were drawn, and texture features were extracted, selected, and scored with a fuzzy classification method using a C++ program. Then, patients with unresectable pancreatic cancer were enrolled to receive EUS-guided iodine 125 radioactive seed implantation. Their fuzzy classification scores, tumor volumes, and carbohydrate antigen 199 (CA199) levels before and after the brachytherapy were recorded. The association between the changes in these parameters and overall survival was analyzed statistically. RESULTS: EUS images of 153 patients with pancreatic cancer and 63 non-cancer patients were analyzed. A total of 25 consecutive patients were enrolled, and they tolerated the brachytherapy well without any complications. There was a correlation between the change in the fuzzy classification score and overall survival (Spearman test, r = 0.616, P = 0.001), whereas no correlation was found to be significant between the change in tumor volume (P = 0.663), CA199 level (P = 0.659), and overall survival. There were 15 patients with a decrease in their fuzzy classification score after brachytherapy, whereas the fuzzy classification score increased in another 10 patients. There was a significant difference in overall survival between the two groups (67 d vs 151 d, P = 0.001), but not in the change of tumor volume and CA199 level. CONCLUSION: Using the fuzzy classification method to analyze EUS images of pancreatic cancer is feasible, and the method can be used to make prognosis judgments for patients with unresectable pancreatic cancer treated by interstitial brachytherapy. PMID:24151368

Xu, Wei; Liu, Yan; Lu, Zheng; Jin, Zhen-Dong; Hu, Yu-Hong; Yu, Jian-Guo; Li, Zhao-Shen

2013-01-01

356

Quantitative Evaluation of Contrast-Enhanced Ultrasonography in the Diagnosis of Chronic Ischemic Renal Disease in a Dog Model  

PubMed Central

Objectives The aim of this feasibility study was to prospectively explore in a dog model of chronic ischemic renal disease (CIRD) the hypothesis that real-time contrast-enhanced ultrasonography (CEUS) can quantitatively evaluate the early perfusion changes of renal cortex. Materials and Methods In this animal care and use committee-approved study, the model of CIRD was carried out in healthy dogs (10.0?12.0 kg, n?=?5), by placing the Ameroid ring constrictors on the distal portion of right renal artery through operation. CEUS monitoring of right kidney perfusion was performed by intravenous bolus injection of 0.6 ml Sulfur hexafluoride filled microbubbles (SonoVue; Bracco S.P.A., Milan, Italy) every week after operation. The slope rate of ascending curve (A) and descending curve (?), area under curve (AUC), derived peak intensity (DPI), and time to peak (TTP) were measured in renal cortex using commercial quantification software (Q-LAB version 6; Philips Medical Systems, Bothell,WA,USA). The sensitivity of CEUS was compared with blood serum urea nitrogen (BUN) and serum creatinine (SCr) level. Results With the progression of CIRD, dogs showed delayed enhancement and perfusion in renal CEUS curve. Earliest significant changes happened 4 weeks after operation on DPI and TTP which changed from 13.04±2.71 to 15.58±4.75 dB and 9.03±2.01 to 10.62±6.04 sec, respectively (P<.05). Conclusions CEUS can display the perfusion changes of CIRD in the early period. PMID:23936410

Dong, Yi; Wang, Wenping; Cao, Jiaying; Fan, Peili; Lin, Xiyuan

2013-01-01

357

Prostate Volume Measurement by Transrectal Ultrasonography: Comparison of Height Obtained by Use of Transaxial and Midsagittal Scanning  

PubMed Central

Purpose The purpose of this study was to compare prostate volume measured by transrectal ultrasonography (TRUS) between transaxial scanning and midsagittal scanning. We tried to determine which method is superior. Materials and Methods A total of 968 patients who underwent TRUS for diagnosis of any diseases related to the prostate were included in this study. When measuring prostate volume by TRUS, we conducted the measurements two ways at the same time in all patients: by use of height obtained by transaxial scanning and by use of height obtained by midsagittal scanning. Prostate volume was calculated by using the ellipsoid formula ([height×length×width]×?/6). Results For prostate volume measured by TRUS, a paired t-test revealed a significant difference between using height obtained by transaxial scanning and that obtained by midsagittal scanning in all patients (28.5±10.1 g vs. 28.7±9.9 g, respectively, p=0.004). However, there were no significant differences in the prevalence of prostate volume more than 20 g (known benign prostatic enlargement [BPE]) between the two methods by chi-square test (90.5% [n=876], 90.8% [n=879], respectively; p=0.876). When analyzed in the same way, there were no significant differences in the prevalence of prostate volume more than 30 g (generally, high-risk BPE) between the two methods (34.5% [n=334], 36.3% [n=351], respectively; p=0.447). Conclusions Although prostate volume by TRUS differed according to the method used to measure height, that is, transaxial or midsagittal scanning, we conclude that there are no problems in diagnosing BPE clinically by use of either of the two methods. PMID:25045446

Kim, Sung Bin; Cho, In-Chang

2014-01-01

358

Short-term effects of intravitreal triamcinolone acetonide injection on ocular blood flow evaluated with color Doppler ultrasonography  

PubMed Central

AIM To evaluate the changes in ocular blood flow with color Doppler ultrasonography (CDU) after intravitreal triamcinolone acetonide (IVTA) injection. METHODS A total of 46 patients who underwent IVTA (4 mg/0.1 mL) injection for diabetic macular edema (DME) (n=22), central retinal vein occlusion (CRVO) (n=12) and choroidal neovascular membrane (CNVM) (n=12) were included in the study. Peak systolic velocity (PSV), end diastolic velocity (EDV) and resistivity index (RI) were measured from the ophthalmic artery (OA), the central retinal artery (CRA) and the posterior ciliary artery (PCA) of each patient with CDU before, at the end of the first week and at the end of the first month following IVTA injection. RESULTS In the DME group, PSV of OA at the first of the first month (mean±SD) (37.48±10.87 cm/s) increased compared to pre-injection value (31.39±10.84 cm/s) (P=0.048). There was a statistically significant decrease (P=0.049) in PSV of CRA at the end of the first month (7.97±2.67 cm/s) compared to the pre-injection (9.47±3.37 cm/s). There was not any statistically significant difference on the other parameters in the DME group. Also, there was not any statistically significant difference on the ocular blood flow values in the CRVO and CNVM groups. CONCLUSION We observed that 4 mg/0.1 mL IVTA increased PSV of OA and decreased PSV of CRA in DME patients and did not have any effect on ocular blood flow values of CRVO and CNVM patients. PMID:25349798

Anayol, Mustafa Alpaslan; Toklu, Yasin; Kamberoglu, Elif Asik; Raza, Sabri; Arifoglu, Hasan Basri; Simavli, Huseyin; Altintas, Ayse Gul Kocak; Simsek, Saban

2014-01-01

359

[Description and determination of the diameter of arteries and veins in the hindlimb of cattle using B-mode ultrasonography].  

PubMed

The large arteries and veins of both metatarsal and digital regions of 14 healthy, non-pregnant cows with a mean age of 6.1 +/- 1.7 years were examined sonographically (real-time B-mode system with a 7.5 MHz linear-transducer). The ultrasonographic imaging of the larger vessels was investigated, diameters were measured, especially of the digital veins, in which intravenous regional anaesthesia and antibiosis is usually applied. Three measurements per cow on each distal hindlimb were noted over a period of 3 weeks using defined anatomical locations. The mean diameter of the vessels were as follows: Arteria (A.) dorsalis pedis 4.1 +/- 0.4 mm, Vena (V.) dorsalis pedis 5.2 +/- 0.5 mm, A. metatarsea dorsalis III 3.3 +/- 0.4 mm, A. digitalis dorsalis communis III 3.9 +/- 0.4 mm, V. digitalis dorsalis communis III 2.7 +/- 0.4 mm, V. digitalis plantaris communis IV 2.1 +/- 0.4 mm, V. digitalis plantaris communis II 2.1 +/- 0.3 mm, V. metatarsea plantaris lateralis 4.5 +/- 0.8 mm, V. metatarsea plantaris medialis 4.4 +/- 0.6 mm. The Ramus cranialis of the V. saphena lateralis, the A. and V. digitalis plantaris communis III and the A. digitalis plantaris communis II and IV could only be imaged in a few cases. Except for V. digitalis dorsalis communis III, statistical analysis of the mean diameters of the examined vessels of the right and the left distal hindlimb in 14 cows revealed no significant differences (P < 0.05). B-mode ultrasonography proved a suitable method for imaging and examination of the vessels larger than 1 mm in the distal bovine hindlimb and can be recommended as the non-invasive method of choice for the examination of blood vessels in cattle. PMID:7495164

Kofler, J

1995-06-01

360

Ovarian ultrasonography correlated with fecal progestins and estradiol during the estrous cycle and early pregnancy in giraffes (Giraffa camelopardalis rothschildi).  

PubMed

Fecal and urinary progestin analyses have shown that giraffes express a short reproductive cycle, averaging 15 days, compared with other large ruminants. However, actual ovarian events have not been correlated with the hormonal pattern. In this study, mature cycling female Rothschild giraffes (Giraffa camelopardalis rothschildi) were repeatedly examined by transrectal ultrasonography to correlate ovarian function with changes in fecal progestin (fP4 [n(c) = 6]) and estradiol (fE2 [n(c) = 6]) and serum progestin (n(c) = 2) as measured by enzyme immunoassay. Five females became pregnant and were monitored during early gestation. In this study, we discovered that hormone values for fP4 in cycling giraffes do not correlate with the classic profile of follicular development, ovulation, and luteogenesis. The corpus luteum (CL) and the next dominant follicle were forming simultaneously. A mean +/- SD peak in fE2 of 254.92 +/- 194.76 ng/g and subsequent ovulation occurred as early as 1 day after the fall in fP4. In pregnant giraffes, the CL reached a diameter significantly larger (mean +/- SD, 41.02 +/- 2.70 mm; P = 0.0126) than that during the cycle (33.48 +/- 2.80 mm), while follicular activity and fluctuating fE2 were still present. With this research, we demonstrated that the progesterone profile typically used to characterize the ovarian cycle does not correlate with luteal development in the ovaries of this species. Furthermore, we conclude that the giraffe could have evolved a short reproductive cycle because of the almost parallel order of ovarian events. PMID:19587331

Lueders, Imke; Hildebrandt, Thomas B; Pootoolal, Jason; Rich, Peter; Gray, Charlie S; Niemuller, Cheryl A

2009-11-01

361

Esophago-Glottal Closure Reflex in Human Infants: A Novel Reflex Elicited With Concurrent Manometry and Ultrasonography  

PubMed Central

BACKGROUND AND AIMS Our aims were to identify and characterize the glottal response to esophageal mechanostimulation in human infants. We tested the hypotheses that glottal response is related to the type of esophageal peristaltic response, stimulus volume, and respiratory phase. METHODS Ten infants (2.8 kg, SD 0.5) were studied at 39.2 wk (SD 2.4). Esophageal manometry concurrent with ultrasonography of the glottis (USG) was performed. The sensory-motor characteristics of mechanostimulation-induced esophago-glottal closure reflex (EGCR, adduction of glottal folds upon esophageal provocation) were identified. Mid-esophageal infusions of air (N 41) were given and the temporal relationships of glottal response with deglutition, secondary peristalsis (SP), and the respiratory phase were analyzed using multinomial logistic regression models. RESULTS The frequency occurrence of EGCR (83%) was compared (P < 0.001) with deglutition (44%), SP (34%), and no esophageal responses (22%). The odds ratios (OR, 95% CI) for the coexistence of EGCR with SP (0.4, 0.06–2.2), deglutition (1.9, 0.1–26), and no response (1.9, 0.4–9.0) were similar. The response time for esophageal reflexes was 3.8 (SD 1.8) s, and for EGCR was 0.4 (SD 0.3) s (P < 0.001). Volume-response relationship was noted (1 mL vs 2 mL, P < 0.05). EGCR was noted in both respiratory phases; however, EGCR response time was faster during expiration (P < 0.05). CONCLUSION The occurrence of EGCR is independent of the peristaltic reflexes or the respiratory phase of infusion. The independent existence of EGCR suggests a hypervigilant state of the glottis to prevent retrograde aspiration during GER events. PMID:17617206

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

2014-01-01

362

A New Methodology of Viewing Extra-Axial Fluid and Cortical Abnormalities in Children with Autism via Transcranial Ultrasonography  

PubMed Central

Background: Autism spectrum disorders (ASDs) are developmental conditions of uncertain etiology which have now affected more than 1% of the school-age population of children in many developed nations. Transcranial ultrasonography (TUS) via the temporal bone appeared to be a potential window of investigation to determine the presence of both cortical abnormalities and increased extra-axial fluid (EAF). Methods: TUS was accomplished using a linear probe (10–5?MHz). Parents volunteered ASD subjects (N?=?23; males 18, females 5) for evaluations (mean?=?7.46?years?±?3.97?years), and 15 neurotypical siblings were also examined (mean?=?7.15?years?±?4.49?years). Childhood Autism Rating Scale (CARS2®) scores were obtained and the ASD score mean was 48.08?+?6.79 (Severe). Results: Comparisons of the extra-axial spaces indicated increases in the ASD subjects. For EAF we scored based on the gyral summit distances between the arachnoid membrane and the cortical pia layer (subarachnoid space): (1) <0.05?cm, (2) 0.05–0.07?cm, (3) 0.08–0.10?cm, (4) >0.10?cm. All of the neurotypical siblings scored 1, whereas the ASD mean score was 3.41?±?0.67. We also defined cortical dysplasia as the following: hypoechoic lesions within the substance of the cortex, or disturbed layering within the gray matter. For cortical dysplasia we scored: (1) none observed, (2) rare hypoechogenic lesions and/or mildly atypical cortical layering patterns, (3) more common, but separated areas of cortical hypoechogenic lesions, (4) very common or confluent areas of cortical hypoechogenicity. Again all of the neurotypical siblings scored 1, while the ASD subjects’ mean score was 2.79?±?0.93. Conclusion: TUS may be a useful screening technique for children at potential risk of ASDs which, if confirmed with repeated studies and high resolution MRI, provides rapid, non-invasive qualification of EAF, and cortical lesions. PMID:24459462

Bradstreet, James Jeffrey; Pacini, Stefania; Ruggiero, Marco

2014-01-01

363

Assessments Introduction to Assessments  

E-print Network

negotiated rate Campus Assessment: A 3% campus charge is applied to all revenue with the following exemptionsAssessments Introduction to Assessments There are two code types ­ Campus Assessments and Non-University Differential (NUD) Assessments. Campus Assessments are required for all accounts that generate revenue. NUD

Ferrara, Katherine W.

364

Assessing the efficacy of aspiration and ethanol injection in recurrent endometrioma before IVF cycle: A randomized clinical trial  

PubMed Central

Background: Endometriosis is a common hormone-dependent gynecologic disease with a high recurrence. Laparotomy or laparoscopy is the standard surgery for the large endometrioma. Also, sclerotherapy is basically used to treat different diseases one of which is endometrioma. Objective: The study was designed to assess the value of transvaginal ultrasound-guided ethanol sclerotherapy in patients with a recurrent endometrioma. Materials and Methods:In a randomized clinical trial, an interventional group of 20 patients underwent transvaginal ethanol sclerotherapy for recurrent ovarian endometrioma. The patients were followed up first after one and two weeks and then after one, two, and three months. If the patients had no endometrioma, they were treated with in vitro fertilization (IVF) (standard long protocol). A control group of 20 patients with endometrioma were enrolled for an IVF protocol. They had no treatment by ethanol sclerotherapy. IVF parameters, pregnancy rates, and implantation rates were compared in both groups. Results: The demographic data showed no difference between the two groups. The initial mean endometria size was 41.45±15.9 cm, the recurrence rate after 6 months was 4 (20%), FSH before and after sclerotherapy was 6.97±2.25 IU/L and 6.78±1.88 IU/L (p=0.343). The clinical pregnancy rate was 6 (33.3%) vs. 3 (15%), (p=0.616). The fertilization rate emerged 63.06% in study group vs. 60.38%, (p=0.57). The implantation rate turned out 12.9% in study group vs. 7.5%, (p=0.52). None of these results were significant. However, the data pointed to a better trend toward the ethanol sclerotherapy group. Conclusion:Ethanol sclerotherapy could be an effective strategy for the treatment of recurrent endometrioma especially before IVF. PMID:24639744

Aflatoonian, Abass; Rahmani, Elham; Rahsepar, Mozhgan

2013-01-01

365

Imaging diagnosis--nasal septal and laryngeal cyst-like malformationsin a Thoroughbred weanling colt diagnosed using ultrasonography and magnetic resonance imaging.  

PubMed

A foal was examined for abnormal upper airway noise. Endoscopically, there were narrowed nasal passages and an extralumenal mass of the cranial trachea. Using ultrasonography and magnetic resonance (MR) imaging of the larynx and cranial cervical trachea, irregular margins of the laryngeal cartilages and first tracheal ring containing areas consistent with fluid were identified. In MR images, a widened nasal septum was seen that contained material consistent with fluid. Postmortem examination confirmed the diagnosis of nasal septal, laryngeal, and cranial cervical tracheal cyst-like lesions. This is a unique congenital condition, in which premortem imaging was instrumental in defining the abnormalities. PMID:20973382

Garrett, Katherine S; Woodie, J Brett; Cook, Jeffery L; Williams, Neil M

2010-01-01

366

The value of chest tomosynthesis in locating a ground glass nodule (GGN) during endobronchial ultrasonography with a guide sheath: a case report  

PubMed Central

A 74-year-old man was referred to our department for work-up of a pure ground glass nodule (GGN) on computed tomography (CT). He was suspected to have lung cancer by CT scan, but no lesion was visible on chest X-ray. Chest tomosynthesis was performed before bronchoscopy, showing a clear GGN. We could not detect a tumor signal on endobronchial ultrasonography so we relied on the chest tomosynthesis image as a guide during transbronchial biopsy. The diagnosis of adenocarcinoma was confirmed on histopathology. In this case, transbronchial biopsy under the guidance of chest tomosynthesis was useful for the diagnosis of GGN. PMID:23825787

Sasada, Shinji; Chavez, Christine; Nagai, Yuuichi; Kitagawa, Mayumi; Torii, Jun; Iwase, Takumi; Aso, Tomohiko; Nakamura, Yukiko; Mizumori, Yasuyuki; Deng, Chaosheng; Xu, Weihua; Tsuchida, Takaaki; Moriyama, Noriyuki

2013-01-01

367

Is there a real diagnostic impact of elastosonography and contrast-enhanced ultrasonography in the management of thyroid nodules?  

PubMed Central

Ultrasonography (US) and the new applications US elastography (USE) and contrast-enhanced US (CEUS) are used in the screening of thyroid nodules, for which fine-needle aspiration biopsy (FNAB) is the best single diagnostic test. The aim of the study was to compare the sensitivity, specificity, positive predictive value (PPV), and accuracy of the four examinations in nodules with cytological and histological diagnoses. The study used data from US, FNAB, USE (elasticity (ELX 2/1) index), and CEUS (Peak index and time to peak (TTP) index) evaluated in 73 thyroid nodules in 63 consecutive patients likely to undergo surgery. Cytological-histological correlation was available for 38 nodules. No correlation emerged between nodule size and cytological results. A significant (P=0.03) positive correlation between cumulative US findings and cytological results was found. In addition, significant correlations between cumulative US findings and cytology (P=0.02) and between cumulative US findings and histology (P<0.0001) were found. US showed the best specificity and PPV, and FNAB the best sensitivity. There was no significant difference in the ELX 2/1 index, Peak index, or TTP index among nodules subdivided according to cytological scores. No significant correlation was found between ELX 2/1 index, Peak index, and TTP index, on the one hand, and nodule size, US cumulative findings, cytology, and histology on the other hand. The sensitivity of the ELX 2/1 index was high, but its specificity was very low. The accuracy and PPV of USE were lower than those of the other procedures. Only the correlation between Peak index and cumulative US findings reached a value close to significance. Our ultimate aim is to minimise unnecessary thyroidectomy. US and FNAB continue to play a central diagnostic role. The use of a US score showed high specificity and PPV. The specificity of FNAB was low in this selected series because of the numbers of indeterminate cytological responses. USE and CEUS are innovative techniques that need to be standardized. The ELX 2/1 index, Peak index, and TTP index seem to be unrelated to histology. The best statistical data on USE and CEUS concerned their sensitivity and PPV, respectively. At present, USE and CEUS are too time-consuming and of limited utility in selecting patients for surgery. PMID:23463762

Giusti, Massimo; Orlandi, Davide; Melle, Giulia; Massa, Barbara; Silvestri, Enzo; Minuto, Francesco; Turtulici, Gianni

2013-01-01

368

Ultrasonography and pediatric caudals.  

PubMed

Ultrasound is an important tool for performing pediatric regional blocks, including caudal blocks. We present a case in which the availability of ultrasound allowed us to proceed with a successful caudal block which we otherwise might have abandoned in an infant with difficult anatomy. PMID:18165561

Schwartz, Donald; Raghunathan, Karthik; Dunn, Steven; Connelly, Neil Roy

2008-01-01

369

Bedside musculoskeletal ultrasonography.  

PubMed

Bedside sonography for the evaluation of soft tissue and musculoskeletal conditions has become indispensible for physicians caring for patients in critical, emergency, and urgent care settings. This article reviews indications, techniques, and imaging appearances of common conditions encountered in clinical practice. PMID:24606776

Connell, Mary J; Wu, Teresa S

2014-04-01

370

Application of electromagnetic and sound waves in nutritional assessment  

SciTech Connect

Four relatively new techniques that apply electromagnetic or sound waves promise to play a major role in the study of human body composition and in clinical nutritional assessment. Computerized axial tomography, nuclear magnetic resonance, infrared interactance, and ultrasonography provide capabilities for measuring the following: total body and regional fat volume; regional skeletal muscle volume; brain, liver, kidney, heart, spleen, and tumor volume; lean tissue content of triglyceride, iron, and high-energy intermediates; bone density; and cardiac function. Each method is reviewed with regard to basic principles, research and clinical applications, strengths, and limitations.33 references.

Heymsfield, S.B.; Rolandelli, R.; Casper, K.; Settle, R.G.; Koruda, M.

1987-09-01

371

Dioxin-like compounds are not associated with bone strength measured by ultrasonography in Inuit women from Nunavik (Canada): results of a cross-sectional study  

PubMed Central

Background Bone strength in Inuit people appears lower than that of non-Aboriginals. Inuit are exposed to persistent organic pollutants including dioxin-like compounds (DLCs) through their traditional diet that comprises predatory fish and marine mammal fat. Results from experimental and population studies suggest that some DLCs can alter bone metabolism and increase bone fragility. Objective This cross-sectional descriptive study was conducted to examine the relationship between the stiffness index (SI) and plasma concentrations of total DLCs or specific dioxin-like polychlorinated biphenyls (DL-PCBs) in Inuit women of Nunavik (Northern Quebec, Canada). Methods SI was determined by ultrasonography at the right calcaneus of 194 Inuit women aged 35–72 years who participated to Qanuippitaa? How Are We? Nunavik Inuit Health Survey in 2004. Plasma total DLC levels were quantified by measuring the aryl hydrocarbon receptor–mediated transcriptional activity elicited by plasma sample extracts in a cell-based reporter gene assay. Plasma concentrations of DL-PCBs nos. 105, 118, 156, 157, 167 and 189 were measured by gas chromatography–mass spectrometry. We used multiple linear regression analyses to investigate relations between total DLCs or specific DL-PCBs and SI, taking into consideration several potential confounders. Results Neither total plasma DLCs nor specific DL-PCBs were associated with SI after adjustment for several confounders and covariates. Conclusion Our results do not support a relation between exposure to DLCs and bone strength measured by ultrasonography in Inuit women of Nunavik. PMID:23730628

Paunescu, Alexandra-Cristina; Ayotte, Pierre; Dewailly, Eric; Dodin, Sylvie

2013-01-01

372

Diagnostic accuracy of sonohysterography in the evaluation of uterine cavities in tamoxifen administered asymptomatic postmenopausal breast cancer patients with endometrial thickness ?5 mm  

Microsoft Academic Search

To evaluate diagnostic efficacy of transvaginal saline infusion sonohysterography (TV-SHG) in the evaluation of uterine cavities in tamoxifen (TAM) administered asymptomatic postmenopausal breast cancer patients with increased endometrial thickness, sixty asymptomatic postmenopausal breast cancer women receiving adjuvant TAM treatment for at least 6 months and with endometrial thickness’ ?5 mm measured in transvaginal ultrasonography (TVS) were enrolled. Each patient underwent TV-SHG, followed

M. Inal; Y. Yildirim; A. Incebiyik; M. Sanci; C. Ispahi

2006-01-01

373

risk assessment risk assessment  

E-print Network

can also help you spot hazards and put risks in their true perspective. So can accident and ill-healthFive steps risk assessment Five steps TO risk assessment #12;2 What is risk assessment? A risk is to make sure that no one gets hurt or becomes ill. Accidents and ill health can ruin lives, and affect

Martin, Ralph R.

374

Endoscopic ultrasonography-guided transhepatic antegrade stone removal in patients with surgically altered anatomy: case series and technical review (with videos).  

PubMed

Recently, endoscopic ultrasonography (EUS)-guided transhepatic antegrade interventions have been introduced in patients with a surgically altered anatomy. Herein, we focused on and reviewed EUS-guided transhepatic antegrade stone removal (EUS-TASR) in patients with a surgically altered anatomy and native papilla. The basic technique of EUS-TASR involves the following steps: (1) EUS-guided needle puncture; (2) guidewire placement; (3) tract dilation; (4) balloon sphincteroplasty; (5) stone removal; and (6) stent placement if needed. Based on reports in the literature including our cases, the complete stone extraction rate is 71.4% (10/14) including five of our cases (60% success rate) at one session without serious complications. In conclusion, EUS-TASR appears to be feasible and useful in selected patients although its application may be limited depending on anatomical factors and current devices used. PMID:25231935

Itoi, Takao; Sofuni, Atsushi; Tsuchiya, Takayoshi; Ijima, Masashi; Iwashita, Takuji

2014-12-01

375

Carotid Intima-Media Thickness Is Predicted by Combined Eotaxin Levels and Severity of Hepatic Steatosis at Ultrasonography in Obese Patients with Nonalcoholic Fatty Liver Disease  

PubMed Central

Background Non-Alcoholic Fatty Liver Disease (NAFLD) is a distinct coronary artery disease (CAD) risk factor. The atherosclerotic process predisposing to CAD includes altered lipid profile and inflammatory processes. The available evidence suggests that increased circulating levels of eotaxin, an eosinophil chemoattractant cytokine implicated in allergic responses, are detected in the serum of patients with CAD. Relationships were sought between serum eotaxin on the one hand, and intima-media thickness—an early predictor of the atherosclerotic process, hepatic steatosis, arterial blood pressure values, as well as inflammation/immune markers and angiogenetic factors—on the other. Methods Eighty obese patients with NAFLD, diagnosed at ultrasonography, without evident cytolysis, formed our study population. Anthropometric measures, metabolic profile, serum concentrations of interleukin-1?, C-reactive protein, interleukin-6, fibrinogen, ferritin, TNF-?, spleen size, vascular endothelial growth factor, platelet-derived growth factor-BB and heat shock protein-70 were evaluated. Results Serum eotaxin concentrations were distinctly associated with TNF ?, IL-6, IL-1?, VEGF and PDGF-BB levels but not with CRP, fibrinogen, heat shock protein-70 or spleen size. Among the metabolic and anthropometric parameters, a significant predictive power emerged when comparing eotaxin to insulin resistance, expressed as HOMA. NAFLD was distinctly associated with HOMA (P?=?0.0005). Intima-media thickness was well predicted by both eotaxin levels and severity of NAFLD at ultrasonography, although no relation was detected between these last two variables. Discussion and Conclusion A role for insulin resistance in mediating the interplay between eotaxin and other inflammation/immune parameters could be evidenced in the induction/maintenance of atherosclerosis of obese patients with NAFLD. PMID:25268946

Tarantino, Giovanni; Costantini, Susan; Finelli, Carmine; Capone, Francesca; Guerriero, Eliana; La Sala, Nicolina; Gioia, Saverio; Castello, Giuseppe

2014-01-01

376

Ultrasonography-based 2D motion-compensated HIFU sonication integrated with reference-free MR temperature monitoring: a feasibility study ex vivo.  

PubMed

Magnetic resonance imaging (MRI) and ultrasonography have been used simultaneously in this ex vivo study for the image-guidance of high intensity focused ultrasound (HIFU) treatment in moving tissue. A ventilator-driven balloon produced periodic and non-rigid (i.e. breathing-like) motion patterns in phantoms. MR-compatible ultrasound (US) imaging enabled near real-time 2D motion tracking based on optical flow detection, while near-harmonic reference-free proton resonance frequency shift (PRFS) MR thermometry (MRT) was used to monitor the thermal buildup on line. Reference-free MRT was applied to gradient-echo echo-planar imaging phase maps acquired at the frame rate of 250 to 300 ms/slice with voxel size 1.25×1.25×5 mm(3). The MR-US simultaneous imaging was completely free of mutual interferences while minor RF interferences from the HIFU device were detected in the far field of the US images. The effective duty-cycle of the HIFU sonication was close to 100 % and no off-interval was required to temporally decouple it from the ultrasonography. The motion compensation of the HIFU sonication was achieved with an 8 Hz frame rate and sub-millimeter spatial accuracy, both for single-focus mode and for an iterated multi-foci line scan. Near harmonic reference-less PRFS MRT delivered motion-robust thermal maps perpendicular or parallel to the HIFU beam (0.7 °C precision, 0.5 °C absolute accuracy). Out-of-plane motion compensation was not addressed in this study. PMID:22517112

Auboiroux, Vincent; Petrusca, Lorena; Viallon, Magalie; Goget, Thomas; Becker, Christoph D; Salomir, Rares

2012-05-21

377

Intraductal US in assessing the effects of radiation therapy and prediction of patency of metallic stents in extrahepatic bile duct carcinoma  

Microsoft Academic Search

Background: We assessed the local effects of radiation therapy using intraductal ultrasonography (US) to predict the subsequent patency of metallic stents in bile duct carcinoma. Methods: Data from 16 patients with extrahepatic-suprapancreatic bile duct carcinoma were prospectively analyzed. Thin-caliber US probes (2.0 mm diameter\\/20 MHz frequency and 2.8 mm diameter\\/10 MHz frequency) were inserted into the bile duct via a

Kiichi Tamada; Shinichi Wada; Akira Ohashi; Takeshi Tomiyama; Yukihiro Satoh; Takamitsu Miyata; Kenichi Ido; Masanori Nakazawa; Kentaro Sugano

2000-01-01

378

Assessing Classroom Assessment Techniques  

ERIC Educational Resources Information Center

Classroom assessment techniques (CATs) are teaching strategies that provide formative assessments of student learning. It has been argued that the use of CATs enhances and improves student learning. Although the various types of CATs have been extensively documented and qualitatively studied, there appears to be little quantitative research…

Simpson-Beck, Victoria

2011-01-01

379

Metabolic predictors for early identification of fatty liver using doppler and B-mode ultrasonography in overweight and obese adolescents  

Microsoft Academic Search

The aims of our study were: (1) to evaluate the frequency of asymptomatic fatty liver disease (FLD) using both Doppler and\\u000a B-mode ultrasound (US) in overweight and obese adolescents; (2) to compare metabolic findings of fatty liver (FL) assessed\\u000a by two methods; and (3) to evaluate metabolic predictors of FL shown by these methods. Fifty-nine overweight and obese adolescents\\u000a aged

Mine Ozkol; Betül Ersoy; Erhun Kasirga; Fatma Taneli; I??l Esen Bostanci; Bayram Ozhan

2010-01-01

380

Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury  

Microsoft Academic Search

Objective  To assess at admission to the ICU the relationship between optic nerve sheath diameter (ONSD) and intracranial pressure (ICP)\\u000a and to investigate whether increased ONSD at patient admission is associated with raised ICP in the first 48?h after trauma.\\u000a \\u000a \\u000a \\u000a Design and setting  Prospective, blind, observational study in a surgical critical care unit, level 1 trauma center.\\u000a \\u000a \\u000a \\u000a Patients and participants  31 adult patients with

Thomas Geeraerts; Yoann Launey; Laurent Martin; Julien Pottecher; Bernard Vigué; Jacques Duranteau; Dan Benhamou

2007-01-01

381

Early prediction of response to neoadjuvant chemotherapy in patients with breast cancer using diffusion-weighted imaging and gray-scale ultrasonography.  

PubMed

Neoadjuvant chemotherapy (NACT) is a widely accepted therapeutic option for patients with breast cancer. Although NACT produces good results for breast cancer patients, it has the potential to delay effective treatment in patients with chemotherapy-resistant breast cancer. The purpose of the present study was to evaluate the utility of the pretreatment apparent diffusion coefficient (ADC), which is calculated from diffusion-weighted imaging (DWI), the change in ADC after first administration of NACT, and the change in tumor greatest diameter on ultrasonography in the early prediction of the tumor response to NACT. The response rate of breast tumors to NACT was calculated by the greatest diameter measured by contrast-enhanced MRI obtained before and after NACT. Only the change in ADC was significantly correlated with the response rate. The area under the curve of the change in ADC was sufficiently high (0.90, 95% confidence interval, 0.760-1.040) to discriminate between responders and non-responders. Calculation of the ADC from DWI-MRI was found to be useful for predicting breast tumor response to NACT. Further studies are required to investigate the benefit of changing systemic therapy for breast cancer based on the prediction of the response to NACT by DWI-MRI. PMID:24535214

Iwasa, Hitomi; Kubota, Kei; Hamada, Norihiko; Nogami, Munenobu; Nishioka, Akihito

2014-04-01

382

Plasma level of asymmetric dimethylarginine (ADMA) as a predictor of carotid intima-media thickness progression: six-year prospective study using carotid ultrasonography.  

PubMed

This study was designed to determine the relationship between plasma asymmetric dimethylarginine (ADMA) and the development of carotid atherosclerosis. Cross-sectional studies have revealed that plasma ADMA concentration is correlated with the intima-media thickness (IMT) of the carotid artery, but no prospective studies have appeared. Therefore we prospectively investigated whether or not plasma ADMA level can predict IMT progression. In a community-based cohort, we enrolled 712 subjects who were over 40 years old and who had no apparent cardiovascular diseases according to high-resolution carotid ultrasonography. Blood chemistries including ADMA were measured at baseline. In 575 subjects, IMT was re-measured 6 years later. The value of baseline ADMA for predicting IMT changes was investigated by multivariable analysis. At baseline, there was a significant (beta=0.321; p<0.001) relationship between IMT and ADMA levels. Multiple linear regression analysis revealed that baseline ADMA (beta=0.241; p<0.01) was the only predictor of IMT progression after adjustments for age, sex, baseline IMT, and four major risk factors (hypertension, hypercholesterolemia, diabetes mellitus, and smoking) plus hyperuricacidemia. Plasma ADMA was a predictor of carotid IMT progression. PMID:18716367

Furuki, Kumiko; Adachi, Hisashi; Enomoto, Mika; Otsuka, Maki; Fukami, Ako; Kumagae, Shun-ichi; Matsuoka, Hidehiro; Nanjo, Yasuki; Kakuma, Tatsuyuki; Imaizumi, Tsutomu

2008-06-01

383

Comparison of Endoscopic Ultrasonography and Multislice Spiral Computed Tomography for the Preoperative Staging of Gastric Cancer - Results of a Single Institution Study of 610 Chinese Patients  

PubMed Central

Background This study compared the performance of endoscopic ultrasonography (EUS) and multislice spiral computed tomography (MSCT) in the preoperative staging of gastric cancer. Methodology/Principal Findings A total of 610 patients participated in this study, all of whom had undergone surgical resection, had confirmed gastric cancer and were evaluated with EUS and MSCT. Tumor staging was evaluated using the Tumor-Node-Metastasis (TNM) staging and Japanese classification. The results from the imaging modalities were compared with the postoperative histopathological outcomes. The overall accuracies of EUS and MSCT for the T staging category were 76.7% and 78.2% (P=0.537), respectively. Stratified analysis revealed that the accuracy of EUS for T1 and T2 staging was significantly higher than that of MSCT (P<0.001 for both) and that the accuracy of MSCT in T3 and T4 staging was significantly higher than that of EUS (P<0.001 and 0.037, respectively). The overall accuracy of MSCT was 67.2% when using the 13th edition Japanese classification, and this percentage was significantly higher than the accuracy of EUS (49.3%) and MSCT (44.6%) when using the 6th edition UICC classification (P<0.001 for both values). Conclusions/Significance Our results demonstrated that the overall accuracies of EUS and MSCT for preoperative staging were not significantly different. We suggest that a combination of EUS and MSCT is required for preoperative evaluation of TNM staging. PMID:24223855

Luo, Guang-yu; Wu, Jing; Zhou, Zhi-wei; Li, Wei; Sun, Xiao-wei; Li, Yuan-fang; Xu, Da-zhi; Guan, Yuan-xiang; Chen, Shi; Zhan, You-qing; Zhang, Xiao-shi; Xu, Guo-liang; Zhang, Rong; Chen, Ying-bo

2013-01-01

384

Value of ultrasonography-guided fine needle aspiration cytology in the investigative sequence of hepatic lesions with an emphasis on hepatocellular carcinoma  

PubMed Central

Background: The evaluation and management of various hepatic lesions is a common clinical problem and their appropriate clinical management depends on accurate diagnoses. Aims: To study the cytomorphological features of distinctive non-neoplastic and neoplastic lesions of the liver and to evaluate the sensitivity, specificity and diagnostic accuracy of ultrasonography (USG)-guided fine needle aspiration cytology (FNAC) in the diagnosis of liver diseases. Materials and Methods: Seventy-two patients with evidence of liver diseases underwent USG-guided, percutaneous FNAC. Cytomorphological diagnoses were correlated with clinical, biochemical and radiological findings, histopathological diagnoses and follow-up information. Results: The age of the patients ranged from eight months to 90 years with 48 males (66.67%) and 24 females (33.33%). Of the 72 cases, the cytological diagnosis was rendered in 71 patients and smears were inadequate for interpretation in one case. Neoplastic lesions (68.06%) were more common than non-neoplastic lesions (30.56%). The majority of the neoplastic lesions were hepatocellular carcinomas (36.12%) followed by metastatic adenocarcinomas (19.45%). Among non-neoplastic lesions, cirrhosis was the commonest lesion (8.34%). The overall diagnostic accuracy of FNAC was 97.82% with a sensitivity and specificity of 96.87 and 100% respectively. Conclusion: USG-guided FNAC of the liver is a safe, simple, cost-effective and accurate method for cytological diagnosis of hepatic diffuse, focal/nodular and cystic lesions with good sensitivity and specificity. PMID:22090691

Swamy, Mallikarjuna CM; Arathi, CA; Kodandaswamy, CR

2011-01-01

385

Combined statistical analysis of vasodilation and flow curves in brachial ultrasonography: technique and its connection to cardiovascular risk factors  

NASA Astrophysics Data System (ADS)

Clinical studies report that impaired endothelial function is associated with Cardio-Vascular Diseases (CVD) and their risk factors. One commonly used mean for assessing endothelial function is Flow-Mediated Dilation (FMD). Classically, FMD is quantified using local indexes e.g. maximum peak dilation. Although such parameters have been successfully linked to CVD risk factors and other clinical variables, this description does not consider all the information contained in the complete vasodilation curve. Moreover, the relation between flow impulse and the vessel vasodilation response to this stimulus, although not clearly known, seems to be important and is not taken into account in the majority of studies. In this paper we propose a novel global parameterization for the vasodilation and the flow curves of a FMD test. This parameterization uses Principal Component Analysis (PCA) to describe independently and jointly the variability of flow and FMD curves. These curves are obtained using computerized techniques (based on edge detection and image registration, respectively) to analyze the ultrasound image sequences. The global description obtained through PCA yields a detailed characterization of the morphology of such curves allowing the extraction of intuitive quantitative information of the vasodilation process and its interplay with flow changes. This parameterization is consistent with traditional measurements and, in a database of 177 subjects, seems to correlate more strongly (and with more clinical parameters) than classical measures to CVD risk factors and clinical parameters such as LDL- and HDL-Cholesterol.

Boisrobert, Loic; Laclaustra, Martin; Bossa, Matias; Frangi, Andres G.; Frangi, Alejandro F.

2005-04-01

386

A Standardized Assessment of Thyroid Nodules in Children Confirms Higher Cancer Prevalence Than in Adults  

PubMed Central

Context: Thyroid cancer is the most common endocrine malignancy, but due to its rare occurrence in the pediatric population, the cancer risk of childhood thyroid nodules is incompletely defined, and optimal management of children with suspected nodules is debated. Objective: The aim was to study the presenting features and cancer risk of sporadic childhood thyroid nodules using a standardized clinical assessment and management plan. Design and Setting: Boston Children's Hospital and Brigham and Women's Hospital collaborated to create a multidisciplinary pediatric thyroid nodule clinic and implement a standardized assessment plan. Upon referral for a suspected nodule, serum TSH was measured and hypothyrotropinemic patients underwent 123I scintigraphy. All others underwent thyroid ultrasonography, and if this confirmed nodule(s) ? 1 cm, ultrasound-guided fine-needle aspiration was performed. Medical records were retrospectively reviewed and compared to a control population of 2582 adults evaluated by identical methods. Patients and Results: Of 300 consecutive children referred for the initial evaluation of suspected thyroid nodules from 1997 to 2011, 17 were diagnosed with autonomous nodules by scintigraphy. Neck ultrasonography performed in the remainder revealed that biopsy was unnecessary in over half, either by documenting only sub-centimeter nodules or showing that no nodule was present. A total of 125 children met criteria for thyroid biopsy, which was performed without complication. Their rate of cancer was 22%, significantly higher than the adult rate of 14% (P = .02). Conclusions: Neck ultrasonography and biopsy were key to the evaluation of children with suspected thyroid nodules. Although the relative cancer prevalence of sonographically confirmed nodules ? 1 cm is higher in pediatric patients than adults, most children referred for suspected nodules have benign conditions, and efforts to avoid unnecessary surgery in this majority are warranted. PMID:23737541

Gupta, Anjuli; Ly, Samantha; Castroneves, Luciana A.; Frates, Mary C.; Benson, Carol B.; Feldman, Henry A.; Wassner, Ari J.; Smith, Jessica R.; Marqusee, Ellen; Alexander, Erik K.; Barletta, Justine; Doubilet, Peter M.; Peters, Hope E.; Webb, Susan; Modi, Biren P.; Paltiel, Harriet J.; Kozakewich, Harry; Cibas, Edmund S.; Moore, Francis D.; Shamberger, Robert C.; Larsen, P. Reed

2013-01-01

387

Assessing Understanding  

NSDL National Science Digital Library

Try using an assessment cycle to effectively probe students' understanding of scientific concepts. The diagnostic, formative, summative, and confirmatory assessment can be embedded into any unit of study.

Sterling, Donna R.

2005-01-01

388

Prenatal ultrasonography and Doppler sonography for the clinical investigation of isolated ventricular septal defects in a late second-trimester population  

PubMed Central

Background The purpose of this study was to evaluate the efficacy of prenatal ultrasonography and Doppler sonography in detecting isolated ventricular septal defects (VSDs) in a late-second-trimester population. Methods Fetal echocardiography, Doppler ultrasound, and biometry were used to evaluate 2,661 singleton fetuses (1,381 male fetuses and 1,280 female fetuses) between 1 August 2006 and 31 May 2010. The efficacy of each fetal biometry, Doppler ultrasound, and nasal bone length (NBL) measurement was evaluated in all of the fetuses. A standard fetal echocardiographic evaluation, including two-dimensional gray-scale imaging and color and Doppler color flow mapping, was performed on all fetuses. Results We detected isolated VSDs in 124 of the 2,661 singleton fetuses between 19 and 24 weeks of gestation. The prevalence of isolated VSDs in the study population was 4.66%. A multiple logistic regression analysis indicated that short fetal NBL (odds ratio?=?0.691, 95% confidence interval: 0.551 to 0.868) and the pulsatility index (PI) of the umbilical artery (odds ratio?=?8.095, 95% confidence interval: 4.309 to 15.207) and of the middle cerebral artery (odds ratio?=?0.254, 95% confidence interval: 0.120 to 0.538) are significantly associated with isolated VSDs. Conclusion Late-second-trimester fetal NBL, umbilical artery PI, and middle cerebral artery PI are useful parameters for detecting isolated VSDs, and can be used to estimate the a priori risk of VSDs in women at high risk and at low risk of isolated VSDs. PMID:24456562

2014-01-01

389

Ultrasonography of lower limb vascular angiopathy and plaque formation in type 2 diabetes patients and finding its relevance to the carotid atherosclerotic formation  

PubMed Central

Objective: One of the major complications of diabetes is blood vessel disease, termed angiopathy, which is characterized by abnormal angiogenesis. The objective of this study was to discuss the characteristics of lower limb vascular angiopathy and plaque formation in type 2 diabetes patients and finding its relevance to the carotid atherosclerotic plaque formation, thus directing the clinical diagnosis and treatment. Methods: The ultrasonography was used to monitor the patients with carotid artery and lower limb artery. Results: Compared with the control group, decreased blood flow to lower limb and lower limb angiopathy occurred more obviously in dorsal artery of foot than in popliteal artery. The study revealed that the detection rate of the prevalence of carotid atherosclerosis plaque and lower limb arterial plaque and the combination of plaque both carotid and lower limb arteries in diabetic patients was 369:342:296 (about 1.25:1.15:1) and that the prevalence of carotid plaque and lower limb arterial plaque in all subjects with plaque was 71.3%. The risk of plaque formation also had positive correlation with patient’s age. Color Doppler ultrasound had a clinical significance in the early diagnosis and curative effect observation in type 2 diabetes with lower limb angiopathy. The risk of simultaneous plaque formation in both carotid artery and lower extremity artery was greater in type 2 diabetes than that of control subjects, but they were not necessarily to occur simultaneously. The symptoms were inconspicuous in the early course of diabetes. Conclusion: The application of ultrasound monitoring in patients with carotid artery and lower limb artery might play a role in early warning, delaying the occurrence of macrovascular diseases, and slowing down the development of macroangiopathy such as cerebral infarction and diabetic foot and so on, thus providing a significant basis for clinical diagnosis and treatment. PMID:24639831

Duan, Jun; Zheng, Chenglong; Gao, Kuo; Hao, Meina; Yang, Lin; Guo, Dandan; Wu, Jingping; Tian, Yan; Song, Xueni; Liu, Jian; Guo, Shuwen; Murtaza, Ghulam; Zheng, Min

2014-01-01

390

Ten-core versus 16-core transrectal ultrasonography guided prostate biopsy for detection of prostatic carcinoma: a prospective comparative study in Indian population  

PubMed Central

Purpose: To compare the cancer detection rate in patients with raised serum prostate-specific antigen (PSA) or abnormal digital rectal examination (DRE) results between the 10-core and the 16-core biopsy techniques in an Indian population. Methods: Between November 2010 and November 2012, 95 men aged >50 years who presented to the Urology Department with lower urinary tract symptoms, elevated serum PSA, and/or abnormal DRE findings underwent transrectal ultrasonography (TRUS)-guided prostate biopsy. A total of 53 patients underwent 10-core biopsy and 42 patients underwent 16-core biopsy. Results: Of the 53 men in the 10-core group, 8 had cancer, whereas in the 16-core biopsy group, 23 of 42 men had cancer. Detection of prostate cancer was significantly higher in patients who underwent 16-core biopsy than in those who underwent 10-core biopsy (P<0.001). Among the 95 men, 44 men had abnormal DRE findings (46.3%), of whom 23 showed cancer (52.27%). Of 51 men with normal DRE findings and elevated PSA, 8 men had malignancy with a cancer detection rate of 15.68%. Among 20 men with PSA between 4.1 and 10 ng/mL, 2 (10%) had cancer. In 31 men with PSA between 10.1 and 20 ng/mL, 3 cancers (9.67%) were detected, and in 44 men with PSA >20 ng/mL, 26 cancers were detected (59.09%). Conclusions: The cancer detection rate with 16-core TRUS-guided biopsy is significantly higher than that with 10-core biopsy (54.76% vs. 15.09%, P<0.001). In patients with both normal and abnormal DRE findings, 16-core biopsy has a better detection rate than the 10-core biopsy protocol. With increasing PSA, there is a high rate of detection of prostate cancer in both 10-core and 16-core biopsy patients. PMID:24392441

Prakash, V. Surya; Mohan, G. Chandra; Krishnaiah, S. Venkata; Vijaykumar, V.; Babu, G. Ramesh; Reddy, G. Vijaya Bhaskar; Mahaboob, V. S.

2013-01-01

391

Comparison of SPECT imaging using monoclonal antibodies with computed tomography (CT) and ultrasonography (US) for detection of recurrences of colorectal carcinoma: A prospective clinical study  

SciTech Connect

A prospective clinical study compared SPECT imaging, ultrasonography (US), and computed tomography (CT) in 22 patients clinically or biologically (increased CEA and/or CA 19-9 serum concentration) suspected of recurrence of colorectal carcinoma. The recordings were performed 3 to 5 days after injection of 111 to 129.5 MBq of cocktail of I-131-labeled anti-CEA and 19-9 (F(ab')2 fragments) monoclonal antibodies. Twenty nine tumor sites were demonstrated by surgery or concordant results of conventional diagnostic methods. SPECT visualized 21 of these 29 tumor sites (72%). It was negative in 4 cases with no demonstrated recurrence (by any method and follow-up). With respect to localization of tumor sites, SPECT visualized 7/12 liver metastases, 8/8 local pelvic recurrences and 6/8 abdominal recurrences. CT and US, systematically performed blind after SPECT, respectively visualized 9/10 and 9/12 liver metastases, 7/12 and 4/13 pelvic and abdominal recurrences. Image interpretation of SPECT was difficult due to poor tumor contrast and the large number of low-intensity, nonspecific radioactive foci. A focus had to recur in at least 3 successive slices to be considered pathological. Four tumor sites were visualized with SPECT and not with US and CT (negative or uncertain results). SPECT would appear to be useful for localizing pelvic or abdominal recurrences in cases in which interpretation of US and CT images is difficult, often because their nonspecific approach does not make it possible to differentiate a tumor recurrence from post-operative anatomical changes.

Chatal, J.F.; Saccavini, J.C.; Douillard, J.Y.; Curtet, C.; Kremer, M.; Le Mevel, B.

1985-05-01

392

3D-Ultrasonography for evaluation of facial muscles in patients with chronic facial palsy or defective healing: a pilot study  

PubMed Central

Background While standardized methods are established to examine the pathway from motorcortex to the peripheral nerve in patients with facial palsy, a reliable method to evaluate the facial muscles in patients with long-term palsy for therapy planning is lacking. Methods A 3D ultrasonographic (US) acquisition system driven by a motorized linear mover combined with conventional US probe was used to acquire 3D data sets of several facial muscles on both sides of the face in a healthy subject and seven patients with different types of unilateral degenerative facial nerve lesions. Results The US results were correlated to the duration of palsy and the electromyography results. Consistent 3D US based volumetry through bilateral comparison was feasible for parts of the frontalis muscle, orbicularis oculi muscle, depressor anguli oris muscle, depressor labii inferioris muscle, and mentalis muscle. With the exception of the frontal muscle, the facial muscles volumes were much smaller on the palsy side (minimum: 3% for the depressor labii inferior muscle) than on the healthy side in patients with severe facial nerve lesion. In contrast, the frontal muscles did not show a side difference. In the two patients with defective healing after spontaneous regeneration a decrease in muscle volume was not seen. Synkinesis and hyperkinesis was even more correlated to muscle hypertrophy on the palsy compared with the healthy side. Conclusion 3D ultrasonography seems to be a promising tool for regional and quantitative evaluation of facial muscles in patients with facial palsy receiving a facial reconstructive surgery or conservative treatment. PMID:24782657

2014-01-01

393

Embarazo ectópico bilateral espontáneo  

Microsoft Academic Search

Spontaneous bilateral ectopic pregnancy is a rare event and is difficult to diagnose preoperatively. We report a case diagnosed by transvaginal ultrasonography in a patient without risk factors. Laparoscopic left salpingectomy and right linear salpingostomy were performed. This case illustrates the importance of carefully examining both adnexa when ultrasound examination or surgery are performed.

Lorenzo Mier Lobato; M. del Carmen Bango Álvarez

2006-01-01

394

Tratamiento médico del embarazo ectópico instersticial: descripción de un caso clínico  

Microsoft Academic Search

Traditional management of interstitial pregnancy involves laparotomy with cornual resection. Recent advances in transvaginal ultrasonography and sensitive beta-hCG assays have led to earlier diagnosis of these cases. We report a case of interstitial pregnancy successfully treated with parenteral methotrexate. Prompt recognition of interstitial pregnancy allows conservative approachment and systemic methotrexate presents as an effective and safe option.

Begoña Adiego Burgos; María Herrera de la Muela; Felipe Ojeda Pérez; María Dolores Merinero Palomares; Manuel Víctor Albi González; Antonio López Salvá

2007-01-01

395

Comparison of saline infusion sonography with office hysteroscopy for the evaluation of the endometrium  

Microsoft Academic Search

OBJECTIVE: Intrauterine infusion of saline solution during transvaginal ultrasonography enhances visualization of the endometrium. We compared the accuracy and pain rating of saline infusion sonography with those of flexible office hysteroscopy. STUDY DESIGN: The uterine cavities of 130 patients with abnormal bleeding were evaluated by two physicians in an office setting. Findings of endometrial polyps, submucous myomas, synechiae, endometrial hyperplasia,

Theresa Widrich; Linda D. Bradley; Allison R. Mitchinson; Robert L. Collins

1996-01-01

396

Transvaginal fluoroscopic recanalization of a proximally occluded oviduct  

SciTech Connect

A hysterosalpingogram performed on a patient with infertility showed bilateral interstitial obstruction with partial intramural patency of the right tube and complete intramural obstruction of the left. Recanalization of the tube under fluoroscopy resulted in unilateral tubal patency and an intrauterine pregnancy followed. 7 references, 3 figures.

Platia, M.P.; Krudy, A.G.

1985-11-01

397

Transvaginal fluoroscopic recanalization of a proximally occluded oviduct  

Microsoft Academic Search

A hysterosalpingogram performed on a patient with infertility showed bilateral interstitial obstruction with partial intramural patency of the right tube and complete intramural obstruction of the left. Recanalization of the tube under fluoroscopy resulted in unilateral tubal patency and an intrauterine pregnancy followed. 7 references, 3 figures.

M. P. Platia; A. G. Krudy

1985-01-01

398

Perineural cysts resembling complex cystic adnexal masses on transvaginal sonography.  

PubMed

Perineural cysts may be discovered incidentally on pelvic sonography and can easily mimic more common gynecologic masses. We report the complex cystic adnexal mass like appearance of these incidentally noted cysts which mimicked malignancy on sonography in a postmenopausal female, with stage I breast cancer and vaginal spotting. PMID:22105304

Saboo, Sachin S; Di Salvo, Donald

2013-01-01

399

Managing Assessment.  

ERIC Educational Resources Information Center

This document, which is intended for curriculum managers at British further education colleges, presents guidelines for developing and implementing a college assessment policy based on the principle that the objectives of all assessment procedures and policies are as follows: enhance the assessment provision within colleges; ensure that assessment

Further Education Development Agency, London (England).

400

Measuring Morbidity Associated with Urinary Schistosomiasis: Assessing Levels of Excreted Urine Albumin and Urinary Tract Pathologies  

PubMed Central

Background Urinary schistosomiasis is responsible for a variety of debilitating conditions; foremost perhaps are urinary tract pathologies (UTPs). Although portable ultrasonography can be used to detect UTPs visually, there is still a need for rapid morbidity assessment (henceforth referred to as RaMA) tools that can be deployed in the field during implementation, monitoring and evaluation of control programmes. We therefore aimed to determine associations between excreted urine-albumin, as measured using a HemoCue photometer, and UTPs, as detected by ultrasonography, in children and adults from an urinary schistosomiasis endemic area in Zanzibar. Methodology/Principal Findings In a survey of 140 school-children of both sexes (aged 9 to 15 yr) and 47 adult males (?16 yr) on the island of Unguja, the prevalence of egg-patent urinary schistosomiasis was 36.4% (CI95 28.5–45.0%) and 46.8% (CI95 32.1–61.9%) (P?=?0.14), and that of UTPs was 39.4% (CI95 31.0–48.3%) and 64.4% (CI95 48.8–78.1%) (P?=?0.006), respectively. In school-children, raised urine-albumin concentrations (>40 mg/L) were associated, albeit non-significantly, with prevalence of infection (OR?=?3.1, P?=?0.070), but more specifically and significantly with the prevalence of micro-haematuria (OR?=?76.7, P<0.0001). In adults, elevated urine-albumin excretion was associated with UTPs, particularly lesions of the bladder wall (OR?=?8.4, P?=?0.013). Albuminuria showed promising diagnostic performance, especially in school-aged children with sensitivity of 63.3% and specificity of 83.1% at detecting lower UTPs, i.e. bladder-wall lesions (ultrasonography as ‘gold standard’). Conclusion/Significance This study indicates that albuminuria assays could be used as a RaMA tool for monitoring UTP prevalence during control programmes, as well as a tool for selecting those with more chronic bladder-wall lesions without resorting to ultrasonography. PMID:19806223

Sousa-Figueiredo, Jose C.; Basanez, Maria-Gloria; Khamis, I. Simba; Garba, Amadou; Rollinson, David; Stothard, J. Russell

2009-01-01

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