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Sample records for transvaginal ultrasonography assessment

  1. Transvaginal ultrasonography and hysteroscopy as predictors of endometrial polyps in postmenopause.

    PubMed

    de Godoy Borges, Pítia Cárita; Dias, Rogério; Bonassi Machado, Rogério; Borges, João Bosco Ramos; Spadoto Dias, Daniel

    2015-01-01

    The study compared ultrasound and ambulatorial hysteroscopy as diagnostic methods detecting endometrial polyps in postmenopause women. 281 women aged 41-82 years who underwent ambulatorial hysteroscopy were analyzed for presence of uterine bleeding and/or altered transvaginal ultrasound (endometrial thickness ≥5 mm). Ultrasonography detected endometrial polyps in 22.8% of patients and endometrial thickening in the other 59.8%. Hysteroscopy diagnosed endometrial polyps in 80.8%. Ultrasonography showed sensitivity of 88.7%, specificity of 25.4%, positive predictive value of 81.7%, negative predictive value of 37.5% and accuracy of 75.4% in diagnosing endometrial polyps. Hysteroscopy showed 96.4% sensitivity, 74.6% specificity, 93.4% positive predictive value, 84.6% negative predictive value and 91.8% accuracy. Hysteroscopy demonstrated more accuracy than ultrasonography, which is not sufficient for accurate diagnosis.

  2. Comparison of transvaginal ultrasonography and hysteroscopy in the diagnosis of uterine pathologies.

    PubMed

    Babacan, Ali; Gun, Ismet; Kizilaslan, Cem; Ozden, Okan; Muhcu, Murat; Mungen, Ercument; Atay, Vedat

    2014-01-01

    A thorough evaluation of the uterine cavity is frequently required in gynecology practice. The aim of this study was to compare the diagnostic values of transvaginal ultrasound examination and hysteroscopy in detecting uterine abnormalities in a group of patients within a range of menopausal status and symptomatology. This study included 285 patients admitted with complaints of abnormal uterine bleeding, postmenopausal bleeding, lower abdominal pain, abnormal vaginal discharge or for a routine gynecological examination. All patients had available transvaginal ultrasonography and hysteroscopy data for evaluation. A biopsy was obtained from all patients during the hysteroscopy session. Sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratio were calculated for both methods and compared, considering the histopathological diagnosis as the gold standard. The mean age of the patients was 49.5±12.9 years (range, 24-89 y). Majority of the patients admitted for abnormal uterine bleeding (n=198, 69.4%). For the diagnosis of polyps of any size, hysteroscopy had better sensitivity (p<0.001), however, specificities did not differ (p=1.0). On the other hand, hysteroscopy did not have a sensitivity advantage over TVU in diagnosing polyps greater than 1 cm (p=0.077), although this time hysteroscopy had better specificity (p<0.001). Combined approach did not offer diagnostic advantage for any of the specific pathologies. Although TVU represents a practical approach for the initial evaluation of uterine pathologies, hysteroscopy seems to offer better diagnostic value for uterine pathologies in general, and uterine polyps in particular.

  3. Role of bedside transvaginal ultrasonography in the diagnosis of tubo-ovarian abscess in the emergency department.

    PubMed

    Adhikari, Srikar; Blaivas, Michael; Lyon, Matthew

    2008-05-01

    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 TOA using bedside transvaginal US. ED US examinations were performed by emergency medicine residents and ultrasound-credentialed attending physicians within 1 h after clinical assessment. ED US logs were reviewed for the diagnosis of TOA. Medical records were reviewed for risk factors, medical and sexual history, physical examination findings, laboratory results, additional diagnostic testing, hospital course, and a discharge diagnosis of TOA by the admitting gynecology service. A total of 20 patients with TOA were identified over a 3-year period. Ages ranged from 14 to 45 years (mean 27 years). Seven (35%) patients reported a prior history of PID or sexually transmitted disease, and 1 (5%) was febrile. All had lower abdominal tenderness and 9 (45%) had cervical motion or adnexal tenderness. The sonographic abnormalities included 14 (70%) with a complex adnexal mass, 5 (25%) with echogenic fluid in the cul-de-sac, and 3 (15%) patients with pyosalpinx. The discharge diagnosis was TOA by the admitting gynecology service for all patients. Our study illustrates the limitations of clinical criteria in diagnosing TOA and supports the use of bedside US when evaluating patients with pelvic pain and symptoms that do not meet classic Centers for Disease Control and Prevention criteria for PID.

  4. Identification of benign and malignant endometrial cancer with transvaginal ultrasonography combined with elastography and tissue hardness analysis.

    PubMed

    Zhang, Y; Luo, L; Luo, Q

    2015-01-01

    This study was designed to explore tissue hardness and distinguish benign and malignant endometrial cancer with the use of transvaginal ultrasonography combined with elastography. Color Doppler ultrasonic diasonograph was used to carry out transvaginal ultrasonography and elastography. Once the nidus was observed, features of the 2D image were analyzed. Then features of elasticity of the uterine cavity in different states were analyzed by elastography, and strain rate ratio was measured. Finally, elasticity scoring (0~5 points) was made. Receiver operating characteristic (ROC) curve was drawn based on elasticity score and strain rate ratio. The area under the elasticity score curve and strain rate ratio curve was 0.761 and 0.852, respectively, and there was no statistically significant difference between them (c2= 4.663, P>0.05). Then 2.98 was confirmed as the diagnostic cut-off value of benign and malignant lesions, based on strain rate ratio. Ultrasonic elastography as an effective assistance for transvaginal ultrasonography provides more valuable information for confirmation of lesions and offers more accurate evidence for diagnosis of disease in the uterine cavity.

  5. Transvaginal ultrasound

    MedlinePlus

    ... Uterine bleeding - transvaginal ultrasound; Menstrual bleeding - transvaginal ultrasound; Infertility - transvaginal ultrasound; Ovarian - transvaginal ultrasound; Abscess - transvaginal ultrasound

  6. Achondrogenesis type I diagnosed by transvaginal ultrasonography at 13 weeks' gestation.

    PubMed

    Meizner, I; Barnhard, Y

    1995-11-01

    We present the first transvaginal first-trimester diagnosis of achondrogenesis type I confirmed by radiographic and histologic studies. The ultrasonographic signs included severe short limb mesomelic dwarfism, large head with decreased ossification, and lack of vertebral ossification.

  7. Cervical Length Measured by Transvaginal Ultrasonography and Cervicovaginal Infection as Predictor of Preterm Birth Risk

    PubMed Central

    Banicevic, Arnela Ceric; Popovic, Miroslav; Ceric, Amela

    2014-01-01

    Introduction: The study shows possibilities of transvaginal sonographic measurement of the cervix in prediction of premature birth risk. Goals: The aim of the study was to follow up the cervical length in the pregnant from 16th to 37th week, as well as to do a microbiological analysis of the vaginal and cervical flora and to identify relation between the cervical shortening and microbiological flora as well as with a premature birth. Material and methods: The investigation was conducted as a prospective study on two groups of female patients in Clinical Centre of Banja Luka. In the high risk group we had 8% of patients with cervical length bellow than 15mm, 30% of patients with cervical length from 15 to 25m and 62% of patients with cervical length bigger than 25mm. In the low risk group we had no patients with cervical length bellow 15mm, 95% of patients had cervical length bigger than 25mm and 5% of patients had cervical length from 15 do 25mm. Results: The regression coefficient of the cervical length in the high risk group was 0.44mm, while in the low risk group it was 0.26mm. In the high risk group 67.56% patients had a positive cervical smear finding, while in the low risk group it was 4%. A high premature birth (defined as birth before 36.6 weeks) incidence of 50% was presented in patients with cervical length bellow 15mm. In the group of patients with cervical length up to 25mm the premature risk incidence was 10.52±0.05. In the high risk group of patients with a positive cervical smear finding, regarding the cervical length the percentage was as follows; in the subgroup of 15mm length 88,89±11,87, in subgroup from 15 to 25mm was 62,07±11,43 and in the subgroup bigger than 25mm, 60.06±8.05. Conclusion: By the analysis of the first and second goal of our study we can conclude that ultrasound assessment of cervical length is simple and feasible in the 16th week of pregnancy in both groups, with high and low risk. The length of the cervix in this period is

  8. Cervical length measured by transvaginal ultrasonography versus Bishop score to predict successful labour induction in term pregnancies

    PubMed Central

    Groeneveld, Y.J.B.; Bohnen, A.M.; Van Heusden, A.M.

    2010-01-01

    Objectives: To compare the value of transvaginal ultrasonographic measurement of the cervical length versus the Bishop score, prior to induction of labour, in predicting the mode of delivery within four days. Materials and Methods: This longitudinal study included 110 women (at term, singleton, vertex presentation) in whom induction of labour was performed at 37-42 weeks of gestation. Cervical length on transvaginal ultrasound and the Bishop score were assessed prior to induction according to standard protocol. Medical records were reviewed for relevant demographic and clinical data. Primary outcome criterion was successful vaginal delivery within 96 h. Univariate analyses and receiver operating characteristic (ROC) curves were used to examine differences between variables possibly predicting outcome. Results: Of the 110 women 66 were nulliparous and 44 multiparous. Vaginal delivery within 96 h was successful in 48 (73%) nulliparous and in 40 (91%) multiparous women ( i.e. in 80% of the total population). The overall rate of caesarean delivery was 17%. There was a significant difference between nulliparous and multiparous women in age, cervical length (mean in mm in nulliparous women: 29.31, range: 5.00-56.00; in multiparous women: 37.04, range: 12.00-56.00), Bishop score and successful induction, but no significant difference between these subgroups in neonatal outcomes. Only the Bishop score in nulliparous women showed a significant relationship between this variable and predicting successful labour induction (area under the ROC curve 0.679; standard error 0.73; p < 0.05; 95% CI: 0.536-0.823). The best cut-off value for the Bishop score was 3, with a sensitivity of 56.3% and a specificity of 72.2%. Conclusion: In this study group significant independent prediction of vaginal delivery within 96 h is provided by the Bishop score but only in nulliparous women. Transvaginal ultrasonographic measurement of cervical length is not a significant independent predictor

  9. Accuracy of transvaginal ultrasonography compared to endometrial biopsy for the etiological diagnosis of abnormal perimenopausal bleeding

    PubMed Central

    NICULA, RENATA; DICULESCU, DORU; LENCU, CODRUŢA CLAUDIA; CIORTEA, RĂZVAN; BUCURI, CARMEN ELENA; OLTEAN, IOANA ADRIANA; TRIF, IOANA ALEXANDRA; MIHU, DAN

    2017-01-01

    Background and aims Perimenopause is marked by clinical manifestations which disturb everyday life and which may also hide a pathomorphological, more precisely endometrial, substrate. An accurate early diagnosis established by accessible, non-invasive methods is very important for the therapeutic management. Method The study included 103 patients aged between 41.5–55.11 years, divided into 3 age groups: 40–44 years (n=10), 45–49 years (n=54) and ≥50 years (n=39). Results Certain risk factors of endometrial neoplasm or premalignant conditions were evidenced, their accurate identification being useful in limiting the number of patients with abnormal uterine bleeding (AUB) submitted to diagnostic screening. The most common cause of AUB in our study was fibroma, followed by functional causes. Conclusions Transvaginal ultrasound (TVUS) represents a minimally invasive method for the screening of perimenopausal patients with AUB, especially to rule out endometrial adenocarcinoma (EAC). TVUS sensitivity was higher than clinical diagnosis in case of leiomioma, polypi and EAC. TVUS was more accurate in the diagnosis of EAC, polypi and leiomioma. PMID:28246495

  10. Usefulness of ultrasonography in assessment of laryngeal carcinoma

    PubMed Central

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

    2013-01-01

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

  11. Ultrasonography - A viable tool for airway assessment

    PubMed Central

    Reddy, Preethi B; Punetha, Pankaj; Chalam, Kolli S

    2016-01-01

    Background and Aims: Accurate prediction of the Cormack-Lehane (CL) grade preoperatively can help in better airway management of the patient during induction of anaesthesia. Our aim was to determine the utility of ultrasonography in predicting CL grade. Methods: We studied 100 patients undergoing general endotracheal anaesthesia. Mallampati (MP) class, thyromental distance (TMD) and sternomental distance (SMD) were noted. Ultrasound measurements of the anterior neck soft tissue thickness at the level of the hyoid (ANS-Hyoid), anterior neck soft tissue thickness at the level of the vocal cords (ANS-VC) and ratio of the depth of the pre-epiglottic space (Pre-E) to the distance from the epiglottis to the mid-point of the distance between the vocal cords (E-VC) were obtained. CL grade was noted during intubation. Chi-square test was employed to determine if there was any statistical difference in the measurements of patients with different CL grades. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were calculated for the various parameters. Results: The incidence of difficult intubation was 14%. An ANS-VC >0.23 cm had a sensitivity of 85.7% in predicting a CL Grade of 3 or 4, which was higher than that of MP class, TMD and SMD. However, the specificity, PPV and accuracy were lower than the physical parameters. The NPV was comparable. Conclusion: Ultrasound is a useful tool in airway assessment. ANS-VC >0.23 cm is a potential predictor of difficult intubation. ANS-Hyoid is not indicative of difficult intubation. The ratio Pre-E/E-VC has a low to moderate predictive value. PMID:27942053

  12. Assessing Ultrasonography as a Diagnostic Tool for Porcine Cysticercosis

    PubMed Central

    Pray, Ian W.; Santivaňez, Saul J.; Ayvar, Viterbo; Gamboa, Ricardo; Muro, Claudio; Moyano, Luz Maria; Benavides, Victor; Garcia, Hector H.; O’Neal, Seth E.

    2017-01-01

    Background Taenia solium inflicts substantial neurologic disease and economic losses on rural communities in many developing nations. “Ring-strategy” is a control intervention that targets treatment of humans and pigs among clusters of households (rings) that surround pigs heavily infected with cysticerci. These pigs are typically identified by examining the animal’s tongue for cysts. However, as prevalence decreases in intervened communities, more sensitive methods may be needed to identify these animals and to maintain control pressure. The purpose of this study was to evaluate ultrasonography as an alternative method to detect pigs heavily infected with T. solium cysts. Methodology/Principal Findings We purchased 152 pigs representing all seropositive animals villagers were willing to sell from eight communities (pop. 2085) in Piura, Peru, where T. solium is endemic. Tongue and ultrasound examinations of the fore and hind-limbs were performed in these animals, followed by necropsy with fine dissection as gold standard to determine cyst burden. We compared the sensitivity and specificity of ultrasonography with tongue examination for their ability to detect heavy infection (≥ 100 viable cysts) in pigs. Compared to tongue examination, ultrasonography was more sensitive (100% vs. 91%) but less specific (90% vs. 98%), although these differences were not statistically significant. The greater sensitivity of ultrasound resulted in detection of one additional heavily infected pig compared to tongue examination (11/11 vs. 10/11), but resulted in more false positives (14/141 vs. 3/141) due to poor specificity. Conclusions/Significance Ultrasonography was highly sensitive in detecting heavily infected pigs and may identify more rings for screening or treatment compared to tongue examination. However, the high false positive rate using ultrasound would result in substantial unnecessary treatment. If specificity can be improved with greater operator experience

  13. Transvaginal ultrasound (image)

    MedlinePlus

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

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

    PubMed

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

    2015-10-01

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

  15. Transvaginal ultrasound ovarian diathermy: sheep as an experimental model

    PubMed Central

    2012-01-01

    Background Some techniques of transvaginal ovarian drilling have been previously described. Nevertheless a monopolar transvaginal ovarian cauterization, that use the expertise and safety of transvaginal puncture for oocyte captation seems to be an easier and feasible approach. The aim of this study was to develop a minimally invasive ovarian cauterization technique under transvaginal ultrasound control, and to evaluate the safety of the transvaginal ovarian monopolar cauterization, female sheep at reproductive age were used as an experimental model. Findings An experimental study was performed in a university research center. Seventeen female sheep (15 Corriedale e 2 Suffolk) in reproductive age were submitted to transvaginal ovarian cauterization with a monopolar Valleylab Force 2 electrocautery. Macroscopic and microscopic lesions were assessed. Ovarian size were 1.31 cm2 ± 0,43 (Corriedale) and 3.41 cm2 ± 0,64 (Suffolk). From 30 ovaries from Corriedale sheep punctured, only 3 were cauterized, presenting macroscopic and typical microscopic lesion. In the Suffolk sheep group, only one ovary was cauterized. No lesion could be found in the needle path. Conclusions This is the first experimental animal model described for ovarian cauterization needle guided by transvaginal ultrasound. The sheep does not seem to be the ideal animal model to study this technique. Another animal model, whose ovaries are better identified by transvaginal ultrasound should be sought for this technique, theoretically less invasive, before it could be offered safely to women with polycystic ovary syndrome. PMID:22243998

  16. Diagnostic endoscopic ultrasonography: assessment of safety and prevention of complications.

    PubMed

    Jenssen, Christian; Alvarez-Sánchez, Maria Victoria; Napoléon, Bertrand; Faiss, Siegbert

    2012-09-14

    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.

  17. Assessment of pre-gastroscopy fasting period using ultrasonography.

    PubMed

    Spahn, Thomas Werner; Wessels, Anne; Grosse-Thie, Wolfram; Mueller, Michael Karl

    2009-03-01

    Discomfort is frequent in patients undergoing esophagogastroduodenoscopy who are routinely recommended to abstain at least for 6 h from liquid or solid food prior to the procedure. We investigated the minimal period of time required for the stomach to clear fluids in order to define a safe minimal pre-endoscopy fasting period. Gastric emptying was sonographically assessed in 54 patients by measurement of the antrum surface area prior to, immediately after, and 30, 60, and 90 min after ingestion of 300 ml water and water containing 75 g glucose or apple juice. Esophagogastroduodenoscopy was performed subsequently. Ingestion of water required 1 h for complete clearance. Three hundred milliliters glucose solution and apple juice were cleared more slowly, 90 min after drinking. Ingestion of water or glucose solution prior to esophagogastroduodenoscopy in patients without a history of gastric emptying dysfunction is safe when observing a 90 min latency period and might prevent discomfort.

  18. Ultrasonography for the assessment of the upper trapezius properties in healthy females: a reliability study

    PubMed Central

    Adigozali, Hakimeh; Shadmehr, Azadeh; Ebrahimi, Esmail; Rezasoltani, Asghar; Naderi, Farrokh

    2016-01-01

    Summary Background to date, an assessment of morphometric features, muscle stiffness and blood flow in the upper trapezius among healthy females at rest and contraction states has not been conducted. So, in the current research, the intra-rater reliability of ultrasonographic features of upper trapezius in healthy females was examined. Method in this study stiffness and thickness of the upper trapezius in rest and contraction states were measured by ultrasonography on 12 healthy female subjects (28.33±5.05 years old). Color Doppler imaging was used to assess muscle circulation in the rest state only. Every step and calculation of measurements was repeated 3 times with the same rater. Therefore, in total 36 measurements were done for each variable. Results according to the analysis, the value of intra class correlation coefficient (ICC) for total variables showed an excellent level of reliability. Thickness at contraction had maximum reliability (ICC= 0.993) and Minimum Diastolic Velocity had the lowest reliability (ICC=0.771). Conclusions the results of current research demonstrated that real time ultrasonography is a reliable method for measurement of various parameters of upper trapezius, including morphometric features, its stiffness and blood supply in non-symptomatic females. These mentioned variables can likely be used for objective assessment and provide numerical reference value for clinical plans. PMID:27331047

  19. Utility of Ultrasonography in Assessing the Effectiveness of Extracorporeal Shock Wave Therapy in Insertional Achilles Tendinopathy

    PubMed Central

    Zhang, Jian

    2016-01-01

    Introduction. The aim of this study was to investigate the utility of ultrasonography (US) for predicting and assessing the effectiveness of extracorporeal shock wave therapy (ESWT) in insertional Achilles tendinopathy (IAT). Methods. A total of 42 patients with an established diagnosis of chronic IAT were examined by US before ESWT and at 4 weeks and 12 weeks after ESWT. The thickness and cross-sectional area (CSA) of the Achilles tendon, size of calcific plaques, tendon structure score, and neovascularization score were measured at each time point. Results. After therapy, Victorian Institute of Sport Assessment-Achilles (VISA-A) scores increased significantly, and the size of calcific plaques decreased (P < 0.05). Neovascularization scores increased at the 4th week and then decreased at the 12th week (P < 0.05). The thickness, CSA, and structure of the Achilles tendon did not change. Variables observed by US at baseline were not associated with changes in VISA-A scores at follow-up. However, the changes in calcific plaque size and neovascularization scores were related to the improvement of VISA-A scores between pre- and posttherapy (P < 0.01). Conclusion. Ultrasonography can reveal some changes in the insertion of the Achilles tendon after ESWT, but the outcome of ESWT in IAT cannot be predicted by the variables observed by US. PMID:28004000

  20. Transabdominal color doppler ultrasonography: A relevant approach for assessment of effects of uterine torsion in buffaloes

    PubMed Central

    Devender; Chandolia, Ramesh Kumar; Pandey, Anand Kumar; Yadav, Vishal; Kumar, Parveen; Dalal, Jasmer

    2016-01-01

    Aim: The present study was conducted on advanced pregnant buffaloes suffering from uterine torsion to assess the status of fetus and uterus by transabdominal ultrasonography, and the findings were compared with normal advanced pregnant buffaloes. Materials and Methods: The study was conducted on 20 clinical cases of uterine torsion and 20 normal advanced pregnant buffaloes (control group). The lower ventral area just lateral to linea alba (on both sides of the udder) in standing animals was scanned transabdominally by the two-dimensional convex transducer for various ultrasonographic findings. The data collected were statistically analyzed by “one-way ANOVA” and “independent sample t-test” using computerized SPSS 16.0 software program. Results: Transabdominal ultrasonography revealed dead fetus in 95% uterine torsion cases and proved useful in imaging internal structures of fetuses while no dead fetus was reported in the control group. Size of umbilicus was found significantly decreased (p<0.05) in uterine torsion group in comparison to control animals, but the decrease in placentomal area was marginal (p>0.05) in uterine torsion group. Average thickness of the uterine wall and mean pixel values of fetal fluids (echogenicity) were found significantly increased (p<0.05) in uterine torsion affected buffaloes in comparison to control group. Conclusion: Status of fetus (whether live or dead), internal status of uterus, and its contents could be determined by transabdominal ultrasonography in uterine torsion cases and thus determining the prognosis of the uterine torsion cases before going for further manipulations. This will also help in taking all the precautions to avoid death of the fetus. PMID:27651672

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

    SciTech Connect

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

    1999-11-15

    Purpose: To report our preliminary experience concerning the use of Doppler ultrasonography (DUS) techniques after intravenous injection of the galactose-based contrast agent Levovist in the assessment of hepatocellular carcinoma (HCC) treated with transcatheter arterial chemoembolization (TACE). The sonographic findings are correlated with those obtained using iodized oil (Lipiodol) helical computed tomography (CT). Methods: For 7 months we studied 28 patients with cirrhosis and HCC (a total of 43 nodules) who had undergone TACE between 18 and 30 days previously. The lesions were investigated with color Doppler ultrasonography (CDUS) and power Doppler ultrasonography (PDUS), before and after infusion of the echo-contrast agent (300 mg/ml, maximum 1 injection for each nodule, administered at constant velocity within 60-90 sec), and with helical Lipiodol-CT (0-7 days after DUS). In the retrospective analysis, special attention was given to the Doppler signals related to pulsatile intra- and perinodular flow and to the detection of new vessels after contrast agent injection. The signal intensity was graded as 0 (absent), 1 (low), 2 (medium), or 3 (high), while its distribution was classified as peripheral, central, or diffuse. Oily agent retention on CT scans was assessed as 0 (absent), I (<10%), II (<50%), III (>50%), or IV (homogeneous). These scores were awarded separately, without knowledge of the other judgments. Results: An hepatic global echo-enhancing effect was identified in all cases and always lasted long enough to allow an accurate analysis of all parenchymal lesions (at least 8 min). The signal scores could be evaluated in 39 of 43 HCCs, as follows: basal CDUS: grade 0 in 17 lesions, grade 1 in 16, grade 2 in 6; contrast-enhanced CDUS: grade 0 in 12 lesions, grade 1 in 10, grade 2 in 14, grade 3 in 3; basal PDUS: grade 0 in 15 lesions, grade 1 in 13, grade 2 in 9, grade 3 in 2; contrast-enhanced PDUS: grade 0 in 11 lesions, grade 1 in 9, grade 2 in 15

  2. Assessment of embryo/fetus during pregnancy by threedimensional ultrasonography using the HD live software: iconographic essay.

    PubMed

    Araujo Júnior, Edward; Santana, Eduardo Félix Martins; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes

    2015-01-01

    Fetal development is studied since the advent of two-dimensional ultrasonography. However, a detailed assessment of structures and surfaces improved with three-dimensional ultrasonography. Currently, it is possible to identify embryonic components and fetal parts with greater detail, at all pregnancy trimesters, using the HD live software, where the images gain realistic features by means of appropriate control of lighting and shadowing effects. In the present study, the authors utilized this resource to follow-up, by means of images, the development of a normal pregnancy along all trimesters.

  3. Colour Doppler Ultrasonography as a Tool to Assess Luteal Function in Santa Inês Ewes.

    PubMed

    Figueira, L M; Fonseca, J F; Arashiro, Ekn; Souza-Fabjan, Jmg; Ribeiro, Acs; Oba, E; Viana, Jhm; Brandão, F Z

    2015-08-01

    The aim of this study was to evaluate luteal dynamics in the Santa Inês ewes using colour Doppler (CD) ultrasonography. Oestrus was synchronized in nulliparous females (n = 18), and subsequently, they were only teased (n = 6) or teased and mated (n = 12). Blood samples were collected daily for plasma progesterone (P4 ) concentrations. Ultrasonographic images of corpora lutea (CL) in CD mode were obtained for further analysis in its largest diameter. The CD mode allowed an early sequential monitoring of CL that was visualized by the first time 0.77 ± 0.62 days after ovulation, with luteal area 29.68 ± 13.21 mm(2) . During the luteogenesis, a progressive increase was observed, followed by a plateau of luteal area, vascularization area and plasma concentrations of P4 reaching maximum values in D11 (124.0 ± 38.0 mm(2) , 52.78 ± 24.08 mm(2) and 11.23 ± 4.89 ng/ml, respectively). In the luteolysis, the plasma concentrations of P4 decreased sharply, whereas luteal and vascularization area gradually. The vascularization area was positively correlated with plasma concentrations of P4 during the luteogenesis (r = 0.22) and luteolysis (r = 0.48). The luteal dynamics of Santa Inês ewes showed patterns similar to those observed in other sheep breeds studied. The CD ultrasonography has the potential to be used as a tool to assess luteal function in sheep.

  4. Ultrasonography for interval assessment in the nonoperative management of hepatic trauma.

    PubMed

    Chiu, William C; Wong-You-Cheong, Jade J; Rodriguez, Aurelio; Shanmuganathan, K; Mirvis, Stuart E; Scalea, Thomas M

    2005-10-01

    Abdominal ultrasonography (US) is gaining widespread acceptance as a valuable diagnostic tool in the initial evaluation of trauma victims. We investigated the utility of US as a follow-up radiologic study in nonoperative hepatic trauma. Patients with liver injury designated for nonoperative management were prospectively studied over a 2-year period at our primary adult resource center for trauma. Computed tomography (CT) and radiologist-performed US were obtained at admission and at 1 week. The ability of US to detect lesions, fluid, and complications was evaluated by comparing with the corresponding CT. Twenty-five hepatic trauma patients in the study were successfully managed nonoperatively and had both initial and follow-up US and CT scans: 1 (4%) grade I, 5 (20%) grade II, 7 (28%) grade III, 7 (28%) grade IV, and 5 (20%) grade V. Four complications developed [biloma (3) and biliary fistula (1)] in 3 patients with grade IV injury and 1 with a grade II injury. Interval US appropriately detected a complication or confirmed the absence of complication in all (13/13, 100%) patients with low-grade (I-III) injury and only missed a small biloma in one patient with a grade IV injury. Interval US and CT agreement was 92 per cent for change in hemoperitoneum or parenchymal lesion. Ultrasonography is a convenient imaging modality in the evaluation of hepatic trauma. US is sufficient to detect or exclude complications in low-grade injuries. In high-grade injuries, US may be an adjunct to CT for definitive interval assessment.

  5. Assessment of Mandibular Distraction Regenerate Using Ultrasonography and Cone Beam Computed Tomography: A Clinical Study

    PubMed Central

    Dabas, Jitender; Mohanty, Sujata; Chaudhary, Zainab; Rani, Amita

    2015-01-01

    Distraction osteogenesis (DO) is becoming a popular method of reconstruction for maxillofacial bony deformities or defects secondary to trauma or surgical tumor ablation. However, the technique is very sensitive in terms of the rate and rhythm of distraction. Because of this, there is a need for monitoring of the distraction regenerate during the distraction as well as the consolidation period. The present study was conducted to assess the regenerate using two imaging modalities, namely, ultrasonography (USG) and cone beam computed tomography (CBCT) to determine their relative efficacies and to weigh their clinical usefulness in assessment of DO regenerate. The study was conducted on 12 patients (18 sites) who underwent mandibular distraction for correction of facial deformities. The results showed that overall USG correlated better with the condition of regenerate (r = 0.606) as compared with CBCT (r = 0.476). However, USG was less effective as compared with CBCT in assessing the regenerate once corticomedullary differentiation occurred in the bone. PMID:26889351

  6. Assessment of Skeletal Muscle Perfusion using Contrast-Enhanced Ultrasonography: Technical Note

    PubMed Central

    Qureshi, Adnan I.; Saleem, Muhammad A.; Aytac, Emrah; Wallery, Shawn S.

    2017-01-01

    Background Intravenous contrast-enhanced ultrasonography is a recently developed technique for assessment of tissue perfusion, but has not been used for assessment of skeletal muscle perfusion. Methods We studied a 42-year-old woman in whom myonecrosis was suspected due to systemic vasculitis and ischemia. The biceps brachii (right) and quadriceps femoris (vastus medialis) on right-hand side and subsequently left-hand side were imaged. Intravenous bolus of activated perflutren lipid microspheres was injected and B-Flow color mode (brown color) was used within a selected region of interest to image the passage of contrast through muscle parenchyma throughout three cardiac cycles. Results Visual interpretation of muscle perfusion was performed based on the maximal intensity of contrast in the muscle, and the speed of contrast replenishment. No deficits were noted in the perfusion pattern. The arterial phase demonstrated stellate vascularity, centrifugal filling, and homogeneous hypervascularity at peak enhancement. Conclusions The bolus of contrast resulted in good signal persistence and satisfactory imaging for multiple muscle groups. PMID:28243350

  7. [Pancreatic ultrasonography].

    PubMed

    Fernández-Rodríguez, T; Segura-Grau, A; Rodríguez-Lorenzo, A; Segura-Cabral, J M

    2015-04-01

    Despite the recent technological advances in imaging, abdominal ultrasonography continues to be the first diagnostic test indicated in patients with a suspicion of pancreatic disease, due to its safety, accessibility and low cost. It is an essential technique in the study of inflammatory processes, since it not only assesses changes in pancreatic parenchyma, but also gives an indication of the origin (bile or alcoholic). It is also essential in the detection and tracing of possible complications as well as being used as a guide in diagnostic and therapeutic punctures. It is also the first technique used in the study of pancreatic tumors, detecting them with a sensitivity of around 70% and a specificity of 90%.

  8. Small intestine contrast ultrasonography for the detection and assessment of Crohn disease

    PubMed Central

    Zhu, Chenjing; Ma, Xuelei; Xue, Luqi; Xu, Jing; Li, Qingfang; Wang, Yun; Zhang, Jing

    2016-01-01

    Abstract Background: Crohn disease (CD) is a chronic relapsing disease. Imaging modalities are essential for the diagnosis and assessment of CD. Small intestine contrast ultrasonography (SICUS) is a well-tolerated, noninvasive and radiation-free modality and has shown potential in CD assessment. We aimed at evaluating the diagnostic accuracy of SICUS in the detection and assessment of small-bowel lesions and complications in CD. Methods: We searched PubMed database for relevant studies published before April 24, 2016. We integrated the true positive, false positive, false negative, and true negative into the pooled estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio. Forest plots were to represent the pooled results of all studies. Results: Thirteen articles were finally considered eligible. The pooled sensitivity and specificity of SICUS in detecting small-bowel lesions were 0.883 (95% confidence interval (CI) 0.847–0.913) and 0.861 (95% CI 0.828–0.890), respectively. The pooled diagnostic odds ratio was 39.123 (95% CI 20.014–76.476) and the area under the curve of summary receiver operating characteristic was 0.9273 (standard error: 0.0152). In subgroup analyses, SICUS represented fine sensitivity and specificity in proximal and distal small intestine lesion, as well as in CD-related complications such as stricture, dilation, abscess, and fistula. Conclusion: SICUS is accurate enough to make a complete assessment about the location, extent, number, and almost all kinds of complications in CD small-bowel lesions. PMID:27495028

  9. Comparing Color Doppler Ultrasonography and Angiography to Assess Traumatic Arterial Injuries of the Extremities

    PubMed Central

    Pezeshki Rad, Masoud; Mohammadifard, Mahyar; Ravari, Hassan; Farrokh, Donya; Ansaripour, Emad; Saremi, Elena

    2015-01-01

    Background: Traumatic events are one of the major causes of arterial injuries. Physical examination is not a good predictor of the extent of injuries and arteriography is considered as the gold standard for this purpose. In the recent years, noninvasive modalities are increasingly replacing diagnostic arteriography. Color Doppler ultrasonography (USG) is an excellent method to investigate arterial diseases. Objectives: The present study aimed to evaluate the diagnostic value of color Doppler USG compared to conventional angiography in traumatic arterial injuries of extremities. Patients and Methods: Seventy-five patients with extremity trauma suspicious for arterial injury were examined by color Doppler USG just before angiography. Doppler pattern and flow states were assessed, then angiography was performed. The results of duplex USG were compared with angiography. Results: Color Doppler USG had a sensitivity of 95% and specificity of 98% in diagnosis of arterial injury. Positive and negative predictive values of Doppler USG were 92.5% and 94.2%, respectively. Conclusions: Color Doppler USG can be used as a reliable modality with acceptable sensitivity and specificity values to screen hemodynamically stable patients with limb trauma suspicious for arterial injury. PMID:25785180

  10. Fetal ultrasonography.

    PubMed Central

    Garmel, S H; D'Alton, M E

    1993-01-01

    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

  11. Contrast-enhanced harmonic endoscopic ultrasonography for assessment of lymph node metastases in pancreatobiliary carcinoma

    PubMed Central

    Miyata, Takeshi; Kitano, Masayuki; Omoto, Shunsuke; Kadosaka, Kumpei; Kamata, Ken; Imai, Hajime; Sakamoto, Hiroki; Nisida, Naoshi; Harwani, Yogesh; Murakami, Takamichi; Takeyama, Yoshifumi; Chiba, Yasutaka; Kudo, Masatoshi

    2016-01-01

    AIM: To assess the usefulness of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for lymph node metastasis in pancreatobiliary carcinoma. METHODS: All patients suspected of pancreatobiliary carcinoma with visible lymph nodes after standard EUS between June, 2009 and January, 2012 were enrolled. In the primary analysis, patients with successful EUS-fine needle aspiration (FNA) were included. The lymph nodes were assessed by several standard EUS variables (short and long axis lengths, shape, edge characteristic and echogenicity), color Doppler EUS variable [central intranodal blood vessel (CIV) presence] and CH-EUS variable (heterogeneous/homogeneous enhancement patterns). The diagnostic accuracy relative to EUS-FNA was calculated. In the second analysis, N-stage diagnostic accuracy of CH-EUS was compared with EUS-FNA in patients who underwent surgical resection. RESULTS: One hundred and nine patients (143 lymph nodes) fulfilled the criteria. The short axis cut-off ≥ 13 mm predicted malignancy with a sensitivity and specificity of 72% and 85%, respectively. These values were 72% and 63% for the long axis cut-off ≥ 20 mm, 62% and 75% for the round shape variable, 81% and 30% for the sharp edge variable, 66% and 61% for the hypoechogenicity variable, 70% and 72% for the CIV-absent variable, and 83% and 91% for the heterogeneous CH-EUS-enhancement variable, respectively. CH-EUS was more accurate than standard and color Doppler EUS, except the short axis cut-off. Notably, three patients excluded because of EUS-FNA failure were correctly N-staged by CH-EUS. CONCLUSION: CH-EUS complements standard and color Doppler EUS and EUS-FNA for assessment of lymph node metastases. PMID:27022220

  12. Do postmenopausal women with thickened endometrium on trans-vaginal ultrasound in the absence of vaginal bleeding need hysteroscopic assessment? A Pilot Study.

    PubMed

    Laiyemo, R; Dudill, W; Jones, S E; Browne, H

    2016-01-01

    We aimed to determine the incidence of endometrial cancer in a cohort of postmenopausal women with thickened endometrium but no bleeding referred for hysteroscopy and determine the risk estimate of cancer using a cut-off of > 11 mm. This retrospective study of asymptomatic postmenopausal women with thickened endometrium on trans-vaginal scan referred for hysteroscopy was performed using data from 2008 to 2010. In total 63 women were identified. 2 cases of endometrial cancer were identified with an incidence of 3.17%. 22 cases had endometrial thickness (ET) > 11 mm of which 2 were malignant giving a risk estimate for endometrial cancer of 9.1%. 61 women had benign pathology, 40.98% had atrophic endometrium and 59.02% had benign polyp. In conclusion, the incidence of endometrial cancer in postmenopausal women with thickened endometrium on transvaginal scan without vaginal bleeding is low and ET of 11 mm or more seems realistic to use as a cut-off for referral for hysteroscopy.

  13. Rheumatoid shoulder assessed by ultrasonography: prevalence of abnormalities and associated factors

    PubMed Central

    Elbinoune, Imane; Amine, Bouchra; Wabi, Moudjibou; Rkain, Hanan; Aktaou, Souad; Hajjaj-Hassouni, Najia

    2016-01-01

    Introduction The shoulder involvement in rheumatoid arthritis (RA) is common. It can be subclinical and compromise the function of the upper limb. Musculoskeletal ultrasonography can detect subclinical abnormalities in rheumatoid shoulder. Our aim was to assess the prevalence of ultrasound abnormalities in rheumatoid shoulder, and investigate their association with different parameters. Methods Cross-sectional study including 37 patients with RA, meeting the ACR/EULAR 2010 classification criteria, who were enrolled during a month. A questionnaire with sociodemographic, clinical and laboratory data was filled in for all patients. Ultrasound evaluation was performed by a single experienced operator. For each patient, both of shoulders were evaluated. Results Mean age was 50 years with female predominance. Median disease duration of RA was 7.5 years. All patients had a seropositive form of RA. Mean clinical DAS28 was 5.1. Mean HAQ was 1.2. Thirty-one (83.8%) patients had involvement of the shoulder: unilateral in 9(24.3%) cases and bilateral in 22(59.5%) cases. Synovitis was found in 16(43.2%) patients with Doppler in 4 (10.8%) cases. Sub-acromial bursitis was noted in 14 (37.8%) cases and the effusion in 20 (54.1%). Synovitis was noted especially in elderly individuals (p: 0.01). The Doppler was visualized in elderly patients (p: 0.01), with a shorter disease duration (p: 0.02) and with a high SDAI (p: 0.006). US inflammatory findings in anterior recess of glenohumeral joint were linked to a higher synovial index (p: 0.03) and a higher level of rheumatoid factor (p: 0.01). Conclusion 59.5% of our RA patients had bilateral involvement of the shoulder which was related to the disease activity. Ultrasound should be a systematic tool to look for the involvement of this joint in RA patients. PMID:27800090

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

    PubMed Central

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

    2015-01-01

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

  15. A comparison of transvaginal and abdominal ultrasound in visualizing the first trimester conceptus.

    PubMed

    Cullen, M T; Green, J J; Reece, E A; Hobbins, J C

    1989-10-01

    Ultrasound visualization of the first trimester embryo was compared using abdominal and transvaginal sonography. The parameters evaluated included the ability to obtain biometry, the ability to visualize detailed internal anatomy, and a subjective assessment of the overall image clarity. In 120 patients studied, transvaginal sonography was superior to abdominal sonography in obtaining biometric measurements in 51 cases (43%) and for visualizing internal anatomy in 45 cases (38%); also the image clarity of transvaginal sonography was subjectively better in 75 cases (63%). Vaginal sonography was superior to abdominal sonography in gestations less than or equal to 10 weeks, in obese patients, and in patients with retroverted uteri. The major difficulty encountered with transvaginal sonography was the limited maneuverability of the probe to generate specific views. Vaginal sonography can be a valuable tool in imaging the first trimester fetus, complementing, not replacing, abdominal sonography.

  16. Evaluation of Efficacy of Ultrasonography in the Assessment of Transcutaneous Electrical Nerve Stimulation in Subjects with Myositis and Myofascial Pain

    PubMed Central

    Patil, Seema; Iyengar, Asha R; B V, Subash; Joshi, Revan Kumar

    2016-01-01

    Background The study aimed to determine if ultrasonography of masseter can be used to evaluate the outcome of transcutaneous electrical nerve stimulation (TENS) in subjects with temporomandibular disorders (TMDs) such as myositis and myofascial pain. Methods Fifteen TMD subjects with myofascial pain/myositis who satisfied the RDC/McNeil criteria were included in the study. All the subjects were administered TENS therapy for a period of 6 days (30 minutes per session). The mouth opening (in millimeters) and severity of pain (visual analogue scale score) and ultrasonographic thickness of the masseter (in millimeters) in the region of trigger/tender areas was assessed in all the subjects both prior and post TENS therapy. A comparison of the pre-treatment and post-treatment values of the VAS score, mouth opening and masseter thickness was done with the help of a t-test. Results There was a significant reduction in the thickness of masseter muscle (P = 0.028) and VAS scores (P < 0.001) post TENS therapy. There was also a significant improvement in the mouth opening (P = 0.011) post TENS therapy. Conclusions In the present study, ultrasonography was found to be an effective measuring tool in the assessment of TENS therapy in subjects with myositis and myofascial pain. PMID:26839665

  17. Pediatric ultrasonography

    SciTech Connect

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

    1987-01-01

    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.

  18. Role of Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography in the Clinical Assessment of Pancreatic Neoplasms.

    PubMed

    Varadarajulu, Shyam; Bang, Ji Young

    2016-04-01

    Accurate diagnosis and staging of pancreatic neoplasms is essential for surgical planning and identification of locally advanced and metastatic disease that is incurable by surgery. The ability to position the endoscopic ultrasonography (EUS) transducer close to the pancreas combined with the use of fine-needle aspiration enables the accurate diagnosis of pancreatic cysts and solid masses. EUS is also increasingly being used to procure core tissue for molecular analysis that facilitates personalized treatment of pancreatic cancer. Various therapeutic interventions can be undertaken under EUS guidance. This article focuses on the applications of EUS and endoscopic retrograde cholangiopancreatography in pancreatic neoplasms.

  19. Sexual function in women before and after transvaginal mesh repair for pelvic organ prolapse.

    PubMed

    Sentilhes, Loïc; Berthier, Aurélien; Sergent, Fabrice; Verspyck, Eric; Descamps, Philippe; Marpeau, Loïc

    2008-06-01

    The aim of the study was to assess sexual function in women before and after surgery with transvaginal mesh for pelvic organ prolapse. Women were invited to complete a sexual function questionnaire including the Lemack and the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaires (PISQ-12) before undergoing surgery and 1 year after surgery. Eighty-three complete pre and postoperative questionnaires were analyzed. Mean age was 65.1 years. Forty-six were sexually inactive and 37 were sexually active women. Two sexually active women completed the preoperative PISQ-12 questionnaire retrospectively after surgery. There were no significant differences after surgery in the answers to the Lemack questionnaire and PISQ-12 scores. These results suggest that nonabsorbable transvaginal mesh repair of genital prolapse does not impair sexual function 1 year after surgery. Nevertheless, patients should not necessarily expect a significant improvement in sexual function outcome following transvaginal mesh repair for genital prolapse.

  20. Application of ultrasonography in the assessment of skeletal muscles in children with and without neuromuscular disorders: a systematic review.

    PubMed

    Rahmani, Nahid; Mohseni-Bandpei, Mohammad Ali; Vameghi, Roshanak; Salavati, Mahyar; Abdollahi, Iraj

    2015-09-01

    The purpose of this study was to systematically review published studies (2000-2014) carried out on the application of ultrasonography (US) to evaluation of skeletal muscle size in children with and without neuromuscular disorders. Different databases including PubMed, Science Direct, OVID, MEDLINE, CINAHL, EMBASE, ProQuest and Google Scholar were searched. The key words used were: "children," "ultrasound," "skeletal muscles," "neuromuscular disease," "neurogenic disorders," "spina bifida," "myelomeningocele" and "reliability." Eighteen articles were found to be relevant. Eight studies applied US in combination with additional methods of assessment. Four of the 18 studies did not have a control group. Ten studies applied only US in the assessment of skeletal muscles in children with and without neuromuscular diseases. In 9 studies, there were children ranging widely in age, and in 3 studies US was used to determine normal values for skeletal muscles. According to the results of these 18 reviewed articles, US is an appropriate, reliable and highly predictive method for assessment of skeletal muscles in children.

  1. Oxidation and degradation of polypropylene transvaginal mesh.

    PubMed

    Talley, Anne D; Rogers, Bridget R; Iakovlev, Vladimir; Dunn, Russell F; Guelcher, Scott A

    2017-04-01

    Polypropylene (PP) transvaginal mesh (TVM) repair for stress urinary incontinence (SUI) has shown promising short-term objective cure rates. However, life-altering complications have been associated with the placement of PP mesh for SUI repair. PP degradation as a result of the foreign body reaction (FBR) has been proposed as a contributing factor to mesh complications. We hypothesized that PP oxidizes under in vitro conditions simulating the FBR, resulting in degradation of the PP. Three PP mid-urethral slings from two commercial manufacturers were evaluated. Test specimens (n = 6) were incubated in oxidative medium for up to 5 weeks. Oxidation was assessed by Fourier Transform Infrared Spectroscopy (FTIR), and degradation was evaluated by scanning electron microscopy (SEM). FTIR spectra of the slings revealed evidence of carbonyl and hydroxyl peaks after 5 weeks of incubation time, providing evidence of oxidation of PP. SEM images at 5 weeks showed evidence of surface degradation, including pitting and flaking. Thus, oxidation and degradation of PP pelvic mesh were evidenced by chemical and physical changes under simulated in vivo conditions. To assess changes in PP surface chemistry in vivo, fibers were recovered from PP mesh explanted from a single patient without formalin fixation, untreated (n = 5) or scraped (n = 5) to remove tissue, and analyzed by X-ray photoelectron spectroscopy. Mechanical scraping removed adherent tissue, revealing an underlying layer of oxidized PP. These findings underscore the need for further research into the relative contribution of oxidative degradation to complications associated with PP-based TVM devices in larger cohorts of patients.

  2. Assessment of renal artery stenosis using both resting pressures ratio and fractional flow reserve: relationship to angiography and ultrasonography.

    PubMed

    Kadziela, Jacek; Witkowski, Adam; Januszewicz, Andrzej; Cedro, Krzysztof; Michałowska, Ilona; Januszewicz, Magdalena; Kabat, Marek; Prejbisz, Aleksander; Kalińczuk, Lukasz; Zieleń, Piotr; Michel-Rowicka, Katarzyna; Warchoł, Ewa; Rużyłło, Witold

    2011-08-01

    BACKGROUND. Clinical benefit from renal artery revascularization remains controversial, probably because of inaccurate stenosis severity assessment. Objective. The aim of the study was to evaluate resting translesional pressures ratio and renal fractional flow reserve (rFFR) in relation to angiography and Doppler duplex ultrasonography in patients with at least moderate renal artery stenosis (RAS). METHODS. 44 hypertensive patients (48% of males, mean age 65 years) with at least moderate RAS were investigated. Translesional systolic pressure gradient (TSPG), resting Pd/Pa ratio (the ratio of mean distal to lesion and mean proximal pressures) and hyperemic rFFR - after intrarenal administration of papaverine - were evaluated. Quantitative angiographic analysis of stenosis severity was performed including minimal lumen diameter (MLD) and percent diameter stenosis (DS) assessment. Renal/aortic ratio (RAR), resistive index (RI) and deltaRI (side-to side difference) were obtained in Doppler-duplex ultrasonography. The predictive value of selected variables was calculated using receiver-operating characteristics curves. RESULTS. Mean Pd/Pa ratio was 0.86 ± 0.12 and decreased to 0.79 ± 0.13 after papaverine administration. Both Pd/Pa ratio and rFFR strongly correlated with TSPG (r = -0.92, p < 0.0001 and r = -0.88, p < 0.0001, respectively) and moderately with MLD (r = 0.62, p < 0.0001 and r = 0.66, p < 0.0001) and DS (r = -0.63, p < 0.0001 and r = -0.70, p < 0.0001). To identify more than 70% RAS, considered severe, the most predictive cut-off values were 0.93 for Pd/Pa ratio and 0.80 for rFFR. CONCLUSIONS. Mean Pd/Pa ratio and rFFR strongly correlated with angiographic data and in less pronounced manner with ultrasound parameters reflecting intrarenal blood flow. The best accuracy cut-off points for severe RAS predicting were 0.93 and 0.80, respectively.

  3. Comparison between muscle activation measured by electromyography and muscle thickness measured using ultrasonography for effective muscle assessment.

    PubMed

    Kim, Chang-Yong; Choi, Jong-Duk; Kim, Suhn-Yeop; Oh, Duck-Won; Kim, Jin-Kyung; Park, Ji-Whan

    2014-10-01

    In this study, we aimed to compare the intrarater reliability and validity of muscle thickness measured using ultrasonography (US) and muscle activity via electromyography (EMG) during manual muscle testing (MMT) of the external oblique (EO) and lumbar multifidus (MF) muscles. The study subjects were 30 healthy individuals who underwent MMT at different grades. EMG was used to measure the muscle activity in terms of ratio to maximum voluntary contraction (MVC) and root mean square (RMS) metrics. US was used to measure the raw muscle thickness, the ratio of muscle thickness at MVC, and the ratio of muscle thickness at rest. One examiner performed measurements on each subject in 3 trials. The intrarater reliabilities of the % MVC RMS and raw RMS metrics for EMG and the % MVC thickness metrics for US were excellent (ICC=0.81-0.98). There was a significant difference between all the grades measured using the % MVC thickness metric (p<0.01). Further, this % MVC thickness metric of US showed a significantly higher correlation with the EMG measurement methods than with the others (r=0.51-0.61). Our findings suggest that the % MVC thickness determined by US was the most sensitive of all methods for assessing the MMT grade.

  4. Ultrasonography of ovarian masses using a pattern recognition approach

    PubMed Central

    Jung, Sung Il

    2015-01-01

    As a primary imaging modality, ultrasonography (US) can provide diagnostic information for evaluating ovarian masses. Using a pattern recognition approach through gray-scale transvaginal US, ovarian masses can be diagnosed with high specificity and sensitivity. Doppler US may allow ovarian masses to be diagnosed as benign or malignant with even greater confidence. In order to differentiate benign and malignant ovarian masses, it is necessary to categorize ovarian masses into unilocular cyst, unilocular solid cyst, multilocular cyst, multilocular solid cyst, and solid tumor, and then to detect typical US features that demonstrate malignancy based on pattern recognition approach. PMID:25797108

  5. Ultrasonography of ovarian masses using a pattern recognition approach.

    PubMed

    Jung, Sung Il

    2015-07-01

    As a primary imaging modality, ultrasonography (US) can provide diagnostic information for evaluating ovarian masses. Using a pattern recognition approach through gray-scale transvaginal US, ovarian masses can be diagnosed with high specificity and sensitivity. Doppler US may allow ovarian masses to be diagnosed as benign or malignant with even greater confidence. In order to differentiate benign and malignant ovarian masses, it is necessary to categorize ovarian masses into unilocular cyst, unilocular solid cyst, multilocular cyst, multilocular solid cyst, and solid tumor, and then to detect typical US features that demonstrate malignancy based on pattern recognition approach.

  6. [Ultrasound of cervix uteri transvaginal in preterm birth].

    PubMed

    Onofriescu, M; Târnovanu, Mihaela; Scurtu, B; Luca, A; Radu, E; Iftime, Irina

    2006-01-01

    Premature birth is a social problem due to its implications in the natal mortality and morbidity. This is the reason why it is necessary to establish new methods which could identify pregnant women with high risk of premature birth. Besides the measurable biochemical factors such as fetal fibronectin and salivary estriol, I1-6 sonography is a simple method highly efficient and of reasonable financial costs among all the sonographic means of observing the cervix uteri. The transvaginal sonography is the "golden standard", permitting the most faithful assessment of the pursued parameters--the length of the cervix, the aspect of the internal os (funneling), the cervix index. The experience gathered up to now shows that all of these investigations have a predictive value which is more negative than positive, but when used together they could lead to an improved result.

  7. The comparisons between thermography and ultrasonography with physical examination for wrist joint assessment in juvenile idiopathic arthritis.

    PubMed

    Lerkvaleekul, Butsabong; Jaovisidha, Suphaneewan; Sungkarat, Witaya; Chitrapazt, Niyata; Fuangfa, Praman; Ruangchaijatuporn, Thumanoon; Vilaiyuk, Soamarat

    2017-03-01

    This study aimed to assess infrared thermography (IRT) and ultrasonography (US) for detecting wrist arthritis in juvenile idiopathic arthritis (JIA) patients. Although IRT could help us detecting joint inflammation, IRT studies in JIA patients with wrist arthritis are still limited. Currently, no validated US criteria exist for detecting arthritis, and the most useful parameters between Gray-scale ultrasound (GSUS) or Power Doppler ultrasound (PDUS) remain unclear. Therefore, this study focused on detecting wrist arthritis in varying degrees using IRT and US compared with physical examination. Of 46 JIA patients, 16 had previous wrist arthritis but currently inactive, 30 still had wrist arthritis, and the median ages (IQR) were 7.7 (4.3) and 10.2 (4.8) years respectively. Fifteen healthy participants were included, with a median age (IQR) of 9.2 (2.0) years. Using IRT, mean temperature (Tmean) and maximum temperature (Tmax) at skin surface in the region of interest (ROI) in the arthritis group were higher than in the inactive group and the healthy controls with p < 0.05. When patients with arthritis were subgroup analyzed by disease severity based on physical examination, the moderate to severe arthritis had Tmean and Tmax higher than the mild arthritis group with statistical significance. The Heat Distribution Index (HDI), two standard deviations of all pixel temperature values in the ROI, in the moderate to severe arthritis group was higher than in the healthy controls (p = 0.027). The receiver operating characteristic analysis in arthritis detection revealed diagnostic sensitivity of 85.7% and 71.4% and specificity of 80.0% and 93.3% at a cut-off points of Tmean ≥ 31.0 C and Tmax ≥ 32.3 C respectively. For US, GSUS and PDUS are useful in detecting arthritis, providing high sensitivity (83.3%) and specificity (81.3%). Our study demonstrated that both IRT and US were applicable tools for detecting wrist arthritis.

  8. Transvaginal ultrasonographic cervical measurement in predicting failed labor induction and cesarean delivery for failure to progress in nulliparous women.

    PubMed

    Park, Kyo Hoon

    2007-08-01

    The aim of this study was to evaluate the value of transvaginal sonographic cervical measurement in predicting failed labor induction and cesarean delivery for failure to progress in nulliparous women. One hundred and sixty-one women scheduled for labor induction underwent transvaginal ultrasonography and digital cervical examinations. Logistic regression demonstrated that cervical length and gestational age at induction, but not the Bishop score, significantly and independently predicted failed labor induction. According to the receiver operating characteristic curves analysis, the best cut-off value of cervical length for predicting failed labor induction was 28 mm, with a sensitivity of 62% and a specificity of 60%. In terms of the likelihood of a cesarean delivery for failure to progress as the outcome variable, logistic regression indicated that maternal height and birth weight, but not cervical length or Bishop score, were significantly and independently associated with an increased risk of cesarean delivery for failure to progress. Transvaginal sonographic measurements of cervical length thus independently predicted failed labor induction in nulliparous women. However, the relatively poor predictive performance of this test undermines its clinical usefulness as a predictor of failed labor induction. Moreover, cervical length appears to have a poor predictive value for the likelihood of a cesarean delivery for failure to progress.

  9. A comparison of colour duplex ultrasonography after transurethral alprostadil and intracavernous alprostadil in the assessment of erectile dysfunction.

    PubMed

    Ahn, H S; Lee, S W; Yoon, S J; Hann, H J; Hong, J M

    2004-01-01

    This study aimed to investigate whether transurethral alprostadil could be used for the diagnosis of erectile dysfunction using colour duplex ultrasound. The ultrasonography results were compared after transurethral and intracavernous alprostadil administration in 20 patients with erectile dysfunction. There were no significant differences in the mean peak systolic velocities (PSVs) between the two routes of administration, but the mean end diastolic velocities (EDVs) showed significant differences, with patients treated with transurethral alprostadil having higher EDVs. Linear regression analysis of the PSVs reached following the two routes of administration showed a moderate relationship, but linear regression analysis of the EDVs showed no relationship. We concluded that transurethral alprostadil was an inappropriate vasoactive drug to use with colour duplex ultrasonography for the evaluation of patients with erectile dysfunction because it required a longer scan time and it was less effective and less reliable than intracavernous alprostadil at stimulating complete corporeal smooth muscle relaxation.

  10. Assessment of contrast-enhanced ultrasonography of the hepatic vein for detection of hemodynamic changes associated with experimentally induced portal hypertension in dogs.

    PubMed

    Morishita, Keitaro; Hiramoto, Akira; Michishita, Asuka; Takagi, Satoshi; Hoshino, Yuki; Itami, Takaharu; Lim, Sue Yee; Osuga, Tatsuyuki; Nakamura, Sayuri; Ochiai, Kenji; Nakamura, Kensuke; Ohta, Hiroshi; Yamasaki, Masahiro; Takiguchi, Mitsuyoshi

    2017-04-01

    OBJECTIVE To assess the use of contrast-enhanced ultrasonography (CEUS) of the hepatic vein for the detection of hemodynamic changes associated with experimentally induced portal hypertension in dogs. ANIMALS 6 healthy Beagles. PROCEDURES A prospective study was conducted. A catheter was surgically placed in the portal vein of each dog. Hypertension was induced by intraportal injection of microspheres (10 to 15 mg/kg) at 5-day intervals via the catheter. Microsphere injections were continued until multiple acquired portosystemic shunts were created. Portal vein pressure (PVP) was measured through the catheter. Contrast-enhanced ultrasonography was performed before and after establishment of hypertension. Time-intensity curves were generated from the region of interest in the hepatic vein. Perfusion variables measured for statistical analysis were hepatic vein arrival time, time to peak, time to peak phase (TTPP), and washout ratio. The correlation between CEUS variables and PVP was assessed by use of simple regression analysis. RESULTS Time to peak and TTPP were significantly less after induction of portal hypertension. Simple regression analysis revealed a significant negative correlation between TTPP and PVP. CONCLUSIONS AND CLINICAL RELEVANCE CEUS was useful for detecting hemodynamic changes associated with experimentally induced portal hypertension in dogs, which was characterized by a rapid increase in the intensity of the hepatic vein. Furthermore, TTPP, a time-dependent variable, provided useful complementary information for predicting portal hypertension. IMPACT FOR HUMAN MEDICINE Because the method described here induced presinusoidal portal hypertension, these results can be applied to idiopathic portal hypertension in humans.

  11. Gallbladder emptying in diabetic patients and control subjects assessed by real-time ultrasonography and cholescintigraphy: a methodological comparison.

    PubMed

    Krönert, K; Götz, V; Reuland, P; Luft, D; Eggstein, M

    1989-01-01

    Gallbladder motor function was studied in nine diabetic patients and nine control subjects matched for sex, age, and weight. None of the subjects had gallstones. Two different techniques were employed: real-time ultrasonography and cholescintigraphy using 99mTc-HIDA as imaging agent. Gallbladder volumes were determined sonographically by using three dimensions: length, lateral, and anterior-posterior diameters. Gallbladder emptying was stimulated by a standard test drink (Biloptin). Ejection fraction was computed and the results obtained by both techniques were compared. Fasting and residual gallbladder volumes after contraction were significantly larger in the diabetic patients than in the control subjects (15.9 +/- 7.6 cm3 vs. 2.3 +/- 1.3 cm3, p less than .0007; and 9.2 +/- 9.8 cm3 vs. 0.7 +/- 0.7 cm3, p less than .0007). Ejection fractions (ultrasonography/cholescintigraphy) were lower in the diabetic patients compared with the control subjects (59.9 +/- 26.6% and 63.1 +/- 23.2% vs. 73.2 +/- 23.8% and 75.3 +/- 24.8%), however, this difference was not statistically significant. Sonographically and scintigraphically determined ejection fractions were closely correlated (r = 0.90, p less than .00005).

  12. Standards for scrotal ultrasonography

    PubMed Central

    Tyloch, Janusz F.

    2016-01-01

    The paper presents a description of essential equipment requirements for scrotal ultrasonography, including current ultrasound techniques, as well as a review of the most common scrotal pathologies. Patient preparation for the examination as well as ultrasound methodology for the assessment of scrotal and inguinal canal structures are discussed. The standard for scrotal ultrasound examination includes a precise B-mode evaluation, including testicular volumetric assessment performed using automatic measurement options based on the formula of a rotating ellipsoid or three measurements perpendicular to one another. Also, criteria for morphological assessment of abnormalities within testicular or epididymal parenchyma, including a precise evaluation of lesion size, delineation, shape and vascular pattern obtained with Doppler US, have been proposed. Standard assessment further includes epididymal evaluation, including epididymal size in the case of enlargement. The paper additionally discusses the method of ultrasonographic examination and describes the most common pathologies occurring within scrotal structures, including a quantitative analysis of hydrocele and other abnormal fluid reservoirs. We have also presented criteria for the assessment of varicocele as well as color and spectral Doppler flows in scrotal pathologies. Furthermore, we have proposed key components of scrotal ultrasound documentation, so that the contained data could be used to establish appropriate diagnosis, allowing for both adequate clinical management and the reproducibility of subsequent US evaluations performed by either the same or a different examiner. The most common causes of diagnostic errors have also been discussed. PMID:28138410

  13. Feasibility and Technique for Transvaginal Natural Orifice Transluminal Endoscopic Surgery Liver Resection: A Porcine Model

    PubMed Central

    Katagiri, Toshio; Horgan, Santiago; Sandler, Bryan J.; Jacobsen, Garth R.; Coker, Alisa M.; Tsuchiya, Masaru; Maeda, Tetsuya; Kaneko, Hironori

    2017-01-01

    Introduction: Natural orifice transluminal endoscopic surgery (NOTES) is a challenging minimally invasive procedure. Although laparoscopic techniques for liver resection are gaining acceptance worldwide, few studies have investigated NOTES liver resection. We used a porcine model to assess the feasibility and safety of transvaginal NOTES liver resection (TV NOTES LR). Materials and Methods: Nine female pigs underwent TV NOTES LR. A nonsurvival acute porcine model with general anesthesia was used in all cases. Using hybrid NOTES technique, we placed only 1 umbilical 12-mm umbilical trocar in the abdominal wall, which was used to create pneumoperitoneum. A laparoscope was then advanced to obtain intra-abdominal visualization. A 15-mm vaginal trocar was inserted under direct laparoscopic vision, and a flexible endoscope was introduced through the vaginal trocar. A long, flexible grasper and endocavity retractor were used to stably retract the liver. The liver edge was partially transected using energy devices inserted through the umbilical trocar. To transect the left lateral lobe, a flexible linear stapler was inserted alongside the vaginal trocar. A specimen extraction bag was deployed and extracted transvaginally. Blood loss, bile leakage, operative time, and specimen size were evaluated. Necropsy studies were performed after the procedures. Results: Eighteen transvaginal NOTES partial liver resections and 4 transvaginal NOTES left lateral lobectomies were successfully performed on 9 pigs. Mean operative time was 165.8 minutes, and mean estimated blood loss was 76.6 mL. All TV NOTES LRs were performed without complications or deaths. Necropsy showed no bile leakage from remnant liver. Conclusions: Our porcine model suggests that TV NOTES LR is technically feasible and safe and has the potential for clinical use as a minimally invasive alternative to conventional laparoscopic liver resection. PMID:28030435

  14. Transvaginal Ultrasound for the Diagnosis of Abnormal Uterine Bleeding.

    PubMed

    Wheeler, Karen C; Goldstein, Steven R

    2017-03-01

    Transvaginal ultrasound is the first-line imaging test for the evaluation of abnormal uterine bleeding in both premenopausal and postmenopausal women. Transvaginal ultrasound can be used to diagnose structural causes of abnormal bleeding such as polyps, adenomyosis, leiomyomas, hyperplasia, and malignancy, and can also be beneficial in making the diagnosis of ovulatory dysfunction. Traditional 2-dimensional imaging is often enhanced by the addition of 3-dimension imaging with coronal reconstruction and saline infusion sonohysterography. In this article we discuss specific ultrasound findings and technical considerations useful in the diagnosis of abnormal uterine bleeding.

  15. [Diagnosing pneumothorax with ultrasonography].

    PubMed

    Lasarte Izcue, A; Navasa Melado, J M; Blanco Rodríguez, G; Fidalgo González, I; Parra Blanco, J A

    2014-01-01

    The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.

  16. Transvaginal Hybrid NOTES Procedure for Treatment of Gallstone Ileus

    PubMed Central

    Tomizawa, Naoki; Andoh, Tatsumasa; Arakawa, Kazuhisa; Enokida, Yasuaki; Ozawa, Naoya

    2016-01-01

    Gallstone ileus is a rare mechanical bowel obstruction, and previously reported cases have been treated laparoscopically with good results. Although transvaginal hybrid NOTES without a minilaparotomy has been reported to decrease the incidence of surgical wound complications, to our knowledge, this procedure has not been used previously to treat gallstone ileus. We present a case of a 63-year-old woman who underwent transvaginal hybrid NOTES procedure for treatment of gallstone ileus. This case was admitted to our hospital following acute-onset abdominal pain and vomiting. We diagnosed gallstone ileus with cholecystoduodenal fistula by computed tomography and performed totally laparoscopic surgery using only three 5 mm abdominal ports with transvaginal specimen extraction and enterectomy. The patient's postoperative course was uneventful, and laparoscopic cholecystectomy and fistula repair were performed 8 months after the initial surgery. The patient experienced additional pain relief and good cosmetic outcomes. In conclusion, using transvaginal hybrid NOTES may become a future option to minimize the invasiveness of other laparoscopic procedures. PMID:27429831

  17. Ultrasonography of the scrotum in adults

    PubMed Central

    2016-01-01

    Ultrasonography is the ideal noninvasive imaging modality for evaluation of scrotal abnormalities. It is capable of differentiating the most important etiologies of acute scrotal pain and swelling, including epididymitis and testicular torsion, and is the imaging modality of choice in acute scrotal trauma. In patients presenting with palpable abnormality or scrotal swelling, ultrasonography can detect, locate, and characterize both intratesticular and extratesticular masses and other abnormalities. A 12-17 MHz high frequency linear array transducer provides excellent anatomic detail of the testicles and surrounding structures. In addition, vascular perfusion can be easily assessed using color and spectral Doppler analysis. In most cases of scrotal disease, the combination of clinical history, physical examination, and information obtained with ultrasonography is sufficient for diagnostic decision-making. This review covers the normal scrotal anatomy as well as various testicular and scrotal lesions. PMID:26983766

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

    PubMed Central

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

    2015-01-01

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

  19. Ultrasonography of intrauterine devices

    PubMed Central

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

    2015-01-01

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

  20. [Carotid ultrasonography: evaluation of carotid ultrasonography].

    PubMed

    Taniuchi, Ryosui

    2007-02-01

    Carotid ultrasonography is a laboratory procedure showing how arteriosclerosis screening can diagnose carotid artery occlusion and high-grade stenosis. It is useful for inspection in general practice because of its non-invasiveness, development of sonography equipment, laboratory methods and the establishment of an evaluation method. We generally use a linear array probe of around 7-8MHz for carotid observation and combine the B mode method, color and power Doppler method, and pulsed Doppler method for inspection. At vessel analysis, the intima-media thickness, the property of plaque and stenotic ratio are evaluated. We observe the direction of bloodstream and presence of stricture by Doppler color flow imaging and measure flow velocity and the wave pattern by pulsed Doppler method and, with the B mode method, evaluate the extent or degree of stricture. This can be depicted well using a convex array probe and sector array probe when the mental change caused by disease is deep, and depiction is difficult by linear array probe.

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

    PubMed Central

    2011-01-01

    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

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

    PubMed

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

    2014-10-01

    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.

  3. [Carotid duplex ultrasonography for neurosurgeons].

    PubMed

    Sadahiro, Hirokazu; Ishihara, Hideyuki; Oka, Fumiaki; Suzuki, Michiyasu

    2011-12-01

    Carotid duplex ultrasonography (CDU) is one of the most well-known imaging methods for arteriosclerosis and ischemic stroke. For neurosurgeons, it is very important for the details of carotid plaque to be thoroughly investigated by CDU. Symptomatic carotid plaque is very fragile and easily changes morphologically, and so requires frequent CDU examination. Furthermore, after carotid endarterectomy (CEA) and carotid artery stenting (CAS), restenosis is evaluated with CDU. CDU facilitates not only morphological imaging in the B mode, but also allows a flow study with color Doppler and duplex imaging. So, CDU can help assess the presence of proximal and intracranial artery lesions in spite of only having a cervical view, and the patency of the extracranial artery to intracranial artery bypass is revealed with CDU, which shows a rich velocity and low pulsatility index (PI) in duplex imaging. For the examiner, it is necessary to ponder on what duplex imaging means in examinations, and to summarize all imaging finding.

  4. Evaluation of clinical effect of transabdominal sonography and transvaginal sonography in early diagnosis of ectopic gestation

    PubMed Central

    Li, Yinghui; Feng, Tao; Sun, Jiandong

    2017-01-01

    Objective: To analyze the application of transabdominal sonography and transvaginal sonography in early diagnosis of pregnancy and to provide a reference for the selection of diagnosis methods in clinic. Methods: One hundred and eighty patients who were admitted into the hospital from February 2013 to February 2014, received clinical diagnosis and were confirmed as ectopic gestation by surgery were selected as research objects. They were examined by transabdominal sonography, transvaginal sonography, and transabdominal sonography in combination with transvaginal sonography respectively. Besides, the ultrasonic performance was observed and compared with surgical pathological results to analyze and compare diagnostic accordance rate. Results: The positive rate of transabdominal sonography in combination with transvaginal sonography was much higher than that of transabdominal sonography and transvaginal sonography and the differences had statistical significance (P<0.05). The detection rate of different positive characteristics using the combined examination was much higher than that of transabdominal sonography and transvaginal sonography, and the differences had statistical significance (P<0.05). The detection rates of different types of ectopic gestation and different sizes of mass using transabdominal sonography in combination of transvaginal sonography were higher than that of transabdominal sonography and transvaginal sonography (P<0.05). Conclusion: Transabdominal sonography in combination with transvaginal sonography can complement information, improve detection rate, and reduce or avoid misdiagnosis and missed diagnosis, which provides a scientific basis for the formulation of clinical treatment scheme. PMID:28367172

  5. Laparoscopic sacrocolpopexy versus transvaginal mesh for recurrent pelvic organ prolapse.

    PubMed

    Iglesia, Cheryl B; Hale, Douglass S; Lucente, Vincent R

    2013-03-01

    Both expert surgeons agree with the following: (1) Surgical mesh, whether placed laparoscopically or transvaginally, is indicated for pelvic floor reconstruction in cases involving recurrent advanced pelvic organ prolapse. (2) Procedural expertise and experience gained from performing a high volume of cases is fundamentally necessary. Knowledge of outcomes and complications from an individual surgeon's audit of cases is also needed when discussing the risks and benefits of procedures and alternatives. Yet controversy still exists on how best to teach new surgical techniques and optimal ways to efficiently track outcomes, including subjective and objective cure of prolapse as well as perioperative complications. A mesh registry will be useful in providing data needed for surgeons. Cost factors are also a consideration since laparoscopic and especially robotic surgical mesh procedures are generally more costly than transvaginal mesh kits when operative time, extra instrumentation and length of stay are included. Long-term outcomes, particularly for transvaginal mesh procedures, are lacking. In conclusion, all surgery poses risks; however, patients should be made aware of the pros and cons of various routes of surgery as well as the potential risks and benefits of using mesh. Surgeons should provide patients with honest information about their own experience implanting mesh and also their experience dealing with mesh-related complications.

  6. Focused Real-Time Ultrasonography for Nephrologists

    PubMed Central

    Kaptein, Matthew J.

    2017-01-01

    We propose that renal consults are enhanced by incorporating a nephrology-focused ultrasound protocol including ultrasound evaluation of cardiac contractility, the presence or absence of pericardial effusion, inferior vena cava size and collapsibility to guide volume management, bladder volume to assess for obstruction or retention, and kidney size and structure to potentially gauge chronicity of renal disease or identify other structural abnormalities. The benefits of immediate and ongoing assessment of cardiac function and intravascular volume status (prerenal), possible urinary obstruction or retention (postrenal), and potential etiologies of acute kidney injury or chronic kidney disease far outweigh the limitations of bedside ultrasonography performed by nephrologists. The alternative is reliance on formal ultrasonography, which creates a disconnect between those who order, perform, and interpret studies, creates delays between when clinical questions are asked and answered, and may increase expense. Ultrasound-enhanced physical examination provides immediate information about our patients, which frequently alters our assessments and management plans. PMID:28261499

  7. Achondrogenesis type 2 diagnosed by transvaginal ultrasound at 12 weeks' gestation.

    PubMed

    Soothill, P W; Vuthiwong, C; Rees, H

    1993-06-01

    Ultrasound examination at 12 weeks' gestation revealed severe generalised subcutaneous oedema in a pregnancy at risk for achondrogenesis type II. Transvaginal scanning confirmed the oedema and suggested abnormal limb development. The prenatal diagnosis was confirmed by X-ray examination after transvaginal termination.

  8. Complications of endoscopic ultrasonography.

    PubMed

    Fabbri, C; Luigiano, C; Cennamo, V; Ferrara, F; Pellicano, R; Polifemo, A M; Tarantino, I; Barresi, L; Morace, C; Consolo, P; D'Imperio, N

    2011-06-01

    Since its development in the 1980s, endoscopic ultrasonography (EUS) has undergone a great deal of technological modifications. EUS has become an important tool in the evaluation of patients with various clinical disorders and is increasingly being utilized in many centers. EUS has been evolving over the years; EUS-guided fine needle aspiration (FNA) for cytological and/or histological diagnosis has become standard practice and a wide array of interventional and therapeutic procedures are performed under EUS guidance for diseases which otherwise would have needed surgery, with its associated morbidities. EUS shares the risks and complications of other endoscopic procedures. This article addresses the specific adverse effects and risks associated with EUS, EUS-FNA and interventional EUS, namely perforation, bleeding, pancreatitis and infection. Measures to help minimizing these risks will also be discussed.

  9. Ultrasonography of the eye and orbit.

    PubMed

    Dudea, Sorin M

    2011-06-01

    Ultrasonography (US) is, quite often, the first imaging modality used in eye and orbit assessment. The indications of ophthalmic US cover a wide range of disease where direct clinical assessment is impossible or of little value. Doppler US enhances the ability to assess blood flow in the main arteries and veins. In order to take full advantage of all the possibilities US has to offer the examiner thorough knowledge of the examination technique and normal US anatomy of the eye and orbit is required. This paper reviews the basics of the examination technique and ultrasound anatomy of the eye and orbit.

  10. Color Doppler ultrasonography of the abdominal aorta.

    PubMed

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

    2010-09-01

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

  11. Intraoperative endovascular ultrasonography

    NASA Astrophysics Data System (ADS)

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

    1991-05-01

    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.

  12. Ultrasonography of the hip.

    PubMed

    Nestorova, Rodina; Vlad, Violeta; Petranova, Tzvetanka; Porta, Francesco; Radunovic, Goran; Micu, Mihaela C; Iagnocco, Annamaria

    2012-09-01

    A complete physical examination of the hip is often difficult due to its size and deep position. During the last two decades, ultrasonography (US) of the hip has been widely accepted as a useful diagnostic tool in patients with hip pain and /or limited range of motion. It is commonly used in both adults and children. This technique allows evaluation of different anatomical structures and their pathological changes, such as joint recess (joint effusion, synovial hypertrophy), changes within the bursae (bursitis), tendons and muscles (tendinopathy, ruptures, calcifications), as well as changes in the bony profile of the joint surfaces, ischial tuberosity, and greater trochanter (erosions, osteophytes, calcific deposits). US is very useful for guided procedures in hip joint and periarticular soft tissues under direct visualization. The needle aspiration of synovial fluid and steroid injections are commonly-applied activities in daily rheumatology practice. The relatively limited acoustic windows available to the US beam are the principal limitations to hip US. Therefore, conducting a detailed examination of some important structures together with the interpretation of Doppler signal (sometimes undetectable) is not easy, requiring good knowledge of the modality. The aim of this review is to analyze the current literature about US of the hip and to describe the most frequently-observed normal and pathological findings.

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

    SciTech Connect

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

    2006-06-15

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

  14. A transvaginal removal and repair of vesicovaginal fistula due to mesh erosion

    PubMed Central

    Mishra, Vineet V.; Tanvir, Tanvir; Choudhary, Sumesh; Goraniya, Nilesh

    2016-01-01

    Vesicovaginal fistula (VVF) is a devastating social problem. It can either result from obstetric trauma or following gynecological surgeries, malignancy, or radiation. We present a case of a 70-year-old woman who had a VVF following mesh augmentation surgery for anterior compartment prolapse. She required a transvaginal removal of the eroded mesh followed by a transvaginal repair of VVF using a Martius flap, 6 weeks later. Transvaginal removal of mesh is technically feasible and a good approach. Timing and route of surgery should be individualized. PMID:27499600

  15. Emergency medicine ultrasonography

    PubMed Central

    Woo, Michael Y.; Nussbaum, Chris; Lee, A. Curtis

    2009-01-01

    ABSTRACT OBJECTIVE To survey program directors of family medicine–emergency medicine (CCFP[EM]) training programs regarding current and future emergency medicine ultrasonography (EMUS) training. DESIGN A Web-based survey using a modified Dillman method. Two academic emergency physicians reviewed the validity and reliability of the survey. SETTING Canada. PARTICIPANTS Program directors of all 17 Canadian CCFP(EM) residency training programs in 2006. MAIN OUTCOME MEASURES Characteristics of EMUS training currently offered and program directors’ perceptions of needs for future EMUS training. RESULTS The survey, performed in 2006, had a response rate of 100% (17/17), although not all respondents answered all questions. At the time of the study, 82.4% of respondents’ programs used EMUS. Although all program directors recommended that residents attend introductory EMUS courses, only 71.4% (10/14) of programs offered such courses; 60.0% (9/15) of those were mandatory. In one-third of the programs, more than 75% of the attending staff used EMUS. A total of 76.5% of program directors thought that introductory courses in EMUS should be mandatory; 62.5% (10/16) believed that residents were able to acquire sufficient experience to use EMUS independently to make practice decisions before completion of their residency; and 88.2% believed that EMUS should be a part of the scope of practice for emergency medicine physicians. Only 58.8% believed that there should be questions about EMUS on the CCFP(EM) Certification examination. Open responses indicated that funding, resources, and standardization were issues that needed to be addressed. CONCLUSION Formal EMUS training for CCFP(EM) programs is being introduced in Canada. Quality assurance needs to be strengthened. Most program directors thought that an introductory course in EMUS should be mandatory. Fewer directors, however, believed EMUS should be on the CCFP(EM) Certification examination until further funding, resources

  16. Ultrasonography applications in diagnosis and management of early rheumatoid arthritis.

    PubMed

    Thiele, Ralf G

    2012-05-01

    Ultrasonography is an elegant tool for the detection of tenosynovitis, synovitis, and erosions very early in rheumatoid arthritis, and the presence of a power Doppler signal is one of the best predictors of joint damage. Although clinical scores remain the mainstay of disease activity assessment, ultrasonography has proved to be a remarkably robust tool for reliable assessment of changes in rheumatoid arthritis. There is no evidence to suggest that problems with operator dependence would be greater than with other imaging modalities or physical examination, if performed by trained providers.

  17. Transvaginal repair of unrecognized bladder injury after transobturator tape surgery

    PubMed Central

    Bayrak, Ömer; Erbağcı, Ahmet; Şen, Haluk; Erturhan, Sakıp; Yağcı, Faruk; Seçkiner, İlker

    2013-01-01

    Currently, minimally invasive surgeries, which are often characterized by reliable and successful results, are preferred for the treatment of stress urinary incontinence. Although all of the currently used surgeries are minimally invasive, morbidities, including hemorrhage, voiding dysfunction, infection, pain, skin infection and erosion, and bladder injuries, are observed. We detected bladder injury in a 42-year-old female patient with complaints of burning and pain during urination who had previously undergone transobturator tape (TOT) surgery. Complete abdominal hysterectomy for a secondary myoma and a TOT procedure had been simultaneously performed 3 months prior to her presentation. Cystoscopy demonstrated a foreign body compatible with sling material in the bladder which was extracted transvaginally. PMID:26328124

  18. Risk Factors for Mesh Exposure after Transvaginal Mesh Surgery

    PubMed Central

    Niu, Ke; Lu, Yong-Xian; Shen, Wen-Jie; Zhang, Ying-Hui; Wang, Wen-Ying

    2016-01-01

    Background: Mesh exposure after surgery continues to be a clinical challenge for urogynecological surgeons. The purpose of this study was to explore the risk factors for polypropylene (PP) mesh exposure after transvaginal mesh (TVM) surgery. Methods: This study included 195 patients with advanced pelvic organ prolapse (POP), who underwent TVM from January 2004 to December 2012 at the First Affiliated Hospital of Chinese PLA General Hospital. Clinical data were evaluated including patient's demography, TVM type, concomitant procedures, operation time, blood loss, postoperative morbidity, and mesh exposure. Mesh exposure was identified through postoperative vaginal examination. Statistical analysis was performed to identify risk factors for mesh exposure. Results: Two-hundred and nine transvaginal PP meshes were placed, including 194 in the anterior wall and 15 in the posterior wall. Concomitant tension-free vaginal tape was performed in 61 cases. The mean follow-up time was 35.1 ± 23.6 months. PP mesh exposure was identified in 32 cases (16.4%), with 31 in the anterior wall and 1 in the posterior wall. Significant difference was found in operating time and concomitant procedures between exposed and nonexposed groups (F = 7.443, P = 0.007; F = 4.307, P = 0.039, respectively). Binary logistic regression revealed that the number of concomitant procedures and operation time were risk factors for mesh exposure (P = 0.001, P = 0.043). Conclusion: Concomitant procedures and increased operating time increase the risk for postoperative mesh exposure in patients undergoing TVM surgery for POP. PMID:27453227

  19. [Chest ultrasonography in pleurapulmonary disease].

    PubMed

    Gallego Gómez, M P; García Benedito, P; Pereira Boo, D; Sánchez Pérez, M

    2014-01-01

    Although the initial diagnosis and follow-up of pleuropulmonary disease are normally done with plain chest films and the gold standard for chest disease is computed tomography, diverse studies have established the usefulness of chest ultrasonography in the diagnosis of different pleuropulmonary diseases like pleural effusion and lung consolidation, among others. In this article, we show the different ultrasonographic patterns for pleuropulmonary disease. The availability of ultrasonography in different areas (ICU, recovery areas) makes this technique especially important for critical patients because it obviates the need to transfer the patient. Moreover, ultrasonography is noninvasive and easy to repeat. On the other hand, it enables the direct visualization of pleuropulmonary disease that is necessary for interventional procedures.

  20. [Diagnosis and prognosis of preterm labor: physical examination and ultrasonography].

    PubMed

    Goffinet, F; Kayem, G

    2002-11-01

    Diagnosis. Preterm labor is defined by cervical changes associated with regular painful uterine contractions (UC) between 22 and 36 weeks + 6 days. Tocometry does not improve diagnosis or prognosis, despite the identification of more UC (NP 4). Electromyography and cervical distensibility (cervicotonometer) are promising techniques but are still in the research field. Clinical markers for prognosis. Clinical markers associated with clinical cervical examination tested in scoring systems are not validated and can't be recommended in clinical practise (NP 4). Ultrasonographic examination of the cervix. Technical evaluation of ultrasonographic examination of the cervix is satisfactory (NP 3); the transvaginal technical have to be used (NP 3). This method has a better accuracy and reproducibility than clinical examination provided a good apprenticeship (NP 3). Three ultrasound abnormal criteria are defined: a short length, a large internal cervical os and the presence of a funnel in the cervical canal. The best cut-off of cervical length to predict preterm delivery lies between 18 and 30 mm (NP 3). The choice of the cutt-off level depends on the prectitioner: high sensitivity but with many false-positives (cut-off close to 30 mm) or lower sensitivity with few false-positives (close to 20 mm). Cervical length seems to be more accurate that internal os or presence of a funnel which should be used with caution in clinical decisions (NP 3). There is no comparative study about the use of ultrasonographic examination of the cervix in women with preterm labor to evaluate benefits and adverse effects in clinical practice. However, ultrasonographic examination of the cervix supply a progress identifying women at risk of preterm delivery and this technique has a better predictive value than clinical cervical examination (NP 3). It seems reasonable to recommend utilisation of ultrasonographic examination of the cervic in preterm labor. It would not seem reasonable to replace the

  1. Transvaginal Ultrasound-Guided Biopsy of Deep Pelvic Masses: How We Do It.

    PubMed

    Plett, Sara K; Poder, Liina; Brooks, Rebecca A; Morgan, Tara A

    2016-06-01

    The purpose of this review is to discuss the rationale and indications for transvaginal ultrasound-guided biopsy. Transvaginal ultrasound-guided biopsy can be a helpful tool for diagnosis and treatment planning in the evaluation of pelvic masses, particularly when the anatomy precludes a transabdominal or posterior transgluteal percutaneous biopsy approach. A step-by-step summary of the technique with preprocedure and postprocedure considerations is included.

  2. Assessment of the SonixGPS system for its application in real-time ultrasonography navigation-guided percutaneous nephrolithotomy for the treatment of complex kidney stones.

    PubMed

    Li, Xiang; Long, Qingzhi; Chen, Xingfa; He, Dalin; He, Hui

    2017-04-01

    SonixGPS is a novel real-time ultrasonography navigation technology, which has been demonstrated to promote accuracy of puncture in surgical operations. The aim of this study is to evaluate its application in guiding the puncture during percutaneous nephrolithotomy (PCNL). We retrospectively reviewed our experience in treating a total of 74 patients with complex kidney stones with PCNL, in which puncture in 37 cases were guided by SonixGPS system, while the other 37 by conventional ultrasound. The effectiveness of operation was evaluated in terms of stone clearance rate, operation time, time to successful puncture, number of attempts for successful puncture and hospital stay. The safety of operation was examined by evaluating postoperative complications. Our retrospective review showed that although there were no significant differences in stone clearance rates between the groups, SonixGPS guidance resulted in more puncture accuracy with shorter puncture time and higher successful puncture rate. Under the help of SonixGPS, most patients (92 %) had no or just mild complications, compared to that (73 %) in conventional ultrasound group. Post-operative decrease of hemoglobin in SonixGPS group was 13.79 (7-33) mg/dl, significantly lower than that 20.97 (8-41) mg/dl in conventional ultrasound group. Our experience demonstrates that SonixGPS is superior to conventional ultrasound in guiding the puncture in PCNL for the treatment of complex kidney stone.

  3. The accuracy of ultrasonography in the diagnosis of superficial bladder tumors in patients presenting with hematuria

    PubMed Central

    Stamatiou, Konstantinos; Papadoliopoulos, Ioannis; Dahanis, Stefanos; Zafiropoulos, Grigoris; Polizois, Konstantinos

    2009-01-01

    Ultrasonography has been proposed as the initial test for detection of bladder carcinomas in patients presenting with hematuria, but the accuracy of transabdominal ultrasonography in the diagnosis of superficial bladder carcinoma has not been assessed. We prospectively evaluated 173 patients presenting to the outpatient department with painless hematuria by transabdominal ultrasound and cystoscopy. The tolerability of cystoscopy was also assessed. Of 148 patients who met the inclusion criteria, 39 with bladder carcinoma were identified by cystoscopy as having bladder carcinoma, while 34 were identified by ultrasonography. For ultrasonography, the sensitivity (87.1%), specificity (98.1%), positive predictive value (94.4%) and negative predictive value (95.4%) were good but not as good as cystoscopy. While the tolerability of cystoscopy is relatively low, it is still superior to ultrasonography in the evaluation of the bladder as a possible source of hematuria. PMID:19318748

  4. The accuracy of ultrasonography in the diagnosis of superficial bladder tumors in patients presenting with hematuria.

    PubMed

    Stamatiou, Konstantinos; Papadoliopoulos, Ioannis; Dahanis, Stefano; Zafiropoulos, Grigoris; Polizois, Konstantinos

    2009-01-01

    Ultrasonography has been proposed as the initial test for detection of bladder carcinomas in patients presenting with hematuria, but the accuracy of transabdominal ultrasonography in the diagnosis of superficial bladder carcinoma has not been assessed. We prospectively evaluated 173 patients presenting to the outpatient department with painless hematuria by transabdominal ultrasound and cystoscopy. The tolerability of cystoscopy was also assessed. Of 148 patients who met the inclusion criteria, 39 with bladder carcinoma were identified by cystoscopy as having bladder carcinoma, while 34 were identified by ultrasonography. For ultrasonography, the sensitivity (87.1%), specificity (98.1%), positive predictive value (94.4%) and negative predictive value (95.4%) were good but not as good as cystoscopy. While the tolerability of cystoscopy is relatively low, it is still superior to ultrasonography in the evaluation of the bladder as a possible source of hematuria.

  5. Ultrasonography of Extravaginal Testicular Torsion in Neonates

    PubMed Central

    Bombiński, Przemysław; Warchoł, Stanisław; Brzewski, Michał; Majkowska, Zofia; Dudek-Warchoł, Teresa; Żerańska, Maria; Panek, Małgorzata; Drop, Magdalena

    2016-01-01

    Summary Background Extravaginal testicular torsion (ETT), also called prenatal or perinatal, occurs prenatally and is present at birth or appears within the first month of life. It has different etiology than intravaginal torsion, which appears later in life. Testicular torsion must be taken into consideration in differential diagnosis of acute scrotum and should be confirmed or ruled out at first diagnostic step. Ultrasonography is a basic imaging modality, however diagnostic pitfalls are still possible. There is still wide discussion concerning management of ETT, which varies from immediate orchiectomy to conservative treatment resulting in testicle atrophy. Material/Methods In this article we present ultrasonographic spectrum of ETT in neonates, which were diagnosed and treated in our hospital during the last 8 years (2008–2015), in correlation with clinical and intraoperative findings. Results Thirteen neonates with ETT were enrolled in the study – 11 patients with a single testicle affected and 2 patients with bilateral testicular torsion. Most common signs on clinical examination were: hardened and enlarged testicle and discoloration of the scrotum. Most common ultrasonographic signs were: abnormal size or echostructure of the affected testicle and absence of the blood flow in Doppler ultrasonography. In 3 patients ultrasound elastography was performed, which appeared very useful in testicle structure assessment. Conclusions Testicular torsion may concern boys even in the perinatal period. Ultrasonographic picture of acute scrotum in young boys may be confused. Coexistence of the abnormal size or echostructure of the torsed testicle with absence of the blood flow in Doppler ultrasonography appear as very specific but late ultrasonographic sings. Ultrasound elastography may be a very useful tool for visualisation of a very common clinical sign – hardening of the necrotic testicle. PMID:27757176

  6. Comparison of two- and three-dimensional transvaginal ultrasound in the visualisation of intrauterine devices

    PubMed Central

    Dunham, R; Wolstenhulme, S; Wilson, J

    2014-01-01

    The aims of the study were to evaluate whether three-dimensional transvaginal ultrasound (3D TV US) is superior to two-dimensional transvaginal ultrasound (2D TV US) at visualising intrauterine devices and determining their position. This prospective study included 52 participants with an intrauterine device fitted, who underwent 2D TV US and 3D TV US. 2D TV US and 3D-reconstructed coronal images were reviewed by two gynaecological radiologists to assess ease of visualisation and position of the intrauterine devices. Statistical analysis was performed using Wilcoxon signed-rank, McNemar and Chi-squared tests. The inter-observer agreement was measured using Cohen’s Kappa. Intrauterine device visualisation scores were significantly higher with 2D TV US compared with 3D TV US (Radiologist 1 p = <0.001, Radiologist 2 p = 0.007). A significant number of T-arms appeared to perforate into the adjacent myometrium on the 3D-reconstructed coronal image, but were normal on the 2D images (Radiologist 1 p = <0.001, Radiologist 2 p = 0.008). Radiologist 1 found 19 perforated T-arms on 3D TV US compared with four on 2D TV US. Radiologist 2 found 13 perforated T-arms on 3D TV US compared with five on 2D TV US. Both radiologists agreed on the positions of the intrauterine devices substantially with 3D TV US (Kappa = 0.69) and moderately with 2D TV US (Kappa = 0.55). The 3D TV US did not visualise an intrauterine device better than 2D TV US. The 3D-reconstructed coronal image of the uterus can reliably display cases of T-arm perforation into the adjacent myometrium, which could be missed on 2D TV US images. The 3D TV US should be used in addition to 2D TV US in all cases where an intrauterine device is under evaluation. PMID:27433211

  7. The contribution of ultrasonography to intrauterine contraception.

    PubMed

    Defoort, P; Thiery, M

    1981-01-01

    Various methods of assessing the presence and position of the IUD device within the uterine cavity have been developed (barium sulfate in the IUD matrix, tail strings, uterine sounding, radiography), but all have distinct disadvantages (risk of infection, inadvertent displacing of IUD). Diagnostic ultrasound, or ultrasonography, is a non-invasive, rapid technic with no known biological side effects. It requires no patient preparation except a distended bladder, and it can be repeated at will. This paper reviews the possibilities and limitations of ultrasound, and discusses principles of echographic IUD detection. Ultrasonography can prove the presence and location of an IUD in utero in uncomplicated cases of missing threads. It reduces pregnancy rates significantly by establishing early displacement or expulsion of IUD. It is important that the echographer be aware of the clinical context, and if possible, the type of IUD he is looking for, especially in diagnosing partial penetration and breakage. In a small number of cases, there are situations in which the method will be unreliable, and anticipated success rates will be similar to those of blind clinical trials (e.g., significant number of misdiagnoses). These include: 1) the missing tail, where the uterus appears not to contain the IUD; and 2) incipient pregnancy. Radiographic studies are indicated for both situations.

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

    PubMed Central

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

    2001-01-01

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

  9. Evolution of fetal ultrasonography.

    PubMed

    Avni, F E; Cos, T; Cassart, M; Massez, A; Donner, C; Ismaili, K; Hall, M

    2007-02-01

    The authors wish to highlight the evolution that has occurred in fetal ultrasound in recent years. A first significant evolution lies in the increasing contribution of first trimester ultrasound for the detection of fetal anomalies. Malformations of several organs and systems have been diagnosed during the first trimester. Furthermore the systematic measurement of the fetal neck translucency has led to increasing rate of detection of aneuploidies and heart malformations. For several years now, three-dimensional (3D) and 4D ultrasound (US) have been used as a complementary tool to 2D US for the evaluation of fetal morphology. This brings an improved morphologic assessment of the fetus. Applications of the techniques are increasing, especially for the fetal face, heart and extremities. The third field where fetal US is continuously providing important information is the knowledge of the natural history of diseases. This has brought significant improvement in the postnatal management of several diseases, especially urinary tract dilatation and broncho-pulmonary malformation.

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

    PubMed

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

    2014-03-01

    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.

  11. Attitudes toward transvaginal mesh among patients in a urogynecology practice

    PubMed Central

    Dessie, Sybil G.; Hacker, Michele R.; Haviland, Miriam J.; Rosenblatt, Peter L.

    2015-01-01

    Introduction and hypothesis There has been increasing media attention regarding transvaginal mesh (TVM). We hypothesized that new urogynecology patients have limited knowledge and negative opinions of TVM. Methods An anonymous survey was distributed to all new patients presenting to the Mt Auburn Hospital urogynecology practice from 1 November 2012 to 31 January 2013. A total of 146 patients completed the questionnaire. The survey was designed to elicit information on participants’ knowledge and opinions about TVM and knowledge about recent FDA safety communications. All statistical tests were two-sided, and P values <0.05 were considered statistically significant. Results Analyses were restricted to the 77 women who had either heard of TVM or were unsure if they had heard of TVM. A minority (32.5 %) of these women correctly defined TVM, and 33.8 % had a negative impression of TVM. Respondents obtained their information on TVM from the media (48.1 %), the Internet (24.7 %), family or friends (22.1 %), and health care providers (18.2 %). The majority (71.4 %) agreed that they needed more information about TVM before making any decisions about using it to treat their condition. Nearly one quarter of respondents (23.4 %) agreed that they would not want their doctor to use TVM on them for any reason. When asked about recent FDA communications, 27.3 % of patients correctly responded that the FDA had released a safety communication regarding TVM. Conclusions The majority of participants had limited knowledge of TVM; however, only a minority had negative opinions. Given our findings, it is important that providers spend more time during the consent process explaining TVM and its risks and benefits as a treatment option. PMID:25595568

  12. Diagnosis of Pentalogy of Cantrell in the First Trimester Using Transvaginal Sonography and Color Doppler

    PubMed Central

    Türkçapar, Ayşe Figen; Sargın Oruc, Ayla; Öksüzoglu, Aysegül; Danışman, Nuri

    2015-01-01

    We report the prenatal diagnosis of Cantrell syndrome in the first trimester. During a routine transabdominal ultrasonographic examination, a midline supraumbilical abdominal wall defect including herniated liver and ectopia cordis with a large omphalocele containing the intestines and cystic hygroma was incidentally identified at the 12th week of gestation. A transvaginal sonography examination revealed a severe lumbosacral scoliosis in addition to the inability to visualize the abdominal aorta which was indicative of a severe intracardiac defect. The parents opted for pregnancy to be terminated. In this case report, we discuss the complementary role of transvaginal sonography and Doppler imaging in the diagnosis of Cantrell syndrome in early pregnancy. PMID:25802780

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

    PubMed

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

    2014-05-01

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

  14. [Utility of muscle ultrasonography for the diagnosis of amyotrophic lateral sclerosis].

    PubMed

    Misawa, Sonoko

    2014-03-01

    The diagnosis of amyotrophic lateral sclerosis (ALS) is frequently challenging, because motor neuron involvement is usually focal at disease onset and many syndromes mimic ALS. Neurological examination and needle EMG are important in the diagnosis of ALS, and patients with early-stage ALS usually undergo several EMG examinations before the diagnosis is confirmed. Ultrasonography has recently been used for the non-invasive assessment of neuromuscular disorders. This review discusses the recent advances in ultrasonography for ALS diagnosis. Ultrasonography could help detect lower motor neuron involvement by evaluating muscle volume, echo intensity, and fasciculations. Previous reports have documented the diagnostic values of all these parameters. In particular, fasciculations are characteristic features of ALS that can be easily and reliably visualized using ultrasonography. Moreover, the combined use of ultrasonography and EMG to detect fasciculations could substantially increase the diagnostic sensitivity of Awaji criteria for ALS. Attempts to utilize ultrasonography for ALS diagnosis have started only recently, and the technique used is yet to be standardized. However, ultrasonography has a major advantage over EMG in that it is non-invasive. Further studies are needed to understand the use of ultrasound as a novel non-invasive tool for ALS diagnosis.

  15. [Application of ultrasonography in central venous catheterization; access sites and procedure techniques].

    PubMed

    Czyzewska, Dorota; Ustymowicz, Andrzej; Klukowski, Mark

    2016-08-05

    Central venous catheterization is commonly performed in clinical practice. Traditional procedural technique is based on anatomical landmarks, but is associated with a high risk of failure and complications. To decrease their incidence European and American societies recommend application of ultrasonography. Preliminary ultrasonographic examination allows for assessment of local anatomical relations as well as vessel morphology (diameter, patency), while real-time ultrasonography increases chances of successful needle insertion. This paper presents the most common venous access sites and procedure techniques.

  16. Hybrid Transvaginal NOTES and Mini-Laparoscopic Colectomy: Benefit Through Synergy

    PubMed Central

    Gan, Philip S. L.

    2016-01-01

    Background and Objectives: Hybrid-natural orifice surgery combines the advantages of traditional transabdominal laparoscopic surgery, while limiting surgical trauma to the abdominal wall. Among various routes of intra-abdominal access, the transvaginal method is most appealing because of its utility and proven safety. We describe a series of 4 colonic resections performed with this approach, combined with minilaparoscopy and needlescopic approaches, and discuss the technical aspects, efficacy, and applicability of this technique. Methods: Three patients were selected to undergo hybrid transvaginal natural-orifice right hemicolectomy. A fourth patient, who underwent a segmental resection of a splenic flexure carcinoma, was included. Transvaginal port access was obtained via posterior colpotomy, and was used for dissection, vascular ligation, bowel division, and anastomosis. We used a combination of standard laparoscopic, minilaparoscopic, and needlescopic instruments transabdominally, focusing on reduced size and number of access points. Results: Duration of laparoscopy, oncologic outcomes and rate of operative morbidity were comparable to the published literature. Early return of gastrointestinal function and low analgesic requirements was observed in all patients. No morbidity related to transvaginal access was observed and the procedure was performed without difficulty in all cases. Conclusion: Colonic resection performed by hybrid natural-orifice technique offers several advantages over purely transabdominal laparoscopic procedures. Transvaginal access is easy to perform and offers excellent safety, efficacy, and versatility, especially for right hemicolectomy. Techniques to reduce abdominal wall surgical trauma, such as minilaparoscopy and needlescopic graspers, can be combined effectively in colonic resections, and may act synergistically to reduce postoperative pain and improve outcomes. PMID:27904307

  17. Ultrasonography in the diagnosis of Hashimoto's thyroiditis.

    PubMed

    Wu, Guihua; Zou, Dazhong; Cai, Haiyun; Liu, Yajun

    2016-06-01

    Hashimoto's thyroiditis is a type of autoimmune thyroid disease with an increasing prevalence in past decades. Its diagnosisis mostly based on ultrasonography. Ultrasonography is a useful and essential tool to make this diagnosis based on the characteristics of the disease. In the differential diagnosis of thyroid nodules, ultrasound-guided fine-needle biopsy is an effective method to distinguish Hashimoto's thyroiditis from other thyroid disorders. One exciting and recent advance is that non-invasive ultrasound-based methods have supplemented fine-needle aspiration to diagnose Hashimoto's thyroiditis under more complex conditions. In this review, we discuss the recent advantages of ultrasonography in the diagnosis of Hashimoto's thyroiditis.

  18. Ultrasonography in the evaluation of renal scarring using DMSA scan as the gold standard.

    PubMed

    Moorthy, Ima; Wheat, Deirdre; Gordon, Isky

    2004-02-01

    Dimercaptosuccinic acid (DMSA) renal scan is presently the technique of choice for assessing renal scars. Recent advances suggest that ultrasonography could replace DMSA scan for this purpose. This paper describes the experience of a tertiary pediatric referral hospital performing ultrasonography and DMSA scans in the assessment of renal scarring. Investigations were conducted 3-6 months after patients presented with urinary tract infection (UTI). Results were extracted from the radiology information system and recorded for analysis. All children with a UTI who had undergone DMSA and ultrasound examination on the same day between January 1995 and December 1999 were included; 930 kidneys were compared. DMSA scan was utilized as the reference method. When used to detect focal renal scarring, ultrasonography had a sensitivity of 5.2%, specificity of 98.3%, a positive predictive value (PPV) of 50% and a negative predictive value (NPV) of 75.8%. When used to detect diffuse renal scarring, ultrasonography had a sensitivity of 47.2%, specificity of 91.8%, PPV of 60.8% and NPV of 86.6%. Our results demonstrate that although ultrasonography has a good specificity for the detection of renal scarring compared with DMSA, it has low sensitivity, PPV and NPV. Ultrasonography cannot be substituted for DMSA scan in the evaluation of focal renal scarring.

  19. Portable ultrasonography in mass casualty incidents: The CAVEAT examination

    PubMed Central

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

    2010-01-01

    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

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

    PubMed

    Ching, Kevin C; Sumkin, Jules H

    2015-01-01

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

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

    PubMed

    Hata, Toshiyuki; Tanaka, Hirokazu; Noguchi, Junko

    2012-03-01

    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.

  2. Technology Insight: the role of color and power Doppler ultrasonography in rheumatology.

    PubMed

    Schmidt, Wolfgang A

    2007-01-01

    An increasing number of rheumatologists have access to ultrasound equipment that provide both color and power Doppler modes, which can be used to investigate musculoskeletal and vascular pathologies. Musculoskeletal Doppler ultrasonography can be used to estimate levels of inflammation, to document the anti-inflammatory effect of agents such as corticosteroids and tumor necrosis factor inhibitors, to differentiate between inflammatory and degenerative disease, and to distinguish between normal and inflamed joints in cases of minor synovial swelling. Vascular Doppler ultrasonography can be used to determine organ involvement in small-vessel vasculitides, to delineate aneurysms in vasculitides of medium-sized arteries, and to assess the characteristic findings in large-vessel vasculitis. Numerous studies, including a meta-analysis, have been published on the use of temporal-artery ultrasonography for the diagnosis of giant cell arteritis. Duplex ultrasonography is a sensitive approach for detecting characteristic edematous wall swellings in active temporal arteritis and for assessing vasculitis of the axillary arteries (large-vessel giant cell arteritis) in patients with suspected temporal arteritis, polymyalgia rheumatica, or fever of unknown origin. Duplex ultrasonography can also be used to assess vasculitis of subclavian and carotid arteries in younger patients with Takayasu's arteritis and acute finger artery occlusions in patients with small-vessel vasculitides.

  3. Ultrasonography for the diagnosis of acute appendicitis.

    PubMed

    Himeno, Shinji; Yasuda, Seiei; Oida, Yasuhisa; Mukoyama, Sayuri; Nishi, Takayuki; Mukai, Masaya; Nakasaki, Hisao; Makuuchi, Hiroyasu

    2003-04-01

    Acute appendicitis is usually encountered clinically as acute abdomen. Typical cases are easy to diagnose, but it can sometimes be very difficult to make a diagnosis in atypical cases. We retrospectively studied patients who underwent ultrasonography for right-sided lower abdominal pain suggesting acute appendicitis, and assessed the accuracy of ultrasonic diagnosis. The subjects were 202 patients (100 males and 102 females) aged 6-89 years (mean: 33.3 years). From the ultrasonic findings, appendicitis was classified as follows: 1) catarrhal: a clear layer structure of the appendiceal wall and mucosal edema; 2) phlegmonous: an ill-defined layer structure of the appendiceal wall, moderate enlargement of the apendix, and maximum transverse dimension of > or = 10 mm; and 3) gangrenous: unidentifiable layer structure of the appendiceal wall and marked enlargement to form a mass. The appendix was visualized in 142 of the 202 patients (70.3 %). When the appendix was detected, the sensitivity, specificity and accuracy of ultrasound for making a diagnosis of appendicitis were 97.6%, 82.0 %, 91.5 %, respectively. With regard to assessment of the severity of inflammation, ultrasonic and histologic findings were concordant in 61.2 % of the patients. However, ultrasound was shown to possibly underestimate the extent of inflammation. On the other hand, 11 of the 60 patients with an undetectable appendix (18.3 %) were clinically diagnosed as having appendicitis. The pathologic diagnosis was catarrhal appendicitis in 3 patients and phlegmonous appendicitis in 8 patients. In patients with an undetectable appendix, the possibility of catarrhal or phlegmonous appendicitis should be kept in mind.

  4. Quantitative Muscle Ultrasonography in Carpal Tunnel Syndrome

    PubMed Central

    2016-01-01

    Objective To assess the reliability of quantitative muscle ultrasonography (US) in healthy subjects and to evaluate the correlation between quantitative muscle US findings and electrodiagnostic study results in patients with carpal tunnel syndrome (CTS). The clinical significance of quantitative muscle US in CTS was also assessed. Methods Twenty patients with CTS and 20 age-matched healthy volunteers were recruited. All control and CTS subjects underwent a bilateral median and ulnar nerve conduction study (NCS) and quantitative muscle US. Transverse US images of the abductor pollicis brevis (APB) and abductor digiti minimi (ADM) were obtained to measure muscle cross-sectional area (CSA), thickness, and echo intensity (EI). EI was determined using computer-assisted, grayscale analysis. Inter-rater and intra-rater reliability for quantitative muscle US in control subjects, and differences in muscle thickness, CSA, and EI between the CTS patient and control groups were analyzed. Relationships between quantitative US parameters and electrodiagnostic study results were evaluated. Results Quantitative muscle US had high inter-rater and intra-rater reliability in the control group. Muscle thickness and CSA were significantly decreased, and EI was significantly increased in the APB of the CTS group (all p<0.05). EI demonstrated a significant positive correlation with latency of the median motor and sensory NCS in CTS patients (p<0.05). Conclusion These findings suggest that quantitative muscle US parameters may be useful for detecting muscle changes in CTS. Further study involving patients with other neuromuscular diseases is needed to evaluate peripheral muscle change using quantitative muscle US. PMID:28119835

  5. Ultrasonography of the hand, wrist, and elbow.

    PubMed

    Bodor, Marko; Fullerton, Brad

    2010-08-01

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

  6. Ultrasonography in diagnosing chronic pancreatitis: New aspects

    PubMed Central

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

    2013-01-01

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

  7. Diagnostic Ultrasonography of an Ankle Fracture Undetectable by Conventional Radiography: A Case Report

    PubMed Central

    Daniels, Clinton J.; Welk, Aaron B.; Enix, Dennis E.

    2016-01-01

    Objective The purpose of this study is to present diagnostic ultrasonography assessment of an occult fracture in a case of persistent lateral ankle pain. Clinical Features A 35-year-old woman presented to a chiropractic clinic with bruising, swelling, and pain along the distal fibula 3 days following an inversion ankle trauma. Prior radiographic examination at an urgent care facility was negative for fracture. Conservative care over the next week noted improvement in objective findings, but the pain persisted. Intervention and Outcome Diagnostic ultrasonography was ordered to assess her persistent ankle pain and showed a minimally displaced fracture of the fibula 4 cm proximal to the lateral malleolus. The patient was referred to her primary care physician and successfully managed with conservative care. Conclusion In this case, diagnostic ultrasonography was able to identify a Danis-Weber subtype B1 fracture that was missed by plain film radiography. PMID:27069430

  8. Efficacy of Endoscopic Ultrasonography in Evaluation of Undetermined Etiology of Common Bile Duct Dilatation on Abdominal Ultrasonography

    PubMed Central

    Sotoudehmanesh, Rasoul; Nejati, Naimeh; Farsinejad, Maryam; Kolahdoozan, Shadi

    2016-01-01

    BACKGROUND The cause of common bile duct (CBD) dilatation cannot be determined by imaging modalities in many patients. The aim of this study was to assess the value of endoscopic ultrasonography (EUS) in detecting the cause of CBD dilatation in patients in whom ultrasonography could not demonstrate the cause of dilation. METHODS Prospectively, 152 consecutive patients who were referred for evaluation of dilated CBD (diameter ≥7 mm) of undetermined origin by ultrasonography were included in this study. All the patients underwent EUS. Final diagnoses were determined by using endoscopic retrograde cholangiopancreatography (ERCP), EUS-guided fine needle aspiration (FNA), surgical exploration, or follow-up for at least 10 months. Patients with choledocholithiasis were referred for ERCP and sphincterotomy, and patients with operable tumors were referred for surgery.Patients with inoperable tumors underwent biliary stenting with or without tchemoradiotherapy. RESULTS 152 patients (54% female) with dilated CBD were included. Mean (±SD) age of the patients was 60.4 (±17.3) years. The mean CBD diameter for all study group in transabdominal ultrasonography and EUS were 11.7 millimeter and 10.1 millimeter, respectively. Most of the patients with dilated CBD and abnormal liver function test (LFT) had an important finding in EUS and follow-up diagnosis including peri-ampullary tumors. Mean diameter of CBD in patients with and without abnormal LFT were 10.5 IU/L and 12.1 IU/L, respectively. Final diagnoses included choledocholithiasis in 32 (21.1%),passed CBD stone in 35 (23%), opium-induced CBD dilation in 14 (9.2%), post-cholecystectomy states in 20 (13.1%), ampullary adenoma/carcinoma in 15 (15.8%), cholangiocarcinoma in 14 (9.2%), and pancreatic head cancer in9 (5.9%) patients. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of EUS for patients with abnormal EUS were 89.5%, 100.0%, 100.0%, 91.2%, and 90.9%, respectively

  9. Diagnostic vascular ultrasonography with the help of color Doppler and contrast-enhanced ultrasonography

    PubMed Central

    2016-01-01

    The use of ultrasonography and especially of contrast-enhanced ultrasonography (CEUS) in the diagnosis of vascular pathologies before and after interventions has significantly increased over the past years due to the broader availability of modern ultrasound systems with CEUS capabilities and more trained user experience in this imaging modality. For the preinterventional and postinterventional work-up of carotid diseases, duplex ultrasound as well as CEUS have been established as the standard-of-care examination procedures for diagnosis, evaluation, and follow-up. In addition to its use for carotid arterial diseases, ultrasonography has also become the primary modality for the screening of vascular pathologies. This review describes the most common pathologies found in ultrasonography of the carotid arteries, the abdominal aorta, and the femoral arteries. PMID:27669962

  10. Use of ultrasonography to make management decisions

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  11. Ultrasonography of the Kidney: A Pictorial Review

    PubMed Central

    Hansen, Kristoffer Lindskov; Nielsen, Michael Bachmann; Ewertsen, Caroline

    2015-01-01

    Ultrasonography of the kidneys is essential in the diagnosis and management of kidney-related diseases. The kidneys are easily examined, and most pathological changes in the kidneys are distinguishable with ultrasound. In this pictorial review, the most common findings in renal ultrasound are highlighted. PMID:26838799

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

    PubMed

    Koski, Michelle E; Rovner, Eric S

    2014-02-01

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

  13. Transvaginal Small Bowel Evisceration in Known Case of Uterine Prolapse Due to Trauma

    PubMed Central

    Gheewala, Umesh; Shukla, Radha; Bhatt, Ravi; Srivastava, Shirish

    2015-01-01

    Spontaneous transvaginal bowel evisceration is a rare surgical emergency with only a few cases reported and particularly postmenopausal, posthysterectomy, multiparous elderly women are considered to be at higher risk for development of bowel evisceration. It is difficult to manage such a patient for any surgeon and poses significant challenges especially intraoperatively. Here, we report a case of vaginal vault rupture with small bowel evisceration through the vagina in a known case of uterine prolapse and highlight the risk factors, clinical presentation, and treatment options for this rare surgical emergency PMID:25738028

  14. Prenatal 2-dimensional and 3-dimensional ultrasonography diagnosis and autoptic findings of isolated ectopia cordis.

    PubMed

    Bianca, S; Bartoloni, G; Auditore, S; Reale, A; Tetto, C; Ingegnosi, C; Pirruccello, B; Ettore, G

    2006-01-01

    Ectopia cordis is a very rare congenital malformation, commonly associated with intracardiac anomalies. It is due to a defect in fusion of the anterior chest wall resulting in an extrathoracic location of the heart. We report prenatal 2-dimensional (2D) and 3D ultrasonography diagnosis and postnatal autoptic findings of an isolated ectopia cordis with tricuspid atresia. Ectopia cordis prenatal diagnosis is easily made with ultrasound by visualizing the heart outside the thoracic cavity. 3D ultrasonography may add more detailed visualization of the heart anomaly even if the 2D ultrasonography alone permits the prenatal diagnosis. Obstetrical management should include a careful search for associated anomalies, especially cardiac, and the assessment of fetal karyotype. As this is considered a sporadic anomaly, the recurrence risk is low and no genetic origin is known.

  15. Ultrasonography survey and thyroid cancer in the Fukushima Prefecture.

    PubMed

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

    2014-05-01

    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.

  16. Contrast-Enhanced Ultrasonography in Crohn's Disease Diagnostics.

    PubMed

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Liebert, Ariel; Kłopocka, Maria; Serafin, Zbigniew

    2015-06-01

    The chronic nature of Crohn's disease (CD) implicates necessity of multiple control assessments throughout patient's life. It is accepted that in patients with CD requiring disease monitoring, magnetic resonance enterography (MRE) and computed tomography enterography (CTE) are--apart from endoscopy--imaging studies of first choice. In practice, diagnostic imaging of patients with CD is troublesome, since MRE is an expensive and complicated study, and CTE exposes patients to high doses of ionizing radiation. Therefore, there is a need for new, both non-invasive and effective, methods of imaging in CD. Contrast-Enhanced Ultrasonography (CEUS) is a relatively new method using gas-filled microbubbles serving as contrast agent. It allows for detailed assessment of blood perfusion within intestine wall and peri-intestinal tissues, which enables detection and monitoring of inflammation and its qualitative assessment. The purpose of this paper is to describe CEUS examination technique and its clinical applications in patients with Crohn's disease.

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

    PubMed Central

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

    2015-01-01

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

  18. Use of intraoperative ultrasonography in canine spinal cord lesions.

    PubMed

    Nanai, Beatrix; Lyman, Ronald; Bichsel, Pierre S

    2007-01-01

    The purpose of this retrospective study was to describe the intraoperative appearance of various spinal cord conditions, and to investigate how intraoperative ultrasonography assisted in modification of surgical and postoperative treatment plans. Intraoperative ultrasonography (B-mode, and power Doppler mode) was used in 25 dogs undergoing spinal surgery. The neurologic conditions included cervical spondylomyelopathy, intervertebral disc (IVD) protrusion, IVD extrusion, spinal tumors, nerve sheath mass, granulomatous myelitis, and discospondylitis. All of these diagnoses were supported by histopathologic and/or cytologic evaluation. It was possible to visualize the spinal cord and the abnormal spinal tissue in all of the patients. Power Doppler imaging allowed assessment of the spinal cord microcirculation, and assisted in judgment of the degree of decompression. Ultrasound imaging directly impacted the surgical and the medical treatment plans in four patients. Owing to the intraoperative imaging, two hemilaminectomies were extended cranially and caudally, and additional disc spaces were fenestrated, one hemilaminectomy site was extended dorsally to retrieve the disc material from the opposite side, and one intramedullary cervical spinal cord lesion was discovered, aspirated, and consequently diagnosed as granulomatous inflammation, which altered the long-term medication protocol in that dog. This study suggests that intraoperative sonographic spinal cord imaging is a useful and viable technique.

  19. The role of intraductal ultrasonography in pancreatobiliary diseases

    PubMed Central

    Sun, Bo; Hu, Bing

    2016-01-01

    Intraductal ultrasonography (IDUS) provides real-time, cross-sectional imaging of pancreatobiliary ducts and surrounding structures during endoscopic retrograde cholangiopancreatography using a high-frequency ultrasound (US) transducer. Hence, IDUS has been considered a sensitive tool in the evaluation of suspicious choledocholithiasis and neoplasms, to help distinguish between benign and malignant bile duct strictures or wall thickness, and to assess tumor extension and invasion depth. With the rapid development and enriched choices of sensitive diagnostic modalities include but are not limited to endoscopic US, peroral cholangioscopy, and confocal laser endomicroscopy, it is needed to systematically assess the role of IDUS in the investigation of pancreatobiliary diseases. Some new developments and innovative use of IDUS techniques will be discussed in this paper with the review of literature. PMID:27803901

  20. Bedside ultrasonography in the ICU: part 2.

    PubMed

    Beaulieu, Yanick; Marik, Paul E

    2005-09-01

    This is the second of a two-part review on the application of bedside ultrasonography in the ICU. In this part, the following procedures will be covered: (1) echocardiography and cardiovascular diagnostics (second part); (2) the use of bedside ultrasound to facilitate central-line placement and to aid in the care of patients with pleural effusions and intra-abdominal fluid collections; (3) the role of hand-carried ultrasound in the ICU; and (4) the performance of bedside ultrasound by the intensivist. The safety and utility of bedside ultrasonography performed by adequately trained intensivists has now been well demonstrated. This technology, as a powerful adjunct to the physical examination, will become an indispensable tool in the management of critically ill patients.

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

    PubMed

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

    2013-12-01

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

  2. Ability of Ultrasonography in Detection of Different Extremity Bone Fractures; a Case Series Study

    PubMed Central

    Bozorgi, Farzad; Shayesteh Azar, Massoud; Montazer, Seyed Hossein; Chabra, Aroona; Heidari, Seyed Farshad; Khalilian, Alireza

    2017-01-01

    Introduction: Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. Methods: This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture. After initial assessment, ultrasonography of suspected bones was performed by a trained emergency medicine resident and prevalence of true positive and false negative findings were calculated compared to plain radiology. Results: 108 patients with the mean age of 44.6 ± 20.4 years were studied (67.6% male). Analysis was done on 158 sites of fracture, which were confirmed with plain radiography. 91 (57.6%) cases were suspected to have upper extremity fracture(s) and 67 (42.4%) to have lower ones. The most frequent site of injuries were forearm (36.7%) in upper limbs and leg (27.8%) in lower limbs. Prevalence of true positive and false negative cases for fractures detected by ultrasonography were 59 (64.8%) and 32 (35.52%) for upper and 49 (73.1%) and 18 (26.9%) for lower extremities, respectively. In addition, prevalence of true positive and false negative detected cases for intra-articular fractures were 24 (48%) and 26 (52%), respectively. Conclusion The present study shows the moderate sensitivity (68.3%) of ultrasonography in detection of different extremity bone fractures. Ultrasonography showed the best sensitivity in detection of femur (100%) and humerus (76.2%) fractures, respectively. It had low sensitivity in detection of in intra-articular fractures. PMID:28286822

  3. Ultrasonography alone for diagnosis of breast cancer in women under 40

    PubMed Central

    Appleton, DC; Hackney, L

    2014-01-01

    Introduction Recent guidelines suggest that ultrasonography should be used as the primary imaging modality in women under 40 years of age with mammography being offered if further imaging is required. The aim of this study was to assess the adequacy of ultrasonography and the utility of mammography in this patient group by reviewing the role these imaging techniques had in the diagnosis of breast cancer in our unit. Methods All breast cancers diagnosed in patients 39 years or younger from June 2009 to June 2011 were reviewed. This was a retrospective review of presentation, clinical findings, imaging modality (ultrasonography, mammography, magnetic resonance imaging [MRI]) and histology. Mammography was the primary imaging modality until May 2011 in women between 35 and 39 years of age. Both invasive and intraductal carcinoma were included in the study but lobular carcinoma in situ was excluded. Results A total of 2,495 patients were referred to the symptomatic breast clinic in this age group during the study period. Thirty women were identified with either invasive cancer (n=27) or ductal carcinoma in situ (n=3). Twenty-eight patients underwent mammography, graded as uncertain, suspicious or malignant in the majority. Malignancy was missed in one patient. All 30 patients underwent ultrasonography, reported as uncertain, suspicious or malignant, an indication for diagnostic core biopsy. Ultrasonography alone did not miss any cancers but did fail to detect multifocal disease in one patient. Conclusions In this study group, ultrasonography was reliable as the primary imaging modality for women under 40, identifying all cancers in this cohort. Mammography and/or MRI remain essential adjuncts to accurately determine multifocality and/or the extent of disease. PMID:24780784

  4. Ultrasonography of the hip and lower extremity.

    PubMed

    Malanga, Gerard A; Dentico, Richard; Halperin, Jonathan S

    2010-08-01

    Musculoskeletal ultrasonographic evaluation of the proximal lower limb includes the evaluation of the soft tissue structures, including tendons, ligaments, or muscles, and the bony structures of this region, include the hip, pubic symphysis, and sacroiliac joints. The evaluation of the hip or proximal lower limb region can be performed in an efficient and systematic manner. Ultrasonography of the lateral hip, intra-articular hip, medial thigh, and posterior thigh are discussed in the article.

  5. Assessment of ultrasonographic features of polycystic ovaries is associated with modest levels of inter-observer agreement

    PubMed Central

    Lujan, Marla E; Chizen, Donna R; Peppin, Andrew K; Dhir, Anita; Pierson, Roger A

    2009-01-01

    Background There is growing acceptance that polycystic ovaries are an important marker of polycystic ovary syndrome (PCOS) despite significant variability when making the ultrasound diagnosis. To better understand the nature of this variability, we proposed to evaluate the level of inter-observer agreement when identifying and quantifying individual ultrasonographic features of polycystic ovaries. Methods Digital recordings of transvaginal ultrasound scans performed in thirty women with PCOS were assessed by four observers with training in Radiology or Reproductive Endocrinology. Observers evaluated the scans for: 1) number of follicles ≥ 2 mm per ovary, 2) largest follicle diameter, 3) ovarian volume, 4) follicle distribution pattern and 5) presence of a corpus luteum (CL). Lin's concordance correlation coefficients and kappa statistics for multiple raters were used to assess inter-observer agreement. Results Agreement between observers ranged from 0.08 to 0.63 for follicle counts, 0.27 to 0.88 for largest follicle diameter, 0.63 to 0.86 for ovarian volume, 0.51 to 0.76 for follicle distribution pattern and 0.76 to 0.90 for presence of a CL. Overall, reproductive endocrinologists demonstrated better agreement when evaluating ultrasonographic features of polycystic ovaries compared to radiologists (0.71 versus 0.53; p = 0.04). Conclusion Inter-observer agreement for assessing ultrasonographic features of polycystic ovaries was moderate to poor. These findings support the need for standardized training modules to characterize polycystic ovarian morphology on ultrasonography. PMID:19515259

  6. Evaluation of transvaginal sonography in detecting endometrial polyps and the pregnancy outcome following hysteroscopic polypectomy in infertile women

    PubMed Central

    Zhu, Huili; Fu, Jing; Lei, Haike; Song, Yong; Shen, Licong; Huang, Wei

    2016-01-01

    The aims of the present study were to evaluate the effectiveness of transvaginal sonography (TVS) in the detection of endometrial polyps (EPs), and to assess the pregnancy outcome in infertile women following hysteroscopic polypectomy. A total of 145 women diagnosed with primary or secondary infertility and intrauterine disorders by TVS and hysterosalpingography (HSG) were included in the current study. All subjects were divided into three groups based on hysteroscopic findings, including the EP, intrauterine adhesion and normal groups. EPs were removed for biopsy and intrauterine adhesions were treated. Pregnancy rates between groups were compared. In total, 34 EPs were detected by TVS, while 45 subjects were later confirmed with EP by hysteroscopy. The sensitivity, specificity, positive predictive value and negative predictive value of TVS in the detection of EPs were 67, 96, 88.23 and 86.49%, respectively. Of the included patients, 120 subjects were followed up, including 40 patients diagnosed with EPs, 42 with intrauterine adhesions and 38 with normal cavities. The results indicated no statistically significant differences in the age, type and duration of infertility, least function (LF) score and classification of the extent of tubal disease with the distal fimbrial obstruction between the three groups. In addition, pregnancy rate and spontaneous abortion rate in the EP group following hysteroscopic polypectomy were 45 and 5.6%, respectively. No significant difference was observed in the fertility rate following surgery. In conclusion, TVS features high sensitivity, specificity and certain unique sonographic characteristics in diagnosing EPs, and may be used as a preliminary diagnostic procedure to select patients for hysteroscopy. Furthermore, hysteroscopic polypectomy is an important approach for the treatment of infertile patients with EPs and appears to help increase the pregnancy rate of previously infertile women. PMID:27446343

  7. Pre- and posttreatment ultrasonography of the thyroid gland in hyperthyroid cats.

    PubMed

    Barberet, Virginie; Baeumlin, Yseult; Taeymans, Olivier; Duchateau, Luc; Peremans, Kathelijne; van Hoek, Ingrid; Daminet, Sylvie; Saunders, Jimmy H

    2010-01-01

    Ultrasonography is useful for assessing the morphology of the thyroid gland in hyperthyroid cats. Our aim was to describe the ultrasonographic changes of the thyroid gland in hyperthyroid cats after 131I therapy. Ultrasonography was performed in 15 hyperthyroid cats at initial presentation and 6 months after 131I using a multifrequency linear transducer set at 12 MHz. The following criteria were evaluated: length, width, height, volume, shape, homogeneity, and vascularity, using Power Doppler. Pretreatment, 10 cats had bilaterally abnormal thyroid lobes, four cats one abnormal lobe with the contralateral lobe being normal or reduced in size, and one cat with one normal lobe and one lobe not visible. Six months after 131I therapy, there was a reduction in median volume from 819 to 210 mm3, reduced rounding, reduced heterogeneity, and decreased vascularity. In conclusion, ultrasonography may be used to monitor thyroid changes in order to assess 131I treatment response. Further studies are necessary to determine whether ultrasonography could contribute to the detection of a relapsing course of hyperthyroidism.

  8. Acute pulmonary edema caused by takotsubo cardiomyopathy in a pregnant woman undergoing transvaginal cervical cerclage

    PubMed Central

    Lee, Jae-Young; Kwon, Hyun-Jung; Park, Sang-Wook; Lee, Yu-Mi

    2017-01-01

    Abstract Background: The physiological changes associated with pregnancy may predispose pregnant women to pulmonary edema. Other known causes of pulmonary edema during pregnancy include tocolytic drugs, preeclampsia, eclampsia, and peripartum cardiomyopathy. Methods: We describe a rare case of pulmonary edema caused by takotsubo cardiomyopathy in a pregnant woman at 14 weeks of gestation who was undergoing emergency transvaginal cervical cerclage. Results: Intraoperative chest radiography revealed severe pulmonary edema and echocardiography indicated moderate left ventricular dysfunction with akinesia of the mid to apical left ventricular wall segment, which is reflective of takotsubo cardiomyopathy. Conclusion: With early detection and appropriate management, the patient was stabilized in a relatively short period of time. Based on her clinical signs and symptoms, we suspect that the pulmonary edema was caused by takotsubo cardiomyopathy. PMID:28072695

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

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

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

  10. Relationship between atherosclerosis and knee osteoarthritis as graded by radiography and ultrasonography in females

    PubMed Central

    Ekim, Ayşe Aydemir; İnal, Esra Erkol; Kaya, Dilek Serin; Yılmazer, Şebnem; Kuzgun, Selen; Mumcu, Gamze; Yurdasiper, Alper; Musmul, Ahmet

    2016-01-01

    [Purpose] The aim of this study was to assess the relationship between atherosclerosis and knee osteoarthritis grade in women as assessed by both ultrasonography and radiography. [Subjects and Methods] Seventy women diagnosed with knee osteoarthritis were classified into two groups according to cartilage grading/radiographic grading. Patients with Kellgren-Lawrence grades 1 and 2 were included in group 1, while those with Kellgren-Lawrence grades 3 and 4 were included in group 2. Patients with cartilage grades 1–3 were included in group 1, while those with cartilage grades 4–6 were included in group 2. Patients were clinically assessed using a visual analog scale and the Western Ontario and McMaster Universities Arthritis Index. Radiographic osteoarthritis grade was scored using the Kellgren and Lawrence grading system. Using ultrasonography, symptomatic knees were graded and evaluated for distal femoral cartilage thickness. Carotid intima-media thickness and serum lipid levels were measured to assess atherosclerosis. [Results] Carotid intima-media thickness measurements were higher in group 2 than in group 1 as determined by the Kellgren-Lawrence and cartilage grading systems. Carotid intima-media thickness measurements were positively correlated with both the ultrasonographic cartilage grade and Kellgren-Lawrence. [Conclusion] The results of this study suggest that osteoarthritis as assessed by ultrasonography was successful and comparable to assessment with radiography. We showed a correlation between atherosclerosis and ultrasonographic knee osteoarthritis grade. PMID:27942107

  11. Exploration of the retroperitoneum using the transvaginal natural orifice transluminal endoscopic surgery technique.

    PubMed

    Zacharopoulou, Chrysoula; Nassif, Joseph; Allemann, Pierre; Dallemagne, Bernard; Perretta, Silvana; Marescaux, Jacques; Wattiez, Arnaud

    2009-01-01

    We sought to evaluate the feasibility of the retroperitoneum's exploration via natural orifice transluminal endoscopic surgery (NOTES) using transvaginal access in a porcine model, and its possible application in human beings. Six female pigs (25-30 kg) were used to establish anatomic landmarks and technical steps. Six additional pigs were used for the survival study. Under general anesthesia and with the pig supine, a 1-cm posterolateral colpotomy was performed with the double-channel gastroscope's needle knife. The incision was enlarged laterally using blunt dissection while keeping in contact with the psoas muscle. A retroperitoneal tunnel was created using carbon-dioxide dissection and the movements of the gastroscope up to the level of the kidney. The colpotomy site was closed using interrupted sutures (polyglactin 2/0). A follow-up laparoscopy and necropsy were performed 3 weeks postoperatively. Successful access to the retroperitoneum was achieved in all pigs with a mean operative time of 30 minutes. However, in the first 3 pigs used for the acute study, the peritoneum was perforated during the six-pig dissection and the procedure was abandoned because of the space's collapse. No perforation occurred during the survival study. An excellent view of the retroperitoneal space and structures, such as the vascular and lymphatic tissues, the kidney, the adrenal gland, and the ureter, was obtained. No intraoperative complications or bleeding or injury to any of the retroperitoneal structures occurred. The 3-week follow-up laparoscopy showed no adhesions or abscesses. These findings were confirmed at necropsy. The retroperitoneal space can be successfully accessed via NOTES. Transvaginal NOTES access to the retroperitoneum avoids any transparietal trocars, so it could decrease surgical trauma, be better tolerated, and offer better visualization, with the obvious gender limitation. Future clinical application in human beings may include procedures such as

  12. The current status of three-dimensional ultrasonography in gynaecology

    PubMed Central

    2016-01-01

    Ultrasonography (US) is the most recent cross-sectional imaging modality to acquire three-dimensional (3D) capabilities. The reconstruction of volumetric US data for multiplanar display took a significantly longer time to develop in comparison with computed tomography and magnetic resonance imaging. The current equipment for 3D-US is capable of producing high-resolution images in three different planes, including real-time surface-rendered images. The use of 3D-US in gynaecology was accelerated through the development of the endovaginal volume transducer, which allows the automated acquisition of volumetric US data. Although initially considered an adjunct to two-dimensional US, 3D-US is now the imaging modality of choice for the assessment of Müllerian duct anomalies and the location of intrauterine devices. PMID:26537304

  13. The current status of three-dimensional ultrasonography in gynaecology.

    PubMed

    Ong, Chiou Li

    2016-01-01

    Ultrasonography (US) is the most recent cross-sectional imaging modality to acquire three-dimensional (3D) capabilities. The reconstruction of volumetric US data for multiplanar display took a significantly longer time to develop in comparison with computed tomography and magnetic resonance imaging. The current equipment for 3D-US is capable of producing high-resolution images in three different planes, including real-time surface-rendered images. The use of 3D-US in gynaecology was accelerated through the development of the endovaginal volume transducer, which allows the automated acquisition of volumetric US data. Although initially considered an adjunct to two-dimensional US, 3D-US is now the imaging modality of choice for the assessment of Müllerian duct anomalies and the location of intrauterine devices.

  14. Ultrasonography as a diagnostic aid in bovine musculoskeletal disorders.

    PubMed

    Kofler, Johann

    2009-11-01

    In the last 15 years, ultrasonography of the bovine musculoskeletal system has become an established diagnostic method used routinely in many veterinary teaching hospitals worldwide. Ultrasonography is ideal for the evaluation of musculoskeletal disorders because they are often associated with extensive soft tissue swelling and inflammatory exudation. The goal of this article is to encourage veterinarians to use ultrasonography for the evaluation of bovine orthopedic disorders. Not only does ultrasonography improve the likelihood of a definitive diagnosis, added use of the machine helps recoup expenses.

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

    PubMed Central

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

    1994-01-01

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

  16. Ultrasonography of bovine urinary tract disorders.

    PubMed

    Floeck, Martina

    2009-11-01

    Ultrasonography is a helpful diagnostic tool in cattle with urinary tract disorders. It can be used to diagnose pyelonephritis, urolithiasis, hydronephrosis, renal cysts, renal tumors, amyloidosis, cystitis, bladder paralysis, bladder rupture, bladder neoplasms, and, occasionally, nephrosis, glomerulonephritis, and embolic nephritis. This article describes the anatomy, scanning technique, indications, limitations, normal and pathologic sonographic appearance of the bovine urinary tract. References from horses and humans are included, especially when the sonographic findings in these species may complement the understanding of similar diseases reported in cattle.

  17. [Carpal tunnel syndrome. The contribution of ultrasonography].

    PubMed

    Pardal-Fernandez, J M

    2014-11-16

    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.

  18. Internal snapping hip syndrome in dynamic ultrasonography

    PubMed Central

    Maczuch, Jarosław; Skupiński, Jarosław; Kukawska-Sysio, Karolina; Wawrzynek, Wojciech

    2016-01-01

    Snapping hip syndrome is an audible or palpable snap in a hip joint during movement which may be accompanied by pain or locking. It is typically seen in young athletes performing activities requiring repeated extreme movements of the hip. It may also follow a physical trauma, intramuscular injections or surgeries. There are two main forms of snapping hip: extra- or intra-articular. Extra-articular snapping hip is elicited by an abnormal movement of specific tendons and is divided into two forms: internal and external. The internal form of snapping hip syndrome is attributed to an abrupt movement of an iliopsoas tendon against an iliopectineal eminence. Radiograph results in patients with this form of snapping tend to be normal. Dynamic ultrasound is the gold standard diagnostic technique in both forms of extra-articular snapping hip syndrome. The objective of the following text is to describe a step-by-step dynamic ultrasonography examination in internal extra-articular snapping hip syndrome in accordance to the proposed checklist protocol. To evaluate abrupt movement of an involved tendon, the patient needs to perform specific provocation tests during the examination. With its real-time imaging capabilities, dynamic ultrasonography detects the exact mechanism of the abnormal tendon friction during hip movement in a noninvasive way. It also allows for a diagnosis of additional hip tissue changes which may be causing the pain. PMID:27679733

  19. Impact of combined lipid lowering and blood pressure control on coronary plaque: myocardial ischemia treated by percutaneous coronary intervention and plaque regression by lipid lowering and blood pressure controlling assessed by intravascular ultrasonography (MILLION) study.

    PubMed

    Kawashiri, Masa-Aki; Sakata, Kenji; Hayashi, Kenshi; Gamou, Tadatsugu; Kanaya, Honin; Miwa, Kenji; Ueda, Kosei; Higashikata, Toshinori; Mizuno, Sumio; Michishita, Ichiro; Namura, Masanobu; Nitta, Yutaka; Katsuda, Shoji; Okeie, Kazuyasu; Hirase, Hiroaki; Tada, Hayato; Uchiyama, Katsuharu; Konno, Tetsuo; Ino, Hidekazu; Nagase, Keisuke; Yamagishi, Masakazu

    2016-10-31

    The aim of the study was to elucidate the aggressive reduction of both low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) reduced coronary atherosclerotic plaque volume compared with a standard treatment of LDL-C and BP in Japanese patients with coronary artery disease (CAD). This study is a prospective, randomized, and open-labelled with a blind-endpoint evaluation study. A total of 97 patients (81 men, mean age 62.0 ± 9.6) with CAD undergoing intravascular ultrasonography (IVUS)-guided percutaneous coronary intervention (PCI) were randomized, and 68 patients had IVUS examinations at baseline and at 18-24 months follow-up. Patients were randomly assigned to standard or aggressive strategies targeting LDL-C and a BP of 100 mg/dL and 140/90 mmHg vs. 70 mg/dL and 120/70 mmHg, respectively. The primary endpoint was the percent change in coronary plaque volume. Both standard and aggressive strategies succeeded to achieve target levels of LDL-C and BP; 74.9 ± 14.7 vs. 63.7 ± 11.9 mg/dL (NS) and 124.1 ± 9.4/75.8 ± 7.7 vs. 113.6 ± 9.6/65.8 ± 9.4 mmHg (systolic BP; NS, diastolic BP; p < 0.05), respectively. Both groups showed a significant reduction in the coronary plaque volume of -9.4 ± 10.7% and -8.7 ± 8.6% (NS) in standard and aggressive therapies, respectively. Both standard and aggressive intervention significantly regressed coronary plaque volume by the same degree, suggesting the importance of simultaneous reductions of LDL-C and BP for prevention of CAD.

  20. Real-time ultrasonography for location of IUDs.

    PubMed

    Reiertsen, O

    1981-04-01

    Ultrasonography is a non-invasive, non-ionizing and painless technique used to locate IUDs in the uterine cavity. This study evaluates the reliability and precision of real-time ultrasonography in locating IUDs. 151 IUD users (duration of use, 2 days to 108 months) were subjected to ultrasonography to detect and locate the IUD. Indications for ultrasonography are: 1) no visible IUD strings (61 patients); 2) pregnant after IUD insertion (7); 3) abnormal uterine pain or bleeding (50); and 4) control of IUD (33). 90% of the women used standard copper-bearing devices (Copper 7; Multiload; Gravigard). Ultrasonography detected the IUD in utero in 128 cases with no false positive results. It did not detect the IUD in 23 cases (expulsion occurred in 18 patients; IUD was removed in 2 cases due to IUD perforation; IUD was erroneously not detected in 3 cases (false negative)) Hysterography was performed in 57 women to confirm ultrasonographic findings. Ultrasonography diagnosed IUD in situ in 54 cases; it was confirmed by hysterography in 44 cases (81%). Hysterography diagnosed penetration of the uterine wall by the IUD; ultrasonography failed to detect all cases of penetration. Ultrasonography is reliable in detecting an IUD in utero but not within the uterine cavity. However, it helps in IUD management by increasing contraceptive efficiency through early diagnoses of expulsion and cervical location of the IUD.

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

    NASA Astrophysics Data System (ADS)

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

    2013-03-01

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

  2. Efficacy of transvaginal biofeedback and electrical stimulation in women with urinary urgency and frequency and associated pelvic floor muscle spasm.

    PubMed

    Bendaña, Emma E; Belarmino, James M; Dinh, Jenny H; Cook, Cynthia L; Murray, Brian P; Feustel, Paul J; De, Elise J B

    2009-01-01

    Women with urinary urgency and frequency may also have pelvic floor muscle spasm. Transvaginal biofeedback (TVBF) and electrical stimulation (EStim) is a treatment modality that has been used to treat vaginismus and chronic pelvic pain. In this study, TVBF/EStim was evaluated in women with pelvic floor muscle spasm associated with urinary symptoms. Fifty-two women underwent therapy with TVBF/EStim and reported a mean symptom improvement of 64.5%.

  3. Point-of-care ultrasonography by pediatric emergency medicine physicians.

    PubMed

    Marin, Jennifer R; Lewiss, Resa E

    2015-04-01

    Emergency physicians have used point-of-care ultrasonography since the 1990 s. Pediatric emergency medicine physicians have more recently adopted this technology. Point-of-care ultrasonography is used for various scenarios, particularly the evaluation of soft tissue infections or blunt abdominal trauma and procedural guidance. To date, there are no published statements from national organizations specifically for pediatric emergency physicians describing the incorporation of point-of-care ultrasonography into their practice. This document outlines how pediatric emergency departments may establish a formal point-of-care ultrasonography program. This task includes appointing leaders with expertise in point-of-care ultrasonography, effectively training and credentialing physicians in the department, and providing ongoing quality assurance reviews.

  4. Role of ultrasonography in the diagnosis of rheumatic diseases in light of ACR/EULAR guidelines

    PubMed Central

    Nowakowska-Płaza, Anna; Pracoń, Grzegorz; Sudoł-Szopińska, Iwona

    2016-01-01

    In the past years, ultrasound imaging has become an integral element of the diagnostic process in rheumatic diseases. It enables the identification of a range of inflammatory changes in joint cavities, sheaths and bursae, and allows their activity to be assessed. In 2012, experts of the European Society of Musculoskeletal Radiology prepared recommendations concerning the role of ultrasonography in the diagnosis of musculoskeletal diseases. Ultrasound was considered the method of choice in imaging peripheral synovitis. Moreover, ultrasound imaging has been popularized thanks to the new classification criteria for rheumatoid arthritis issued by the American College of Rheumatology and European League Against Rheumatism in 2010. They underline the role of ultrasound imaging in the detection of articular inflammatory changes that are difficult to assess unambiguously in the clinical examination. These criteria have become the basis for recommendations prepared by experts from the European League Against Rheumatism concerning medical imaging in rheumatoid arthritis. Nine of ten recommendations concern ultrasonography which is relevant in detecting diseases, predicting their progression and treatment response, monitoring disease activity and identifying remission. In the new criteria concerning polymyalgia rheumatica from 2012, an ultrasound scan of the shoulder and pelvic girdle was considered an alternative to clinical assessment. Moreover, the relevance of ultrasonography in the diagnosis and monitoring of peripheral spondyloarthropathies was widely discussed in 2014 during the meeting of the European League Against Rheumatism in Paris. PMID:27104003

  5. Interventional musculoskeletal ultrasonography: Precautions and contraindications.

    PubMed

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

    2010-09-01

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

  6. Fatty meal ultrasonography in chronic acalculous cholecystitis

    PubMed Central

    Donen, Anna; Kantor, Robin

    2014-01-01

    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

  7. Prenatal diagnosis of hypophosphatasia congenita using ultrasonography

    PubMed Central

    2016-01-01

    Congenital hypophosphatasia is a rare fatal skeletal dysplasia. Antenatal determinants of Epub ahead of print lethality include small thoracic circumference with pulmonary hypoplasia and severe micromelia. These features were present in the fetus of a 25-year-old female who came for an anomaly scan in her second trimester of pregnancy. Additional findings of generalized demineralization and osteochondral spurs led to the diagnosis of hypophosphatasia congenita. The pregnancy was terminated, and the findings were confirmed on autopsy. Common differential diagnoses with clues to diagnose the above mentioned condition have been discussed here. Early and accurate detection of this medical condition is important as no treatment has been established for this condition. Therefore, antenatal ultrasonography helps in diagnosing and decision making with respect to the current pregnancy and lays the foundation for the genetic counseling of the couple. PMID:25971898

  8. Current status of ultrasonography of the finger

    PubMed Central

    2016-01-01

    The recent development of advanced high-resolution transducers has enabled the fast, easy, and dynamic ultrasonographic evaluation of small, superficial structures such as the finger. In order to best exploit these advances, it is important to understand the normal anatomy and the basic pathologies of the finger, as exemplified by the following conditions involving the dorsal, volar, and lateral sections of the finger: sagittal band injuries, mallet finger, and Boutonnière deformity (dorsal aspect); flexor tendon tears, trigger finger, and volar plate injuries (volar aspect); gamekeeper’s thumb (Stener lesions) and other collateral ligament tears (lateral aspect); and other lesions. This review provides a basis for understanding the ultrasonography of the finger and will therefore be useful for radiologists. PMID:26753604

  9. Intraportal endovascular ultrasonography for pancreatic cancer.

    PubMed

    Kaneko, T; Nakao, A; Takagi, H

    1998-01-01

    Intraportal endovascular ultrasonography (IPEUS) is a new diagnostic procedure for pancreatic cancer. In portal invasion, subtle invasion and compression are difficult to differentiate with conventional imaging techniques such as computed tomography and angiography. IPEUS is performed with an 8-French, 20-MHz intravascular ultrasound catheter. IPEUS provides high-resolution, real-time images perpendicular to the portal vein axis. With IPEUS, the portal vein wall is visualized as an echogenic band. A subtle portal invasion can be detected by observing this portal vein wall. Moreover, the segment II of the extrapancreatic nerve plexus is visualized as an echogenic area around the inferior pancreaticoduodenal artery (IPDA). The extrapancreatic nerve plexus invasion can be diagnosed as low echoic infiltration of the area around the IPDA. In the diagnosis of portal vein and extrapancreatic nerve plexus invasion, IPEUS provides a good diagnostic value and important information for the staging of local extension of the pancreatic cancer.

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  11. Transvaginal Mesh and Transanal Resection to Treat Outlet Obstruction Constipation Caused by Rectocele

    PubMed Central

    Shi, Yang; Yu, Yongjun; Zhang, Xipeng; Li, Yuwei

    2017-01-01

    Background The aim of this study was to evaluate the curative effect of transvaginal mesh repair (TVMR) and stapled transanal rectal resection (STARR) in treating outlet obstruction constipation caused by rectocele. Material/Methods Patients who had outlet obstruction constipation caused by rectocele were retrospectively analyzed and 39 patients were enrolled the study. Patients were assigned to either the TVMR or STARR group. Postoperative factors such as complications, pain, recurrence rate, and operative time were compared between the 2 groups. Results Total effective rate was 100% in both groups. No long-term chronic pain occurred and discomfort rate of tenesmus was higher in the STARR group than in the TVMR group. Postoperative defecography showed that the rectocele depth was significantly reduced, and the prolapse of the rectal mucosa and the lower rectal capacity was also decreased. Four cases had mesh exposure in the TVMR group and 2 cases in the STARR group had anastomotic bleeding after the surgery. Conclusions For outlet obstruction constipation caused by rectocele, TVMR and STARR both obtained satisfactory results. Although TVMR is complex with longer operative time and hospitalization period, its long-term effect is better than that of STARR. PMID:28146137

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

    PubMed Central

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

    2015-01-01

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

  13. Spontaneous Rupture of Pyometra Causing Peritonitis in Elderly Female Diagnosed on Dynamic Transvaginal Ultrasound.

    PubMed

    Malvadkar, Sharad M; Malvadkar, Madhuri S; Domkundwar, Shilpa V; Mohd, Shariq

    2016-01-01

    Pyometra is collection of pus within the uterine cavity and is usually associated with underlying gynaecological malignancy or other benign causes. Spontaneous rupture of pyometra is a rare complication. We report a case of a 65-year-old female who presented with acute abdomen and was diagnosed with a ruptured uterus secondary to pyometra and consequent peritonitis on dynamic transvaginal sonography (TVS) which was later confirmed on contrast enhanced computed tomography (CECT). An emergency laparotomy was performed and about 800 cc of pus was drained from the peritoneal cavity. A rent was found in the anterior uterine wall and hence hysterectomy was performed. Histopathology revealed mixed inflammatory cell infiltrate with no evidence of malignancy. There are only 31 cases of ruptured pyometra reported till date, most of which were definitively diagnosed only on laparotomy. In only two of these cases the preoperative diagnosis was made on CECT. We report this case, as the correct and definitive diagnosis was made preoperatively on dynamic TVS. To our knowledge, this is the first case report revealing spontaneous ruptured pyometra being diagnosed preoperatively on dynamic TVS. This report is aimed at giving emphasis on the use of simple dynamic TVS for accurate diagnosis of rare spontaneous ruptured pyometra causing peritonitis.

  14. Spontaneous Rupture of Pyometra Causing Peritonitis in Elderly Female Diagnosed on Dynamic Transvaginal Ultrasound

    PubMed Central

    Malvadkar, Sharad M.; Malvadkar, Madhuri S.; Domkundwar, Shilpa V.; Mohd, Shariq

    2016-01-01

    Pyometra is collection of pus within the uterine cavity and is usually associated with underlying gynaecological malignancy or other benign causes. Spontaneous rupture of pyometra is a rare complication. We report a case of a 65-year-old female who presented with acute abdomen and was diagnosed with a ruptured uterus secondary to pyometra and consequent peritonitis on dynamic transvaginal sonography (TVS) which was later confirmed on contrast enhanced computed tomography (CECT). An emergency laparotomy was performed and about 800 cc of pus was drained from the peritoneal cavity. A rent was found in the anterior uterine wall and hence hysterectomy was performed. Histopathology revealed mixed inflammatory cell infiltrate with no evidence of malignancy. There are only 31 cases of ruptured pyometra reported till date, most of which were definitively diagnosed only on laparotomy. In only two of these cases the preoperative diagnosis was made on CECT. We report this case, as the correct and definitive diagnosis was made preoperatively on dynamic TVS. To our knowledge, this is the first case report revealing spontaneous ruptured pyometra being diagnosed preoperatively on dynamic TVS. This report is aimed at giving emphasis on the use of simple dynamic TVS for accurate diagnosis of rare spontaneous ruptured pyometra causing peritonitis. PMID:26989549

  15. Racial and ethnic disparities in universal cervical length screening with transvaginal ultrasound

    PubMed Central

    Haviland, Miriam J; Shainker, Scott A; Hacker, Michele R; Burris, Heather H

    2016-01-01

    Objective Determine if race or ethnicity is associated with missed or late transvaginal cervical length screening in a universal screening program. Methods Retrospective cohort study of nulliparous women with singleton gestations and a fetal anatomical ultrasound from 16-24 weeks' gestation from January, 2012 through November, 2013. We classified women into mutually exclusive racial and ethnic groups: non-Hispanic black (black), Hispanic, Asian, non-Hispanic white (white), and other or unknown race. We used log-binomial regression to calculate the risk ratio (RR) and 95% confidence interval (CI) of missed or late (≥ 20 weeks' gestation) screening vs. optimally-timed screening between the different racial and ethnic groups. Results Among the 2 967 women in our study population, 971 (32.7%) had either missed or late cervical length screening. Compared to white women, black (RR: 1.3; 95% CI:1.1-1.5) and Hispanic (RR:1.2; 95% CI:1.01-1.5) women were more likely to have missed or late screening. Among women screened, black (vs. white) women were more likely to be screened late (RR: 2.2; 95% CI: 1.6-3.1). Conclusions Black and Hispanic women may be more likely to have missed or late cervical length screenings. PMID:26987873

  16. Transvaginal Sonography Versus Cystoscopy for Detecting Urinary Bladder Invasion in Early Stage Cervical Cancer

    PubMed Central

    Zutshi, Vijay; Garg, Anju; Batra, Swaraj

    2017-01-01

    Introduction Cervical cancer is a major cause of mortality from cancer among women. In it’s early stage pre operative staging with cystoscopy is a standard procedure for the detection of urinary bladder involvement. Aim The present study was conducted with the aim to compare the efficacy of Transvaginal Sonography (TVS) and cystoscopy in diagnosing bladder involvement in early stage cervical cancer patients by confirming it intraoperatively and further by histopathologic examination. Materials and Methods A prospective partially blinded study was conducted between March 2006 and September 2008 on 30 patients with early stage cervical cancer (Stage I and IIa) who were planned to undergo radical hysterectomy. Pre operatively, these patients underwent both TVS and cystoscopy to diagnose bladder involvement. Presence or absence of bladder involvement was then confirmed intra operatively and by histopathologic examination. Results In all the 30 patients studied, no bladder involvement was seen on cystoscopy where as TVS showed bladder involvement in three patients. Involvement of the bladder in these three patients was confirmed intra operatively and by histopathologic examination. Thus, in our study, TVS was 100% sensitive in detecting bladder involvement. Conclusion TVS is highly sensitive in diagnosing bladder involvement in early stage cervical cancer and could potentially detect cases missed with a cystoscopy.

  17. Comparison of outcome and side effects between conventional and transvaginal laparoscopic cholecystectomy: a meta-analysis.

    PubMed

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

    2014-10-01

    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.

  18. Endoscopic Ultrasonography in the Diagnosis of Gastric Subepithelial Lesions

    PubMed Central

    Gong, Eun Jeong; Kim, Do Hoon

    2016-01-01

    Subepithelial lesions occasionally found in the stomach of patients undergoing endoscopy may be either benign lesions or tumors with malignant potential. They may also appear due to extrinsic compression. Discrimination of gastric subepithelial lesions begins with meticulous endoscopic examination for size, shape, color, mobility, consistency, and appearance of the overlying mucosa. Accurate diagnosis can be achieved with endoscopic ultrasonography, which provides useful information on the exact size, layer-of-origin, and characteristic morphologic features to support a definitive diagnosis. Endoscopic ultrasonography also aids in the prediction of malignant potential, especially in gastrointestinal stromal tumors. Features of subepithelial lesions identified on endoscopic ultrasonography can be used to determine whether further diagnostic procedures such as endoscopic resection, fine needle aspiration, or core biopsy are required. Endoscopic ultrasonography is a valuable tool for diagnosis and clinical decision making during follow-up of gastric subepithelial lesions. PMID:27744661

  19. The diagnostic value of endoscopic ultrasonography and contrast-enhanced harmonic endoscopic ultrasonography in gastrointestinal stromal tumors

    PubMed Central

    Zhao, Yanchao; Qian, Linxue; Li, Peng; Zhang, Shutian

    2016-01-01

    Objective: To evaluate the diagnostic value of endoscopic ultrasonography (EUS) and contrast-enhanced harmonic (CEH) EUS in patients with gastrointestinal stromal tumors (GISTs). Patients and Methods: About 19 patients with suspected GISTs underwent EUS and CEH-EUS before tumor resection. The malignant potential was assessed according to the modified Fletcher classification system. Patients were divided into lower (Group I) and higher (Group II) malignant potential group. The clinical characteristics and EUS/CEH-EUS features were compared between two groups. Results: The tumor size in Group II was significantly larger than that in Group I (14.6 ± 5.8 mm vs. 32.1 ± 8.4 mm, P < 0.05). Heterogeneous echogenicity was observed in 4 (4/8) cases in Group II and none in Group I (P < 0.05). Irregular intratumoral vessels were detected in 6 cases in Group II and none in Group I (P < 0.05). The sensitivity and specificity of irregular vessel detection for discriminating higher from lower malignant potential GISTs were 75% and 100%, respectively. The positive predictive value and negative predictive value of detection of irregular vessels to high malignant potential GISTs were 33% and 100%, respectively. Conclusion: Detection of irregular intratumoral vessels can predict higher malignant potential before tumor resection. The tumor size and echogenicity are assistant factors for malignant potential assessment. Endoscopic resection is an efficacious treatment with good security for appropriate patients. PMID:27080610

  20. Ultrasonography of the lower extremity veins: anatomy and basic approach

    PubMed Central

    Lee, Dong-Kyu; Kang, Chang Ho; Cho, Sung Bum

    2017-01-01

    Ultrasonography is an imaging modality widely used to evaluate venous diseases of the lower extremities. It is important to understand the normal venous anatomy of the lower extremities, which has deep, superficial, and perforating venous components, in order to determine the pathophysiology of venous disease. This review provides a basic description of the anatomy of the lower extremity veins and useful techniques for approaching each vein via ultrasonography. PMID:28260355

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

    PubMed

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

    2009-09-01

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

  2. The role of orbital ultrasonography in distinguishing papilledema from pseudopapilledema

    PubMed Central

    Carter, S B; Pistilli, M; Livingston, K G; Gold, D R; Volpe, N J; Shindler, K S; Liu, G T; Tamhankar, M A

    2014-01-01

    Purpose To determine the sensitivity and specificity of orbital ultrasonography in distinguishing papilledema from pseudopapilledema in adult patients. Methods The records of all adult patients referred to the neuro-ophthalmology service who underwent orbital ultrasonography for the evaluation of suspected papilledema were reviewed. The details of history, ophthalmologic examination, and results of ancillary testing including orbital ultrasonography, MRI, and lumbar puncture were recorded. Results of orbital ultrasonography were correlated with the final diagnosis of papilledema or pseudopapilledema on the basis of the clinical impression of the neuro-ophthalmologist. Ultrasound was considered positive when the optic nerve sheath diameter was ≥3.3 mm along with a positive 30° test. Results The sensitivity of orbital ultrasonography for detection of papilledema was 90% (CI: 80.2–99.3%) and the specificity in detecting pseudopapilledema was 79% (CI: 67.7–90.7%). Conclusions Orbital ultrasonography is a rapid and noninvasive test that is highly sensitive, but less specific in differentiating papilledema from pseudopapilledema in adult patients, and can be useful in guiding further management of patients in whom the diagnosis is initially uncertain. PMID:25190532

  3. Vascular access: the impact of ultrasonography.

    PubMed

    Almeida, Carlos Eduardo Saldanha de

    2016-01-01

    Vascular punctures are often necessary in critically ill patients. They are secure, but not free of complications. Ultrasonography enhances safety of the procedure by decreasing puncture attempts, complications and costs. This study reviews important publications and the puncture technique using ultrasound, bringing part of the experience of the intensive care unit of the Hospital Israelita Albert Einstein, São Paulo (SP), Brazil, and discussing issues that should be considered in future studies. RESUMO Punções vasculares são muitas vezes necessárias em pacientes gravemente enfermos. São seguras, mas não isentas de complicações. A ultrassonografia associada à técnica de punção gera diminuição do número de tentativas, de complicações e de custos. O presente artigo revisou importantes publicações sobre o tema, bem como técnicas de punções, trazendo parte da experiência do centro de terapia intensiva de adultos do Hospital Israelita Albert Einstein, em São Paulo (SP) e discutindo tópicos que devem ser melhor explorados em estudos futuros.

  4. Training in endoscopic ultrasonography: An Asian perspective.

    PubMed

    Wong, Jennie Y Y; Kongkam, Pradermchai; Ho, Khek Yu

    2017-01-09

    Training of endoscopic ultrasonography (EUS) in Asia faces two major challenges: (i) the ever-increasing demand for skills to handle a growing range of interventional EUS procedures; and (ii) a continual shortage of EUS training programs. As the therapeutic application of EUS continues to expand, the need to train more new endosonographers and upgrade skills of existing ones has become more critical than ever before. A formal fellowship to acquire EUS knowledge and skills in an advanced endoscopy center has always been perceived as the best way of training novices, but such opportunities remain limited in most Asian countries. To keep up with the pace of development in EUS, more short-term EUS programs have been conducted across Asia in recent years. Such programs are generally intensive and may combine didactic lectures, live-case demonstrations, and hands-on training on phantoms, or live animal models for teaching. Although not as rigorous as conventional full-time EUS fellowships, such short-term programs are not necessarily inferior in quality. With courses offered from basic to advanced levels, and at regular intervals, busy practising endoscopists have the flexibility to attend the course that best matches their individual levels of experience, learn at their own pace and acquire EUS knowledge and skills over as many courses as desired. This open-ended progressive learning model is more agile than established fixed-term learning models and is expected to adapt better to future needs.

  5. Endoscopic ultrasonography for gastric submucosal lesions

    PubMed Central

    Papanikolaou, Ioannis S; Triantafyllou, Konstantinos; Kourikou, Anastasia; Rösch, Thomas

    2011-01-01

    Gastric submucosal tumors (SMTs) are a rather frequent finding, occurring in about 0.36% of routine upper GI-endoscopies. EUS has emerged as a reliable investigative procedure for evaluation of these lesions. Diagnostic Endoscopic ultrasonography (EUS) has the ability to differentiate intramural tumors from extraluminal compressions and can also show the layer of origin of gastric SMTs. Tumors can be further characterized by their layer of origin, echo pattern and margin. EUS-risk criteria of their malignant potential are presented, although the emergence of EUS-guided fne needle aspiration (EUS-FNA) has opened new indications for transmural tissue diagnosis and expanded the possibilities of EUS in SMTs of the stomach. Tissue diagnosis should address whether the SMT is a Gastrointestinal stromal tumour (GIST) or another tumor type and evaluate the malignant potential of a given GIST. However, there seems to be a lack of data on the optimal strategy in SMTs suspected to be GISTs with a negative EUS-FNA tissue diagnosis. The current management strategies, as well as open questions regarding their treatment are also presented. PMID:21772939

  6. Ultrasonography of histologically normal parathyroid glands and thyroid lobules in normocalcemic dogs.

    PubMed

    Liles, Sofija R; Linder, Keith E; Cain, Brandon; Pease, Anthony P

    2010-01-01

    The purpose of this study is to characterize the sonographic appearance of canine parathyroid glands using high-resolution ultrasonography. Ten cadaver dogs were studied after euthanasia for reasons not relating to the parathyroid. The cervical region was examined using a 13-5 MHz linear transducer in right and left recumbency. Ultrasonographic features of the parathyroid and thyroid glands were compared with the gross and histopathologic findings. Thirty-five structures were identified sonographically as parathyroid glands but only 26 of 35 glands (74% positive predictive value) were proven to be normal parathyroid glands histopathologically. Of the nine false positives, five (14%) were proven to be lobular thyroid tissue. The remaining four (11%) structures were visible grossly or found histopathologically. There were no statistical differences between ultrasonographic and gross measurements of the parathyroid glands. The average size as seen sonographically was 3.3 x 2.2 x 1.7 mm and the average gross size was 3.7 x 2.6 x 1.6 mm (length, width, height). The average size of the thyroid lobules assessed sonographically was 2.3 x1.6 x 0.8 mm (length, width, height). Normal parathyroid glands can be identified using high-resolution ultrasonography. But some thyroid lobules will be misinterpreted as parathyroid glands; this will result in false positives when identifying parathyroid glands with ultrasonography.

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

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

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

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

    PubMed Central

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

    2015-01-01

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

  9. Power Doppler ultrasonography in the diagnosis of acute childhood pyelonephritis.

    PubMed

    Halevy, Raphael; Smolkin, Vladislav; Bykov, Sergey; Chervinsky, Leonid; Sakran, Waheeb; Koren, Ariel

    2004-09-01

    In the absence of specific symptomatology in children, the early diagnosis of acute pyelonephritis (APN) is a challenge, particularly during infancy. In an attempt to differentiate APN from lower urinary tract infection (UTI), we evaluated the ability of power Doppler ultrasonography (PDU) to predict renal parenchymal involvement, as assessed by dimercaptosuccinic acid ((99m )Tc-DMSA) scintigraphy. The study comprised 62 patients, 46 girls and 16 boys, aged 2 weeks to 5 years, admitted to the pediatric department with febrile UTI. All children were examined by PDU and DMSA scintigraphy within the first 3 days of admission. In the group of 31 patients with one or more DMSA scan abnormalities, the PDU showed a matching perfusion defect in 27 (87%). Of 26 children with normal DMSA scintigraphy, the PDU evaluation was also normal in 24. The sensitivity and specificity of PDU for the detection of affected kidneys were 87% and 92.3%, and the positive predictive value and negative predictive value were 93.1% and 85.7%, respectively. These data indicate the PDU has a high sensitivity and specificity for differentiating APN from lower UTI and may be a useful and practical tool for the diagnosis of APN in infants and children.

  10. Review on the applications of ultrasonography in dentomaxillofacial region

    PubMed Central

    Evirgen, Şehrazat; Kamburoğlu, Kıvanç

    2016-01-01

    Use of ultrasonography (US) in dentomaxillofacial region became popular in recent years owing to increasing radiation dose concerns and economic limitations. It helps to visualize fine detail of the surface structure of the oral and maxillofacial tissues without ionizing radiation. In diagnostic ultrasound, high frequency sound waves are transmitted into the body by a transducer and echoes from tissue interface are detected and displayed on a screen. Sound waves are emitted via piezoelectric crystals from the ultrasound transducer. US technique can be used in dentomaxillofacial region for the examination of bone and superficial soft tissue, detection of major salivary gland lesions, temporomandibular joint imaging, assessment of fractures and vascular lesions, lymph node examination, measurement of the thickness of muscles and visualization of vessels of the neck. It has the potential to be used in the evaluation of periapical lesions and follow up of periapical bone healing. Also, it may be used for the evaluation of periodontal pocket depth and for the determination of gingival thickness before dental implantology. PMID:26834943

  11. The efficiency of ultrasonography in the diagnosis of dermoid cysts.

    PubMed

    Ekici, E; Soysal, M; Kara, S; Dogan, M; Gokmen, O

    1996-01-01

    The aim of the study was to assess the efficiency of sonography in differentiating dermoid cysts of the ovary (mature cystic teratoma) from other adnexal masses. It was carried out prospectively at Dr. Zekai Tahir Burak Women's Hospital of Ankara, Turkey. 943 women with 1035 adnexal masses who had undergone laparotomy and/or laparoscopy between January 1989 and March 1995 were included into the study group. All of these patients had a sonographic preoperatively examination within one week of surgery and the sonographic diagnosis was compared to histopathological findings. The visualization of: 1. echogenic mass with or without acoustic shadowing or enhancement (assumed to represent sebum with lipophilic contaminants or with hair) 2. Dermoid plug; layered lines and dots; fat-fluid level; isolated brigth echogenic foci with acoustic shadowing within the complex mass (assumed to represent Rokitansky protuberance; hair in low viscosity fluid; sebum as a supernatant of serous fluid; teeth or bone fragments respectively) 3. intraovarian echogenic mass with or without acoustic shadowing or enhancement (assumed to represent intraovarian dermoid cyst) were chosen as characteristical sonographic findings of dermoid cysts. Combining these with the subjective visual assessment of the operator, the sensitivity and the specificity were calculated for each visualized adnexal mass to assess the efficiency of sonography in differentiating dermoid cysts from other ovarian masses. All in all 1035 adnexal masses were visualized, 155 were suspected to be dermoid cysts and the diagnosis was confirmed by histopathology in only 147 cases. The sensitivity and specificity of sonography were 94% and 99% respectively. As a conclusion this study demonstrates that ultrasonography has an accuracy of 98% in differentiating dermoid cysts from other adnexal masses with a specificity of 99%.

  12. Collection of oocytes through transvaginal ovum pick-up for in vitro embryo production in Nanyang Yellow cattle.

    PubMed

    Li, F; Chen, X; Pi, W; Liu, C; Shi, Z

    2007-12-01

    The objectives of this study were to use ultrasound-guided transvaginal follicular aspiration to develop a technique for preservation of Nanyang Yellow cattle germ plasm. In Nanyang Yellow heifers, aspiration twice per week yielded a higher mean numbers of aspirated follicles, recovered oocytes and viable oocytes per session than once-weekly aspiration. Intriguingly, twice-weekly aspiration from Holstein heifers yielded a higher mean numbers of aspirated follicles, recovered oocytes and viable oocytes per session than in Nanyang Yellow heifers. Moreover, the oocyte recovery rate was significantly higher in Holstein heifers than in Nanyang Yellow heifers. Importantly, similar rates of embryos undergoing cleavage division were observed in Nanyang Yellow and Holstein, as was the number of viable day 8 blastocysts. These observations demonstrate that twice-weekly aspiration harvested the similar proportions of viable oocytes from Nanyang Yellow and Holstein follicles, and that twice-weekly aspiration yields a higher number of viable oocytes than once-weekly aspiration in Nanyang Yellow heifers. The results also suggest that the combination of ultrasound-guided transvaginal follicular aspiration and in vitro production is an effective and practical strategy for establishment of a germ plasm preservation programme for Nanyang Yellow cattle.

  13. Transvaginal 3D Image-Guided High Intensity Focused Ultrasound Array

    NASA Astrophysics Data System (ADS)

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

    2005-03-01

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

  14. Prevalence in a volunteer population of pelvic cancer detected with transvaginal ultrasound and color flow Doppler.

    PubMed

    Schulman, H; Conway, C; Zalud, I; Farmakides, G; Haley, J; Cassata, M

    1994-09-01

    Our objective was to find the prevalence of non-symptomatic endometrial and ovarian neoplasms in a volunteer population of women, aged 40 and over. We offered a free volunteer screening program to asymptomatic women for a study using transvaginal ultrasound and color flow Doppler for the detection of pelvic cancer. In the first 2 years, 2117 women were examined, 51.3% post-menopausal. An ovarian cyst was defined as having a maximum diameter of more than 2.4 cm. Color flow was used to identify blood vessels feeding pelvic organs and adnexal enlargements. An abnormal Doppler flow velocity for the ovary was defined as a resistance index of less than 0.41. Ovarian cysts of less than 5 cm with normal Doppler indices were followed up in 6 months to 1 year. An adnexal morphology score was created to quantify the usefulness of this parameter, particularly in postmenopausal women. Indications for surgery were pre-defined as a persistent ovarian cyst of more than 5 cm, a persistent suspicious Doppler and a total endometrial thickness of greater than 0.59 cm in postmenopausal women not taking hormones.A total of 202 women (9.5%) had ovarian cysts. Fourteen women were operated upon because of size criteria, one because of family history and three for persistent abnormal flow. By Doppler study, 15 cysts were predicted to be benign and histology was confirmatory. There were two false positives and one true positive, a stage Ib ovarian cancer. There were no false negatives, although a stage I endometrioid cancer of the ovary was detected 8 months after a negative scan. In those cases in which follow-up data were available, 56% of the cysts regressed in premenopausal women. In postmenopausal women, 28% regressed. Twenty of 1086 postmenopausal women had endometrial biopsies. Three had endometrial cancer, two stage I and one stage IIA. Five had atypical or adenomatous hyperplasia, and seven had benign polyps. So many women have small asymptomatic cysts of the ovary that a major

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

    PubMed

    Lüttgenau, J; Bollwein, H

    2014-04-01

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

  16. Immersion ultrasonography: simultaneous A-scan and B-scan.

    PubMed

    Coleman, D J; Dallow, R L; Smith, M E

    1979-01-01

    In eyes with opaque media, ophthalmic ultrasound provides a unique source of information that can dramatically affect the course of patient management. In addition, when an ocular abnormality can be visualized, ultrasonography provides information that supplements and complements other diagnostic testing. It provides documentation and differentiation of abnormal states, such as vitreous hemorrhage and intraocular tumor, as well as differentiation of orbital tumors from inflammatory causes of exophthalmos. Additional capabilities of ultrasound are biometric determinations for calculation of intraocular lens implant powers and drug-effectiveness studies. Maximal information is derived from ultrasonography when A-scan and B-scan techniques are employed simultaneously. Flexibility of electronics, variable-frequency transducers, and the use of several different manual scanning patterns aid in detection and interpretation of results. The immersion system of ultrasonography provides these features optimally.

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

    PubMed Central

    2016-01-01

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

  18. Ultrasonography of hydronephrosis in the newborn: a practical review

    PubMed Central

    2016-01-01

    Widespread use of fetal ultrasonography is accompanied by more frequent detection of antenatal hydronephrosis. Therefore, sonographic evaluation of neonates with a history of antenatal hydronephrosis is becoming more widespread. As an initial postnatal non-invasive imaging modality, ultrasonography is used to screen for persistence of hydronephrosis, determine the level and severity of obstruction, and contribute to appropriate diagnosis and treatment. This review aims to provide a practical overview of the sonographic evaluation of neonatal hydronephrosis and to describe the sonographic findings of conditions associated with hydronephrosis in the newborn. PMID:27156562

  19. Ultrasonography and computed tomography of inflammatory abdominal wall lesions

    SciTech Connect

    Yeh, H.C.; Rabinowitz, J.G.

    1982-09-01

    Twenty-four patients with inflammatory lesions of the abdominal wall were examined by ultrasonography. Nine of these patients underwent computed tomographic (CT) scanning as well. Both ultrasonography and CT clearly delineated the exact location and extent of abdominal wall abscesses. Abscesses were easily differentiated from cellulitis or phlegmon with ultrasound. The peritoneal line was more clearly delineated on ultrasonograms than on CT scans; abscesses were also more distinct on the ultrasonograms because of their low echogenicity compared with the surrounding structures. Gas bubbles, fat density with specific low attenuation values, and underlying inflamed bowel loops in obese patients with Crohn's disease were better delineated by CT.

  20. Pharmaco Penile Duplex Ultrasonography in the Evaluation of Erectile Dysfunction

    PubMed Central

    Ramanjaneyulu, Harshavardhana Kuruba; Susarla, Rammurti; Yarlagadda, Jyotsna; Devraj, Rahul; Palanisamy, Prabakaran

    2017-01-01

    Introduction The National Institute of Health defined ‘erectile dysfunction’ as the persistent inability to achieve and/or to maintain an erection for a satisfactory sexual performance. In last few years, the concept of erectile dysfunction has evolved from that of a disorder referred to as ‘impotence’ which used to be considered predominantly psychogenic to that of ‘Erectile Dysfunction’ (ED), a well understood physiologic result of multiple risk factors, both psychological and organic. The most common cause of organic erectile dysfunction is vasculogenic causes. Doppler evaluation of cavernosal arteries after intracavernosal injection of Papaverine is particularly useful in the evaluation of vasculogenic causes. Aim To define the role of intracavernosal injection of Papaverine in the evaluation of vasculogenic causes of erectile dysfunction that includes arterial insufficiency and veno occlusive nature. Materials and Methods Pharmaco Penile Duplex Ultrasonography (PPDU) was done using a linear broadband phased array transducer (7–12 MHz) on a E-Saote MyLab 60 ultrasound colour Doppler system on 73 patients over a period of three years. Informed consent was taken from all patients. Visual grading score for erection, Cavernosal Artery Diameter (CAD), PSV (Peak Systolic Velocity), EDV (End Diastolic Velocity), RI (Resistive Index), AT (Acceleration Time) and dorsal vein changes were obtained in all patients following intracavernosal injection of Papaverine. Results Visual grading for erectile response was E0 in one patient, E1 in 11 patients, E2 in 9 patients, E3 in 7 patients, E4 in 4 patients and E5 in 41 patients. Eighteen patients were diagnosed as having arterial insufficiency, three patients were diagnosed as having venous insufficiency and two patients showed indeterminate results. Conclusion In our study, Papaverine induced PPDU proved to be highly accurate and excellent method for assessing patients with erectile dysfunction. PMID:28274021

  1. Monitoring of Containment in Perthes' Disease: Can Ultrasonography be Helpful?

    PubMed

    Stuecker, Markus H F; Meiss, A Ludwig

    2004-10-30

    Background. Prevention of loss of containment has become an accepted principle in the treatment of Perthes' disease. The pre-requisite is early recognition. It is based on evaluation of plain radiographs and more recently, on the study of Magnetic Resonance (MR) images which allow discrimination of early cartilaginous changes. Ultrasonography (US) allows visualisation of the lateral cartilaginous portion of the femoral head and the acetabular rim including the labrum and measurement of femoral head protrusion/lateralisation. The purpose of this paper is to highlight its potential for monitoring of containment . Materials and methods. We present typical MR and US images to demonstrate the anatomic landmarks of the normal hip joint and to define the parameters of protrusion in Perthes' disease. We selected three illustrative cases that had undergone routine imaging of both hip joints by MR imaging and ultrasound for evaluation of containment. Radiographs of the hips were also available. In radiographs we assessed the coverage of the femoral head, i.e. containment, by the well established Acetabulum-Head Index (AHI) and in MR imaging by the Cartilaginous Acetabulum-Head Index (CAHI). In US we assessed the uncoverage, i. e. protrusion, by the Lateral Cartilage Distance (LCD). Changes in the important morphological MR containment features were also noted. Results. There was a significant increase in the LCD in all Perthes hips (6.2, 7.4, 11.6 mm) when compared to the unaffected side (5.2, 5.1, 4.1 mm) and also when compared to the published mean normal value (5.4 +/- 0.9 mm). Correspondingly, the CAHI values were significantly decreased (75, 69, 67% versus 87, 79, 81%), also in comparison to the published limits (77, 75, and 73% respectively). As for the AHI only the value of 71 % in the third case represented a definite decrease below published normal limits (86 and 80.7% respectively). In the 1st case we diagnosed adequate containment, in the 2nd containment at risk

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

    PubMed Central

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

    2015-01-01

    AIM: To evaluate transvaginal hybrid-NOTES cholecystectomy (TVC) during its clinical establishment and compare it with the traditional laparoscopic technique (LC). METHODS: The specific problems and benefits of TVC were reviewed using a registry analysis, a comparative cohort study and a randomized clinical trial. At first, feasibility, safety and specific complications of the TVC were analyzed based on the first 488 data sets of the German NOTES Registry (GNR). Hereafter, we compared the early postoperative results of our first 50 TVC-patients with those of 50 female LC-patients matched by age, BMI and ASA classification. The same cohort was contacted an average of two years later to evaluate long-term results concerning pain and satisfaction with the aesthetic results and the overall postoperative results as well as sexual intercourse by means of two domains of the German version of the Female Sexual Function Index (FSFI-d). Consequently, we performed a randomized clinical trial comparing 20 TVC-patients with 20 needlescopic/3-trocar cholecystectomies (NC) also concerning the early postoperative results as well as pain, satisfaction and quality of life by means of the Eypasch Gastrointestinal Quality of Life Index (GIQLI) in the later course. Finally, we discussed the results in accordance with other published studies. RESULTS: The complication (3.5%) and conversion rates (4.1%) for TVC were low in the GNR and comparable to those of the LC. Access related intraoperative complications included injuries to the bladder (n = 4; 0.8%) and bowel (n = 3; 0.6%). The study cohort revealed less postoperative pain after TVC comparing to the LC-patients on the day of surgery (NRS, 1.5/10 vs 3.1/10, P = 0.003), in the morning (NRS, 1.9/10 vs 2.8/10, P = 0.047) and in the evening (NRS, 1.1/10 vs 1.8/10, P = 0.025) of postoperative day (POD) one. The randomized clinical trial consistently found less cumulative pain until POD 2 (NRS, 8/40 vs 14/40, P = 0.043), as well as until

  3. Use of ultrasonography to make reproductive management decisions

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  4. Ultrasonography of the canine shoulder joint and its pathological changes.

    PubMed

    Piórek, A; Adamiak, Z

    2010-01-01

    The objective of this study was to present and discuss the available data on canine shoulder joint ultrasonography. The paper presents the method of ultrasonographic examination of the shoulder joint area, describes the normal structure of the shoulder joint in dogs, and discusses the most frequently encountered shoulder joint pathologies.

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

    PubMed Central

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

    2015-01-01

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

  6. Scintigraphy and Doppler ultrasonography for the evaluation of obstructive urinary calculi.

    PubMed

    Gandolpho, L; Sevillano, M; Barbieri, A; Ajzen, S; Schor, N; Ortiz, V; Heilberg, I P

    2001-06-01

    Forty-seven patients with unilateral obstructive calculi (12 males and 35 females) were submitted to 99mTc-diethylene triamine pentaacetic acid (DTPA) or 99mTc-dimercaptosuccinic acid (DMSA) scans for assessment of renal function. The scans revealed unilateral functional deficit in 68 and 66% of the patients, respectively. A calculus size of 1.1 to 2.0 cm was significantly associated with deficit detected by DTPA, but duration of obstruction and calculus localization were not. After relief of the obstruction, the mean percent renal function of the affected kidney was found to be significantly increased from 25 +/- 12% to 29 +/- 12% in DTPA and from 21 +/- 15% to 24 +/- 12% in DMSA. Initial Doppler ultrasonography performed in 35 patients detected an increased resistive index in 10 (29%). In the remaining patients with a normal resistive index, ureteral urinary jet was observed, indicating partial obstruction. The high frequency of renal function impairment detected by DTPA and of tubulointerstitial damage detected by DMSA as well as the slight amelioration of unilateral renal function after relief of obstruction suggest that scintigraphy assessment may help evaluate the unilateral percentage of renal function and monitor renal function recovery when it occurs. The presence of a urinary jet detected by Doppler ultrasonography further indicates the severity of obstruction and the recovery prognosis.

  7. Randomized controlled trial on effectiveness of ultrasonography screening for breast cancer in women aged 40-49 (J-START): research design.

    PubMed

    Ohuchi, Noriaki; Ishida, Takanori; Kawai, Masaaki; Narikawa, Yoko; Yamamoto, Seiichiro; Sobue, Tomotaka

    2011-02-01

    In cancer screening, it is essential to undertake effective screening with appropriate methodology, which should be supported by evidence of a reduced mortality rate. At present, mammography is the only method for breast cancer screening with such evidence. However, mammography does not achieve sufficient accuracy in breasts with high density at ages below 50. Although ultrasonography achieves better accuracy in Breast Cancer detection even in dense breasts, the effectiveness has not been verified. We have planned a randomized controlled trial to assess the effectiveness of ultrasonography in women aged 40-49, with a design to study 50,000 women with mammography and ultrasonography (intervention group), and 50,000 controls with mammography only (control group). The participants are scheduled to take second round screening with the same modality 2 years on. The primary endpoints are sensitivity and specificity, and the secondary endpoint is the rate of advanced breast cancers.

  8. The utility of thyroid ultrasonography in the management of thyroid nodules

    PubMed Central

    Gamme, Gary; Parrington, Tyler; Wiebe, Edward; Ghosh, Sunita; Litt, Brendan; Williams, David C.; McMullen, Todd P.W.

    2017-01-01

    Background Ultrasonography for thyroid nodules is one of the most common imaging tests performed in the general population. Details from ultrasound reports guide biopsies and surgery. This study quantifies the completeness of these reports based on Thyroid Imaging and Reporting System (TI-RADS) criteria and considers their utility in predicting malignant disease. Methods We retrospectively reviewed ultrasound reports for 329 thyroidectomy patients and extracted data elements using the TI-RADS criteria: nodule size, echogenicity, margins, vascularity, solid/cystic composition and the presence or absence of microcalcifications and the halo sign. We assessed the reports to determine whether individual or multiple criteria were associated with malignancy. Results More than 97% of reports document nodule size; however, more than 90% of the reports noted only 3 or fewer of the 6 remaining TI-RADS criteria. The presence of microcalcifications was the most sensitive marker of malignancy (> 90%), whereas the documentation of irregular margins was the most specific indicator of malignancy (88%). Overall it was clear that microcalcifications, hypoechogenicity, irregular margins and solid nodules were significantly more likely to be found in malignant neoplasms; their absence predicted benign disease. Because so few reports consistently documented all criteria, the overall ability of thyroid ultrasonography to discriminate between lower-and higher-risk nodules is limited. Conclusion Although the accuracy of thyroid ultrasonography is good, few ultrasound reports contain the necessary information, as defined by TI-RADS, to predict malignancy and guide management. When reported, microcalcifications and/or irregular margins are the best predictors of malignancy. PMID:28338469

  9. Factors associated with the differential in actual gestational age and gestational age predicted from transrectal ultrasonography in pregnant dairy cows.

    PubMed

    Fitzgerald, A M; Ryan, D P; Berry, D P

    2015-08-01

    The objective of the study was to determine (1) how gestational age predicted using transrectal ultrasonography related to actual gestational age derived as the number of days from the most recent artificial insemination date, (2) what factors, if any, were associated with the differential between the two measures, and (3) the association between this differential in gestational age and the likelihood of subsequent pregnancy loss, stillbirth, or calving dystocia. The data set contained 7340 ultrasound records from 6805 Holstein Friesian dairy cows in 175 herds. Ultrasonography assessment underestimated gestational age relative to days since last service by 0.51 days (standard error [SE]: 0.040), although the differential was less during embryonic development phase (i.e., ≤42 days of gestation; mean overestimation of 0.31 days) versus fetal development phase (i.e., >42 days of gestation; mean underestimation of 0.81 days). Predicted calving date calculated from ultrasonography was 1.41 days (SE: 0.040) later than the actual subsequent calving date and was, on average, 0.52 days later than predicted calving date, assuming a gestation length of 282 days. Parity of the dam (P < 0.05), stage of pregnancy (P < 0.001), and sex of the calf born (P < 0.001) were all associated with the differential in gestational age based on ultrasonography versus days since last service. No obvious trend among parities was evident in the difference between the methods in predicting gestational age. Ultrasonography underestimated gestational age by 0.83 (SE: 0.15) days in parity 5+ cows and underestimated gestational age by 0.41 (SE: 0.14) days in the first-parity cows. Relative to gestational age predicted from the most recent service, ultrasonography underestimated gestational age by 0.75 (SE: 0.13) days for heifer fetuses and underestimated gestational age by 0.36 (SE: 0.13) days for bull fetuses. The heritability of the differential in gestational age between the methods of

  10. Novel method of laparoendoscopic single-site and natural orifice specimen extraction for live donor nephrectomy: single-port laparoscopic donor nephrectomy and transvaginal graft extraction

    PubMed Central

    Jeong, Won Jun; Choi, Byung Jo; Hwang, Jeong Kye; Yuk, Seung Mo; Song, Min Jong

    2016-01-01

    Laparoscopic live donor nephrectomy (DN) has been established as a useful alternative to the traditional open methods of procuring kidneys. To maximize the advantages of the laparoendoscopic single-site (LESS) method, we applied natural orifice specimen extraction to LESS-DN. A 46-year-old woman with no previous abdominal surgery history volunteered to donate her left kidney to her husband and underwent single-port laparoscopic DN with transvaginal extraction. The procedure was completed without intraoperative complications. The kidney functioned well immediately after transplantation, and the donor and recipient were respectively discharged 2 days and 2 weeks postoperatively. Single-port laparoscopic DN and transvaginal graft extraction is feasible and safe. PMID:26878020

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

    PubMed

    Gaschen, Lorrie; Angelette, Nik; Stout, Rhett

    2010-01-01

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

  12. Utility of ultrasonography for diagnosis of superficial swellings in buffalo (Bubalus bubalis)

    PubMed Central

    ABOUELNASR, Khaled; EL-SHAFAEY, El-Sayed; MOSBAH, Esam; EL-KHODERY, Sabry

    2016-01-01

    We studied 72 buffalo with superficial swellings in the head (n=4), neck (n=5), chest wall (n=4), abdominal wall (n=28), limbs (n=16), gluteal region (n=8), perineal region (n=6) and udder (n=1). Ultrasonographically, the swellings varied according to type, duration, content and location. The clinical use of ultrasound to assess these superficial swellings allowed diagnosis of abscesses (n=21), hematomas (n=11), hernias (n=17), bursitis (n=13), urethral diverticula (n=6) and tumors (n=4). Ultrasonography could precisely discriminate each lesion type (sensitivity, 71–100%; specificity, 75–100%; odds ratio, 1.0–8.4; Confidence Interval, 74.2–20; and P value 0.001). The specificity for ultrasonographic evaluation of superficial swellings was 100% for hernias, urethral diverticula and tumors, whilst the lowest specificity was recorded for hematomas (75%) and abscesses (92%). In conclusion, ultrasonography provides a precise, non-invasive and fast technique for the evaluation, classification and subsequent treatment of a variety of superficial swellings in buffalo. PMID:27181085

  13. Testicular resistive index determined by Doppler ultrasonography in men with spinal cord injury - a case series.

    PubMed

    Krebs, J; Göcking, K; Pannek, J

    2015-09-01

    In this case series, the testicular resistive index was determined in men with spinal cord injury. In ten men participating in our fertility programme, the peak systolic and end-diastolic velocity of centripetal testicular arteries was measured in triplicates by Doppler ultrasonography to calculate the testicular resistive index. Furthermore, the right and left testicular volume was determined by ultrasonography, blood samples were obtained for hormonal evaluation, and sperm analysis was performed according to the WHO guidelines. The median testicular resistive index measured 0.69 and was significantly (P < 0.001) greater than the reported cut-off value of 0.6. The spermiograms were characterised by normal sperm count but decreased sperm motility and plasma membrane integrity. The median right and left testicular volume was significantly (P < 0.01) smaller compared to the volumes measured in able-bodied adult males without scrotal pathology and measured 8.4 ml and 7.2 ml respectively. There was a significant (P = 0.005) correlation (rs  = 0.81) between testicular resistive index and sperm concentration. However, no correlations were observed between testicular resistive index and other variables. The testicular resistive index in men with spinal cord injury was significantly greater than 0.6. Measuring the testicular resistive index may represent a useful additional parameter in the assessment of infertility in spinal cord-injured men.

  14. New ultrasonography-based method for predicting total skeletal muscle mass in male athletes

    PubMed Central

    Toda, Yoko; Kimura, Tetsuya; Taki, Chinami; Kurihara, Toshiyuki; Homma, Toshiyuki; Hamaoka, Takafumi; Sanada, Kiyoshi

    2016-01-01

    [Purpose] This study aimed 1) to assess whether a prediction model for whole body skeletal muscle mass that is based on a sedentary population is applicable to young male athletes, and 2) to develop a new skeletal muscle mass prediction model for young male athletes. [Subjects and Methods] The skeletal muscle mass of 61 male athletes was measured using magnetic resonance imaging (MRI) and estimated using a previous prediction model (Sanada et al., 2006) with B-mode ultrasonography. The prediction model was not suitable for young male athletes, as a significant difference was observed between the means of the estimated and MRI-measured skeletal muscle mass. Next, the same subjects were randomly assigned to a development or validation group, and a new model specifically relevant to young male athletes was developed based on MRI and ultrasound data obtained from the development group. [Results] A strong correlation was observed between the skeletal muscle mass estimated by the new model and the MRI-measured skeletal muscle mass (r=0.96) in the validation group, without significant difference between their means. No bias was found in the new model using Bland-Altman analysis (r=−0.25). [Conclusion] These results validate the new model and suggest that ultrasonography is a reliable method for measuring skeletal muscle mass in young male athletes. PMID:27313370

  15. [Cerebral Doppler ultrasonography in newborn infants].

    PubMed

    Luciano, R; Velardi, F

    1995-01-01

    Following the first study of Bada et al. (1979), Doppler assessment of cerebral blood flow has increasingly been used in newborn infants, matching the technical progress in the available equipment. The experience gathered in recent years has confirmed that Doppler US is a reliable and reproducible examination while precising the limitations and the methodology to be followed in order to prevent gross errors of assessment and interpretation. The interest this procedure has arisen, among other things, stems from being noninvasive and feasible at the patient's bed. These features enable its repeated use in newborn infants in poor clinical condition. The diagnostic and prognostic role of Doppler velocimetry has been shown in a number of neonatal diseases and the cerebral hemodynamics has been assessed in physiologic conditions as well as after drug administration. The most common equipment used in newborn infants is at present Duplex Doppler consisting of a pulsed Doppler combined with bidimensional scanner, which, with visualization of study arteries, enables precise positioning of sample volume and correction of the ultrasonic angle of incidence with respect to the direction of blood flow in the examined vessel. In this report, after a survey of the techniques and modalities of cerebral Doppler examination in newborns, a review of the present state of the art, in neonatal cerebral as well as extracranial disease, is presented.

  16. Endoscopic ultrasonography: Challenges and opportunities in the developing world.

    PubMed

    Ahmed, Furqaan

    2014-05-06

    Endoscopic ultrasonography (EUS) has become a vital diagnostic modality for the evaluation of mediastinal lymphadenopathy, pancreatic cysts and masses, anorectal pathology, subepithelial gastrointestinal lesions, and for the staging of many gastrointestinal and pulmonary malignancies. Establishing a EUS program in a developing country presents many challenges. Doing so in Pakistan has led to the identification of the following challenges: initial investment, ongoing costs (particularly fine needle aspiration needle costs), awareness and cytopathology. Endoscopic ultrasonography has revolutionized aspects of the practice of gastroenterology and oncology in the West. This technique is becoming increasingly available in the developing world, where it poses unique challenges to its practice. These challenges include those relating to service initiation and maintenance costs, physician awareness, and on-site cytopathology access. If these issues are anticipated and addressed in ways appropriate to local circumstances, obstacles to the institution of EUS programs can be overcome.

  17. Diagnostic ultrasonography in cattle with abdominal fat necrosis.

    PubMed

    Tharwat, Mohamed; Buczinski, Sébastien

    2012-01-01

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

  18. FNAC and transabdominal ultrasonography in the diagnosis of prostatomegaly.

    PubMed

    Singh, N; Shenoi, U D; Raghuveer, C V

    1997-10-01

    Transrectal fine needle aspiration cytology (FNAC) was performed in 100 cases of prostatomegaly detected by digital rectal examination (DRE). The cytologic findings were compared with histolgic findings of material obtained by transurethral resection of prostate (TURP) in 84 of the cases. In addition, pre-prostatectomy transabdominal ultrasonography was done in 55 of the cases and the findings were compared with cytologic and histologic diagnoses. The accuracy of diagnosis by FNAC for benign lesions and carcinoma of prostate was 98.33% and 81.81% respectively. The accuracy of transabdominal ultrasonography for benign lesions was 91.66% but that for carcinoma was only 38.46%. The technique of transrectal FNAC was found to be simple quick, economical and easy to repeat with high accuracy and was suitable for outpatients.

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

    PubMed

    Mérot, O; Le Goff, B

    2014-08-01

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

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

    PubMed

    Beltrán, L M; García-Casasola, G

    2014-04-01

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

  1. Accuracy of screening compression ultrasonography and clinical examination for the diagnosis of deep vein thrombosis after total hip or knee arthroplasty

    PubMed Central

    Robinson, K. Sue; Anderson, David R.; Gross, Michael; Petrie, David; Leighton, Ross; Stanish, William; Alexander, David; Mitchell, Michael; Mason, William; Flemming, Bruce; Fairhurst-Vaughan, Marlene; Gent, Michael

    1998-01-01

    Objective To determine whether compression ultrasonography or clinical examination should be considered as screening tests for the diagnosis of deep vein thrombosis (DVT) after total hip or knee arthroplasty in patients receiving warfarin prophylaxis postoperatively. Design A prospective cohort study. Setting A single tertiary care orthopedic centre. Patients One hundred and eleven patients who underwent elective total hip or knee arthroplasty were enrolled. Postoperatively the warfarin dose was adjusted daily to maintain the international normalized ratio between 1.8 and 2.5. Eighty-six patients successfully completed the study protocol. Intervention Before they were discharged from hospital, patients were assessed for DVT by clinical examination, bilateral compression ultrasonography of the proximal venous system and bilateral contrast venography. Results DVT was found in 29 patients (34%; 95% confidence interval [CI] 24% to 45%), and 6 patients (7%; 95% CI 3% to 15%) had proximal DVT. DVT developed in 18 (40%) of 45 patients who underwent total knee arthroplasty and in 11 (27%) of 41 patients who underwent total hip arthroplasty. The sensitivity of compression ultrasonography for the diagnosis of proximal DVT was 83% (95% CI 36% to 99%) and the specificity was 98% (95% CI 91% to 99%). The positive predictive value of compression ultrasonography was 71%. In contrast, clinical examination for DVT had a sensitivity of 11% (95% CI 2% to 28%) and a positive predictive value of 25%. Conclusions DVT is a common complication after total hip or knee arthroplasty. Compression ultrasonography appears to be a relatively accurate noninvasive test for diagnosing postoperative proximal DVT. In contrast, clinical examination is a very insensitive test. Whether routine use of screening compression ultrasonography will reduce the morbidity of venous thromboembolism after joint arthroplasty requires confirmation in a prospective trial involving long-term follow-up of patients

  2. Ultrasonography of the Tympanic Bullae and Larynx in Cattle.

    PubMed

    Gosselin, Véronique Bernier; Babkine, Marie; Francoz, David

    2016-03-01

    Diseases of the middle ear or the larynx are not numerous in cattle but their diagnosis can be challenging for veterinary practitioners in the field. This article presents the ultrasonography of these 2 anatomic structures in order to provide new diagnostic tools to veterinary practitioners in the field. Brief anatomic reminders are first reported. The scanning techniques and normal images are then described. Finally, abnormal images of specific conditions are presented.

  3. On-Farm Use of Ultrasonography for Bovine Respiratory Disease.

    PubMed

    Ollivett, Theresa L; Buczinski, Sébastien

    2016-03-01

    Thoracic ultrasonography (TUS) in young cattle has recently gained momentum as an accurate and practical tool for identifying the lung lesions associated with bovine respiratory disease. As cattle producers increasingly seek input from their veterinarians on respiratory health issues, bovine practitioners should consider adding TUS to their practice models. This article discusses the relevant literature regarding TUS in young cattle, current acceptable techniques, and practical on-farm applications.

  4. Endoscopic ultrasonography in the management of pancreatic cancer

    NASA Astrophysics Data System (ADS)

    Trowers, Eugene A.

    2001-05-01

    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.

  5. Comparison of radionuclide imaging and ultrasonography of the liver

    SciTech Connect

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

    1983-01-01

    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.

  6. Comparison of radionuclide imaging and ultrasonography of the liver

    SciTech Connect

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

    1983-01-01

    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.

  7. Kienbock Disease: A Complicated Postsurgical Case Study Using Diagnostic Ultrasonography

    PubMed Central

    Yochum, Alicia M.; Kettner, Norman W.

    2015-01-01

    Objective The purpose of this case report is to describe a case of Kienbock disease (lunatomalacia) that was identified through diagnostic ultrasonography. Clinical Features A 27-year-old man presented to a chiropractic teaching clinic with a 3-year history of wrist pain. The history of chief concern consisted of lunatomalacia, diagnosed 2 years prior, with surgical intervention consisting of radial osteotomy and vascularized bone graft. Radiography and ultrasonography were performed upon presentation and at 2-year follow-up that demonstrated progressive collapse and fragmentation of his lunate with the development of progressive scapholunate advanced collapse of the wrist. Intervention and Outcome Conservative care included class IV cold laser and a splint worn during strenuous activity and while sleeping. The patient received minimal pain relief and continued to experience chronic left wrist pain. He is continuing conservative care and evaluating options for further surgical intervention. Conclusion This case demonstrates a patient with chronic wrist pain and progressive collapse of the lunate demonstrated on multiple imaging modalities after surgical intervention. To our knowledge, this is the first case demonstrating Kienbock disease using diagnostic ultrasonography. PMID:26257591

  8. [Thyroid ultrasonography--considerations and progress in routine diagnostic examinations].

    PubMed

    Yamamoto, Hiroyuki; Kitaoka, Masafumi

    2014-01-01

    Thyroid ultrasonography is becoming increasingly important because it is easy to perform non-invasively and provides much more information than other imaging devices such as CT and MRI. It is possible to infer the causes of diffuse goiter and thyrotoxicosis by the internal echo level and blood flow analysis. The combination of B mode and color Doppler imaging is also useful for the diagnosis of thyroid nodules. Malignant B mode findings include an irregular shape, indistinct border, hypo and inhomogeneous internal echo, and fine calcification. New diagnostic criteria for thyroid nodules and a flow chart for the selection of indications of aspiration biopsy cytology have been developed by the Japan Association of Breast and Thyroid Sonology. Recent improvements in thyroid ultrasonography include 3D imaging, contrast agents and tissue elasticity imaging. 3D ultrasonography and contrast agents have made it possible to display vascular structures more accurately. Tissue elasticity imaging is expected to play an important role in the diagnosis of thyroid carcinomas since it evaluates tissue stiffness objectively. Tissue elastography may be useful for the differentiation of follicular adenomas from follicular carcinomas, which is still one of the most difficult clinical challenges for all endocrinologists. It also provides detailed information on the efficacy of thyroid interventions. New combinations with tissue elastography and other imaging devices are under development.

  9. Evaluation of Pediatric Liver Transplantation-Related Artery Complications Using Intra-Operative Multi-Parameter Ultrasonography

    PubMed Central

    Ren, Xiuyun; Guan, Junhui; Gao, Nong; Niu, Hong; Tang, Jie

    2016-01-01

    Background This article discusses the value of using multi-parameter evaluation of intra-operative ultrasonography in evaluating pediatric liver transplantation-related arterial complications. Material/Methods Sixty-eight children receiving a liver transplant underwent intraoperative ultrasonography for monitoring of artery hemodynamics. The ultrasonic measurement parameters included the diameters of the hepatic artery (HA) of the donor and anastomotic stoma, peak systolic velocity (PSV), resistance index (RI), acceleration time (SAT), and blood flow volume. Results After being treated immediately using surgery or other means, blood flow returned to normal in 8 cases, and did not in 3 cases, of whom 2 experienced postoperative HAT. There was a significant difference in HA diameter of the donor, anastomotic stoma diameter, PSV, RI, SAT, and blood flow volume before and after treatment of the donor in the complications group. Postoperative complications occurred in 7 of 68 recipients, including the 2 cases exhibiting complications during the surgery (complication group) and 5 without complications during the surgery (no complication group). There was a statistically significant difference (P<0.05) between the 2 groups in intraoperative ultrasonography parameters of HA diameter, anastomotic stoma diameter, RI, and blood flow volume. Conclusions Through intraoperative multi-parameter ultrasonic measurement, a definite diagnosis of hepatic artery complications can be made in liver transplantation patients. HA diameter of the donor, anastomotic stoma diameter, PSV, RI, SAT, and blood flow volume are important in assessing intraoperative artery complications. PMID:27870825

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

    PubMed

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

    2009-07-01

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

  11. Repeated ultrasound-guided transvaginal oocyte retrieval from cyclic Murrah buffaloes (Bubalus bubalis): oocyte recovery and quality.

    PubMed

    Gupta, V; Manik, R S; Chauhan, M S; Singla, S K; Akshey, Y S; Palta, P

    2006-01-01

    The present study was undertaken to explore the potential of the Murrah breed of buffaloes as donors of oocytes and to find out the recovery rate and oocyte quality in cyclic Murrah buffaloes subjected to oocyte recovery once a week. Murrah buffaloes (n = 5) were synchronized for estrus by a single prostaglandin injection schedule. The animals were subjected to transvaginal oocyte retrieval (TVOR) once weekly for 6 weeks, starting from Day 7 of the oestrous cycle (Day 0 = day of oestrus). TVOR was performed using an ultrasound machine with a 5 MHz transvaginal transducer, single lumen 19-gauge, 60 cm long needle and a constant vacuum pressure of 50 mmHg. The number and size of follicles in each ovary was determined before puncture. The follicles were characterized on the basis of their diameter as small (3-5 mm), medium (6-9 mm) and large (> or = 10 mm). The oocytes recovered were classified as grade A, cumulus-oocytes complexes (COCs) with > or = 5 layers of cumulus cells; grade B, those with two to four layers; grade C, partially denuded oocytes; and grade D, completely denuded oocytes. The mean (+/- S.E.M) number of small, medium and large follicles, and the number of total follicles observed per animal per session, which was 2.2 +/- 0.3, 0.6 +/- 0.2, 0.9 +/- 0.1 and 3.7 +/- 0.3, respectively, did not differ between animals or between puncture sessions. Small follicles constituted a major proportion (59%) of the total observed follicles. A mean (+/- S.E.M) number of 3.0 +/- 0.3 follicles were punctured and 2.0 +/- 0.3 oocytes recovered per animal per session, with a recovery rate of 68%. Out of the total 61 oocytes recovered, 36 (59%) were of grades A + B whereas 25 (41%) were of grades C + D. In conclusion, this study describes the potential of cyclic Murrah buffaloes as donors of oocytes collected by repeated TVOR once a week, without any adverse effects on follicular growth and oocyte recovery. It also describes an efficient system for carrying out TVOR in

  12. Ankle-Arm Index, Angiography, and Duplex Ultrasonography After Recanalization of Occlusions in Femoropopliteal Arteries: Comparison of Long-Term Results

    SciTech Connect

    Winter-Warnars, Hillegonda A.O.; Graaf, Yolanda van der; Mali, Willem P.T.M.

    1996-04-15

    Purpose: Comparison of the relative values of the ankle-arm index (AAI) at rest and after exercise, angiography, and duplex ultrasonography for the follow-up of percutaneous transluminal angioplasty (PTA) in patients with peripheral vascular disease. Methods: Thirty-two patients were prospectively followed after technically and clinically successful PTA of a femoropopliteal occlusion. The patency of the femoropopliteal artery was assessed for 1 year using AAI measurements at rest and after exercise; duplex ultrasonography at 4, 12, 24, 36, and 52 weeks; and angiography at 3 and 12 months after PTA. Results: Patency was highly dependent on the measurement technique. The cumulative patency after 1 year determined with the AAI at rest and during exercise, by angiography, and by duplex ultrasonography was 74%, 19%, 31%, and 32%, respectively. Seventy-five percent of the restenoses occurred at the site of the treated occlusion. Conclusion: Duplex ultrasonography is most suitable for this assessment, as it causes no patient discomfort and the specificity is better than AAI after exercise because vascular disease in other, proximal segments does not interfere with the results.

  13. [Current developments in ultrasonography of the meniscus].

    PubMed

    Casser, H R; Füsting, M

    1993-09-01

    Sonography of the meniscus is a new diagnostic method, the instructive value and clinical relevance of which are subject to controversy. Sonographic assessment of the meniscus requires the use of focusing that can cope with the different anatomical conditions of the individual parts of the meniscus and can largely eliminate artifacts by means of wide sound-wave propagation. The dynamic examination technique allows the identification of both longitudinal and flap tears, which are relatively easy to diagnose, and of tear formations that are harder to visualize, such as horizontal and transversal tears. A sonographic criterion of a tear is the detection of a clearly visible, strong-signal double or single-stroke reflection pattern that can be traced in several section planes. While sonographic examination allows location of the tear, definite conclusions as to the shape of the tear are not possible on the basis of the echo pattern. In the literature, the statistical results, depending on the patient group and technical equipment, vary between 76% and 100% for sensitivity and between 50% and 97% for specificity, 74% and 93% for accuracy and between 61% and 95% for the positive prediction value. Sonographic examination of the meniscus is an easily available, noninvasive imaging technique that, as a supplement to clinical findings, can be used to optimize preoperative diagnosis and to check the indication for arthroscopy. Careful consideration of the technical requirements and systematic performance of the dynamic examination should lead to further improvement in the examination results and to growing clinical significance in the future.

  14. Severe haematoperitoneum caused by ovarian bleeding after transvaginal oocyte retrieval: a retrospective analysis and systematic literature review.

    PubMed

    Nouri, Kazem; Walch, Katharina; Promberger, Regina; Kurz, Christine; Tempfer, Clemens B; Ott, Johannes

    2014-12-01

    A case series of haematoperitoneum caused by ovarian bleeding after transvaginal oocyte retrieval (TVOR) is presented and all published cases summarized. In a retrospective case series, four patients with ovarian bleeding after TVOR were included. In addition, a pooled analysis of all published cases (n = 32) who underwent surgical intervention for severe haematoperitoneum caused by ovarian bleeding after TVOR was carried out. Main outcome measures were incidence, risk factors, course and intraoperative findings. In the pooled analysis, the incidence was 0.08%. The first sign of haematoperitoneum was evident in 33.3% within the first postoperative hour, and, cumulatively, in 93.3% within 24 h. The median time between TVOR and surgical intervention was 10 h. In four patients, the ovary could not be preserved, which was associated with a longer time interval between TVOR and the onset of symptoms (median 18 h versus 2.5 h; P = 0.004) as well as between TVOR and surgical intervention (median 21.5 h versus 8.5 h; 0.004). In conclusion, severe haematoperitoneum occurs in 0.08% after TVOR. Late-onset bleeding is common. A longer time interval between TVOR and surgical intervention might put a patient at risk of ovariectomy.

  15. Transvaginal follicle aspiration in Thai swamp buffalo heifers using different vacuum pressures after FSH pretreatment (Bubalus bubalis).

    PubMed

    Techakumphu, Mongkol; Promdireg, Akachart; Phutikanit, Nawapen; Nachiengmai, Anchalee; Thongjan, Sak

    2004-08-01

    The objective of the experiment was to study oocyte recovery by transvaginal, ultrasound-guided, follicle aspiration, from Thai swamp buffalo using different vacuum pressures. Six adult buffalo heifers, aged 2.5-3.0 yrs were treated with a total dose of 280 mg FSH, given twice a day in a divided doses over a three day period (60/60 mg, 50/50 mg, 30/30 mg) at d7 after progesterone implant. Three vacuum pressures were used; 100 (n=12), 80 (n=12) and 60 mmHg (n=12) and all of the pressures were performed in each animal. The animals were treated repeatedly and collection took place using 2 sets of each pressure every 2 months, giving a total of 36 collections from each animal. The oocyte recovery rates from each pressure were 81.2% (69/85) 79.1% (53/67) and 90.3% (93/103) for 100, 80 and 60 mmHg respectively. The number of oocytes collected per donor were 5.33 +/- 3.27, 4.42 +/- 2.71 and 7.75 +/- 4.31 respectively. The quality of the oocytes did not improved with the lower vacuum pressure. In conclusion, the application of FSH pretreatment improves the yield of oocytes from Thai, swamp buffalo heifers after gonadotropin treatment when using the vacuum pressures between 60-100 mmHg.

  16. Randomized double-blind clinical trial comparing two anesthetic techniques for ultrasound-guided transvaginal follicular puncture

    PubMed Central

    de Oliveira, Gilvandro Lins; Serralheiro, Fernando Cesar; Fonseca, Fernando Luiz Affonso; Ribeiro, Onésimo Duarte; Adami, Fernando; Christofolini, Denise Maria; Bianco, Bianca; Barbosa, Caio Parente

    2016-01-01

    ABSTRACT Objective: To compare the anesthetic techniques using propofol and fentanyl versus midazolam and remifentanil associated with a paracervical block with lidocaine in performing ultrasound-guided transvaginal oocyte aspiration. Methods: A randomized double-blind clinical trial (#RBR-8kqqxh) performed in 61 women submitted to assisted reproductive treatment. The patients were divided into two groups: anesthetic induction with 1mcg/kg of fentanyl associated with 1.5mg/kg of propofol (FP Group, n=32), in comparison with anesthetic induction using 0.075mg/kg of midazolam associated with 0.25mcg/kg/min of remifentanil, and paracervical block with 3mL of 2% lidocaine (MRPB Group, n=29). Main outcome measures: human reproduction outcomes, modified Aldrete-Kroulik index, hemodynamic parameters, and salivary cortisol. Results: The results revealed a higher number of embryos formed in the FP Group (p50=2 versus 1; p=0.025), gestation rate two times higher in the FP Group (44.4% versus 22.2%; p=0.127), less time to reach AK=10 in the MRPB Group (p50=10 versus 2; p<0.001), and lower mean of hemodynamic parameters in the MRPB Group (p<0.05). Conclusion: Anesthesia with fentanyl and propofol as well as with midazolam, remifentanil, and paracervical block offered satisfactory anesthetic conditions when performing assisted reproduction procedures, providing comfort for the patient and physician. PMID:27759816

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

    PubMed

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

    2014-08-01

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

  18. Doppler ultrasonography of the lower extremity arteries: anatomy and scanning guidelines

    PubMed Central

    2017-01-01

    Doppler ultrasonography of the lower extremity arteries is a valuable technique, although it is less frequently indicated for peripheral arterial disease than for deep vein thrombosis or varicose veins. Ultrasonography can diagnose stenosis through the direct visualization of plaques and through the analysis of the Doppler waveforms in stenotic and poststenotic arteries. To perform Doppler ultrasonography of the lower extremity arteries, the operator should be familiar with the arterial anatomy of the lower extremities, basic scanning techniques, and the parameters used in color and pulsed-wave Doppler ultrasonography. PMID:28219004

  19. An attempt to bridge muscle architecture dynamics and its instantaneous rate of force development using ultrasonography.

    PubMed

    Li, Jizhou; Zhou, Yongjin; Zheng, Yong-Ping; Li, Guanglin

    2015-08-01

    Muscle force output is an essential index in rehabilitation assessment or physical exams, and could provide considerable insights for various applications such as load monitoring and muscle assessment in sports science or rehabilitation therapy. Besides direct measurement of force output using a dynamometer, electromyography has earlier been used in several studies to quantify muscle force as an indirect means. However, its spatial resolution is easily compromised as a summation of the action potentials from neighboring motor units of electrode site. To explore an alternative method to indirectly estimate the muscle force output, and with better muscle specificity, we started with an investigation on the relationship between architecture dynamics and force output of triceps surae. The muscular architecture dynamics is captured in ultrasonography sequences and estimated using a previously reported motion estimation method. Then an indicator named as the dorsoventrally averaged motion profile (DAMP) is employed. The performance of force output is represented by an instantaneous version of the rate of force development (RFD), namely I-RFD. From experimental results on ten normal subjects, there were significant correlations between the I-RFD and DAMP for triceps surae, both normalized between 0 and 1, with the sum of squares error at 0.0516±0.0224, R-square at 0.7929±0.0931 and root mean squared error at 0.0159±0.0033. The statistical significance results were less than 0.01. The present study suggested that muscle architecture dynamics extracted from ultrasonography during contraction is well correlated to the I-RFD and it can be a promising option for indirect estimation of muscle force output.

  20. A report on an acute, in-hours, outpatient review clinic with ultrasonography facilities for the early evaluation of general surgical patients.

    PubMed

    Pidgeon, T E; Shariff, U; Devine, F; Menon, V

    2016-09-01

    Introduction In 2013 our hospital introduced an in-hours, consultant-led, outpatient acute surgical clinic (ASC) for emergency general surgical patients. In 2014 this clinic was equipped with a dedicated ultrasonography service. This prospective cohort study evaluated this service before and after the introduction of ultrasonography facilities. Methods Data were recorded prospectively for all patients attending the clinic during 2013 and 2014. The primary outcome was patient destination (whether there was follow-up/admission) after clinic attendance. Results The ASC reviewed patients with a wide age range and array of general surgical complaints. In 2013, 186 patients attended the ASC. After the introduction of the ultrasonography service in 2014, 304 patients attended. In 2014, there was a reduction in the proportion of patients admitted to hospital from the clinic (18.3% vs 8.9%, p=0.002). However, the proportion of patients discharged after ASC review remained comparable with 2013 (30.1% in 2013 vs 38.8% in 2014, p=0.051). The proportion of patients undergoing computed tomography (CT) scans also fell (14.0% vs 4.9%, p<0.001). Conclusions The ASC assessed a wide array of general surgical complaints. Only a small proportion required hospital admission. The introduction of an ultrasonography service was associated with a further reduction in admission rates and computed tomography.

  1. A New Soft Tissue Volume Measurement Strategy Using Ultrasonography

    PubMed Central

    Hwang, Ji Hye; Lee, Hae Hyun; Kim, Soo Yeon

    2014-01-01

    Abstract Various techniques are available for measuring the status of lymphedema. A modified imaging technique using ultrasonography was developed to measure the structure of soft tissue area in a cost-effective manner. The purpose of this study was to measure the reliability and the accuracy of this new method. Ultrasonography was performed on both arms of twenty healthy female participants. At 10 cm above (AE) and below (BE) the elbow crease, soft tissue thickness at medial, lateral, inferior, and superior locations were measured by two examiners with minimal unnecessary pressure. After measuring twice on 16 sites for each participant, the amount of soft tissue in the cross-sectional area (ΔCSA) was acquired by a designed formulation. The ΔCSA was also compared with volumetry data (Perometer®). Cronbach's alpha coefficient test was used for statistics. The intra-class and inter-class reliability measurements for all soft tissue areas were very strong (α=0.980 and 0.960, respectively; p<0.01). All AE and BE reliabilities showed very strong correlation and strong correlation of inter-BE measurement. All reliabilities of ΔCSA were very strong (≥0.950). All CCs (correlation coefficients) between ΔCSA, circumference, and volumetry were strong for AE and BE measurements, except for ΔCSA and circumference at BE. The strongest CC was between volumetry and circumference measurements. This study suggests that measuring the ΔCSA by ultrasonography could be an alternative way to measure the status of soft tissue indirectly with structural consideration. PMID:24521479

  2. Arterial diameter measurement using high resolution ultrasonography: in vitro validation.

    PubMed

    Brum, Javier; Bia, Daniel; Benech, Nicolas; Balay, Guillermo; Armentano, Ricardo L; Negreira, Carlos

    2011-01-01

    Simultaneous measurement of pressure and diameter in blood vessels or vascular prosthesis is of great importance in cardiovascular research. Knowledge of diameter changes as response to intravascular pressure is the basis to estimate the biomechanical properties of blood vessel. In this work a new method to quantify arterial diameter based in high resolution ultrasonography is proposed. Measurements on an arterial phantom placed on a cardiovascular simulator were performed. The results were compared to sonomicrometry measurements considered as gold standard technique. The obtained results indicate that the new method ensure an optimal diameter quantification. This method presents two main advantages respect to sonomicrometry: is noninvasive and the vessel wall strain can be measured directly.

  3. Three-dimensional ultrasonography in hepatobiliary and pancreatic diseases.

    PubMed

    Sackmann, M; Pauletzki, J; Zwiebel, F M; Holl, J

    1994-06-01

    Three-dimensional reconstruction of ultrasonographic images was used to visualize hepatobiliary and pancreatic lesions and stones, and to measure gallbladder emptying. The initial experience shows that these reconstructions may be of some help in the identification of the extension of tumors and the invasion into surrounding tissues. Stones and stone fragments in the pancreas and in the gallbladder as well as the wall of the gallbladder were visualized well. If further studies will reveal a benefit for the patient, three-dimensional ultrasonography may be added to the noninvasive methods used in the diagnosis of several hepatobiliary and pancreatic diseases.

  4. Clinical application of endoscopic ultrasonography for esophageal achalasia.

    PubMed

    Minami, Hitomi; Inoue, Haruhiro; Isomoto, Hajime; Urabe, Shigetoshi; Nakao, Kazuhiko

    2015-04-01

    Endoscopic ultrasonography (EUS) has been widely used for evaluating the nature of diseases of various organs. The possibility of applying EUS for esophageal motility diseases has not been well discussed despite its versatility. At present, peroral endoscopic myotomy (POEM) for esophageal achalasia and related diseases has brought new attention to esophageal diseases because POEM provides a more direct approach to the inner structures of the esophageal wall. In the present study, we discuss the clinical utility of EUS in evaluating and treating esophageal motility diseases such as esophageal achalasia and related diseases.

  5. Uterine blood flow during various stages of pregnancy in dairy buffaloes using transrectal Doppler ultrasonography.

    PubMed

    Varughese, E E; Brar, P S; Dhindsa, S S

    2013-07-01

    Reference data to assess function and perfusion of uteroplacental tissues by assessment of uterine blood flow parameters is not available in buffaloes. The objective of the present study was to assess and quantify blood flow parameters at various stages of gestation. A total of 54 Murrah buffaloes, six animals at every month of gestation, from two months to ten months, were subjected to transrectal Doppler ultrasonography to assess uterine blood flow in both the middle uterine arteries. Resistance and pulsatility indices, velocity and volume of blood flow, diameter of the artery and notch signal were measured for different waveforms. The resistance index value was positively correlated with pulsatility index (r=0.94, P<0.05) but negatively correlated with all other parameters for both arteries, ipsilateral and contralateral to the fetus. With a significant advancement of pregnancy, there was reduction in resistance index with a significant increase in velocity, volume of blood flow and diameter in both arteries. There was a significant increase in the volume and velocity of blood flow (P<0.05) during the last trimester with increased growth demands of the fetus. The notch signal disappeared by 20-24 weeks. Thus, transrectal Doppler ultrasongraphy proved to be a useful non-invasive method to assess the uterine blood flow during pregnancy in buffaloes. This could be a valuable tool to ascertain hemodynamic changes in complicated pregnancy (e.g. abnormalities in uterine blood flow/placenta/fetus) and its extent of deviation from normal.

  6. Electroencephalography and transcranial Doppler ultrasonography in neonatal citrullinemia.

    PubMed

    Su, Pen-Hua; Chen, Jia-Yuh; Chen, Yung-Jung; Niu, Dau-Ming; Hsu, Ju-Hui; Lee, Inn-Chi

    2014-11-01

    The authors present a case of citrullinemia with a genotype of argininosuccinate synthetase (ASS1), c.380 G>A (p.R127Q)/c.380 G>A (p.R127Q), in two alleles. A 3-day-old female infant presented with status epilepticus and coma. Laboratory data showed hyperammonemia and marked lactic acidosis in the blood and cerebrospinal fluid; electroencephalography showed severely suppressed cerebral activity and focal paroxysmal volleys of slow and sharp waves (< 1Hz) over the left hemisphere. Real-time transcranial Doppler ultrasonography showed a brain edema and high peaked systolic and low diastolic flows in basal, anterior, and middle cerebral arteries; however, immediately after a blood exchange transfusion, systolic flows were lower and diastolic flows were higher. The resistance indices were significantly different (means: 0.58 vs. 0.37; p=0.01). The patient was placed on diet therapy. After six blood exchange transfusions and peritoneal dialysis, her neurologic examination results and serum ammonia and lactate values were normal. The authors found that electroencephalography and transcranial Doppler ultrasonography were useful for the diagnosis and follow-up treatment of neonatal citrullinemia.

  7. Ultrasonography in pediatric rheumatology in Latin America. Expanding the frontiers.

    PubMed

    Hernández-Díaz, Cristina; Ventura-Ríos, Lucio; Gutiérrez, Marwin; Roth, Johannes

    2016-04-01

    For the past two decades, musculoskeletal ultrasonography (MSKUS) has developed exponentially and has become an essential tool in rheumatology practice. This development has been far more limited in pediatric rheumatology which is partially related to deficits in the evidence base. Many studies have shown that MSKUS is more sensitive than the clinical examination for detecting synovitis and enthesitis in adults. At the same time, there is a lack of studies demonstrating its validity, reliability, and reproducibility in pediatric rheumatology. In addition, clear definitions for the normal pediatric joint and enthesis as well as various findings in pathology associated with juvenile idiopathic arthritis (JIA) and juvenile spondyloarthritis (JSpA) have only started to emerge. Most of this work is being done through the Outcome Measurement in Rheumatology Clinical Trials (OMERACT) ultrasound pediatric task force but the Pan American League of Associations for Rheumatology (PANLAR) US Pediatric Task Force is also working on validating MSKUS in children. In addition, several MSKUS courses for pediatric rheumatologists have been offered in Latin American countries; these will not only complement the scientific work pediatric-specific ultrasonography training, but also represents an essential component for the successful implementation of this technique into daily practice as well.

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

    PubMed Central

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

    2006-01-01

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

  9. AB289. SPR-16 A preliminary evaluation of vaginal alignment following a transvaginal procedure using MatriStem™ pelvic floor matrix in the rhesus macaque

    PubMed Central

    Easley, Deanna C.; Barone, William R.; Moalli, Pamela A.; Abramowitch, Steven D.

    2016-01-01

    Objective Implantation of biological or synthetic mesh is the most common method of surgical intervention for pelvic organ prolapse, however, complications ensuing from these surgical repairs occur in 15.5% of cases. MatristemTM (ACell, Inc., USA) Pelvic Floor Matrix is a urinary bladder matrix (UBM) device indicated for transvaginal repair. This device is remodeled and replaced by host tissue following implantation, which raises the concern that the process may result in a loss of support to the vagina. Thus, the goal of this study was to quantify measurable changes in vaginal alignment via magnetic resonance imaging (MRI) before (pre) and after (10 days and 3 months) a transvaginal procedure with this device in a rhesus macaque model. Methods Two rhesus macaques underwent a transvaginal procedure in accordance with the IACUC at the University of Pittsburgh (protocol #13081928). Level 1 & 2 support to the vagina was transected to simulate compromised support. Two sheets of 6-ply MatriStemTM were implanted to support the anterior and posterior vagina. Vaginal alignment was derived from MRIs taken pre, 10 days, and 3 months after surgery. The border of the vagina was manually traced, and used to calculate the centroid of each tracing. These centroids represent the path of the vagina through the pelvis. Further, a 3D coordinate system was mapped to the pelvis, and lines fit to the proximal and distal vagina were used to measure the angle of each line with respect to a cephalic oriented axis in the mid-sagittal plane, which is referred to as the angle of elevation. Results At 10 days, the angle of elevation became more acute by 8.6% and 17%, respectively. These changes reflect expectations of a tensioned transvaginal fixation of the vagina. At 3 months post-surgery, angles of elevation approached pre surgery conditions, indicating that MatriStemTM was providing a comparable level of support to native tissue, even following remodeling. Conclusions This preliminary

  10. Increasing the Reliability of the Grading System for Voiding Cystourethrograms Using Ultrasonography: An Inter-Rater Comparison

    PubMed Central

    Ozaydin, Seyithan; Celebi, Suleyman; Caymaz, Ismail; Besik, Cemile; Karaaslan, Birgul; Kuzdan, Ozgur; Sander, Serdar

    2016-01-01

    Background To assess the effectiveness of the current vesicoureteral reflux (VUR) grading system according to the international classification of VUR (ICVUR) and to evaluate whether VUR grading accuracy could be improved by renal ultrasonography (RU) according to the Society for Fetal Urology (SFU) grading system. Objectives Therefore, this study assessed the accuracy of the current VCUG staging system by assessing inter-rater reliability among pediatric radiologists and urologists; it also evaluated whether accuracy is increased by RU without consensus (with respect to VCUG grading). Methods Four pediatric urologists and four pediatric radiologists independently graded 120 voiding cystourethrograms (VCUGs). Middle VUR grades were divided into the following three groups: VUR consensus grade III (group 1), VUR consensus grade IV (group 3), and VUR non-consensus grades III and IV (group 2). All groups were compared with respect to hydronephrosis grade using RU. Results The intraclass correlation coefficient (ICC) values ranging from 0.86 to 0.89 reflected good reliability. The lowest agreement was associated with middle grades (III and IV). A marked difference in sensitivity was observed between groups 1 and 3 (35% and 95%, respectively, P < 0.05), indexed by SFU hydronephrosis grade, suggesting that VCUG cases in group 2 (n = 16 at SFU 0 or 1) could be accepted as grade III, and SFU scores of 2, 3, or 4 could be considered grade IV. Conclusions Inter-rater accuracy could be improved at middle grades using renal ultrasonography (USG), which could promote communication between different specialists. PMID:27878111

  11. Ultrasonography for endotracheal tube position in infants and children.

    PubMed

    Jaeel, Pooja; Sheth, Mansi; Nguyen, Jimmy

    2017-03-01

    Ultrasonography (US) has been shown to be effective for verifying endotracheal tube (ETT) position in adults but has been less studied in infants and children. We review the literature regarding US for ETT positioning in the pediatric population. A literature search was conducted using the Ovid and MEDLINE databases with search terms regarding US relating to ETT intubation and positioning in infants and children. Most studies in neonates and infants used the midsagittal suprasternal view. Studies reported >80% visualization of the ETT tip by US, and US interpretation of the ETT position correlated with the XR position in 73-100% of cases. Studies of older children used the suprasternal views, substernal views, and mid-axillary intercostal views. US appears comparable to XR and capnography in determining ETT position in this population.

  12. Prenatal diagnosis of limb abnormalities: role of fetal ultrasonography

    PubMed Central

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

    2009-01-01

    Fetal ultrasonografy is the most important tool to provide prenatal diagnosis of fetal anomalies. The detection of limb abnormalities may be a complex problem if the correct diagnostic approch is not established. A careful description of the abnormality using the rigth nomenclature is the first step. Looking for other associated abnormalities is the threshold to suspect chromosomal abnormalities or single gene disorder. According to the patogenic point of view, limb abnormalities may be the result of malformation, deformation, or disruption. The prenatal diagnosis and the management of limb abnormalities involve a multidisciplinary team of ostetrician, radiologist/sonologist, clinical geneticist, neonatologist, and orthopedic surgeons to provide the parents with the information regarding etiology of the disorder, prognosis, option related to the pregnancy and recurrence risk for future pregnancies. The aim of this review is to describe the importance of detailed fetal ultrasonography in prenatal diagnosis of limb abnormalities. PMID:22439035

  13. Ultrasonography in non-cirrhotic portal hypertension: correlation with splenoportography.

    PubMed

    Nagi, B; Khandelwal, N; Kochhar, R; Gupta, B B; Mehta, S; Singh, K; Mehta, S K

    1989-10-01

    Real time sonography followed by splenoportography was performed in 38 cases with non-cirrhotic portal hypertension. Eleven of these cases, in whom porto-systemic shunt surgery was done, were also evaluated by real time sonography post-operatively. The ultrasound findings correlated well in 37 cases (98%) with splenoportography. All the post-operative cases also revealed a patent portosystemic shunt on sonography. Ultrasonography, a valuable, non-invasive, initial investigation of portal hypertension, may thus be used as the only investigation to distinguish intra- from extra-hepatic obstruction and to evaluate patency of surgically created porto-systemic shunts. Invasive portography may be performed only if surgical treatment is anticipated.

  14. Interventional ultrasonography of the chest: Techniques and indications

    PubMed Central

    Almolla, J.; Balconi, G.

    2011-01-01

    Thoracic ultrasonography can be used for diagnostic purposes as well as a guide for diagnostic and therapeutic interventions. When the lesion or fluid collection has been located and the patient properly positioned, the angle of the needle is identified with respect to the transducer. The insertion tract should transgress the smallest possible area of aerated parenchyma. The needle can be introduced with a free-hand technique or with the aid of a needle guide. Correct planning of the procedure reduces intervention time and decreases the risk of complications. The main indications are superficial masses that require biopsy, pleural and parenchymal lesions formerly biopsied with CT or fluoroscopic guidance, and fluid collections that need to be drained. Ultrasound, thanks to its widespread use, simple execution, and low costs, represents a safe, manageable guide for thoracic interventions. PMID:23396954

  15. Basics, principles, techniques and modern methods in paediatric ultrasonography.

    PubMed

    Riccabona, Michael

    2014-09-01

    Ultrasonography (US) is the mainstay of paediatric Radiology. This review aims at revisiting basic US principles, to list specific needs throughout childhood, and to discuss the application of new and modern US methods. The various sections elude to basic US physics, technical requisites and tips for handling, diagnostically valuable applications of modern techniques, and how to properly address hazards, risks and limitations. In conclusion, US holds vast potential throughout childhood in almost all body regions and many childhood specific queries - helping to reduce the need for or to optimize more invasive or irradiating imaging. Make the most of US and offerings a dedicated paediatric US service throughout the day, the week and the year thus is and will stay a major task of Paediatric Radiology.

  16. Understanding abdominal ultrasonography in horses: which way is up?

    PubMed

    Henry Barton, Michelle

    2011-09-01

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

  17. Hysterosalpingography and ultrasonography findings of female genital tuberculosis.

    PubMed

    Shah, Hardik Uresh; Sannananja, Bhagya; Baheti, Akshay Dwarka; Udare, Ashlesha Satish; Badhe, Padma Vikram

    2015-01-01

    Genital tuberculosis (TB) is an important cause of female infertility in the world, especially in developing countries. Majority of infertility cases are due to involvement of the fallopian tubes (92%-100%), endometrial cavity (50%), and ovaries (10%-30%); cervical and vulvovaginal TB are uncommon. Genital TB has characteristic radiological appearances based on the stage of the disease process (acute inflammatory or chronic fibrotic) and the organ of involvement. Hysterosalpingography (HSG) and ultrasonography (US) remain the main imaging modalities used in the diagnosis of genital TB. HSG is the primary modality for evaluating uterine, fallopian tube, and peritubal involvement and also helps in evaluating tubal patency. US, on the other hand, allows simultaneous evaluation of ovarian and extrapelvic involvement.

  18. Value of sagittal color Doppler ultrasonography as a supplementary tool in the differential diagnosis of fetal cleft lip and palate

    PubMed Central

    2017-01-01

    Purpose The purpose of this study was to evaluate the feasibility and usefulness of sagittal color Doppler ultrasonography (CDUS) for the diagnosis of fetal cleft lip (CL) and cleft palate (CP). Methods We performed targeted ultrasonography on 25 fetuses with CL and CP, taking coronal and axial images of the upper lip and maxillary alveolar arch in each case. The existence of defects in and malalignment of the alveolus on the axial image, hard palate defects on the midsagittal image, and flow-through defects on CDUS taken during fetal breathing or swallowing were assessed. We compared the ultrasonography findings with postnatal findings in all fetuses. Results Alveolar defects were detected in 16 out of 17 cases with CP and four out of eight cases with CL. Alveolar malalignment and hard palate defects were detected in 11 out of 17 cases and 14 out of 17 cases with CP, respectively, but not detected in any cases with CL. Communicating flow through the palate defect was detected in 11 out of 17 cases of CL with CP. The accuracy of detection in axial scans of an alveolar defect and malalignment was 80% and 76%, respectively. Accuracy of detection of in mid-sagittal images of hard palate defect and flow was 80% and 86%, respectively. The overall diagnostic accuracy of combined axial and sagittal images with sagittal CDUS was 92%. Conclusion Sagittal CDUS of the fetal hard palate is a feasible method to directly reveal hard palate bony defects and flow through defects, which may have additional value in the differential diagnosis of fetal CL and CP. PMID:27764909

  19. Comparison of Ultrasonography and Radiography in Detection of Thoracic Bone Fractures; a Systematic Review and Meta-Analysis

    PubMed Central

    Yousefifard, Mahmoud; Baikpour, Masoud; Ghelichkhani, Parisa; Asady, Hadi; Darafarin, Abolfazl; Amini Esfahani, Mohammad Reza; Hosseini, Mostafa; Yaseri, Mehdi; Safari, Saeed

    2016-01-01

    Introduction: The potential benefit of ultrasonography for detection of thoracic bone fractures has been proven in various surveys but no comprehensive conclusion has been drawn yet; therefore, the present study aimed to conduct a thorough meta-analytic systematic review on this subject. Methods: Two reviewers independently carried out a comprehensive systematic search in Medline, EMBASE, ISI Web of Knowledge, Scopus, Cochrane Library, and ProQuest databases. Data were summarized as true positive, false positive, true negative and false negative and were analyzed via STATA 11.0 software using a mixed-effects binary regression model. Sources of heterogeneity were further assessed through subgroup analysis. Results: Data on 1667 patients (807 subjects with and 860 cases without thoracic fractures), whose age ranged from 0 to 92 years, were extracted from 17 surveys. Pooled sensitivity and specificity of ultrasonography in detection of thoracic bone fractures were 0.97 (95% CI: 0.90-0.99; I2= 88.88, p<0.001) and 0.94 (95% CI: 0.86-0.97; I2= 71.97, p<0.001), respectively. The same measures for chest radiography were found to be 0.77 (95% CI: 0.56-0.90; I2= 97.76, p<0.001) and 1.0 (95% CI: 0.91-1.00; I2= 97.24, p<0.001), respectively. The sensitivity of ultrasonography was higher in detection of rib fractures, compared to fractures of sternum or clavicle (97% vs. 91%). Moreover, the sensitivity was found to be higher when the procedure was carried out by a radiologist in comparison to an emergency medicine specialist (96% vs. 90%). Conclusion: Base on the findings of the present meta-analysis, screening performance characteristic of ultrasonography in detection of thoracic bone fractures was found to be higher than radiography. However, these characteristics were more prominent in detection of rib fractures and in cases where was performed by a radiologist. PMID:27274514

  20. Contrast-Enhanced Ultrasonography Features of Breast Malignancies with Different Sizes: Correlation with Prognostic Factors

    PubMed Central

    Zhao, Li-Xia; Liu, Hui; Wei, Qing; Xu, Guang; Wu, Jian; Xu, Hui-Xiong; Wu, Rong; Pu, Huan

    2015-01-01

    This study was to investigate the correlation between contrast-enhanced ultrasonography (CEUS) characteristics with prognostic factors in breast cancers with different sizes. A retrospective analysis of CEUS characteristics of 104 pathologically proven malignant lesions from 104 women was conducted. Lesions were divided into two groups according to their size measured by US (Group 1: maximum diameter ≤20 mm; Group 2: maximum diameter >20 mm). Features including enhancement degree, order and pattern, enlargement of the enhancement area, and penetrating vessels on CEUS were evaluated. Pathologic prognostic factors, including estrogen and progesterone receptor status, and the expression of c-erb-B2, p53, Ki-67, and VEGF were assessed. Comparison of enhancement pattern parameters between Group 1 and Group 2 showed statistically significant differences (P < 0.0001). A significant correlation was found between enlargement of the enhancement area and ER positivity in Group 1 (P = 0.032). In Group 2 the absence of penetrating vessels was significantly associated with VEGF negativity (P = 0.022) and ER negativity (P = 0.022). Centripetal enhancement reflected VEGF negativity (P = 0.033) in lesions with diameter >20 mm. Thus, breast cancers with different sizes show different CEUS features; small breast cancers show homogeneous enhancement pattern while cancers with diameter >20 mm show homogeneous enhancement pattern. Some CEUS characteristics of differently sized breast cancers could be correlated with prognostic factors, which may be useful in prognosis assessment. PMID:26881202

  1. Color Doppler ultrasonography: diagnosis of ectopic thyroid gland in patients with congenital hypothyroidism caused by thyroid dysgenesis.

    PubMed

    Ohnishi, Hisashi; Sato, Hirokazu; Noda, Hiromasa; Inomata, Hiroaki; Sasaki, Nozomu

    2003-11-01

    The etiology of congenital hypothyroidism (CH) may play an important role in determining disease severity, outcome, and, therefore, its treatment schedule. Radionuclide imaging (RI) is currently the most precise diagnostic technique to establish the etiology of CH. Conventional ultrasound can identify an athyrotic condition at the normal neck position and has gained acceptance for the initial evaluation of CH; however, its ability in delineating ectopic thyroid is limited. We used color Doppler ultrasonography (CDU) to assess blood flow and morphology in the detection of ectopic thyroid in 11 CH patients disclosed by neonatal screening; thyroid glands were undetectable at the normal location by gray-scale ultrasonography (GSU). The patients studied consisted of two infants for initial investigation and nine children for reevaluating the cause of CH. All of the patients underwent GSU, CDU, RI, and magnetic resonance imaging (MRI) investigation. We set RI as the defining diagnostic test for detecting ectopic thyroid and compared the imaging of CDU with those of GSU and MRI. The results of RI showed 10 ectopic thyroids and one athyreosis. In the patients with ectopic thyroid, the sensitivity of CDU, GSU, and MRI for detecting ectopic thyroid was 90, 70, and 70%, respectively. We conclude that CDU is superior to GSU and MRI for detecting ectopic thyroid and that CDU may be adopted as the diagnostic tool for the initial investigation of suspected CH.

  2. Cost-effectiveness analysis of population-based screening of hepatocellular carcinoma: Comparing ultrasonography with two-stage screening

    PubMed Central

    Kuo, Ming-Jeng; Chen, Hsiu-Hsi; Chen, Chi-Ling; Fann, Jean Ching-Yuan; Chen, Sam Li-Sheng; Chiu, Sherry Yueh-Hsia; Lin, Yu-Min; Liao, Chao-Sheng; Chang, Hung-Chuen; Lin, Yueh-Shih; Yen, Amy Ming-Fang

    2016-01-01

    AIM: To assess the cost-effectiveness of two population-based hepatocellular carcinoma (HCC) screening programs, two-stage biomarker-ultrasound method and mass screening using abdominal ultrasonography (AUS). METHODS: In this study, we applied a Markov decision model with a societal perspective and a lifetime horizon for the general population-based cohorts in an area with high HCC incidence, such as Taiwan. The accuracy of biomarkers and ultrasonography was estimated from published meta-analyses. The costs of surveillance, diagnosis, and treatment were based on a combination of published literature, Medicare payments, and medical expenditure at the National Taiwan University Hospital. The main outcome measure was cost per life-year gained with a 3% annual discount rate. RESULTS: The results show that the mass screening using AUS was associated with an incremental cost-effectiveness ratio of USD39825 per life-year gained, whereas two-stage screening was associated with an incremental cost-effectiveness ratio of USD49733 per life-year gained, as compared with no screening. Screening programs with an initial screening age of 50 years old and biennial screening interval were the most cost-effective. These findings were sensitive to the costs of screening tools and the specificity of biomarker screening. CONCLUSION: Mass screening using AUS is more cost effective than two-stage biomarker-ultrasound screening. The most optimal strategy is an initial screening age at 50 years old with a 2-year inter-screening interval. PMID:27022228

  3. Chronically Symptomatic Patients with Undetectable Gall Bladder on Ultrasonography Could Benefit from Early Cholecystectomy

    PubMed Central

    Adams, Stephen D.; Blackburn, Simon C.; Adewole, Victoria A.; Mahomed, Anies A.

    2013-01-01

    90 percent of symptomatic patients undergoing cholecystectomy have cholelithiasis with 10% categorized as asymptomatic cholecystitis. In both instances, the gallbladder is evident on ultrasonography. In children with symptomatic biliary dyspepsia, the decision to proceed to cholecystectomy is made difficult if choleliths are not seen on ultrasonography. This decision is made even more difficult if the gallbladder itself is not seen on repeated imaging. In a cohort of 54 cholecystectomies, 3 cases, with recurrent right upper quadrant pain and undetectable gallbladders on repeat ultrasonography, were identified. After prolonged observation all underwent successful cholecystectomy. Histology demonstrated a markedly fibrotic and thickened gallbladder in all. Given this experience, we suggest that nonvisibility of the gallbladder, in fact, maybe be a feature of a chronic acalculous cholecystitis. We advise consideration of cholecystectomy for chronic biliary dyspepsia where repeat ultrasonography fails to demonstrate a gallbladder. PMID:23401761

  4. Synchronization of follicular wave emergence following ultrasound-guided transvaginal follicle ablation or estradiol-17β administration in water buffalo (Bubalus bubalis).

    PubMed

    Honparkhe, M; Gandotra, V K; Matharoo, J S; Ghuman, S P S; Dadarwal, D; Singh, Jaswant

    2014-04-01

    The aim of this study was to assess the synchrony in follicular wave emergence and subsequent ovulation following dominant follicle ablation or estradiol-17β administration. Six cycling Murrah buffaloes were sequentially allotted to three groups, that is, control, follicular ablation, and estradiol-17β groups. For the control group, buffaloes at random stages of estrous cycle were examined daily by transrectal ultrasonography for 14 days and the day of wave emergence was recorded. Following induced luteolysis and ovulation (Day 0), these buffaloes were included in the ablation group. All follicles (>5mm) were ablated on Day 3 or 5 or 7 (n=2 each day). Seven days after the ablation, these buffaloes were administered prostaglandin F2α to induce luteolysis and ovulation. Following this, buffaloes were included in the estradiol treatment group with estradiol administered on similar days as for ablation in the ablation group. Luteolysis was induced nine days after the estradiol injection. All animals of the treatment groups were subjected to transrectal ultrasound and blood samplings daily from treatment to induced ovulation. The follicular waves emerged significantly earlier (P=0.001) in both the ablation (2.1±0.79 days) and estradiol (4.0±0.25 days) treatment groups than the control group (8.3±0.88 days). The deviation from mean day of ovulation was greater (P=0.02) for the control group buffaloes (1.66±0.3 day) than those of the treatment groups (ablation, 0.76±0.2 and estradiol, 0.58±0.2 day). In conclusion, both ablation and estradiol resulted in synchronous emergence of a new follicular wave irrespective of stage at which the treatment was given, with greater synchrony of ovulations in water buffalo.

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

    PubMed

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

    1999-07-01

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

  6. Annular pancreas complicated by carcinoma of the bile duct: diagnosis by MR cholangiopancreatography and endoscopic ultrasonography.

    PubMed

    Yamaguchi, Y; Sugiyama, M; Sato, Y; Mine, Y; Yamato, T; Ishida, H; Takahashi, S

    2003-01-01

    It has been reported that annular pancreas should be evaluated for coexisting malignant tumors. However, no cases have been reported in which magnetic resonance cholangiopancreatography and endoscopic ultrasonography clearly demonstrated an annular pancreas complicated by bile duct carcinoma. We present a case that emphasizes the importance of magnetic resonance cholangiopancreatography and endoscopic ultrasonography in directly confirming a diagnosis of annular pancreas complicated by bile duct carcinoma.

  7. Venous thromboembolism after radical cystectomy: Experience with screening ultrasonography

    PubMed Central

    Murray, Katie M.; Parker, William; Stephany, Heidi; Redger, Kirk; Mirza, Moben; Lopez-Corona, Ernesto; Holzbeierlein, Jeffrey M.; Lee, Eugene K.

    2015-01-01

    Objectives To detect the incidence of immediate postoperative deep vein thrombosis (DVT) using screening lower extremity ultrasonography (US) in patients undergoing radical cystectomy (RC) and to determine the rate of symptomatic pulmonary embolism (PE) after RC and identify risk factors for venous thromboembolic (VTE) events in a RC population. Patients and methods We performed a retrospective review of prospective data collected on patients who underwent RC between July 2008 and January 2012. These patients underwent screening US at 2/3 days after RC to determine the rate of asymptomatic DVT. A chart review was completed to identify those who had a symptomatic PE. Univariate and multivariable analysis was used to identify risk factors associated with DVT, PE and total VTE events. Results In all, 221 patients underwent RC and asymptomatic DVT was identified in 21 (9.5%) on screening US. Nine (4.5%) developed symptomatic PE at a median of 9 days, of which no patients had positive lower extremity US postoperatively. Increased length of hospital stay, increased estimated blood loss, and lower body mass index were linked to risk of PE, and only a previous history of DVT was associated with postoperative DVT. Conclusion Patients who undergo RC are at high-risk for thromboembolic events and multimodal prophylaxis should be administered. Clinicians should be especially vigilant in those who demonstrate factors associated with higher risk for VTE events. PMID:26966592

  8. Sensitivity of ultrasonography in detecting renal parenchymal defects in children.

    PubMed

    Levart, Tanja Kersnik; Kenig, Anton; Fettich, Jure J; Kljucevsek, Damjana; Novljan, Gregor; Kenda, Rajko B

    2002-12-01

    Renal parenchymal defects (RPD) -- scars, hypoplasia/dysplasia -- in children are a major risk factor for chronic renal failure. Most authors would agree that RPD should be detected and followed by a 99mTc-dimercaptosuccinic acid renal scan (DMSA), as ultrasonography (US) does not seem to be sensitive enough for this purpose. However, it might well be that DMSA is too sensitive and detects RPD that are too small to be clinically significant. The purpose of this study was to evaluate the sensitivity of US in identifying patients with clinically significant RPD and in detecting RPD of various grades as seen by DMSA. In 89 children with abnormal DMSA, a second DMSA, US, and other tests for evaluating renal function were performed at least 1 year after the first DMSA. The extent of RPD detected by DMSA and US was correlated with renal function parameters. In all 5 patients with diminished renal function, RPD were detected by both DMSA scan and US. In addition, US detected clinically insignificant RPD in 48 of 67 cases (71.6%). The present study has shown that, compared with DMSA, US is sensitive enough to detect clinically significant RPD in children. The substitution of DMSA with US would be beneficial, as this would eliminate radiation exposure, reduce costs, and increase availability.

  9. Cerebral monitoring during carotid endarterectomy by transcranial Doppler ultrasonography

    PubMed Central

    2017-01-01

    Purpose To evaluate the efficacy and safety of cerebral monitoring by transcranial Doppler ultrasonography (TCD) for the detection of cerebral ischemia during carotid endarterectomy (CEA). Methods From August 2004 to December 2013, 159 CEAs were performed in a tertiary hospital. All procedures were performed under general anesthesia. Intraoperative TCD was routinely used to detect cerebral ischemia. Of the 159 patients, 102 patients were included in this study, excluding 27 patients who had a poor transtemporal isonation window and 30 patients who used additional cerebral monitoring systems such as electroencephalography or somatosensory evoked potentials. When mean flow velocity in the ipsilateral middle cerebral artery decreased by >50% versus baseline during carotid clamping carotid shunting was selectively performed. The carotid shunt rate and incidence of perioperative (<30 days) stroke or death were investigated by reviewing medical records. Results Carotid shunting was performed in 31 of the 102 patients (30%). Perioperative stroke occurred in 2 patients (2%); a minor ischemic stroke caused by embolism in one and an intracerebral hemorrhage in the other. Perioperative death developed in the latter patient. Conclusion TCD is a safe cerebral monitoring tool to detect cerebral ischemia during CEA. It can reduce use of carotid shunt. PMID:28203558

  10. Non-contact photoacoustic tomography and ultrasonography for biomedical imaging

    NASA Astrophysics Data System (ADS)

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

    2012-02-01

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

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

    PubMed

    Miletić, D; Fuckar, Z; Mraović, B; Dimec, D; Mozetic, V

    1999-08-01

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

  12. New developments in ultrasonography for the detection of prostate cancer.

    PubMed

    de la Rosette, J J; Aarnink, R G

    2001-02-01

    The introduction of contrast agents has changed the diagnostic role of ultrasonography dramatically. Advanced ultrasound techniques, although currently largely unexplored, especially for prostate applications, were introduced to improve, for example, differential diagnosis. Also, new technologies became available using the interaction of the angioemboli with the transmitted ultrasound waves, and sensitive methods to detect microbubbles were developed. As the traveling of microbubbles through the vascular system is a dynamic process, new information becomes available: when the concentration of the contrast agent can be determined as a function of time, a measure for the actual blood flow can be obtained that provides quantitative information. Initially developed to enhance the ultrasound examinations in cardiac applications, contrast agents can currently be found in radiologic applications as well. The first reports of enhanced Doppler examinations of prostatic blood flow have been published, and the results indicate that contrast agents are a promising addition to the conventional ultrasound examination. In this paper, we present a short overview of the status of transrectal ultrasound imaging in prostate cancer, background information on contrast agents and imaging modalities, and early results of enhanced Doppler studies of the prostate to identify cancer. The early results suggest the feasibility of using angioemboli to enhance ultrasound imaging of prostate diseases, and although many issues remain to be solved, angioemboli in combination with a dedicated imaging modality have the potential to improve the diagnostic application of ultrasound in evaluating the prostate for disease.

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

    PubMed

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

    2012-02-01

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

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

    PubMed Central

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

    2012-01-01

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

  15. New perspectives in facial contouring using external ultrasonography.

    PubMed

    Wilkinson, T S

    2001-10-01

    The use of XUAL ultrasonic energy to "fractionate" and redistribute facial fat is a valuable adjunct in facial plastic surgery. The 59 patients enrolled in the author's preliminary evaluation of XUAL under the auspices of the American Society of Aesthetic Plastic Surgery Innovative Procedures Committee had in addition to the body liposculpture external ultrasonography application to "superwet" anesthetized face and neck with or without physical removal of fat or skin. When no excisions or liposuctioning were performed, there was visible and photographic improvement in facial contouring. Interview comments ranged from "I can see my cheek bones now" to questions as to whether or not a facelift had indeed been performed. Individuals who had submental resculpturing ("submental tuck") or simple "safe zone" liposuction in the submental area, jowl, and nasolabial zones also showed a remarkable degree of skin tightening and contouring beyond the area of actual fat removal. Those individuals who have been observed closely for more than 12 months still have the improvement. Redistribution of fat and skin tightening initially noted between the second and eighth weeks have persisted unchanged, often in spite of fat accumulation elsewhere from weight gain.

  16. Neck ultrasonography for detection of non-recurrent laryngeal nerve

    PubMed Central

    Citton, Marilisa; Viel, Giovanni

    2016-01-01

    Background Non-recurrent laryngeal nerve (NRLN) is a rare anatomical variant (0.3–6%) that is associated with some arterial abnormalities (absence of the brachiocephalic trunk and presence of a right aberrant subclavian lusorian artery). The availability of a preoperative diagnosis of NRLN may reduce the risk of nerve injuries. Preoperative ultrasonography (US) has been suggested as a reliable diagnostic tool to detect the arterial abnormalities associated with NRLN, but the literature is relatively scarce. This paper was aimed to review the literature, in order to offer an up to-date on this technique and its results. Methods A web search, focusing on humans, was performed by PubMed database, including papers published up to August 2016, using the key words “ultrasonography” AND “non-recurrent laryngeal nerve” or “nonrecurrent laryngeal nerve”. Results Eight papers, including 3,740 patients who underwent neck US for the detection of NRLN were selected. Only five studies focused on the preoperative use of US. The incidence of NRLN varied between 0.4% and 1.94%. The sensitivity and specificity varied between 99–100% and 41–100%, respectively. Conclusions US is a simple, non-invasive and cost-effective method to detect NRLN, also if its accuracy is not absolute. It may be used preoperatively and to prevent the intraoperative nerve damage, since the risk of NRLN palsies is significantly reduced when a preoperative diagnosis is available. PMID:28149804

  17. Percutaneous Liver Biopsies Guided with Ultrasonography: A Case Series

    PubMed Central

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

    2013-01-01

    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

  18. Technical note: Mammary gland ultrasonography to evaluate mammary parenchymal composition in prepubertal heifers.

    PubMed

    Albino, R L; Guimarães, S E F; Daniels, K M; Fontes, M M S; Machado, A F; Dos Santos, G B; Marcondes, M I

    2017-02-01

    Bovine mammary gland development studies are often terminal or involve invasive biopsy procedures. Therefore, noninvasive means of assessing mammary development should be considered as alternative methods in live animals. The objective was to test if mammary ultrasonography can be used as a noninvasive way to estimate mammary parenchyma (PAR) composition in prepubertal dairy heifers with different average daily body weight gains. In the 84 d preceding, the ultrasound exam heifers were maintained in 1 of 3 treatment groups. Individual heifers were fed a high gain (1 kg/d; n = 6), low gain (0.5 kg/d, n = 6), or maintenance (n = 6) treatment diet. To achieve desired body weight gains, heifers were fed differing amounts of the same silage-based diet. Mammary glands of 18 crossbred heifers Holstein:Gyr underwent a single mammary ultrasound exam immediately before heifer slaughter, which took place when heifers weighed 142.0 ± 8.0 kg and were 200 d old. The 4 mammary glands of each heifer were evaluated using a real-time B-mode ultrasound machine equipped with a 6.5-MHz micro-convex transducer. Digital images (8-bit) of glands were obtained and PAR was identified within gland. Average pixel values per unit of PAR area were determined for each gland and analyzed at the level of heifer. Pixel results were interpreted on the basis that lower average pixel values reflect PAR with relatively high amounts of protein as opposed to fat. To help validate that the pixel value within PAR is associated with composition of PAR, pixel findings were compared with histological [number of adipocytes in PAR (Nad) and epithelial area in PAR (Ep)] and biochemical [percent crude protein in PAR (%CP), percent ether extract in PAR (%EE), PAR weight (WPAR), and mammary fat pad weight (WFAT)] composition of PAR in these same heifers. Within PAR, %EE and WFAT were positively correlated with pixel values, whereas %CP, Ep, and Nad were negatively correlated. Parenchyma weight did not correlate

  19. Comparison of scar thickness measurements using trans-vaginal sonography and MRI in cases of pregnancy with previous caesarean section. Do they correlate with actual scar thickness?

    PubMed

    Singh, N; Tripathi, R; Mala, Y M; Dixit, R; Tyagi, S; Batra, A

    2013-11-01

    The aim of this study was to evaluate scar thickness in cases of pregnancy with previous caesarean section, by trans-vaginal sonography (TVS) and magnetic resonance imaging (MRI), and to correlate precision of radiologically-measured scar thickness with actual measurement of scar thickness. A total of 35 pregnant patients with previous caesarean section planned for elective caesarean section, were evaluated prospectively. Their scar thickness was measured by TVS and MRI on the day of elective repeat caesarean section. These measurements were correlated with each other and with scar thickness measured during elective repeat caesarean section by using a caliper. The correlation coefficients between scar thickness measured by TVS and MRI with peroperative evaluation with a caliper, were +0.72 and +0.59, respectively. The study concluded that as MRI is a costlier modality and TVS has better correlation coefficient with actual scar thickness, TVS can be considered to be the better modality for antenatal scar thickness measurement.

  20. Cardiac ultrasonography over 4G wireless networks using a tele-operated robot.

    PubMed

    Avgousti, Sotiris; Panayides, Andreas S; Jossif, Antonis P; Christoforou, Eftychios G; Vieyres, Pierre; Novales, Cyril; Voskarides, Sotos; Pattichis, Constantinos S

    2016-09-01

    This Letter proposes an end-to-end mobile tele-echography platform using a portable robot for remote cardiac ultrasonography. Performance evaluation investigates the capacity of long-term evolution (LTE) wireless networks to facilitate responsive robot tele-manipulation and real-time ultrasound video streaming that qualifies for clinical practice. Within this context, a thorough video coding standards comparison for cardiac ultrasound applications is performed, using a data set of ten ultrasound videos. Both objective and subjective (clinical) video quality assessment demonstrate that H.264/AVC and high efficiency video coding standards can achieve diagnostically-lossless video quality at bitrates well within the LTE supported data rates. Most importantly, reduced latencies experienced throughout the live tele-echography sessions allow the medical expert to remotely operate the robot in a responsive manner, using the wirelessly communicated cardiac ultrasound video to reach a diagnosis. Based on preliminary results documented in this Letter, the proposed robotised tele-echography platform can provide for reliable, remote diagnosis, achieving comparable quality of experience levels with in-hospital ultrasound examinations.

  1. Assigning sex and reproductive stage to adult Lake Sturgeon using ultrasonography and common morphological measurements

    USGS Publications Warehouse

    Chiotti, Justin A.; Boase, James C.; Hondorp, Darryl W.; Briggs, Andrew S.

    2016-01-01

    Sex determination of fish species is difficult to assess when sexual dimorphism and gametes are not apparent. For threatened and endangered fish species, noninvasive techniques are needed when determining sex to minimize stress and the potential for mortality. We evaluated the use of a portable ultrasound unit to determine sex of Lake Sturgeon Acipenser fulvescens in the field. Ultrasound images were collected from 9 yellow-egg (F2, F3), 32 black-egg (F4, F5), and 107 fully developed male (M2) Lake Sturgeon. Two readers accurately assigned sex to 88–96% of fish, but accuracy varied in relation to maturity stage. Black-egg females and fully developed males were correctly identified for 89–100% of the fish sampled, while these two readers identified yellow-egg females only 33% and 67% of the time. Time spent collecting images ranged between 2 and 3 min once the user was comfortable with operating procedures. Discriminant analysis revealed the total length : girth ratio was a strong predictor of sex and maturity, correctly classifying 81% of black-egg females and 97% of the fully developed males. However, yellow-egg females were incorrectly classified on all occasions. This study shows the utility of using ultrasonography and a total length : girth ratio for sex determination of Lake Sturgeon in later reproductive stages around the spawning season.

  2. Birth weight from pregnancies dated by ultrasonography in a multicultural British population.

    PubMed

    Wilcox, M; Gardosi, J; Mongelli, M; Ray, C; Johnson, I

    1993-09-04

    A new set of standard curves of birth weight for singleton pregnancies with gestational age dated by ultrasonography was generated for the British population. The source of data was a computerized obstetric database of 41,718 pregnancies delivered between 168 and 300 days' gestation, taken from 3 large maternity units in East Midlands, the Nottingham University and City Hospitals, and Derby City Hospital. There were significant differences between the birthweights of 37,336 babies of mothers of English-European origin (3357 gm), 1008 babies of Afro-Caribbean origin (3173 gm), and 1547 babies of Indian subcontinent origin (3096 gm). There were also significant differences between ethnic groups for gestational length, parity, maternal height, weight, and smoking. These differences were greater than smoking was controlled. The effect of smoking was dose-related: at 40 weeks' gestation mean birthweights were 3580 gm for nonsmokers, 3416 gm for 1-9 cigarettes daily, 3374 gm for 10-19 cigarettes daily, and 3377 gm, for over 20 cigarettes daily. About 30% of the European and Afro-Caribbean women smoker, but almost none of the east Indians did. As had been seen elsewhere, ultrasound dating showed a lower gestational age than did menstrual dating (276 vs. 279 days), a discrepancy that is most likely to be clinically relevant in postdate gestations. While ultrasound dating is much more accurate, ethnic origin must be taken into account when assessing individuals.

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

    PubMed

    Querol, F; Rodriguez-Merchan, E C

    2012-05-01

    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.

  4. Ultrasonography Guided Fine Needle Aspiration Cytology with Preparation of Cell Blocks in the Diagnosis of Intra- Abdominal Masses

    PubMed Central

    Muniyappa, Bharathi

    2015-01-01

    Background Ultrasonography guided Fine Needle Aspiration Cytology (FNAC) is currently the most favoured and increasingly used pre-operative diagnostic procedure in various deep seated neoplastic and non-neoplastic mass lesions. Cell blocks prepared from residual fine needle aspiration (FNA) material can aid in better morphologic assessment and contribute to establish a more definitive cytopathologic diagnosis. Aim To assess the value of ultrasonography guided FNAC in the diagnosis of intra-abdominal (non-pelvic) masses. Objectives To determine the reliability of ultrasonography guided FNAC in distinguishing neoplastic from non-neoplastic intra-abdominal mass lesions. To assess the usefulness of cell block as a complimentary diagnostic material in the morphologic evaluation of the lesions. Materials and Methods Aspirate material was collected from 62 patients with clinically and/or radiologically detected abdominal mass under ultrasonographic (USG) guidance. Pelvic masses were excluded from the study. In every case an attempt was made to prepare cell block (CB) from any residual material after preparation of routine smears. The final cytomorphologic diagnosis was correlated with clinical and radiologic findings, histopathologic diagnosis, follow up and response to therapy information. Results The diagnostic yield of USG guided FNAC was 96.77%. The cases included 42 malignant (67.74%), two (3.23%) benign, and 16 (25.8%) non-neoplastic lesions. Two (3.23%) smears were unsatisfactory for evaluation. In 45 out of 62 cases (72.58%) CB preparations were available. There was a good agreement between smear diagnosis and that observed on CB section. Additionally CB yielded better diagnostic material in 15.55% of cases and aided in establishing a more precise final cytopathologic diagnosis. Confirmation of diagnosis in the form of biopsy and/or surgically resected specimen and follow up was available in 56 cases. The overall diagnostic accuracy of USG guided FNAC was 96

  5. Does normal thyroid gland by ultrasonography match with normal serum thyroid hormones and negative thyroid antibodies?

    PubMed

    Trimboli, P; Rossi, F; Condorelli, E; Laurenti, O; Ventura, C; Nigri, G; Romanelli, F; Guarino, M; Valabrega, S

    2010-10-01

    Few papers have shown that a hypoechoic appearance of the thyroid gland at ultrasonography (US) is related to a hypofunction and serum positivity of thyroid antibodies (T-Ab). However, it is not ascertained if normal thyroid appearance at US correspond to normal thyroid laboratory tests. The aim of this study was to assess the value of normal thyroid at US in predicting normal thyroid hormones and negative T-Ab in a cohort of 48 adult patients. All patients (37 females and 11 males) were referred to our hospital to undergo their first thyroid US examination, followed by a thyroid function evaluation. All subjects had normal thyroid gland at US. As a control group 65 patients with hypoechoic and inhomogeneous thyroid gland were enrolled. All 48 patients had normal free-T (3) and free-T (4) levels. While 41 patients (85.4%) showed normal TSH, in 7 subjects (14.6%) TSH was elevated and a significant (p < 0.001) difference was recorded between the two groups in mean TSH value. Positive T-Ab value was found in 5 patients (10.4%) and the remaining 43 patients (89.6%) had negative T-Ab. TSH was not significantly correlated with age, thyroid volume or BMI. The multivariate model showed that only BMI was significantly correlated to thyroid volume (p < 0.01, r(2)=0.31). These results showed that normal thyroid recorded by US matches with normal thyroid laboratory assessment to a large degree. These preliminary data need to be confirmed in a prospective study and in a larger series and should suggest the evaluation of thyrotropin and thyroid antibodies in subjects with normal thyroid gland as assessed by US.

  6. Contrast-enhanced ultrasonography of the hepatic vein in normal dogs

    PubMed Central

    MORISHITA, Keitaro; HIRAMOTO, Akira; OSUGA, Tatsuyuki; LIM, Sue Yee; KHOIRUN, Nisa; SASAKI, Noboru; NAKAMURA, Kensuke; OHTA, Hiroshi; YAMASAKI, Masahiro; TAKIGUCHI, Mitsuyoshi

    2016-01-01

    Contrast-enhanced ultrasonography (CEUS) of the hepatic vein can assess intrahepatic hemodynamic changes and has been studied as a noninvasive method to assess the severity of portal hypertension and hepatic fibrosis in humans. However, few reports have described its usefulness in veterinary medicine. The purpose of this study was to characterize CEUS findings of the hepatic vein in normal dogs and assess the repeatability of this method both in a conscious group (n=6) and a sedated group (n=6). Sonazoid® (0.01 ml/kg) was used as a contrast agent, and scanning of the hepatic vein was performed for 2 min. Time-intensity curves were generated from regions of interest in the hepatic vein. Four perfusion parameters were measured for quantitative analysis: hepatic vein arrival time (HVAT), time to peak (TTP), time to peak phase (TTPP) and wash-out ratio (WR). CEUS examinations were performed three times in each dog. The median (range) values of HVAT, TTP, TTPP and WR in the conscious group were 13.5 sec (9–22 sec), 12.5 sec (6–24 sec), 8 sec (6–13 sec) and 78.0% (60.7–91.7%), respectively. Median (range) values of HVAT, TTP, TTPP and WR in the sedated group were 12 sec (8–17 sec), 12.5 sec (9–17 sec), 9 sec (7–13 sec) and 84.1% (63.0–94.4%), respectively. The coefficients of variation of these parameters in the conscious and sedated groups were 7.6–29.7% and 11.8–14.8%, respectively. PMID:27534912

  7. Relationship Between Near-Infrared Spectroscopy and Transabdominal Ultrasonography: Noninvasive Monitoring of Intestinal Function in Neonates

    PubMed Central

    Akotia, Devang H.; Durham, Jayson T.; Arnell, Kathy M.; Petruzelli, Deborah L.; Katheria, Anup C.

    2016-01-01

    Background Near-infrared spectroscopy (NIRS) has the potential to continuously and noninvasively monitor intestinal function. This technology may be valuable because among neonates, intestinal maturity is highly variable and difficult to assess based solely on clinical signs. The aim of this study was to determine if there is an association between NIRS-based StO2 measurements and peristaltic activity assessed by transabdominal ultrasonography (US). Material/Methods Nineteen neonates of gestational age >32 weeks were categorized according to “no/low” versus “normal/hyperactive” motility levels, based on blinded US scan results. StO2 was recorded every 2 s for 24 h, following the ultrasound recording. Differences between the resulting estimates of average StO2 (bias of fits) and goodness-of-fit (residuals) were evaluated. Results Newborns with normal/hyperactive motility had higher mean StO2 than newborns with no/low motility (72.3±4.4 vs. 65.5±7.9, p<0.05, F=5.65). Residual errors were not significantly different between the 2 groups (p=0.213, F=0.213). A multivariate linear regression model using the means, residuals, and pairwise products of both, demonstrated more significant separation (0.47±0.26 vs. −0.24±0.33, p<0.01, F=27.4). A non-linear variant of the multivariate linear regression model demonstrated greatest separation (0.68±0.24 vs. −0.49±0.53, p<0.01, F=41.9). Conclusions This is the first study to demonstrate an association between NIRS-based StO2 measurements and peristaltic activity visualized by ultrasound imaging. NIRS may offer a continuous, noninvasive method to assess motility. This may have significant implications in premature infants at risk for feeding intolerance or necrotizing enterocolitis. PMID:26736134

  8. Ultrasonography of entheseal insertions in the lower limb in spondyloarthropathy

    PubMed Central

    Balint, P; Kane, D; Wilson, H; McInnes, I; Sturrock, R

    2002-01-01

    Objective: To compare ultrasonography (US) with clinical examination in the detection of entheseal abnormality of the lower limb in patients with spondyloarthropathy (SpA). Methods: 35 patients with SpA (ankylosing spondylitis 27; psoriatic arthritis 7; reactive arthritis 1) underwent independent clinical and ultrasonographic examination of both lower limbs at five entheseal sites—superior pole and inferior pole of patella, tibial tuberosity, Achilles tendon, and plantar aponeurosis. US was performed using an ATL (Advanced Technology Laboratories, Bothell, Washington, USA) high definition imaging 3000 machine with linear 7–4 MHz and compact linear 10–5 MHz probes to detect bursitis, structure thickness, bony erosion, and enthesophyte (bony spur). An enthesitis score was formulated from these US findings giving a possible maximum total score of 36. Results: On clinical examination 75/348 (22%) entheseal sites were abnormal and on US examination 195/348 (56%) sites were abnormal. In 19 entheseal sites with bursitis on US, only five were detected by clinical examination. Compared with US, clinical examination had a low sensitivity (22.6%) and moderate specificity (79.7%) for the detection of enthesitis of the lower limbs. There was no significant correlation between the US score of enthesitis and acute phase parameters such as erythrocyte sedimentation rate (ESR) or C reactive protein (CRP). The intraobserver κ value for analysis of all sites was 0.9. Conclusions: Most entheseal abnormality in SpA is not detected at clinical examination. US is better than clinical examination in the detection of entheseal abnormality of the lower limbs in SpA. A quantitative US score of lower limb enthesitis is proposed but further studies are required to validate it in SpA. PMID:12228161

  9. Contrast-enhanced harmonic endoscopic ultrasonography of solid pancreatic lesions.

    PubMed

    Kwek, Boon Eu Andrew; Ang, Tiing Leong; Seo, Dong Wan; Imazu, Hiroo

    2013-07-01

    Endoscopic ultrasonography is the best modality for pancreatic lesion evaluation as its superior spatial resolution allows small lesions to be identified and fine needle aspiration (FNA) cytology performed under ultrasound-guidance. Despite this, differentiating benign from malignant lesions remains a challenge as conventional ultrasound imaging is unable to differentiate lesions accurately and tissue yield is poorly diagnostic or limited in patients with the chronic inflammation. Contrast-harmonic technology uses a wide-band transducer capable of inducing sufficient acoustic energy to create harmonic microbubble oscillations of the newer second-generation ultrasound contrast agents (UCAs). These microbubbles are more stable, remaining within the intravascular component longer and emit significantly more harmonic content than surrounding tissue, thus allowing pancreatic parenchymal differentiation and microvascular architecture visualization. The use of UCAs is generally safe, but should be especially avoided in patients with unstable ischemic heart disease. During CH endosonography, pancreatic adenocarcinoma is commonly seen as an inhomogenous hypoenhancing lesion, focal pancreatitis as a hypo- or iso-enhancing lesion and neuroendocrine tumor as a hyperenhancing lesion. The presence of hyperenhancement is a strong predictor of non-adenocarcinoma etiology. Furthermore, in patients with the chronic pancreatitis or biliary stents that may obscure pancreatic inspection, the addition of contrast-harmonic endosonography to guide FNA cytology improves its diagnostic yield and accuracy. Quantitative analysis of perfusion through the time intensity curve is promising as an objective and accurate method to differentiate pancreatic lesions. Furthermore, studies are required to fully determine the role of contrast harmonic endosonography in the differential diagnosis of solid pancreatic lesions.

  10. [Operative ultrasonography of the brain and spinal cord pathology].

    PubMed

    Machi, J; Sigel, B; Menoni, R; Jafar, J J; Beitler, J C; Crowell, R M

    1984-07-01

    B-mode real-time ultrasound using 5 or 7.5 MHz transducer has been employed during 21 operations for brain pathology and spinal cord lesions. Ultrasonic scanning was performed at the following operations: 10 brain tumors (4 glioblastomas multiforme, 2 astrocytomas, 1 medulloblastoma, 2 metastatic tumors), 2 brain cysts (arachnoid, epidermoid), 1 tuberculous abscess, 3 cerebral hematomas: 2 spinal cord tumors (malignant melanoma, glioma), 2 syringomyelias, 1 posterior longitudinal ligament thickening. Operative ultrasound was useful prior to dural incisions and particularly for subcortical lesions. In addition, ultrasound provided assistance at spinal cord surgery. Our experience has been reviewed and summarized in this report in terms of specific usefulness of assistance of this method which has proven helpful to the neurosurgeons. The types of assistance provided by operative ultrasonography include: Location of dural incision. Localization of brain and spinal cord lesions prior to biopsy. Diagnosis which has not been made preoperatively (e.g. necrosis or cystic area in tumor). Consistency of each lesion (e.g. solid or cystic, necrosis, loculation). Size, extent and depth of brain tumor, cyst, abscess and hematoma. Presence and extent of spinal cord syrinx. Relation of tumor to spinal cord and dura. Access route for biopsy and drainage (avoiding critical areas such as motor strip). Exclusion of bleeding or hematoma following biopsy. Confirmation of the effectiveness of drainage or resection of lesions. Relationship between pathology and surrounding anatomic structures. A number of important assistance by the utilization of ultrasound during neurological surgery have been identified.(ABSTRACT TRUNCATED AT 250 WORDS)

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

    SciTech Connect

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

    2008-01-15

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

  12. Contrast-enhanced ultrasonography to diagnose complicated acute cholecystitis.

    PubMed

    Sagrini, Elisabetta; Pecorelli, Anna; Pettinari, Irene; Cucchetti, Alessandro; Stefanini, Federico; Bolondi, Luigi; Piscaglia, Fabio

    2016-02-01

    Gangrenous cholecystitis and perforation are severe complications of acute cholecystitis, which have a challenging preoperative diagnosis. Early identification allows better surgical management. Contrast-enhanced computed tomography (ceCT) is the current diagnostic gold standard. Contrast-enhanced ultrasonography (CEUS) is a promising tool for the diagnosis of gallbladder perforation, but data from the literature concerning efficacy are sparse. The aim of the study was to evaluate CEUS findings in pathologically proven complicated cholecystitis (gangrenous, perforated gallbladder, pericholecystic abscess). A total of 8 patients submitted to preoperative CEUS, and with subsequent proven acute complicated cholecystitis at surgical inspection and pathological analysis, were retrospectively identified. The final diagnosis was gangrenous/phlegmonous cholecystitis (n. 2), phlegmonous/ulcerative changes plus pericholecystic abscess (n. 2), perforated plus pericholecystic abscess (n. 3), or perforated plus pericholecystic biliary collection (n. 1). Conventional US findings revealed irregularly thickened gallbladder walls in all 8 patients, with vaguely defined walls in 7 patients, four of whom also had striated wall thickening. CEUS revealed irregular enhancing gallbladder walls in all patients. A distinct wall defect was seen in six patients, confirmed as gangrenous/phlegmonous cholecystitis at pathology in all six, and in four as perforation at macroscopic surgical inspection. CEUS is a non-invasive easily repeatable technique that can be performed at the bedside, and is able to accurately diagnose complicated/perforated cholecystitis. Despite the limited sample size in the present case series, CEUS appears as a promising tool for the management of patients with the clinical possibility of having an acute complicated cholecystitis.

  13. Accuracy of endoscopic ultrasonography for diagnosing ulcerative early gastric cancers

    PubMed Central

    Park, Jin-Seok; Kim, Hyungkil; Bang, Byongwook; Kwon, Kyesook; Shin, Youngwoon

    2016-01-01

    Abstract Although endoscopic ultrasonography (EUS) is the first-choice imaging modality for predicting the invasion depth of early gastric cancer (EGC), the prediction accuracy of EUS is significantly decreased when EGC is combined with ulceration. The aim of present study was to compare the accuracy of EUS and conventional endoscopy (CE) for determining the depth of EGC. In addition, the various clinic-pathologic factors affecting the diagnostic accuracy of EUS, with a particular focus on endoscopic ulcer shapes, were evaluated. We retrospectively reviewed data from 236 consecutive patients with ulcerative EGC. All patients underwent EUS for estimating tumor invasion depth, followed by either curative surgery or endoscopic treatment. The diagnostic accuracy of EUS and CE was evaluated by comparing the final histologic result of resected specimen. The correlation between accuracy of EUS and characteristics of EGC (tumor size, histology, location in stomach, tumor invasion depth, and endoscopic ulcer shapes) was analyzed. Endoscopic ulcer shapes were classified into 3 groups: definite ulcer, superficial ulcer, and ill-defined ulcer. The overall accuracy of EUS and CE for predicting the invasion depth in ulcerative EGC was 68.6% and 55.5%, respectively. Of the 236 patients, 36 patients were classified as definite ulcers, 98 were superficial ulcers, and 102 were ill-defined ulcers, In univariate analysis, EUS accuracy was associated with invasion depth (P = 0.023), tumor size (P = 0.034), and endoscopic ulcer shapes (P = 0.001). In multivariate analysis, there is a significant association between superficial ulcer in CE and EUS accuracy (odds ratio: 2.977; 95% confidence interval: 1.255–7.064; P = 0.013). The accuracy of EUS for determining tumor invasion depth in ulcerative EGC was superior to that of CE. In addition, ulcer shape was an important factor that affected EUS accuracy. PMID:27472672

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

    PubMed

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

    2012-01-01

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

  15. Transperineal ultrasonography in stress urinary incontinence: The significance of urethral rotation angles

    PubMed Central

    Al-Saadi, Wasan Ismail

    2015-01-01

    Objective To assess, using transperineal ultrasonography (TPUS), the numerical value of the rotation of the bladder neck [represented by the difference in the anterior (α angle) and posterior urethral angles (β angle)] at rest and straining, in continent women and women with stress urinary incontinence (SUI), to ascertain if there are significant differences in the angles of rotation (Rα and Rβ) between the groups. Patients, subjects and methods In all, 30 women with SUI (SUI group) and 30 continent women (control group) were included. TPUS was performed at rest and straining (Valsalva manoeuver), and the threshold value for the urethral angles (α and β angles) for each group were estimated. The degree of rotation for each angle was calculated and was considered as the angle of rotation. Results Both the α and β angles were significantly different between the groups at rest and straining, and there was a significant difference in the mean increment in the value of each angle. Higher values of increment (higher rotation angles) were reported in the SUI group for both the α and β angles compared with those of the control group [mean (SD) Rα SUI group 19.43 (12.76) vs controls 10.53 (2.98) °; Rβ SUI group 28.30 (12.96) vs controls 16.33 (10.8) °; P < 0.001]. Conclusion Urethral rotation angles may assist in the assessment and diagnosis of patients with SUI, which may in turn reduce the need for more sophisticated urodynamic studies. PMID:26966596

  16. Ultrasonography in the evaluation of the mid-palatal suture in rapid palatal expansion

    PubMed Central

    Gumussoy, I; Bayrakdar, I S; Dagistan, S; Caglayan, F

    2014-01-01

    Objectives: Orthodontists usually evaluate the mid-palatal sutural opening with occlusal radiography. The purpose of this article is to evaluate the sutural opening with ultrasonography (USG) in a series of patients undergoing rapid palatal expansion (RPE). Methods: The study included 87 USG images and 87 occlusal radiographs from 29 healthy patients (mean age, 13.9 years; range, 11–20 years; boys, 12; girls, 17) who required RPE treatment. The sutural opening was assessed with USG, and the amount of sutural expansion as mesiodistal length was measured immediately after appliance practice (T0), 10 turns (T1) and 20 turns (T2) during the expansion period. Sutural expansion evaluated by occlusal radiographs was scored at every stage. Measurements obtained by USG and scores observed in the occlusal radiographs were compared by non-parametric Kendall's tau test. Results: Both USG and radiographic images revealed normal anatomical structure during pre-expansion (stage T0). On USG, sutural expansion was seen in 19 patients at stage T1. There was no expansion at this stage in ten patients. At stage T2, on USG and radiography, an increase in the amount of expansion was observed in 19 patients with sutural expansion at stage T1 and sutural expansion was observed in 5 patients without sutural expansion at stage T1. No expansion was observed at both stages T1 and T2 in five patients. USG measurements and occlusal scores in both T1 and T2 turns showed statistically significant correlation (p < 0.001). Conclusions: The results indicate that USG might be a useful method to assess mid-palatal sutural opening in patients undergoing RPE. PMID:25168810

  17. COMPARATIVE ANALYSIS OF PREOPERATIVE ULTRASONOGRAPHY REPORTS WITH INTRAOPERATIVE SURGICAL FINDINGS IN CHOLELITHIASIS

    PubMed Central

    KREIMER, Flávio; CUNHA, Daniel José Dias; FERREIRA, Carolina Cavalcanti Gonçalves; RODRIGUES, Thais Menezes; FULCO, Lucas Gomes de Morais; GODOY, Eduardo Sávio Nascimento

    2016-01-01

    Background: Laparoscopic cholecystectomy is widely used for cholelithiasis. Abdominal ultrasonography often precedes this operation and can prove diagnosis, as well as helps in showing possible complications during the perioperative period. Aim: Evaluate the description of variables of gallbladder and bile ducts present in reports of preoperative abdominal ultrasonography in cholelithiasis comparing with surgical findings. Methods: Were studied 91 patients who underwent elective laparoscopic cholecystectomy with previous abdominal ultrasonography. Variables such as identification and amount of gallstones involved were evaluated, both in preoperative ultrasonography and during surgery to evaluate sensitivity, specificity, concordance and positive and negative predictive values. Results: The reports did not mention diameter of vesicular light (98.9%), organ distension (62.6%), gallstone sizes (58.2%), wall thickness (41.8%) and evaluation of the common bile duct (39.6%). Ultrasound had high values for sensitivity, consistency and positive predictive value for identifying the presence/absence of gallstones: 98.8%, 96.7% and 97.8% respectively. As for the amount of stones, ultrasonography showed agreement in 82.7%, negative predictive value in 89.1% and specificity in 87.7%, with lower values for sensitivity (68.2%) and positive predictive value (65.2%). Conclusions: The ultrasound reports were flawed in standardization. Significant percentage of them did not have variables that could predict perioperative complications and surgical conversion. PMID:27120735

  18. Accuracy of ultrasonography and pregnancy-associated glycoprotein test for pregnancy diagnosis in buffaloes.

    PubMed

    Karen, A; Darwish, S; Ramoun, A; Tawfeek, K; Van Hanh, N; de Sousa, N M; Sulon, J; Szenci, O; Beckers, J F

    2007-11-01

    The aims of the present study were to evaluate and compare the accuracy of transrectal ultrasonography and pregnancy-associated glycoprotein radioimmunoassay (PAG-RIA) test for diagnosis of pregnancy in buffaloes. Two hundred and seventy-five buffalo cows and heifers were examined once for pregnancy diagnosis by transrectal ultrasonography using a 5 MHz linear-array transducer between Days 19 and 55 after mating. After ultrasound scanning, a blood sample was withdrawn from jugular vein of each animal for measuring pregnancy-associated glycoprotein using a heterologous double-antibody RIA. Based on palpation of the uterus per rectum at Days 75-90, 87 animals were designated pregnant and 188 as non-pregnant. The sensitivity of transrectal ultrasonography at Days 19-24 was 44.4%, reaching 100% from Day 31 after mating. The specificity of transrectal ultrasonography ranged between 92.5 and 100% from Days 19 to 55 after mating. The sensitivity of PAG-RIA test was 11.1% at Days 19-24 and reached 100% from Day 31 after mating. The specificity of PAG-RIA test ranged from 90 to 100% from Days 19 to 55 after mating. There were no significant differences between the sensitivity and specificity of the two tests in all examined periods. In conclusion, transrectal ultrasonography and PAG-RIA test are highly accurate tests for detecting pregnant buffaloes from Day 31 after mating onwards.

  19. Screening Characteristics of Bedside Ultrasonography in Confirming Endotracheal Tube Placement; a Diagnostic Accuracy Study

    PubMed Central

    Zamani Moghadam, Hamid; Sharifi, Mohamad Davood; Rajabi, Hasan; Mousavi Bazaz, Mojtaba; Alamdaran, Ali; Jafari, Niazmohammad; Hashemian, Seyed Amir Masoud; Talebi Deloei, Morteza

    2017-01-01

    Introduction: Confirmation of proper endotracheal tube placement is one of the most important and lifesaving issues of tracheal intubation. The present study was aimed to evaluate the accuracy of tracheal ultrasonography by emergency residents in this regard. Method: This was a prospective, cross sectional study for evaluating the diagnostic accuracy of ultrasonography in endotracheal tube placement confirmation compared to a combination of 4 clinical confirmation methods of chest and epigastric auscultation, direct laryngoscopy, aspiration of the tube, and pulse oximetry (as reference test). Results: 150 patients with the mean age of 58.52 ± 1.73 years were included (56.6% male). Sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratio of tracheal ultrasonography in endotracheal tube confirmation were 96 (95% CI: 92-99), 88 (95% CI: 62-97), 98 (95% CI: 94-99), 78 (95% CI: 53-93), 64 (95% CI: 16-255), and 0.2 (95% CI: 0.1-0.6), respectively. Conclusion: The present study showed that tracheal ultrasonography by trained emergency medicine residents had excellent sensitivity (>90%) and good specificity (80-90) for confirming endotracheal tube placement. Therefore, it seems that ultrasonography is a proper screening tool in determining endotracheal tube placement. PMID:28286826

  20. Ultrasonography of Leprosy Neuropathy: A Longitudinal Prospective Study

    PubMed Central

    Frade, Marco Andrey Cipriani; Marques-Jr, Wilson; Foss, Norma Tiraboschi

    2016-01-01

    Background Previous studies have shown that leprosy multi-drug therapy (MDT) does not stop the progression of nerve function impairment. There are no prospective studies investigating the evolution of nerve anatomic abnormalities after treatment. We examined leprosy patients aiming to investigate the evolution of nerve ultrasonography (US) abnormalities and the risk factors for poor outcomes after MDT. Methodology/Principal findings We performed bilateral US of the ulnar (U), median (M) and common fibular (CF) nerves in 9 paucibacillary (PB) and 64 multibacillary (MB) patients before and after MDT. Forty-two patients had leprosy reactions (type 1, type 2, acute neuritis) during the study. We analyzed nerve maximum cross-sectional areas (CSA), echogenicity and Doppler signal. Poor outcomes included a post-treatment CSA above normal limits with a reduction of less than 30% (U, M) or 40% (CF) from the baseline, echogenicity abnormalities or intraneural Doppler in the post-treatment study. We found that PB and patients without reactions showed significant increases in CSA at CF, whereas MB and patients with reactions had CSA reduction in some nerves after treatment (p<0.05). Despite this reduction, we observed a greater frequency of poor CSA outcomes in the MB compared to the PB (77.8% and 40.6%; p>0.05) and in the patients with reactions compared to those without (66.7% and 38.7%; p<0.05). There was significantly higher odds ratio (7.75; 95%CI: 1.56–38.45) for poor CSA outcomes only for M nerve in patients with reactions. Poor echogenicity outcomes were more frequent in MB (59.4%) compared to PB (22.2%) (p<0.05). There was significant association between poor Doppler outcomes and neuritis. Gender, disease duration, and leprosy classification were not significant risk factors for poor outcomes in CSA, echogenicity or Doppler. Conclusions/Significance US nerve abnormalities can worsen after treatment despite the leprosy classification or the presence of reactions

  1. Comparison of ultrasonography, computerized tomography, and radionuclide imaging in the diagnosis of acute and chronic cholecystitis

    SciTech Connect

    Matolo, N.M.; Stadalnik, R.C.; McGahan, J.P.

    1982-12-01

    Seventy-five patients with abdominal pain in the right upper quadrant who were subsequently confirmed operatively and histologically to have acute or chronic cholecystitis underwent radionuclide imaging of the biliary tree, ultrasonography, and/or computerized tomography before operation. fifty-eight of the patients had acute cholecystitis and 17 had chronic cholecystitis and cholelithiasis. Analysis of our data indicates that ultrasonography is an accurate and better screening test than cholescintigraphy in the diagnosis of chronic cholecystitis and cholelithiasis, but it is less accurate in the detection of acute cholecystitis. On the other hand, radionuclide imaging is highly sensitive and specific in the early diagnosis of acute cholecystitis, but it is poor in the diagnosis of chronic cholecystitis and cholelithiasis unless the cystic duct is obstructed. CT scanning is more expensive than ultrasonography but may be extremely helpful in problematic cases such as the diagnosis of the cause in biliary obstruction or in imaging of the pancreas.

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

    PubMed

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

    2015-12-01

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

  3. Hyalinizing trabecular tumor of the thyroid gland: characteristic features on ultrasonography.

    PubMed

    Kobayashi, Kaoru; Hirokawa, Mitsuyoshi; Jikuzono, Tomoo; Fukata, Shuji; Amino, Nobuyuki; Miyauchi, Akira; Nakamura, Yasushi

    2007-03-01

    We report a case of hyalinizing trabecular tumor of the thyroid gland and describe the characteristic ultrasonographic features of this tumor. This was a rare tumor of follicular cell origin with a trabecular pattern of growth and marked intratrabecular hyalinization. The tumor had an irregular shape, a delicately jagged border, and hypoechoic and heterogeneous internal echoes on B-mode ultrasonography. Very rich intratumoral blood flow, the so-called "tumor inferno" was evident on power Doppler ultrasonography. In the clinical management of thyroid nodules, clinicians should be aware of this peculiar type of thyroid tumor and its characteristic ultrasonographic findings.

  4. Specific Challenges in Conducting and Reporting Studies on the Diagnostic Accuracy of Ultrasonography in Bovine Medicine.

    PubMed

    Buczinski, Sébastien; O'Connor, Annette M

    2016-03-01

    Ultrasonography is used by bovine practitioners more for reproductive issues than as a diagnostic test for medical and surgical diseases. This article reviews the specific challenges and standards concerning reporting of studies on diagnostic accuracy of ultrasound in cattle for nonreproductive issues. Specific biases and applicability concerns in studies reporting ultrasonography as a diagnostic test are also reviewed. Better understanding of these challenges will help the practitioner to interpret and apply (or not) diagnostic accuracy study results depending on the field context. Examples of application of sensitivity and specificity results in a clinical context are given using the Bayes theorem.

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

    PubMed Central

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

    2014-01-01

    IMPORTANCE Over 300,000 surgeries are performed annually in the United States for pelvic organ prolapse. Sacrospinous ligament fixation (SSLF) and uterosacral ligament suspension (ULS) are commonly performed transvaginal surgeries to correct apical prolapse. Little is known about their comparative efficacy and safety, and it is unknown whether perioperative behavioral therapy with pelvic floor muscle training (BPMT) improves outcomes of prolapse surgery. OBJECTIVE To compare outcomes between 1) SSLF and ULS and 2) perioperative BPMT and usual perioperative care in women undergoing surgery for vaginal prolapse and stress urinary incontinence. DESIGN, SETTING AND PARTICIPANTS Multi-center, 2×2 factorial randomized trial of 374 women undergoing surgery to treat both apical vaginal prolapse and stress urinary incontinence was conducted between 2008 and 2013 at 9 U.S. medical centers. Two-year follow-up rate was 84.5%. INTERVENTIONS Surgical intervention: Transvaginal surgery including mid-urethral sling with randomization to SSLF (n = 186) or ULS (n=188); Behavioral intervention: Randomization to perioperative BPMT (n = 186) or usual care (n=188). MAIN OUTCOME MEASURES The primary outcome for the surgical intervention (surgical success) was defined as: 1) no apical descent greater than one-third into vaginal canal or anterior or posterior vaginal wall beyond the hymen (anatomic success); 2) no bothersome vaginal bulge symptoms and 3) no retreatment for prolapse at 2 years. For the behavioral intervention, primary outcome at 6 months was urinary symptom scores (Urinary Distress Inventory; range 0–300, higher scores worse), and primary outcomes at 2 years were prolapse symptom scores (Pelvic Organ Prolapse Distress Inventory; range 0–300, higher scores worse) and anatomic success. RESULTS At 2 years, surgical group was not significantly associated with surgical success rates [ULS 59.2% (93/154) vs. SSLF 60.5% (92/152), OR 0.9 (95% CI 0.6, 1.5)] or serious adverse

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

    PubMed Central

    2011-01-01

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

  7. ULTRASONOGRAPHY, AN EFFECTIVE TOOL IN DIAGNOSING PLANTAR FASCIITIS: A SYSTEMATIC REVIEW OF DIAGNOSTIC TRIALS

    PubMed Central

    Wyland, Matthew; Applequist, Lee; Bolowsky, Erin; Klingensmith, Heather; Virag, Isaac

    2016-01-01

    Background Plantar fasciitis (PF) is the most common cause of heel pain that affects 10% of the general population, whether living an athletic or sedentary lifestyle. The most frequent mechanism of injury is an inflammatory response that is caused by repetitive micro trauma. Many techniques are available to diagnose PF, including the use of ultrasonography (US). Purpose The purpose of this study is to systematically review and appraise previously published articles published between the years 2000 and 2015 that evaluated the effectiveness of using US in the process of diagnosing PF, as compared to alternative diagnostic methods. Methods A total of eight databases were searched to systematically review scholarly (peer reviewed) diagnostic and intervention articles pertaining to the ability of US to diagnose PF. Results Using specific key words the preliminary search yielded 264 articles, 10 of which were deemed relevant for inclusion in the study. Two raters independently scored each article using the 15 point modified QUADAS scale. Discussion Six studies compared the diagnostic efficacy of US to another diagnostic technique to diagnose PF, and four studies focused on comparing baseline assessment of plantar fascia before subsequent intervention. The most notable US outcomes measured were plantar fascia thickness, enthesopathy, and hypoechogenicity. Conclusion US was found to be accurate and reliable compared to alternative reference standards like MRI in the diagnosis of PF. The general advantages of US (e.g. cost efficient, ease of administration, non-invasive, limited contraindications) make it a superior diagnostic modality in the diagnosis of PF. US should be considered in rehabilitation clinics to effectively diagnose PF and to accurately monitor improvement in the disease process following rehabilitation interventions. Level of Evidence 1A PMID:27757279

  8. Outcomes of Iodine-125 Plaque Brachytherapy for Uveal Melanoma With Intraoperative Ultrasonography and Supplemental Transpupillary Thermotherapy

    SciTech Connect

    Badiyan, Shahed N.; Rao, Rajesh C.; Apicelli, Anthony J.; Acharya, Sahaja; Verma, Vivek; Garsa, Adam A.; DeWees, Todd; Speirs, Christina K.; Garcia-Ramirez, Jose; Esthappan, Jacqueline; Grigsby, Perry W.; Harbour, J. William

    2014-03-15

    Purpose: To assess the impact on local tumor control of intraoperative ultrasonographic plaque visualization and selective application of transpupillary thermotherapy (TTT) in the treatment of posterior uveal melanoma with iodine-125 (I-125) episcleral plaque brachytherapy (EPB). Methods and Materials: Retrospective analysis of 526 patients treated with I-125 EPB for posterior uveal melanoma. Clinical features, dosimetric parameters, TTT treatments, and local tumor control outcomes were recorded. Statistical analysis was performed using Cox proportional hazards and Kaplan-Meier life table method. Results: The study included 270 men (51%) and 256 women (49%), with a median age of 63 years (mean, 62 years; range, 16-91 years). Median dose to the tumor apex was 94.4 Gy (mean, 97.8; range, 43.9-183.9) and to the tumor base was 257.9 Gy (mean, 275.6; range, 124.2-729.8). Plaque tilt >1 mm away from the sclera at plaque removal was detected in 142 cases (27%). Supplemental TTT was performed in 72 patients (13.7%). One or 2 TTT sessions were required in 71 TTT cases (98.6%). After a median follow-up of 45.9 months (mean, 53.4 months; range, 6-175 months), local tumor recurrence was detected in 19 patients (3.6%). Local tumor recurrence was associated with lower dose to the tumor base (P=.02). Conclusions: Ultrasound-guided plaque localization of I-125 EPB is associated with excellent local tumor control. Detection of plaque tilt by ultrasonography at plaque removal allows supplemental TTT to be used in patients at potentially higher risk for local recurrence while sparing the majority of patients who are at low risk. Most patients require only 1 or 2 TTT sessions.

  9. Scientific publications in endoscopic ultrasonography: changing trends in the third millennium.

    PubMed

    Fusaroli, Pietro; Kypreos, Dimitrios; Alma Petrini, Chiara Ada; Caletti, Giancarlo

    2011-01-01

    The literature about endoscopic ultrasonography (EUS) is still very prolific although it was introduced in the early 1980s. We aimed to review last decade's scientific production and to compare it with our earlier data about the period from 1980 to 2000. EUS publications of the period January 2001 to January 2010 were retrieved. Reviews, prospective, and retrospective studies, randomized controlled trials, meta-analyses, surveys, guidelines, and case-series were assessed. Data were collected on the subject-matter, type of publication, number of patients included, publishing journal, most recent impact factor, year of publication, and country accredited for publication. A total of 1763 relevant papers were published in more than 250 journals. The main areas of research were pancreatic disorders, tumors of the gastrointestinal wall, the extrahepatic biliary tree, submucosal lesions, lung cancer, and mediastinal masses. It is interesting to note that the therapeutic applications of EUS accounted for a new field of investigation. The majority of articles comprised retrospective trials and reviews, followed by prospective studies and case series. However, a considerable number of randomized controlled trials and meta-analyses was retrieved, which were absent in the earlier survey. United States, Europe, and Japan still possessed a pivotal role on EUS research, but an increasing number of publications has also emerged from other countries. The available literature on EUS keeps expanding, encompassing not only its well-established diagnostic role, but also novel indications and therapeutic interventions. EUS has evolved into a valuable implement of modern clinical practice, with a critical effect on patients' management. A trend toward well-structured studies is evident.

  10. Impact of endoscopic ultrasonography and physician specialty on the management of patients with esophagus cancer.

    PubMed

    Gines, A; Cassivi, S D; Martenson, J A; Schleck, C; Deschamps, C; Sinicrope, F A; Alberts, S R; Murray, J A; Zinsmeister, Alan R; Vazquez-Sequeiros, Enrique; Nichols, F C; Miller, R C; Quevedo, J F; Allen, M S; Alexander, J A; Zais, T; Haddock, M G; Romero, Y

    2008-01-01

    While endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) are the most accurate techniques for locoregional staging of esophageal cancer, little evidence exists that these innovations impact on clinical care. The objective on this study was to determine the frequency with which EUS and EUS-FNA alter the management of patients with localized esophageal cancer, and assess practice variation among specialists at a tertiary care center. Three gastroenterologists, three medical oncologists, three radiation oncologists and four thoracic surgeons were asked to independently report their management recommendations as the anonymized staging information of 50 prospectively enrolled patients from another study were sequentially disclosed on-line. Compared to initial management recommendations, that were based upon history, physical examination, upper endoscopy and CT scan results, EUS prompted a change in management 24% (95% CI: 12-36%) of the time; usually to a more resource-intensive approach (71%), for example from recommending palliation to recommending neoadjuvant chemoradiation therapy. EUS-FNA plus cytology results altered management an additional 8% (95% CI: 6-15%) of the time. Agreement between specialists ranged from fair (intraclass correlation [ICC=0.32) to substantial (ICC=0.65); improving with additional information. Among specialists, agreement was greatest for patients with stage I disease. EUS and EUS-FNA changed patient management the most for patients with stages IIA, IIB or III disease. EUS, with or without FNA, significantly impacts the management of patients with localized esophageal cancer. With respect to the optimal treatment for each patient, agreement among physicians incrementally increases with endoscopic ultrasound results. Specialty training appears to influence therapeutic decision-making behavior.

  11. Radiofrequency ablation of benign thyroid nodules: evaluation of the treatment efficacy using ultrasonography

    PubMed Central

    2016-01-01

    Purpose: The aim of this study was to evaluate the efficacy of radiofrequency (RF) ablation for benign thyroid nodules and assess the usefulness of internal factors (ultrasonographic findings) and external factors (treatment-related findings) in prediction of treatment efficacy. Methods: We evaluated 22 benign thyroid nodules from 19 patients treated with RF ablation between March 2010 and January 2013. The internal and external factors of these nodules were retrospectively reviewed and correlated with the therapeutic success and the volume reduction ratio (VRR). The volume and size of the nodules were determined before treatment, and the VRR was calculated at 6-month and 1-year follow-up examinations after RF ablation. Therapeutic success was defined as a >50% volume reduction. Results: The mean VRRs were 66.1±18.7% at 6 months and 74.3±16.7% at 1 year. The therapeutic success rate after 6 months and 1 year was 81.8% and 90.9%, respectively. At the 1-year follow-up, the margin of the nodule correlated with therapeutic success. Most of the successfully ablated nodules showed well-defined margins on initial ultrasonography (18/20, 90%) (P=0.026). In addition, nodules with ill-defined margins showed a tendency toward having a low VRR at the 6-month and 1-year follow-up examinations. Conclusion: RF ablation was effective in decreasing the volume of benign thyroid nodules. Thyroid nodules with well-defined margins tended to show successful outcomes at the 1-year follow-up examination after RF ablation. PMID:27101983

  12. The effects of twisting and type of aspiration needle on the efficiency of transvaginal ultrasound-guided ovum pick-up in cattle.

    PubMed

    Sasamoto, Yoshihiko; Sakaguchi, Minoru; Katagiri, Seiji; Yamada, Yutaka; Takahashi, Yoshiyuki

    2003-10-01

    The effects of twisting and type (single- or double-lumen) of aspiration needle on the efficiency of transvaginal ultrasound-guided ovum pick-up (US-guided OPU) were investigated in cattle. The first study using slaughterhouse ovaries revealed that twisting of the needle during follicle aspiration improved the oocyte recovery rate without deleterious effects on the attachment of cumulus layers. Vacuum pressure affected the oocyte recovery and cumulus attachment, regardless of the needle type. The needle type did not affect the oocyte recovery or cumulus attachment with an optimized vacuum pressure. In the second study, US-guided OPU was performed in live cows using two types of needles with a vacuum pressure of 75 mmHg. The needle type did not affect the oocyte recovery or cumulus attachment of the recovered oocytes. The results revealed that twisting of the needle is effective in follicle aspiration, and suggested that a single-lumen needle is as useful as a double-lumen needle for US-guided OPU in cattle.

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

    ERIC Educational Resources Information Center

    Ivanusic, Jason; Cowie, Brian; Barrington, Michael

    2010-01-01

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

  14. Characterization of bruises using ultrasonography for potential application in diagnosis of child abuse.

    PubMed

    Mimasaka, Sohtaro; Oshima, Toru; Ohtani, Maki

    2012-01-01

    To protect children from abuse, it is important to identify victims at an early date, but diagnosis is often difficult. We used ultrasonography for objective examination of bruises arising from subcutaneous hemorrhages, and determined whether we could precisely measure the depth and thickness of a subcutaneous hemorrhage. We compared macroscopic findings, microscopic findings and ultrasonographic images of 10 bruises in forensic autopsy cases. In addition, we measured chronologic changes in subcutaneous hemorrhages using ultrasonography of 16 bruises in healthy volunteer children. Mild or moderate subcutaneous hemorrhages spreading along the fibrous partition in subcutaneous fatty tissue were observed by histological examination. There was a thickened fibrous partition or an isoechoic or hyperechoic area in the ultrasonographic images. A good correlation between the thickness of the subcutaneous hemorrhages by macroscopic examination and by ultrasonographic imaging was found in postmortem cases. We were also able to confirm objectively that the thickness of the subcutaneous hemorrhage of healthy children decreased with time. It is possible to measure the depth from the skin surface to the subcutaneous hemorrhage, and the thickness of the subcutaneous hemorrhage accurately using ultrasonography. Thus, the age of a bruise can be estimated more precisely using information on the subcutaneous hemorrhage from ultrasonography in addition to established evaluations by the naked eye and by spectrophotometry.

  15. Comparative study between physical examination, electroneuromyography and ultrasonography in diagnosing carpal tunnel syndrome☆☆☆

    PubMed Central

    de Jesus Filho, Arnaldo Gonçalves; do Nascimento, Bruno Fajardo; Amorim, Marcelo de Carvalho; Naus, Ronald Alan Sauaia; Loures, Elmano de Araújo; Moratelli, Lucas

    2014-01-01

    Objective To evaluate the sensitivity of electromyography and ultrasonography in diagnosing carpal tunnel syndrome (CTS), in comparison with physical examination, which is considered to be the gold standard. Methods In this cross-sectional study, the medical files of 56 patients with 70 hands affected by CTS who were attended between March 2010 and June 2012 were reviewed. The study included patients with a clinical diagnosis of CTS. The sensitivity of the complementary examinations was analyzed and compared with physical examination. Results Nocturnal symptoms were found in 96.4%, thenar atrophy in 62.5% and abnormal sense of touch in 50%. The sensitivities found were: ultrasonography, 67.1% (95% CI: 55.7%–78.6%); an association of physical examination tests, 95.7% (95% CI: 90.0%–100%); and electromyography, 98.6% (95% CI: 95.7%–100%). The presence of atrophy, abnormalities of the sense of touch and longer-duration symptoms increased the sensitivity of ultrasonography and physical examination. Conclusion The sensitivity of ultrasonography for CTS was lower than that of electromyography and physical examination. PMID:26229843

  16. Postmortem ultrasonography of the macerated fetus complements autopsy following in utero fetal demise.

    PubMed

    Cain, Mary Ashley; Guidi, Claude B; Steffensen, Thora; Whiteman, Valerie E; Gilbert-Barness, Enid; Johnson, Dennis R

    2014-01-01

    Postmortem evaluation following an in utero fetal demise is essential for determining cause of death and counseling regarding future pregnancies. Severe maceration and fetal size along with patient desires may limit the physician's ability to perform a complete autopsy. In the cases presented, we demonstrate the utility of postmortem ultrasonography as an adjunct to traditional autopsy following fetal demise.

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

    PubMed

    Stevens, Tyler

    2013-10-01

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

  18. Brain Ultrasonography Findings in Neonatal Seizure; a Cross-sectional Study

    PubMed Central

    Nabavi, Seyed Saeed; Partovi, Parinaz

    2017-01-01

    Introduction: Screening of newborns with seizure, who have curable pathologic brain findings, might be able to improve their final outcome by accelerating treatment intervention. The present study aimed to evaluate the brain ultrasonography findings of newborns hospitalized with complaint of seizure. Methods: The present cross-sectional study designed to evaluate brain ultrasonography findings of hospitalized newborns complaining seizure. Neonatal seizure was defined as presence of tonic, clonic, myoclonic, and subtle attacks in 1 - 28 day old newborns. Results: 100 newborns with the mean age of 5.82 ± 6.29 days were evaluated (58% male). Most newborns were in the < 10 days age range (76%), term (83%) and with normal birth weight (81%). 22 (22%) of the ultrasonography examinations showed a pathologic finding. A correlation was only found between birth age and probability of the presence of a pathologic problem in the brain as the frequency of these problems was significantly higher in pre-term newborns (p = 0.023). Conclusion: Based on the findings of the present study, frequency of pathologic findings in neonatal brain ultrasonography was 22%. Hemorrhage (12%) and hydrocephaly (7%) were the most common findings. The only factor correlating with increased probability of positive findings was the newborns being pre-term. PMID:28286848

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

    ERIC Educational Resources Information Center

    Chi-Fishman, Gloria

    2005-01-01

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

  20. [The use of ultrasonography for diagnosing the cause of colic in cows. A review].

    PubMed

    Braun, U; Nuss, K; Knubben-Schweizer, G; Gerspach, C

    2011-01-01

    Ultrasonography is a very useful technique for diagnosing the cause of colic in cows. It allows visualisation of abnormal reticular contour and occasionally of abnormal contractility in cows with reticuloperitonitis. In right-displaced abomasum, the dilated abomasum can be detected between the right abdominal wall and the liver. Fluid ingesta are seen ventrally and a gas cap of varying size dorsally. Dilated loops of small intestines that are almost always static are the main diagnostic criterion for ileus of the small intestine, but the cause of the ileus can only rarely be determined. Cholestasis can almost always be diagnosed by imaging a dilated biliary system. With obstruction at the level of the hepatic portal, only the intrahepatic biliary ducts are dilated, while a dilatation of the entire biliary tract, including the gallbladder, occurs in the case of an obstruction near the duodenal papilla. Urinary tract diseases cause colic in cows when concrement or inflammatory products become lodged in a ureter. The importance of ultrasonography in the diagnosis of diseases causing colic in cows varies. For example, with colic attributable to ileus of the small intestines, cholestasis or urinary tract disease, ultrasonography is a very useful diagnostic tool. On the other hand, for diagnosis of left or right displacement of the abomasum or caecal dilatation, ultrasonography is generally not required, but it is helpful in difficult cases to confirm or rule out a tentative diagnosis and to avoid an unnecessary exploratory laparotomy.

  1. Use of ultrasonography to identify late-stage maturity in rainbow trout Oncorhynchus mykiss

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Morphometric measurements by ultrasonography has been used to determine gonad and follicle size in many species of fish for purposes of identifying sex and estimating stage of maturation. We have been using a portable ultrasound system (SonoSite MicroMaxx, L25e/13-6 MHz transducer) to identify fem...

  2. [Usefulness of thyroid and neck lymph node screening with carotid artery ultrasonography].

    PubMed

    Bandoh, Nobuyuki; Goto, Takashi; Harabuchi, Yasuaki

    2014-07-01

    Ultrasonography of the carotid artery is routinely used to diagnose carotid artery stenosis and to screen the severity of atherosclerosis. During the performance of the ultrasonography, thyroid lesions or neck lymph node swelling are often observed. In this study, a total of 30,351 persons underwent carotid artery ultrasonography for thyroid and neck lesions as well as the carotid artery from 2008 to 2012. Criteria for further examination were either nodules with high echoic lesions indicating calcification, nodules 2cm or greater in diameter, malignant findings such as irregular shape, ill-defined border character, low and heterogeneous internal echoes, or diffuse swelling in the thyroid. Furthermore, neck lymph node swelling was also included in the criteria. Further examination was required in 650 (2.2%) of all 30,351 persons. In our hospital, 394 (60.6%) patients of the 650 were able to be examined with detailed ultrasonography and/or fine needle aspiration biopsy for thyroid and neck lesions. Finally, 73 patients (0.24%) were diagnosed as having malignant tumors consisting of 67 thyroid papillary carcinoma, two malignant lymphoma, one laryngeal carcinoma, one oropharyngeal carcinoma, one hypophryngeal carcinoma and one parathyroid carcinoma. Findings of the carotid artery ultrasonography for further examination were nodules with high echoic lesion in 370 (56.8%), nodules of 2cm or greater in diameter in 197 (30.2%), malignant findings in 120 (18.4%), diffuse swelling in 38 (5.8%) in the thyroid, and neck lymph node swelling in 38 (5.8%) of the 650 patients. The frequency of the malignant findings and neck lymph node swelling in the carotid artery ultrasonographic findings in thyroid carcinoma patients was significantly higher compared to those in patients with benign thyroid lesion. The tumors in 56 thyroid carcinoma patients which were detected with the carotid artery ultrasonography showed a significantly smaller and earlier stage in pT and pN compared to

  3. Comparative B-mode and Doppler renal ultrasonography with histopathological findings in dogs positive for canine visceral leishmaniasis.

    PubMed

    Baltazar, Pollyana Irene; Da Silva Moura, Laecio; Pessoa, Gerson Tavares; De Sá Rodrigues, Renan Paraguassu; Sanches, Marina Pinto; Das Neves Diniz, Anaemilia; Das Chagas Araújo Sousa, Francisco; Guerra, Porfírio Candanedo; Neves, Willams Costa; Giglio, Robson Fortes; De Jesus Rosa Pereira Alves, Jacyara; De Assis Leite Souza, Francisco; Braga, Juliana Fortes Vilarinho; Alves, Flávio Ribeiro

    2016-07-01

    Morphological parameters and renal flow were assessed and measured in six clinically healthy dogs with negative serological and parasitological examinations for canine visceral leishmaniasis (CVL) and six dogs with CVL-positive serological and parasitological tests and asymptomatic condition of the disease. Kidney length and diameter were measured and compared with the aorta/kidney ratio. Alterations in flow were measured using the flow velocity (cm/s) and resistance index (RI). Renal function was assessed by serum biochemical examination (urea, creatine, total proteins, albumin, and globulin) and urinalysis. CVL-positive animals presented heterogeneous kidney echotexture, reduced vascular flow, hypoperfusion, lesser visualization of the arcuate arteries, high RI values (1.06 ± 0.28 for the right kidney and 1.10 ± 0.30 for the left kidney), reduced diastolic flow, and high systolic peak. They also presented positive creatine/RI correlation and between the renal artery vascular flow and kidney diameter. Histopathological analysis of CVL-positive animals was compatible and confirmed hemodynamic changes observed by Doppler ultrasound. The findings in the present study showed that Doppler ultrasonography is a valid method to assess and detect alterations in flow in renal pathological processes with kidney vascular damage, as in the case of leishmaniasis, and can help in the diagnosis of animals with this infection. Microsc. Res. Tech. 79:637-645, 2016. © 2016 Wiley Periodicals, Inc.

  4. Screening for rheumatoid arthritis with finger joint power Doppler ultrasonography: quantification of conventional power Doppler ultrasonographic scoring.

    PubMed

    Fukae, Jun; Shimizu, Masato; Kon, Yujiro; Tanimura, Kazuhide; Matsuhashi, Megumi; Kamishima, Tamotsu; Koike, Takao

    2009-01-01

    Power Doppler ultrasonography (PD-US) has proved to be a useful technique to measure synovial vascularity due to its capability to provide data that can be used to evaluate the level of joint inflammation and assess rheumatoid arthritis (RA). We have developed a novel PD-US finger joint scoring method that introduces quantitative measurements into the conventional PD-US assessment method. A comparison of the two methods revealed that our novel PD-US method strongly correlates with the conventional method in terms of RA assessment. We performed finger joint PD-US on 69 patients with RA and 70 patients who had multiple joint pain but showed no evidence of inflammatory diseases (non-inflammatory disease, NI) and measured the synovial vascularity of the metacarpophalangeal joints 1-5 and proximal interphalangeal (PIP) joints 1-5 for each patient. We analyzed the data with receiver operating characteristic analysis and, based on the results for the total vascularity of 20 finger joints, defined a cut-off value of 36% as discriminating between RA and NI. This cut-off value was found to be a valuable tool in screening for RA. We conclude that our finger joint PD-US scoring system is both useful and applicable for diagnosing RA.

  5. Management of incidental renal masses: Time to consider contrast-enhanced ultrasonography.

    PubMed

    Di Vece, Francesca; Tombesi, Paola; Ermili, Francesca; Sartori, Sergio

    2016-02-01

    Proliferation of imaging studies for different clinical purposes and continuous improvement of imaging technology have led to an increasing number of incidental findings of renal masses. It is estimated that over 50% of patients older than 50 years have at least one renal mass. The majority of incidental renal masses are simple cysts that can be easily diagnosed by conventional ultrasonography. However, some incidental renal masses are not simple cysts, and differentiation between benign and malignant entities requires further imaging modalities. In the past, multiphase contrast-enhanced computed tomography and magnetic resonance imaging were considered the primary imaging modalities used to characterize and stage complex cystic and solid renal lesions. Currently, contrast-enhanced ultrasonography represents a novel alternative to contrast-enhanced computed tomography and magnetic resonance imaging. Contrast-enhanced ultrasonography employs microbubble contrast agents that allow the study of different enhancement phases of the kidney without risk of nephrotoxicity and radiation exposure. The diagnostic accuracy of contrast-enhanced ultrasonography in the characterization of complex renal cysts is comparable to that of computed tomography and magnetic resonance imaging, and several studies have demonstrated its reliability also in identifying solid lesions such as pseudotumors, typical angiomyolipomas, and clear cell renal carcinomas. Considering the high incidence of incidental renal masses and the need for rapid and reliable diagnosis, contrast-enhanced ultrasonography could be proposed as the first step in the diagnostic work-up of renal masses because of its safety and cost effectiveness. In this paper, we propose a diagnostic algorithm for the characterization of cystic and solid renal masses.

  6. A lexicon for hepatocellular carcinoma surveillance ultrasonography: benign versus malignant lesions

    PubMed Central

    An, Chansik; Rakhmonova, Gulbahor; Han, Kyunghwa; Seo, Nieun; Lee, Jin Young; Kim, Myeong-Jin; Park, Mi-Suk

    2017-01-01

    Background/Aims To suggest a lexicon for liver ultrasonography and to identify radiologic features indicative of benign or malignant lesions on surveillance ultrasonography. Methods This retrospective study included 188 nodules (benign, 101; malignant, 87) from 175 at-risk patients identified during surveillance ultrasonography for hepatocellular carcinoma. We created a lexicon for liver ultrasonography by reviewing relevant literature regarding the ultrasonographic features of hepatic lesions. Using this lexicon, two abdominal radiologists determined the presence or absence of each ultrasonographic feature for the included hepatic lesions. Independent factors associated with malignancy and interobserver agreement were determined by logistic regression analysis and kappa statistics, respectively. Results Larger tumor size (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.06-1.183; P<0.001), multinodular confluent morphology (OR, 7.712; 95% CI, 1.053-56.465; P=0.044), thick hypoechoic rim (OR, 5.878; 95% CI, 2.681-12.888; P<0.001), and posterior acoustic enhancement (OR, 3.077; 95% CI, 1.237-7.655; P=0.016) were independently associated with malignant lesions. In a subgroup analysis of lesions <2 cm, none of the ultrasonographic features were significantly associated with malignancy or benignity. Interobserver agreement for morphology was fair (κ=0.36), while those for rim (κ=0.427), echogenicity (κ=0.549), and posterior acoustic enhancement (κ=0.543) were moderate. Conclusions For hepatic lesions larger than 2 cm, some ultrasonography (US) features might be suggestive of malignancy. We propose a lexicon that may be useful for surveillance US. PMID:28349678

  7. Comparison between Computed Tomography and Ultrasonography in Detecting Foreign Bodies Regarding Their Composition and Depth: An In Vitro Study

    PubMed Central

    Haghnegahdar, Abdolaziz; Shakibafard, Alireza; Khosravifard, Negar

    2016-01-01

    Statement of the Problem Impaction of foreign bodies in the soft tissues is a sequela of traumatic and penetrating injuries. Such foreign bodies should be removed due to the complications they cause. Patient’s history, clinical evaluation and imaging examinations aid in the proper detection and localization of the foreign bodies.   Purpose The aim of the present study was to compare the sensitivity of computed tomography (CT) and ultrasonography for detecting foreign bodies in in-vitro models simulating facial soft tissues. Materials and Method Fifty foreign particles with five different compositions including wood, glass, metal, plastic, and stone were embedded in five calf tongues at 1, 2, 3, 4 and 5 cm depths. CT and ultrasonography were compared regarding their capability of detecting and localizing the foreign bodies. Results Wood and plastic foreign bodies were demonstrated more clearly on ultrasonography images. High density materials such as metal, stone, and glass were detected with almost the same accuracy on CT and ultrasonography examinations. Visibility of the foreign bodies deteriorated on ultrasonography images as their depth increased; however, CT appearances of the foreign particles were not influenced by their depths. Conclusion Ultrasonography is an appropriate technique for detection of foreign bodies especially the ones with low density. Therefore, it seems logical to perform ultrasonography in combination with CT in cases with the suspicion of foreign body impaction. PMID:27602392

  8. Report: Evaluation on diagnosis significance of single high frequency Ultrasonography and mammography and combination on Breast Cancer.

    PubMed

    Sun, Huifang; Wang, Bo; Ding, Changmao; Yu, Zhan; Gao, Jianbo

    2016-07-01

    To evaluate the diagnosis significance of single high-frequency ultrasonography and mammography and combination therapy of both on breast cancer. 352 cases of female breast cancer patients were selected from The First Affiliated Hospital of Zhengzhou University from January 2012 to December 2014. Among the 352 patients, 124 patients had only performed high-frequency ultrasonography detection, 102 cases of patients were only conducted mammography, and 126 patients had applied the combination detection of high-frequency ultrasonography and mammography. The coincidence rate of single mammography detection was 79.4%, the misdiagnosis rate was 10.8%, and the missed diagnosis rate was 9.8%; the coincidence rate of single high frequency ultrasonography detection was 83.9%, the misdiagnosis rate was 11.5%, the missed diagnosis rate was 4.6%; the coincidence rate of combination of high frequency ultrasonography detection was 89.7%, the misdiagnosis rate was 6.3%, the missed diagnosis rate was 4.0%. The detection rate and missed diagnosis rate of combination diagnosis had statistical difference with single high frequency ultrasonography and single mammography. There was no statistical difference on misdiagnosis rate. mammography and high frequency ultrasonography respectively had their own advantages. The combination application of both had better diagnosis complementary, and could significantly improved the detection rate and accuracy rate on breast cancer, and decreased the misdiagnosis rate and missed diagnosis rate.

  9. Uterine cavity assessment prior to IVF.

    PubMed

    Pundir, Jyotsna; El Toukhy, Tarek

    2010-11-01

    Approximately 15% of couples are affected with subfertility, of which up to 20% remain unexplained. Uterine cavity abnormalities can be a contributing cause of subfertility and recurrent implantation failure. Uterine cavity assessment has been suggested as a routine investigation in the evaluation of subfertile women. Traditionally, hysterosalpingography has been the most commonly used technique in the evaluation of infertility. Transvaginal ultrasound scan allows visualization of the endometrial lining and cavity, and has been used as a screening test for the assessment of uterine cavity. Abnormal uterine findings on a baseline scan can be further evaluated with saline hysterosonography, which is highly sensitive and specific in identifying intrauterine abnormalities. Hysteroscopy is considered as the definitive diagnostic tool to evaluate any abnormality suspected on hysterosalpingography, transvaginal ultrasound scan or saline hysterosonography during routine investigation of infertile patients. Minimally invasive hysteroscopes have minimized the pain experienced by patients during the procedure and made it feasible to use hysteroscopy as a routine outpatient examination. Following recurrent IVF failure there is some evidence of benefit from hysteroscopy in increasing the chance of pregnancy in the subsequent IVF cycle, both in those with abnormal and normal hysteroscopic findings. Various possible mechanisms have been proposed for this beneficial effect, but more randomized controlled trials are needed before its routine use in the general subfertile population can be recommended.

  10. Can ultrasonography make identification of asymptomatic hyperuricemic individuals at risk for developing gouty arthritis more crystal clear?

    PubMed

    Schlesinger, Naomi

    2011-04-19

    Hyperuricemia is the most important risk factor for gouty arthritis. The quandary is how to predict which patient with asymptomatic hyperuricemia will develop gouty arthritis. Can ultrasonography help identify hyperuricemic individuals at risk for developing gouty arthritis? In the previous issue of Arthritis Research & Therapy, Pineda and colleagues found ultrasonography changes suggestive of gouty arthritis in 25% of hyperuricemic individuals. These were found exclusively in hyperuricemic individuals but not in normouricemic patients. Ultrasonography may serve as a noninvasive means to diagnose gouty arthritis in hyperuricemic individuals who have yet to develop symptomatic gouty arthritis.

  11. Current Opinion and Use of Transcranial Doppler Ultrasonography in Traumatic Brain Injury in the Pediatric Intensive Care Unit.

    PubMed

    LaRovere, Kerri L; O'Brien, Nicole F; Tasker, Robert C

    2016-12-01

    The purpose of this study was to identify and review clinical studies using transcranial Doppler (TCD) ultrasonography in children with severe traumatic brain injury (TBI) in the pediatric intensive care unit (PICU). We identified 16 articles from January 2005 to July 2015 that met inclusion (TBI, five or more cases in case series, subjects <18 years old, TCD performed in PICU) and exclusion criteria (age not stated, data from subjects <18 years not separated from adult data, <85% study population <18 years in mixed population with adults). TCD parameters were used to assess autoregulation, intracranial pressure, and vasospasm, and to predict neurological outcome. Incidence of impaired autoregulation varied in severe TBI from 25% to 80%. Altered TCD flows and pulsatility index variably predicted intracranial hypertension across studies. Sonographic vasospasm in the middle cerebral artery occurred in 34% of 69 children with severe TBI. Outcomes seem to be related to altered TCD-derived flow velocities while in the ICU. TCD may be a useful tool to assess autoregulation, intracranial pressure, and vasospasm following TBI in the PICU. Further research is needed to establish gold standards and validate the findings in children. TCD may then impact day-to-day management in the PICU, and potentially improve outcomes in children with severe TBI.

  12. The value of ultrasonography in the diagnosis of varicocele

    PubMed Central

    Krupniewski, Leszek; Palczewski, Piotr; Gołębiowski, Marek

    2016-01-01

    A varicocele is described as pathologically enlarged, tortuous veins of the pampiniform plexus, leading to an increased testicular temperature and adrenal metabolite reflux into the testes. Varicocele can impair spermatogenesis and is considered to be the most common cause of male infertility. Patients may palpate a thickening in the scrotum or complain of dull scrotal or inguinal pain, which increases when standing or during erection. In the case of a sudden onset of varicocele in elderly men, it is necessary to exclude renal tumor and extend diagnostic ultrasound with the assessment of the abdominal cavity. The diagnosis of varicocele is based on medical history and physical examination, which involves palpation and observation of the scrotum at rest and during the Valsalva maneuver. Ultrasound is the imaging method of choice. The width and the number of vessels in the pampiniform plexus as well as the evaluation and measurement of regurgitation during the Valsalva maneuver are typical parameters analyzed during ultrasound assessment. However, diagnostic ultrasound is still a controversial method due to numerous and often divergent classification systems for varicocele assessment as well as its poor correlation with clinical manifestations. As a result of introduction of clear ultrasound criteria as well as the development of elastography and nuclear magnetic resonance, diagnostic imaging can play an important role in assessing the risk of damage to the testicular parenchyma, qualifying patients for surgical treatment and predicting the effects of therapy. PMID:28138407

  13. Transperineal ultrasonography in perianal Crohn disease: A valuable imaging modality.

    PubMed

    Wright, Emily K; Novak, Kerri L; Lu, Cathy; Panaccione, Remo; Ghosh, Subrata; Wilson, Stephanie R

    2015-01-01

    Aims of treatment for Crohn disease have moved beyond the resolution of clinical symptoms to objective end points including endoscopic and radiological normality. Regular re-evaluation of disease status to safely, readily and reliably detect the presence of inflammation and complications is paramount. Improvements in sonographic technology over recent years have facilitated a growing enthusiasm among radiologists and gastroenterologists in the use of ultrasound for the assessment of inflammatory bowel disease. Transabdominal intestinal ultrasound is accurate, affordable and safe for the assessment of luminal inflammation and complications in Crohn disease, and can be performed with or without the use of intravenous contrast enhancement. Perianal fistulizing disease is a common, complex and often treatment-refractory complication of Crohn disease, which requires regular radiological monitoring. Endoanal ultrasound is invasive, uncomfortable and yields limited assessment of the perineal region. Although magnetic resonance imaging of the pelvis is established, timely access may be a problem. Transperineal ultrasound has been described in small studies, and is an accurate, painless and cost-effective method for documenting perianal fluid collections, fistulas and sinus tracts. In the present article, the authors review the literature regarding perineal ultrasound for the assessment of perianal Crohn disease and use case examples to illustrate its clinical utility.

  14. Imaging of juvenile idiopathic arthritis. Part II: Ultrasonography and MRI

    PubMed Central

    Grochowska, Elżbieta; Gietka, Piotr; Płaza, Mateusz; Pracoń, Grzegorz; Saied, Fadhil; Walentowska-Janowicz, Marta

    2016-01-01

    Juvenile idiopathic arthritis is the most common autoimmune systemic disease of the connective tissue affecting individuals in the developmental age. Radiography, which was described in the first part of this publication, is the standard modality in the assessment of this condition. Ultrasound and magnetic resonance imaging enable early detection of the disease which affects soft tissues, as well as bones. Ultrasound assessment involves: joint cavities, tendon sheaths and bursae for the presence of synovitis, intraand extraarticular fat tissue to visualize signs of inflammation, hyaline cartilage, cartilaginous epiphysis and subchondral bone to detect cysts and erosions, and ligaments, tendons and their entheses for signs of enthesopathies and tendinopathies. Magnetic resonance imaging is indicated in children with juvenile idiopathic arthritis for assessment of inflammation in peripheral joints, tendon sheaths and bursae, bone marrow involvement and identification of inflammatory lesions in whole-body MRI, particularly when the clinical picture is unclear. Also, MRI of the spine and spinal cord is used in order to diagnose synovial joint inflammation, bone marrow edema and spondylodiscitis as well as to assess their activity, location, and complications (spinal canal stenosis, subluxation, e.g. in the atlantoaxial region). This article discusses typical pathological changes seen on ultrasound and magnetic resonance imaging. The role of these two methods for disease monitoring, its identification in the pre-clinical stage and establishing its remission are also highlighted. PMID:27679727

  15. Manual rupture versus transvaginal ultrasound-guided aspiration of allanto-amniotic fluid in multiple pregnancies: a clinical approach to embryo reduction in dairy cattle.

    PubMed

    Andreu-Vázquez, Cristina; Garcia-Ispierto, Irina; López-Gatius, Fernando

    2012-01-01

    To avoid the problems associated with twinning in dairy cattle, one of the embryos may be eliminated. This study compares the effect on pregnancy maintenance of two embryo reduction techniques, manual rupture (MR) and transvaginal ultrasound-guided aspiration (TUGA) of allanto-amniotic fluid, in Holstein-Friesian cows with multiple pregnancies. In the first experiment, 61 lactating cows bearing unilateral twins (n=27), bilateral twins (n=30) or triplets/quadruplets (n=4) were subjected to MR (n=45) or TUGA using a 17-G neddle (n=16) on day 28-34 of gestation. In 21 and 10 cows undergoing MR and TUGA embryo reduction, respectively, pregnancy loss occurred before day 90 (46.7 vs. 62.5%, P= 0.28). Through binary logistic regression, the type of pregnancy was identified as the only variable significantly affecting pregnancy maintenance (P=0.03). Based on the odds ratio, the risk of pregnancy loss was 4.1 times higher for unilateral twins than for bilateral twins (70.4 vs. 36.7%, respectively, P=0.01). No effect was detected on pregnancy maintenance of the technique used (P=0.17) or of the interaction technique by type of pregnancy (P=0.22). In the second experiment, a 22-G needle was used to perform TUGA on 22 lactating cows. The pregnancy loss rates were 44.4% (4/9), 18.2% (2/11) and 50% (1/2) for cows bearing unilateral twins, bilateral twins and triplets, respectively. The total pregnancy loss rate following TUGA using the 22-G needle tended to be lower than that using the 17-G needle (31.8 vs. 62.5%; P=0.06). Our results suggest that TUGA using a 22-G needle could be the method of choice to perform embryo reduction in cows carrying multiple pregnancies.

  16. Shear wave elastography and contrast-enhanced ultrasonography in the diagnosis of thyroid malignant nodules

    PubMed Central

    Chen, Mei; Zhang, Ke-Qin; Xu, You-Feng; Zhang, Sheng-Min; Cao, Yong; Sun, Wei-Qun

    2016-01-01

    The aim of the present study was to evaluate the value of shear wave elastography (SWE) and contrast-enhanced ultrasonography (CEUS) in the diagnosis of thyroid malignant nodules. A total of 253 patients with 319 thyroid nodules were subjected to two-dimensional ultrasound (2DUS) and CEUS examinations prior to thyroidectomy between March, 2014 and December, 2015. Young's modulus value for each nodule on 2DUS and CEUS images were recorded. The sensitivity, specificity and accuracy of 2DUS, SWE and CEUS in the diagnosis of thyroid malignant nodules were assessed. The results demonstrated that, of the 319 nodules that were pathologically confirmed, 183 were malignant and 136 were benign. The area under the receiver operating characteristic curve as a result of SWE diagnosis was 0.77. When the threshold of the Young's modulus value was ≥27.65 kPa in the diagnosis of malignant thyroid nodules, SWE exhibited a sensitivity of 84.55% (115/136), a specificity of 84.15% (154/183) and an accuracy of 84.32% (269/319). US contrast imaging of malignant thyroid nodules revealed a major tendency for early hypoenhancement and hypoenhancement. CEUS exhibited a sensitivity of 87.5% (119/136), a specificity of 86.33% (158/183) and an accuracy of 86.83% (277/319) in the diagnosis of malignant thyroid nodules. Compared with 2DUS, SWE, CEUS and their combined use exhibited statistically significant differences in the diagnosis of thyroid malignant nodules in terms of sensitivity, specificity and accuracy (χ2=9.220,15.310 and 40.296, respectively; P=0.000); SWE or CEUS did not differ significantly in the diagnosis of thyroid malignant nodules in terms of sensitivity, specificity or accuracy (χ2=0.737;P=0.542); Compared with the use of SWE or CEUS alone, their combination exhibited statistically significant differences in the diagnosis of malignant thyroid nodules in terms of sensitivity, specificity and accuracy (χ2=12.264 and 6.939, respectively; P=0.000,0.005). In conclusion, the

  17. Validity of pre and post-term birth rates based on the date of last menstrual period compared to early obstetric ultrasonography.

    PubMed

    Medeiros, Maria Nilza Lima; Cavalcante, Nádia Carenina Nunes; Mesquita, Fabrício José Alencar; Batista, Rosângela Lucena Fernandes; Simões, Vanda Maria Ferreira; Cavalli, Ricardo de Carvalho; Cardoso, Viviane Cunha; Bettiol, Heloisa; Barbieri, Marco Antonio; Silva, Antônio Augusto Moura da

    2015-04-01

    The aim of this study was to assess the validity of the last menstrual period (LMP) estimate in determining pre and post-term birth rates, in a prenatal cohort from two Brazilian cities, São Luís and Ribeirão Preto. Pregnant women with a single fetus and less than 20 weeks' gestation by obstetric ultrasonography who received prenatal care in 2010 and 2011 were included. The LMP was obtained on two occasions (at 22-25 weeks gestation and after birth). The sensitivity of LMP obtained prenatally to estimate the preterm birth rate was 65.6% in São Luís and 78.7% in Ribeirão Preto and the positive predictive value was 57.3% in São Luís and 73.3% in Ribeirão Preto. LMP errors in identifying preterm birth were lower in the more developed city, Ribeirão Preto. The sensitivity and positive predictive value of LMP for the estimate of the post-term birth rate was very low and tended to overestimate it. LMP can be used with some errors to identify the preterm birth rate when obstetric ultrasonography is not available, but is not suitable for predicting post-term birth.

  18. Diagnostic Accuracy and Impact on Management of Ultrasonography-Guided Fine-Needle Aspiration to Detect Axillary Metastasis in Breast Cancer Patients: A Prospective Study

    PubMed Central

    Diaz-Ruiz, María Jesús; Arnau, Anna; Montesinos, Jesus; Miguel, Ana; Culell, Pere; Solernou, Lluis; Tortajada, Lidia; Vergara, Carmen; Yanguas, Carlos; Salvador-Tarrasón, Rafael

    2016-01-01

    Summary Background The axillary nodal status is essential to determine the stage of disease at diagnosis. Our aim was to prospectively assess the diagnostic accuracy of ultrasonography-guided fine-needle aspiration (US-FNA) for the detection of metastasis in axillary lymph nodes in patients with breast cancer (BC) and its impact on the therapeutic decision. Materials and Methods Ultrasonography (US) was performed in 407 axillae of 396 patients who subsequently underwent surgery. US-FNA was conducted when lymph nodes were detected by US. Axillary dissection (AD) was performed when US-FNA was positive for metastasis. Patients with negative US-FNA and breast tumors of 30 mm in size were candidates for selective sentinel lymph node biopsy (SLNB). The anatomopathological results of AD or SLNB were used as reference tests. Results Lymph nodes were detected by US in 207 (50.8%) axillae. Of these, US-FNA was performed on 180 (86.9%). 94 axillae (52.2%) were positive for carcinoma and 79 women received AD. US-FNA had 77.5% sensitivity, 100% specificity, 100% positive predictive value, 69.3% negative predictive value, and 85.1% diagnostic accuracy. US-FNA avoided SLNB in 18.1% of patients who underwent AD. Conclusions Axillary US-FNA is an accurate technique in the staging of patients with BC. It allows reducing the number of SLNB and, when positive, offers a fast and useful tool. PMID:27051394

  19. Assessment of coronary thrombolysis

    SciTech Connect

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

    1987-02-01

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

  20. Evaluation of acute radiation optic neuropathy by B-scan ultrasonography

    SciTech Connect

    Lovato, A.A.; Char, D.H.; Quivey, J.M.; Castro, J.R. )

    1990-09-15

    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.

  1. Possible Synchronous Lung Metastasis of Breast Mass Detected Using Breast Ultrasonography: A Report of Two Cases

    PubMed Central

    Bekci, Tümay

    2015-01-01

    Ultrasonography (US), which is used for the diagnosis of breast cancer and the evaluation of its local metastasis, has proven its worth as a diagnostic method. In breast ultrasonographic examination peripherally localized metastatic lesions at the posterior of the screened breast tissue can also be detected. In this case report, two female patients whose breast ultrasonography showed lumps. Their peripheral lung metastases were screened ultrasonographically, and the patients were diagnosed in a timely manner. Ultrasonographic examination at a patient’s first appointment – and especially during routine check-ups after the primary treatment – can allow an early diagnosis of peripherally localized lung metastasis at the posterior of the screened breast tissue and make a vital contribution to the patient’s prognosis.

  2. Surface electromyogram and muscle ultrasonography for detection of muscle fasciculations in pediatric peripheral neuropathy.

    PubMed

    Oguri, Masayoshi; Saito, Yoshiaki; Okazaki, Tetsuya; Matsumura, Wataru; Ohno, Koyo; Togawa, Masami; Fukuda, Chisako; Saito, Yuko; Nishino, Ichizo; Maegaki, Yoshihiro

    2017-03-16

    A 12-year-old girl presented with talipes equinus of both legs, attenuation of upper and lower limb tendon reflexes, thermal hyperalgesia, and reduction of vibratory sensation. On clinical examination, muscle twitches of fingers of both hands, as well as the abductor halluces and the dorsal interossei muscles of the right foot were observed. Nerve conduction velocity was significantly declined in the upper and lower extremities. Needle electromyography (EMG) was not performed; however, ultrasonography revealed repetitive, semi-regular muscle twitches lasting 0.2-0.4s, concomitant with muscle discharges on surface EMG in the right foot muscles. These findings were compatible with contraction fasciculation in muscles under chronic reinnervation. Nerve and muscle biopsies were suggestive of chronic motor, sensory, and autonomic neuropathy. This is the first case of pediatric peripheral neuropathy where muscle fasciculation was noninvasively identified by simultaneous surface EMG and ultrasonography.

  3. Diagnostic value of ultrasonography and magnetic resonance imaging in ulnar neuropathy at the elbow.

    PubMed

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

    2012-01-01

    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 mm(2) 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.

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

    PubMed Central

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

    2012-01-01

    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

  5. Method for detection of aspiration based on B-mode video ultrasonography.

    PubMed

    Miura, Yuka; Nakagami, Gojiro; Yabunaka, Koichi; Tohara, Haruka; Murayama, Ryoko; Noguchi, Hiroshi; Mori, Taketoshi; Sanada, Hiromi

    2014-07-01

    In this study, we aimed to develop a new method for detection of aspiration based on B-mode video ultrasonography and to evaluate its performance. To detect aspirated boluses by B-mode video ultrasonography in patients with dysphagia, we placed a linear array transducer above the thyroid cartilage and observed the area around the vocal folds. Forty-two ultrasonographic measurements were obtained from 17 patients with dysphagia who also underwent videofluoroscopy or videoendoscopy measurements at the same time. Aspirated boluses were observed in B-mode video ultrasonographic images as hyperechoic, long, narrow objects that passed through the vocal folds beneath the anterior wall of the trachea, with movement different from that of the surrounding structure. The sensitivity of aspiration detection was 0.64, and the specificity was 0.84. This newly developed detection method will enable patients with dysphagia to receive appropriate daily swallowing care.

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

    Loken, K; Steine, S; Laerum, E

    1999-01-01

    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.

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

    PubMed

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

    2014-11-01

    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.

  9. Significance of clearing differentiated thyroid carcinoma lymph node by high-frequency color Doppler ultrasonography

    PubMed Central

    Liu, Bing; Qin, Huadong; Zhang, Bin; Shi, Tiefeng; Li, Chuanle; Liu, Yao; Song, Meiyue

    2017-01-01

    We compared the clinical effects and prognosis of patients receiving lymph node dissection after surgical removal of the thyroid tissues and those not receiving it after the removal. A total of 80 patients diagnosed with differentiated thyroid carcinoma (DTC) by our hospital from March 2012 to March 2014 were successively included in the study. The cases were divided into the control group (n=36 cases) and observation group (n=44 cases), and the two groups underwent total or subtotal resection of the thyroid. In the control group, patients underwent preoperative high-frequency color ultrasonography, and the most suspicious lymph node was removed. In the observation group, patients underwent preoperative high-frequency color ultrasonography, and the surgeons cleared the lymph node of the widest range. Difference in clinical effects and prognosis of the two groups were compared. After nearly a year's follow-up observation, the tumor recurrence rate of the observation group was significantly lower than that of the control group and the survival rate of the observation group was significantly higher than that of the control group (P<0.05). The rate of surgery complications and comparative difference of the two patient groups had no statistical significance (P>0.05). When comparing the data of lymphatic metastasis tested by preoperative high-frequency color ultrasonography with intraoperative diagnosed figures, sensitivity was 97.4%, specificity 33.3%, positive predictive value 90.2% and the negative predictive value 66.7%. In conclusion, removal of the lymph node for DTC patients having undergone thyroid tissue excision with preoperative high-frequency color ultrasonography can be beneficial to improve the effects along with reduction in the recurrence rate. PMID:28123550

  10. [Imaging of hyperparathyroidism-Ultrasonography and 99mTc-MIBI scintigraphy-].

    PubMed

    Kawabe, Joji; Higashiyama, Shigeaki; Yoshida, Atsushi; Kotani, Kohei; Shiomi, Susumu

    2016-06-01

    Treatments for primary hyperparathyroidism due to adenoma, hyperplasia and carcinoma and secondary hyperparathyroidism are mainly surgical resections of them. Accurate imaging diagnoses of the existences and the regions are very important for reductions of invasiveness. We describe ultrasonography and (99m)Tc-MIBI scintigraphy of hyperparathyroidism. We explain an advantage, a disadvantage and diagnosability of these modalities. We mention utilities of SPECT/CT, too. We show echogram and (99m)Tc-MIBI scintigraphy images about 3 cases of hyperparathyroidism.

  11. Contrast-enhanced ultrasonography in Takayasu arteritis: watching and monitoring the arterial inflammation.

    PubMed

    Herlin, Bastien; Baud, Jean-Michel; Chadenat, Marie-Laure; Pico, Fernando

    2015-10-09

    A 43-year-old man was diagnosed with Takayasu arteritis, and treated with methotrexate and corticosteroids. While under treatment and with normal biological inflammatory parameters, he experienced an ischaemic stroke, successfully treated with intravenous thrombolysis (alteplase). The B-mode ultrasound examination revealed circumferential wall thickening of the left common carotid artery. Contrast-enhanced ultrasonography showed a progressive arterial wall enhancement of the left common carotid artery. This pathological enhancement indicates neovascularisation of the arterial wall, which is supposed to correlate with active vascular inflammation. After an increase in immunosuppressive treatment, follow-up contrast-enhanced ultrasonography no longer showed artery wall enhancement. Contrast-enhanced ultrasound examination is an inexpensive, reproducible and minimally invasive method, providing dynamic information on arterial wall neovascularisation and thus inflammation. This case illustrates that contrast-enhanced ultrasonography can be a useful tool for the management and follow-up of Takayasu arteritis, and its use as a marker of disease activity and arterial inflammation in Takayasu arteritis should be evaluated in further studies.

  12. Comparison of ultrasonography-guided central venous catheterization between adult and pediatric populations.

    PubMed

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

    2008-01-01

    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.

  13. Vascular mapping of the face: B-mode and doppler ultrasonography study

    PubMed Central

    Tucunduva-Neto, Raul; Saieg, Mauro; Costa, Andre-Luiz; de Freitas, Cláudio

    2016-01-01

    Background To analyze the face vascularization pattern using B-mode and Doppler ultrasonography, and also propose an arterial vessel mapping. Material and Methods The investigation was performed on 20 ultrasonography exams of facial vessels through linear and endocavitary transducers. We analyzed and determined the average values for diameters, peak systolic velocity and resistive index of the following arteries: external carotid, lingual, deep lingual, sublingual, facial, submental, inferior labial, superior labial, angular, maxillary inferior alveolar, mental, buccal, greater palatine, infraorbital, superficial temporal, transverse facial and frontal. Results Data was obtained allowing the analysis of the tissue hemodynamics. We were able to map the vascularization of the face and it was possible to access three arteries of small diameter (0,60mm angular artery; 0,55mm greater palatine artery; 0,45mm infraorbital artery). Conclusions The results presented in this article are valid tool supporting the non-invasive mapping of facial vascularization. Key words:Anatomy, vascularization, ultrasonography, doppler. PMID:26827055

  14. Doppler ultrasonography in living donor liver transplantation recipients: Intra- and post-operative vascular complications

    PubMed Central

    Abdelaziz, Omar; Attia, Hussein

    2016-01-01

    Living-donor liver transplantation has provided a solution to the severe lack of cadaver grafts for the replacement of liver afflicted with end-stage cirrhosis, fulminant disease, or inborn errors of metabolism. Vascular complications remain the most serious complications and a common cause for graft failure after hepatic transplantation. Doppler ultrasound remains the primary radiological imaging modality for the diagnosis of such complications. This article presents a brief review of intra- and post-operative living donor liver transplantation anatomy and a synopsis of the role of ultrasonography and color Doppler in evaluating the graft vascular haemodynamics both during surgery and post-operatively in accurately defining the early vascular complications. Intra-operative ultrasonography of the liver graft provides the surgeon with useful real-time diagnostic and staging information that may result in an alteration in the planned surgical approach and corrections of surgical complications during the procedure of vascular anastomoses. The relevant intra-operative anatomy and the spectrum of normal and abnormal findings are described. Ultrasonography and color Doppler also provides the clinicians and surgeons early post-operative potential developmental complications that may occur during hospital stay. Early detection and thus early problem solving can make the difference between graft survival and failure. PMID:27468207

  15. [Physiology and pathology of reproduction in domesticated New World camelids with special emphasis on ultrasonography].

    PubMed

    Hoops, M; Kauffold, J

    2013-01-01

    The number of New World camelids in Germany is increasing. Owners and breeders are usually well educated regarding their animals. For practitioners, this means being up-to-date with respect to their veterinary knowledge. This includes the physiology and pathology of reproduction. Specifics of reproduction in domesticated New World camelids are an induced ovulation, the absence of cyclic sexual activity, a relatively long gestation of 336-349 days and a predominantly left-horn gestation. Ultrasonography plays an important role as part of the gynecological examination. Generally, the ultrasonographic examination can be performed transrectally and transcutaneously in the left or right flanks. Transrectal ultrasonography has to be carried out with particular caution to avoid rectal injuries. An accurate pregnancy diagnosis by transrectal scanning is possible starting from day 20 of pregnancy; using transcutaneous scanning, diagnosis is accurate starting on days 50-60 (left flank) or from day 90 (right flank) of pregnancy, respectively. Ultrasonography is also appropriate to examine the non-gravid uterus and the ovaries. Based on 5 years of experience working with farmed New World camelids, the article describes the physiology and pathology of reproduction in domesticated New World camelids. Particular consideration is given to the ultrasonographical examination of the genital organs.

  16. Transoral carotid ultrasonography using a micro convex probe with B-flow imaging for extracranial internal carotid artery dissection.

    PubMed

    Sakima, Hirokuni; Isa, Katsunori; Anegawa, Takahiro; Kokuba, Kazuhito; Nakachi, Koh; Goya, Yoshino; Tokashiki, Takashi; Ishiuchi, Shogo; Ohya, Yusuke

    2012-11-01

    We report on transoral carotid ultrasonography using a micro convex probe with B-flow imaging for determining spontaneous extracranial internal carotid artery dissection just below the petrous portion. A 49-year-old man suffered cortical and subcortical infarction in the region of the right middle cerebral artery. Magnetic resonance angiography on the third day of admission revealed spontaneous recanalization of the right internal carotid artery associated with an intimal flap-like structure at the petrous portion. Transoral carotid ultrasonography using a micro convex probe revealed right extracranial internal carotid artery dissection, showing an increased diameter of the right extracranial internal carotid artery with double lumen formation, stenosis of the true lumen, and a mobile intimal flap in B-flow imaging. Transoral carotid ultrasonography using a micro convex probe was helpful to attempt a self-expanding stent for recanalizing right extracranial internal carotid artery dissection. The patient recovered and was discharged ambulatory. The size of the micro convex probe was optimum for transoral carotid ultrasonography in our patient. Micro convex probe is more commonly used than the standard transoral carotid ultrasonography probe, which lacks versatility. We consider that transoral carotid ultrasonography using a micro convex probe could be routinely used for ultrasonographic evaluation of extracranial internal carotid artery dissection.

  17. Using ultrasonography to monitor liver blood flow for liver transplant from donors supported on extracorporeal membrane oxygenation.

    PubMed

    Zhu, Xian-Sheng; Wang, Sha-Sha; Cheng, Qi; Ye, Chuang-Wen; Huo, Feng; Li, Peng

    2016-02-01

    Extracorporeal membrane oxygenation (ECMO) has been used to support brain-dead donors for liver procurement. This study investigated the potential role of ultrasonographic monitoring of hepatic perfusion as an aid to improve the viability of liver transplants obtained from brain-dead donors who are supported on ECMO. A total of 40 brain-dead patients maintained on ECMO served as the study population. Hepatic blood flow was monitored using ultrasonography, and perioperative optimal perfusion was maintained by calibrating ECMO. Liver function tests were performed to assess the viability of the graft. The hepatic arterial blood flow was well maintained with no significant changes observed before and after ECMO (206 ± 32 versus 241 ± 45 mL/minute; P = 0.06). Similarly, the portal venous blood flow was also maintained throughout (451 ± 65 versus 482 ± 77 mL/minute; P = 0.09). No significant change in levels of total bilirubin, alanine transaminase, and lactic acid were reported during ECMO (P = 0.17, P = 0.08, and P = 0.09, respectively). Before the liver is procured, ultrasonographic monitoring of hepatic blood flow could be a valuable aid to improve the viability of a liver transplant by allowing for real-time calibration of ECMO perfusion in brain-dead liver donors. In our study, ultrasonographic monitoring helped prevent warm ischemic injury to the liver graft by avoiding both overperfusion and underperfusion of the liver.

  18. The role of transthoracic ultrasonography in predicting the outcome of community-acquired pneumonia in hospitalized children

    PubMed Central

    Chen, I-Chen; Lin, Ming-Yen; Liu, Yi-Ching; Cheng, Hsiao-Chi; Wu, Jiunn-Ren; Hsu, Jong-Hau; Dai, Zen-Kong

    2017-01-01

    Transthoracic ultrasound (TUS) has recently become a valuable tool in the diagnosis of community-acquired pneumonia (CAP). This study assessed the association between TUS findings and clinical outcome in children with CAP. The medical records of pediatric patients hospitalized with CAP who underwent transthoracic ultrasonography within 48 hours of admission were retrospectively reviewed. Associations between the TUS findings and patient outcome were analyzed, including intensive care unit (ICU) admission, length of hospital stay, and tube thoracotomy. The study enrolled 142 patients (median age, 60 months): 28 (19.7%) required ICU admission, 14 (9.89%) underwent tube thoracotomy, and 26 (18.3%) had a hospital stay > 9 days. Multifocal involvement seen by TUS were independently associated with ICU admission, a prolonged hospital stay, and tube thoracotomy (p = 0.0027, p = 0.02, and p = 0.0262, respectively). A pleural effusion and fluid bronchogram were independent predictors of a longer hospital stay (p = 0.003 and p = 0.006, respectively). In addition, a fluid bronchogram was an independent predictor of tube thoracotomy (p = 0.0262). Conclusion TUS findings of fluid bronchogram, multifocal involvement, and pleural effusion were associated with adverse outcomes, including longer hospital stay, ICU admission, and tube thoracotomy in hospitalized CAP children. Therefore, TUS is a novel tool for prognostic stratifications of CAP in hospitalized children. PMID:28301494

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

    PubMed Central

    Chen, Jun; Wu, Shan; Ren, Jun

    2014-01-01

    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. PMID:25422648

  20. Longitudinal evaluation of foetal transverse lie using ultrasonography.

    PubMed

    Oyinloye, Olalekan I; Okoyomo, Alexander A

    2010-03-01

    The purpose of this study was to assess the risk of persistence of transverse lie detected earlier in pregnancy and associated predisposing factors using follow-up ultrasound (US). A longitudinal study was carried out from January 2004 to august 2004 at Federal Medical centre, Lokoja, Nigeria. All singleton pregnancies, with ultrasound diagnosis of transverse lie, between 24-28 weeks were followed to term. At 24-28 weeks, 183 fetuses presented with transverse lie. Thirty seven were lost to follow-up; out of the remaining 146 babies, 22 persisted to term. Overall persistence rate was 15.1%. No identifiable predisposing factors were seen in 91.1%, placenta previa in 5.5%, lower segment fibroids in 2.7%, and ectopic kidney in 0.7%. In conclusion, transverse lie detected early in pregnancy is transient, and majority would convert to a longitudinal lie at term. Potential predisposing factors highlighted above increases the risk of persistent transverse lie at term, with placenta previa and lower segment fibroids being the major predisposing factors.

  1. Transcranial Doppler ultrasonography: From methodology to major clinical applications

    PubMed Central

    D’Andrea, Antonello; Conte, Marianna; Cavallaro, Massimo; Scarafile, Raffaella; Riegler, Lucia; Cocchia, Rosangela; Pezzullo, Enrica; Carbone, Andreina; Natale, Francesco; Santoro, Giuseppe; Caso, Pio; Russo, Maria Giovanna; Bossone, Eduardo; Calabrò, Raffaele

    2016-01-01

    Non-invasive Doppler ultrasonographic study of cerebral arteries [transcranial Doppler (TCD)] has been extensively applied on both outpatient and inpatient settings. It is performed placing a low-frequency (≤ 2 MHz) transducer on the scalp of the patient over specific acoustic windows, in order to visualize the intracranial arterial vessels and to evaluate the cerebral blood flow velocity and its alteration in many different conditions. Nowadays the most widespread indication for TCD in outpatient setting is the research of right to left shunting, responsable of so called “paradoxical embolism”, most often due to patency of foramen ovale which is responsable of the majority of cryptogenic strokes occuring in patients younger than 55 years old. TCD also allows to classify the grade of severity of such shunts using the so called “microembolic signal grading score”. In addition TCD has found many useful applications in neurocritical care practice. It is useful on both adults and children for day-to-day bedside assessment of critical conditions including vasospasm in subarachnoidal haemorrhage (caused by aneurysm rupture or traumatic injury), traumatic brain injury, brain stem death. It is used also to evaluate cerebral hemodynamic changes after stroke. It also allows to investigate cerebral pressure autoregulation and for the clinical evaluation of cerebral autoregulatory reserve. PMID:27468332

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

    NASA Astrophysics Data System (ADS)

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

    2010-03-01

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

  3. Endoscopic ultrasonography for pancreatic cancer: current and future perspectives

    PubMed Central

    Brizzi, Rosario Francesco; Pellicano, Rinaldo

    2013-01-01

    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

  4. Assessment.

    ERIC Educational Resources Information Center

    Reising, Bob

    1998-01-01

    Argues (guided by "The Challenge of Change: Assessment in the 21st Century") that in the decades ahead, assessment will play an unprecedented role as the vehicle that will influence and guide scheduling, curriculum, and instruction. (SR)

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

    NASA Astrophysics Data System (ADS)

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

    2011-03-01

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

  6. Comparing Magnetic Resonance Imaging and High-Resolution Dynamic Ultrasonography for Diagnosis of Plantar Plate Pathology: A Case Series.

    PubMed

    Donegan, Ryan J; Stauffer, Anthony; Heaslet, Michael; Poliskie, Michael

    Plantar plate pathology has gained noticeable attention in recent years as an etiology of lesser metatarsophalangeal joint pain. The heightened clinical awareness has led to the need for more effective diagnostic imaging accuracy. Numerous reports have established the accuracy of both magnetic resonance imaging and ultrasonography for the diagnosis of plantar plate pathology. However, no conclusions have been made regarding which is the superior imaging modality. The present study reports a case series directly comparing high-resolution dynamic ultrasonography and magnetic resonance imaging. A multicenter retrospective comparison of magnetic resonance imaging versus high-resolution dynamic ultrasonography to evaluate plantar plate pathology with surgical confirmation was conducted. The sensitivity, specificity, and positive and negative predictive values for magnetic resonance imaging were 60%, 100%, 100%, and 33%, respectively. The overall diagnostic accuracy compared with the intraoperative findings was 66%. The sensitivity, specificity, and positive and negative predictive values for high-resolution dynamic ultrasound imaging were 100%, 100%, 100%, and 100%, respectively. The overall diagnostic accuracy compared with the intraoperative findings was 100%. The p value using Fisher's exact test for magnetic resonance imaging and high-resolution dynamic ultrasonography was p = .45, a difference that was not statistically significant. High-resolution dynamic ultrasonography had greater accuracy than magnetic resonance imaging in diagnosing lesser metatarsophalangeal joint plantar plate pathology, although the difference was not statistically significant. The present case series suggests that high-resolution dynamic ultrasonography can be considered an equally accurate imaging modality for plantar plate pathology at a potential cost savings compared with magnetic resonance imaging. Therefore, high-resolution dynamic ultrasonography warrants further investigation in

  7. 3-year results of transvaginal cystocele repair with transobturator four-arm mesh: A prospective study of 105 patients

    PubMed Central

    Kdous, Moez; Zhioua, Fethi

    2014-01-01

    Objectives To evaluate the long-term efficacy and safety of transobturator four-arm mesh for treating cystoceles. Patients and methods In this prospective study, 105 patients had a cystocele corrected between January 2004 and December 2008. All patients had a symptomatic cystocele of stage ⩾2 according to the Baden–Walker halfway stratification. We used only the transobturator four-arm mesh kit (Surgimesh®, Aspide Medical, France). All surgical procedures were carried out by the same experienced surgeon. The patients’ characteristics and surgical variables were recorded prospectively. The anatomical outcome, as measured by a physical examination and postoperative stratification of prolapse, and functional outcome, as assessed by a questionnaire derived from the French equivalents of the Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire and the Pelvic Organ Prolapse–Urinary Incontinence-Sexual Questionnaire, were considered as the primary outcome measures. Peri- and postoperative complications constituted the secondary outcome measures. Results At 36 months after surgery the anatomical success rate (stage 0 or 1) was 93%. On a functional level, all the scores of quality of life and sexuality were improved. The overall satisfaction score (visual analogue scale) was 71.4%. There were no perioperative adverse events. Mesh erosion was reported in 7.6% and mesh retraction in 5.7% of the patients. Conclusions If the guidelines and precautions are followed, vaginal prosthetic surgery for genitourinary prolapse has shown long-term benefits. It provides excellent results both anatomically and functionally. However, complications are not negligible and some are specific to prosthetic surgery. PMID:26019962

  8. The accuracy of endorectal ultrasonography in rectal cancer staging

    PubMed Central

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

    2015-01-01

    Background and aims The incidence of rectal cancer in the European Union is about 35% of the total colorectal cancer incidence. Staging rectal cancer is important for planning treatment. It is essential for the management of rectal cancer to have adequate preoperative imaging, because accurate staging can influence the therapeutic strategy, type of resection, and candidacy for neoadjuvant therapy. The aim of this work is to evaluate the accuracy of endorectal ultrasound (ERUS) in rectal cancer staging. Methods A retrospective study was performed to assess the accuracy of ERUS by analyzing patients discharged from Regional Institute of Gastroenterology and Hepatology (IRGH) Cluj-Napoca, Romania, diagnosed with rectal cancer between 01 January 2011 and 31 December 2013. Patients who were preoperatively staged by other imaging methods and those who had ERUS performed in another service were excluded from the analysis. As inclusion criteria remained ERUS performed for patients with rectal cancer in IRGH Cluj-Napoca where they were also operated. We analyzed preoperative T stage obtained by ERUS and it was compared with the histopathology findings. Results The number of patients discharged with a diagnosis of rectal cancer were 200 (operated – 157) in 2011, 193 (operated – 151) in 2012, and 198 (operated – 142) in 2013. We analyzed a total of 51 cases diagnosed with rectal cancer who performed ERUS in IRGH Cluj-Napoca. The results according to the T stage obtained by ERUS and histopathology test were: Under-stage T2= 25.0%, T3=7.9% of cases; Over-stage T2=25.0%, T3=31.6% and T4=60.0% of cases. Less than 20% of patients underwent preoperative radio-chemotherapy. Conclusions ERUS is a method of staging rectal cancer which is human dependent. ERUS is less accurate for T staging of stenotic tumours, but the accuracy may still be within acceptable limits. Surgeons use ERUS to adopt a treatment protocol, knowing the risk of under-staging and over-staging of this method

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

    PubMed

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

    2015-02-01

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

  10. Evaluation of Carotid Ultrasonography Screening Among Kidney Transplant Candidates: A Single-Center, Retrospective Study

    PubMed Central

    Rossitter, Chad W.; Vigo, Ronald B.; Gaber, Ahmed Osama; Swan, Joshua T.; Suki, Wadi N.

    2017-01-01

    Background Kidney transplant candidates undergo rigorous testing prior to clearance for transplantation. Because kidney transplant candidates may be at increased risk for carotid artery stenosis because of arteriosclerosis and atherosclerosis secondary to hypertension, vascular calcification, and diabetes, carotid ultrasound is often performed with the intent of preventing a cerebrovascular accident in the perioperative or posttransplant period. To our knowledge, there has not been a study investigating the utility of screening carotid ultrasonography in pretransplant candidates. The purpose of the present study was to investigate the yield of carotid ultrasonography in end-stage renal disease patients, at high risk for having clinically significant vascular disease evaluated at our center for kidney transplantation during the years 2009 to 2014. Methods Data for carotid ultrasound findings and risk factors for carotid artery disease were extracted from the medical records. Results A total of 882 patients were included in our study of which only 13 patients (1.47% of the cohort) had significant carotid artery stenosis (>70%) on ultrasound testing. Using multiple logistic regression on the outcome of carotid stenosis, congestive heart failure (adjusted odds ratio, 5.2), and peripheral vascular disease (adjusted odds ratio, 4.4) were positively associated with carotid stenosis. Conclusions The prevalence of significant carotid artery stenosis was only 1.47% in our cohort of kidney transplant candidates, and the routine use of carotid ultrasound testing in this population may not be an efficient use of clinical resources. Use of risk factors, such as congestive heart failure or peripheral vascular disease, may identify patients who are more likely to benefit from carotid ultrasonography screening. PMID:28361119

  11. Combining ultrasonography and noncontrast helical computerized tomography to evaluate Holmium laser lithotripsy

    PubMed Central

    Mi, Jia; Li, Jie; Zhang, Qinglu; Wang, Xing; Liu, Hongyu; Cao, Yanlu; Liu, Xiaoyan; Sun, Xiao; Shang, Mengmeng; Liu, Qing

    2016-01-01

    Abstract The purpose of the study was to establish a mathematical model for correlating the combination of ultrasonography and noncontrast helical computerized tomography (NCHCT) with the total energy of Holmium laser lithotripsy. In this study, from March 2013 to February 2014, 180 patients with single urinary calculus were examined using ultrasonography and NCHCT before Holmium laser lithotripsy. The calculus location and size, acoustic shadowing (AS) level, twinkling artifact intensity (TAI), and CT value were all documented. The total energy of lithotripsy (TEL) and the calculus composition were also recorded postoperatively. Data were analyzed using Spearman's rank correlation coefficient, with the SPSS 17.0 software package. Multiple linear regression was also used for further statistical analysis. A significant difference in the TEL was observed between renal calculi and ureteral calculi (r = –0.565, P < 0.001), and there was a strong correlation between the calculus size and the TEL (r = 0.675, P < 0.001). The difference in the TEL between the calculi with and without AS was highly significant (r = 0.325, P < 0.001). The CT value of the calculi was significantly correlated with the TEL (r = 0.386, P < 0.001). A correlation between the TAI and TEL was also observed (r = 0.391, P < 0.001). Multiple linear regression analysis revealed that the location, size, and TAI of the calculi were related to the TEL, and the location and size were statistically significant predictors (adjusted r2 = 0.498, P < 0.001). A mathematical model correlating the combination of ultrasonography and NCHCT with TEL was established; this model may provide a foundation to guide the use of energy in Holmium laser lithotripsy. The TEL can be estimated by the location, size, and TAI of the calculus. PMID:27930563

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

    PubMed

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

    2003-01-01

    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.

  13. Parathyroid ultrasonography and bone metabolic profile of patients on dialysis with hyperparathyroidism

    PubMed Central

    Ribeiro, Cláudia; Penido, Maria Goretti Moreira Guimarães; Guimarães, Milena Maria Moreira; Tavares, Marcelo de Sousa; Souza, Bruno das Neves; Leite, Anderson Ferreira; de Deus, Leonardo Martins Caldeira; Machado, Lucas José de Campos

    2016-01-01

    AIM To evaluate the parathyroid ultrasonography and define parameters that can predict poor response to treatment in patients with secondary hyperparathyroidism due to renal failure. METHODS This cohort study evaluated 85 patients with chronic kidney disease stage V with parathyroid hormone levels above 800 pg/mL. All patients underwent ultrasonography of the parathyroids and the following parameters were analyzed: Demographic characteristics (etiology of chronic kidney disease, gender, age, dialysis vintage, vascular access, use of vitamin D), laboratory (calcium, phosphorus, parathyroid hormone, alkaline phosphatase, bone alkaline phosphatase), and the occurrence of bone changes, cardiovascular events and death. The χ2 test were used to compare proportions or the Fisher exact test for small sample frequencies. Student t-test was used to detect differences between the two groups regarding continuous variables. RESULTS Fifty-three patients (66.4%) had parathyroid nodules with higher levels of parathyroid hormone, calcium and phosphorus. Sixteen patients underwent parathyroidectomy and had higher levels of phosphorus and calcium × phosphorus product (P = 0.03 and P = 0.006, respectively). They also had lower mortality (32% vs 68%, P = 0.01) and lower incidence of cardiovascular or cerebrovascular events (27% vs 73%, P = 0.02). Calcium × phosphorus product above 55 mg2/dL2 [RR 1.48 (1.06, 2.08), P = 0.03], presence of vascular calcification [1.33 (1.01, 1.76), P = 0.015] and previous occurrence of vascular events [RR 2.25 (1.27, 3.98), P < 0.001] were risk factors for mortality in this population. There was no association between the occurrence of nodules and mortality. CONCLUSION The identification of nodules at ultrasonography strengthens the indication for parathyroidectomy in patients with secondary hyperparathyroidism due to renal failure. PMID:27648407

  14. Detection of duct ectasia of mammary gland by ultrasonography in a neonate with bloody nipple discharge.

    PubMed

    Aydin, Ramazan; Gul, Selim Baris; Polat, Ahmet Veysel

    2014-06-01

    Bloody nipple discharge, a rare finding in infants, is associated most often with benign mammary duct ectasia and commonly resolves spontaneously. Ultrasonography is a useful diagnostic imaging method to detect the cause of discharge. The rarity of this symptom in infants and its association with breast carcinoma in adults can lead to unnecessary investigation and treatment. Here, we describe ultrasonographic and color Doppler ultrasonographic findings of a 20-day-old boy with bilateral bloody nipple discharge that resolved spontaneously without treatment after 15 days. We conclude that bloody nipple discharge is usually a benign and self-limited process in infancy, and that it is advisable to avoid unnecessary invasive investigations initially.

  15. [Ultrasonography and magnetic resonance imaging in diagnosing recurrent and metastatic ovarian cancer].

    PubMed

    Bulanova, I M; Bulanova, T V; Burenchev, D V

    2006-01-01

    The paper deals with the capacities of ultrasonography (USG) and magnetic resonance imaging (MRI) in diagnosing recurrent and metastatic ovarian cancer along with routine clinical and laboratory studies (physical examination, measurement of the tumor-associated serum antigen CA-125) in 95 patients with ovarian cancer after primary special treatment. MRI is preferable to USG in evaluating the extent of a tumorous process and the invasion of a tumor into the adjacent tissues, which is of great value in defining a further treatment policy.

  16. Urinary tract ultrasonography in normal rams and in rams with obstructive urolithiasis

    PubMed Central

    Braun, Ueli; Schefer, Ursula; Föhn, Josef

    1992-01-01

    We determined the position, dimensions, and structure of the kidneys, ureters, bladder, and urethra in 20 healthy, adult rams by use of ultrasonography. The findings were compared with those of seven rams with obstructive urolithiasis, thus establishing criteria for the diagnosis of urolithiasis via ultrasonography. A 5.0 MHz convex transducer was placed over the right paralumbar fossa to examine the kidneys, and a 5.0 MHz linear rectal transducer was used to examine the bladder and urethra transrectally. All examinations were performed on standing rams. The left kidney had a length of 8.4 ± 0.3 cm (mean ± SD), a width of 4.7 ± 0.3 cm, and a depth of 4.4 ± 0.3 cm. The diameter of the renal sinus of the left kidney was 1.5 ± 0.2 cm. The circumference of the medullary pyramids measured 2.8 ± 0.3 cm. Similar ultrasonographic measurements were obtained for the right kidney. The mean diameter of the bladder of 12 rams was 7.5 ± 2.8 cm. The diameter of the bladder could not be determined in the remaining eight rams because it was greater than 10 cm and therefore beyond the penetration depth of the scanner. The only part of the urethra which could be visualized ultrasonographically was the internal urethral orifice. It had a diameter of 0.2 ± 0.1 cm. Ultrasonographic examination of seven rams with obstructive urolithiasis revealed a markedly dilated urethra and urinary bladder. Due to severe cystitis, the contents of the urinary bladder appeared as multiple, tiny, uniformly distributed echoes. The renal pelvis and medullary pyramids of both kidneys were dilated in four rams. In two rams, uroperitoneum and accumulation of urine in the abdomen were diagnosed via ultrasonography. In one ram this was due to a ruptured ureter and in one to a ruptured bladder. The results of this study indicate that ultrasonography is a useful aid in the diagnosis of obstructive urolithiasis. ImagesFigure 2.Figure 3.Figure 4.Figure 5.Figure 6.Figure 7. PMID:17424090

  17. Ultrasonography of Various Thyroid Diseases in Children and Adolescents: A Pictorial Essay

    PubMed Central

    Lee, Eun Hye; Jeong, Sun Hye; Park, Jisang; Lee, Heon

    2015-01-01

    Thyroid imaging is indicated to evaluate congenital hypothyroidism during newborn screening or in cases of a palpable thyroid mass in children and adolescents. This pictorial essay reviews the ultrasonography (US) of thyroid diseases in children and adolescents, including normal thyroid gland development, imaging features of congenital thyroid disorders (dysgenesis, [aplasia, ectopy, hypoplasia], dyshormonogenesis, transient hypothyroidism, thyroglossal duct cyst), diffuse thyroid disease (Grave's disease, Hashimoto's thyroiditis, and suppurative thyroiditis), and thyroid nodules. The primary imaging modalities for evaluating thyroid diseases are US and radionuclide scintigraphy. Additionally, US can be used to guide aspiration of detected nodules. PMID:25741204

  18. Ultrasonography of various thyroid diseases in children and adolescents: a pictorial essay.

    PubMed

    Hong, Hyun Sook; Lee, Eun Hye; Jeong, Sun Hye; Park, Jisang; Lee, Heon

    2015-01-01

    Thyroid imaging is indicated to evaluate congenital hypothyroidism during newborn screening or in cases of a palpable thyroid mass in children and adolescents. This pictorial essay reviews the ultrasonography (US) of thyroid diseases in children and adolescents, including normal thyroid gland development, imaging features of congenital thyroid disorders (dysgenesis, [aplasia, ectopy, hypoplasia], dyshormonogenesis, transient hypothyroidism, thyroglossal duct cyst), diffuse thyroid disease (Grave's disease, Hashimoto's thyroiditis, and suppurative thyroiditis), and thyroid nodules. The primary imaging modalities for evaluating thyroid diseases are US and radionuclide scintigraphy. Additionally, US can be used to guide aspiration of detected nodules.

  19. Ultrasonography of the extremities and pelvic girdle and correlation with computed tomography

    SciTech Connect

    Yeh, H.C.; Rabinowitz, J.G.

    1982-05-01

    Ultrasonography was performed on 54 patients with lesions of the extremities and pelvic girdle. Computed tomography (CT) was employed in 8 patients. Focal space-occupying lesions such as tumors, abscesses, hematomas, aneurysms, and popliteal cysts (dissecting or otherwise) were delineated by ultrasound and their extent defined. Differentiation from diffuse changes such as lymphedema, cellulitis, or phlebitis and diagnosis of aneurysms were possible. Popliteal cysts were ususally quite characteristic, while correlation with the clinical features suggested the correct diagnosis in the case of the other lesions. CT correlated well with ultrasound, except for one tumor of the forearm which was not shown by CT.

  20. Recommendations of the ESSR Arthritis Subcommittee on Ultrasonography in Inflammatory Joint Disease.

    PubMed

    Plagou, Athena; Teh, James; Grainger, Andrew J; Schueller-Weidekamm, Claudia; Sudoł-Szopińska, Iwona; Rennie, Winston; Åström, Gunnar; Feydy, Antoine; Giraudo, Chiara; Guerini, Henri; Guglielmi, Giuseppe; Isaac, Amanda; Jans, Lennart; Jurik, Anne Grethe; Kainberger, Franz; Maas, Mario; Martinoli, Carlo; Mascarenhas, Vasco V; Miese, Falk; O'Connor, Philip; Oei, Edwin H; Østergaard, Mikkel; Peetrons, Philippe; Platzgummer, Hannes; Reijnierse, Monique; Robinson, Philip; Rupreht, Mitja; Simoni, Paolo; Wick, Marius C; Zejden, Anna; Klauser, Andrea S

    2016-11-01

    This article presents the recommendations of the European Society of Musculoskeletal Radiology Arthritis Subcommittee on the use of ultrasonography (US) in rheumatic disease, focused on the examination of joints in the adult population. The recommended examination technique and protocols used in a radiologic work-up are discussed. The main US features that can lead to a final diagnosis in the most common rheumatic diseases are addressed. The differential diagnosis that should be considered at image interpretation is presented. The role of US in interventional procedures and clinically important recent developments is also discussed.

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

    PubMed

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

    2011-05-01

    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.

  2. [Hematoma of the psoas. Comparative diagnostic contributions of ultrasonography and x-ray computed tomography].

    PubMed

    Rivasseau, T; Vandermarcq, P; Boissonnot, L; Drouineau, J; Gil, R

    1985-11-01

    A 11 cases study of hematoma of the iliacus muscle underlines better results obtained by C.T. Scanner compared to those of ultrasonography examination in term of definite diagnoses. Comparison of density values and repeated examination were useful to assert diagnosis and to appreciate the course of the illness. Only C.T. Scanner was able to show which portion of the muscle was concerned. Authors correlated the C.T. Scanner results to the nature of the entrapment neuropathy clinically found: an isolated femoral nerve palsy or association with an obturator nerve dysfunction.

  3. Non-mass-like lesions on breast ultrasonography: a systematic review.

    PubMed

    Uematsu, Takayoshi

    2012-10-01

    This article reviews various non-mass-like ultrasonography (US) findings of the breast and the sonographic-pathologic correlation with Doppler techniques, elastography, and MRI. High-resolution US allows for identification of small, clinically occult non-mass-like US findings. Ductal carcinoma in situ and invasive lobular carcinoma usually manifest as a non-mass-like lesion on US. It is useful to classify non-mass-like lesions on US in a similar manner to the classification of non-mass-like enhancement on MRI.

  4. Fibromatosis associated with silicone breast implant: ultrasonography and MR imaging findings.

    PubMed

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

    2014-01-01

    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.

  5. Comparison of contrast media for visualization of the colon of healthy dogs during computed tomography and ultrasonography.

    PubMed

    Cheon, Byunggyu; Moon, Sohyeon; Park, Seungjo; Lee, Sang-Kwon; Hong, Sunghwa; Cho, Hyun; Choi, Jihye

    2016-11-01

    OBJECTIVE To evaluate contrast agents for their ability to improve visualization of the colon wall and lumen during CT and ultrasonography. ANIMALS 10 healthy adult Beagles. PROCEDURES Food was withheld from dogs for 36 hours, after which dogs consumed 250 mL of polyethylene glycol solution. Dogs were then anesthetized, a contrast agent (tap water, diluted barium, or air; order randomly assigned) was administered rectally, iodine contrast medium (880 mg of I/kg) was administered IV, and CT and ultrasonography of the colon were performed. After a 1-week washout period, this process was repeated with a different contrast agent until all agents had been evaluated. Two investigators reviewed the CT and ultrasonographic images for colon wall thickness, conspicuity, artifacts, wall layering, and degree of lumen dilation at 4 sites. RESULTS Thickness of the colon wall was greatest in CT and ultrasonographic images with water used as contrast agent, followed by barium and then air. The CT images obtained after water administration had a smooth appearance that outlined the colonic mucosa and had the highest score of the 3 contrast agents for wall conspicuity. Although no substantial artifacts related to any of the contrast agents were identified on CT images, barium- and gas-induced shadowing and reverberation artifacts hindered wall evaluation during ultrasonography. For ultrasonography, the degree of conspicuity was highest with barium in the near-field wall and with water in the far-field wall. In contrast to CT, ultrasonography could be used to distinguish wall layering, and the mucosal and muscular layers were distinct with all contrast agents. CONCLUSIONS AND CLINICAL RELEVANCE Use of water as a contrast agent for both CT and ultrasonography of the colon in dogs compensated for each imaging modality's disadvantages and could be beneficial in the diagnosis of colon disease.

  6. Vascular waveform analysis of flap-feeding vessels using color Doppler ultrasonography.

    PubMed

    Ogino, Akihiro; Onishi, Kiyoshi

    2014-01-01

    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.

  7. Successful diagnosis of pericardial rupture caused by blunt chest trauma using contrast ultrasonography.

    PubMed

    Tatekoshi, Yuki; Yuda, Satoshi; Ogasawara, Makoto; Muranaka, Atsuko; Kokubu, Nobuaki; Hase, Mamoru; Tachibana, Kazutoshi; Tsuchihashi, Kazufumi; Higami, Tetsuya; Miura, Tetsuji

    2016-01-01

    A 65-year-old male developed acute myocardial infarction due to coronary artery dissection and tricuspid valve injury after blunt chest trauma. Acute myocardial infarction was treated by coronary artery intervention; however, refractory heart failure with pleural effusion remained. The first transthoracic echocardiography (TTE) on admission failed to clearly visualize the tricuspid valve and right ventricle due to poor image quality. A follow-up TTE with contrast ultrasonography revealed pericardial rupture in addition to tricuspid regurgitation. Ruptures of the tricuspid papillary muscle and pericardium were confirmed during surgery and were repaired successfully. Blunt chest trauma results in various cardiac injuries including cardiac rupture, intramural hematoma, valvular injury, coronary artery injury, and electrical disturbances, leading to critical conditions and high mortality. Of such blunt trauma-induced injuries, coronary artery dissection, tricuspid valve injury, and pericardial rupture caused by blunt chest trauma are rare, and simultaneous occurrence of the three types of injuries that were successfully repaired has not been reported. In addition, this case indicates the utility of contrast ultrasonography for diagnosis of pericardial rupture caused by blunt chest trauma.

  8. The Prognostic Value of Using Ultrasonography in Cardiac Resuscitation of Patients with Cardiac Arrest

    PubMed Central

    Bolvardi, Ehsan; Pouryaghobi, Seyyed Mohsen; Farzane, Roohye; Chokan, Niaz Mohamad Jafari; Ahmadi, Koorosh; Reihani, Hamidreza

    2016-01-01

    Cardiopulmonary arrest is the final result of many diseases and therefore, need for a careful implementation of cardiopulmonary resuscitation (CPR) protocols in these cases is undeniably important. The introduction of ultrasound into the emergency department has potentially allowed the addition of an extra data point in the decision about when to cease cardiopulmonary resuscitation (CPR). The aim of this study is to evaluate the ability of cardiac ultrasonography performed by emergency physicians to predict resuscitation outcome in adult cardiac arrest patients. Ultrasonographic examination of the subxiphoid cardiac area was made immediately after admission to the emergency department with pulseless cardiac arrest. Sonographic cardiac activity was defined as any detectable motion within the heart including the atria, ventricles or valves. Successful resuscitation was defined as: return of spontaneous circulation for ≥ 20 min; return of breathing; palpable pulse; measurable blood pressure. The present study includes 159 patients. The presence of sonographic cardiac activity at the beginning of resuscitation was significantly associated with a successful outcome (41/49 [83.7%] versus 15/110 [13.6%] patients without cardiac activity at the beginning of resuscitation). Ultrasonographic detection of cardiac activity may be useful in determining prognosis during cardiac arrest. Further studies are needed to elucidate the predictive value of ultrasonography in cardiac arrest patients. PMID:27829827

  9. Cardiac biomarkers and ultrasonography as tools in prediction and diagnosis of traumatic pericarditis in Egyptian buffaloes

    PubMed Central

    Attia, Noura E.

    2016-01-01

    Aim: This study was designed to evaluate the cardiac biomarkers and ultrasonography in prediction and early diagnosis of traumatic pericarditis (TP) in Egyptian buffaloes. Materials and Methods: A total number of 47 buffaloes were included in the study and divided into two groups: Healthy (n=10) and diseased groups (n=37). Diseased buffaloes were admitted to the Veterinary Teaching Hospital at Zagazig University, Egypt, with a history of anorexia, sudden, and severe reduction of milk production with no response to a previous medical treatment some animals had edema at the dewlap and congestion of the jugulars. These animals were subjected to clinical examination, evaluation by hemato-biochemical analysis including cardiac biomarkers and sonography. Results: The hemato-biochemical analysis revealed leukocytosis with a shift to left and hyperfibrinogenemia (indicating inflammation). Serum cardiac biomarkers including cardiac troponin I (cTnI), cTnT, nitric oxide, creatine kinase myocardial band, and lactic dehydrogenase enzyme were significantly increased in buffaloes with TP compared with control ones. Ultrasonographically, there were hypoechoic materials with echogenic fibrin interspersed in between the pericardial sac. Conclusions: The cardiac biomarkers may be considered a useful index in the early diagnosis of TP. Moreover, ultrasonography is an excellent tool for early prediction and diagnosis of such condition. PMID:27733799

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

    PubMed

    Mlosek, Robert Krzysztof; Malinowska, Sylwia

    2014-09-01

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

  11. Association Between Obstetric Conjugate Diameter Measured by Transabdominal Ultrasonography During Pregnancy and the Type of Delivery

    PubMed Central

    Daghighi, Mohammad Hossein; Poureisa, Masoud; Ranjkesh, Mahnaz

    2013-01-01

    Background Normal morphological features of the maternal pelvis are an important prerequisite to vaginal delivery. Objectives We aimed to evaluate the association between obstetric conjugate diameter (OCD) measured by ultrasonography and the type of delivery, vaginally (V) or by cesarean (C) section. Patients and Methods Pelvimetry was performed in 200 primigravid women for fetal cephalic presentation. The OCD was measured twice by transabdominal ultrasonography during 25-30 weeks and 30-35 weeks of pregnancy. Results The mean OCD of both sonographies in groups V and C was 125.51± 8.35 mm (105-144.5) and 112.99 ± 8.53 mm (96-134.5), respectively, which was significantly lower in group C (P<0.001). The values of OCD between the first and second measurements were not different significantly (P=0.065). C-section was indicated in 65 (32.5%) mothers. The optimal cut-off point for the OCD in the prediction of vaginal delivery was ≥ 119.75 mm, with a sensitivity and specificity of 80% and 78.5%, respectively. Conclusion The US measurement of OCD might be an accurate method that almost always remains constant during late pregnancy; it is easy to measure and might be confidentially employed for predicting C-section, but needs more precise studies to be used widely. PMID:24348610

  12. Utility of high-frequency ultrasonography in the diagnosis of benign and malignant skin tumors.

    PubMed

    Bhatt, Kalpana Deepak; Tambe, Swagata Arvind; Jerajani, Hemangi Rajiv; Dhurat, Rachita S

    2017-01-01

    Various benign and malignant tumors may arise from the skin. These may be of epidermal, dermal, subcutaneous or appendageal origin. Skin biopsy is the gold standard for diagnosis of skin tumors. There is paucity of published data on the role of imaging modalities in diagnosis of skin tumors. High-frequency ultrasonography (7-50 MHz) is a potential non-invasive, objective modality which can be utilized in the diagnosis and localization of skin tumors. It provides valuable information about the tumor characteristics such as size, shape, depth, consistency and vascularity before invasive skin biopsy or surgery is planned. Sentinel lymph nodes in malignant melanoma can be well visualized and studied by this technique. It is also a good modality to detect local recurrence of tumors during post-operative follow up, especially those with a high likelihood of local recurrence or lesions excised with inadequate margins. High-frequency ultrasonography is additive to clinical diagnosis and can be considered a useful non-invasive method to plan the management of various skin tumors and is of prognostic value in some cases.

  13. Double contrast-enhanced two-dimensional and three-dimensional ultrasonography for evaluation of gastric lesions

    PubMed Central

    Shi, Hong; Yu, Xiu-Hua; Guo, Xin-Zhang; Guo, Yuan; Zhang, Hong; Qian, Bin; Wei, Zhang-Rui; Li, Li; Wang, Xian-Chen; Kong, Zi-Xiang

    2012-01-01

    AIM: To investigate the value of two-dimensional (2D) and three-dimensional (3D) double contrast-enhanced ultrasonography (DCUS) imaging for evaluation of gastric lesions. METHODS: 2D and 3D DCUS imaging with both oral and intravenous administrations of contrast agents was used to assess gastroscopiclly-confirmed gastric lesions in 46 patients with benign and malignant diseases. Initially, liquid-based ultrasound contrast agent (Xinzhang®) was given orally at dose of 500-600 mL for conventional ultrasound examination of the gastric lesions, and then a microbubble-based contrast agent (SonoVue) was injected intravenously at dose of 1.2-2.4 mL in bolus fashion to assess the perfusion pattern of the lesions using contrast imaging modes. The parameters derived from time-intensity curves including the arrival time (AT), time to peak (TTP), peak intensity (PI) and enhanced intensity (EI) were measured on the 2D DCUS imaging. 3D DCUS of the lesions was acquired to demonstrate the value of this imaging mode. RESULTS: There were 22 cases with benign lesions including chronic gastritis (n = 5), gastric ulcer (n = 9), gastric polyps (n = 3), gastric stromal tumors (n = 5), and 24 cases with malignant lesions including gastric cancer (n = 20), gastric cardia carcinoma (n = 3) and post-operative recurrent gastric cancer (n = 1) in the study. The oral contrast-enhanced ultrasonography (CEUS) imaging of the stomach clearly demonstrated the anatomy of the stomach and morphologic features of gastric lesions. With optimal scanning window and imaging display under oral CEUS, intravenous CEUS clearly showed the perfusion of gastric lesions with various characteristic manifestations. Both 2D and 3D DCUS images clearly demonstrated normal gastric wall as a three-layer structure, from the inside out, hyperechoic mucosa, hypoechoic muscularis and hyperechoic serosa, respectively. There were statistical significant differences of AT (8.68 ± 2.06 vs 10.43 ± 2.75, P = 0.017), PI (34.64

  14. Time to rethink: an evidence-based response from pelvic surgeons to the FDA Safety Communication: "UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ Prolapse".

    PubMed

    Murphy, Miles; Holzberg, Adam; van Raalte, Heather; Kohli, Neeraj; Goldman, Howard B; Lucente, Vincent

    2012-01-01

    In July of 2011 the U.S. Food and Drug Administration (FDA) released a safety communication entitled "UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ Prolapse." The stated purpose of this communication is to inform health care providers and patients that serious complications with placement of this mesh are not rare and that it is not clear that these repairs are more effective than nonmesh repair. The comments regarding efficacy are based on a systematic review of the scientific literature from 1996-2011 conducted by the FDA. Our review of the literature during this time yields some different conclusions regarding the safety and efficacy of mesh use in prolapse repair. It may be useful to consider this information prior to making recommendations regarding mesh use in prolapse surgery according to the recent UPDATE.

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

    ERIC Educational Resources Information Center

    Akkoc, Yesim; Cinar, Yasemin; Kismali, Erkan

    2012-01-01

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

  16. Color duplex ultrasonography of temporal arteries: role in diagnosis and follow-up of suspected cases of temporal arteritis.

    PubMed

    Habib, Hisham M; Essa, Ashraf A; Hassan, Ayman A

    2012-02-01

    The objectives of this study are to study the diagnostic value of color duplex ultrasonography (CDU) compared with the clinical results and temporal artery biopsy (TAB) in patients with suspected temporal arteritis (TA) and evaluate the prognostic value of CDU in follow-up of patients of sure diagnosis of TA under treatment in correlation to clinical response. The study included 32 consecutive patients of clinically suspected TA, and 30 age- and gender-matched control subjects. Baseline clinical characteristics and bilateral CDU of temporal arteries were performed to all subjects. CDU aimed to assess presence of a dark halo around the arterial lumen (a halo sign) or presence of stenoses and occlusions of temporal arteries. Unilateral TAB was performed then in all patients but not in control subjects. Subsequent CDU examinations were performed at 2, 4, 8, and 12 weeks after onset of treatment in patients with abnormal CDU. A halo sign at baseline CDU was evident in 13 TA patients (81%) and in 2 non-TA patients (12%) but none in control subjects. The presence of a halo sign in total yielded 81% sensitivity and 88% specificity whereas the presence of bilateral halo sign yielded 37% sensitivity and 100% specificity. Subsequent CDU examinations of TA patients showed disappearance of a halo sign in nine patients at 2 weeks and in four patients at 4 weeks with a mean of disappearance of 21 days after initiation of treatment. CDU is non-invasive, easy, and inexpensive method for diagnosis of TA. It is of higher sensitivity and specificity. It can be used in combination with clinical and laboratory tools for diagnosis of TA. It can effectively predict which patient will need TAB. In patients with bilateral halo sign, TAB is not necessary.

  17. Comparison of intraductal ultrasonography-directed and cholangiography-directed endoscopic retrograde biliary drainage in patients with a biliary obstruction

    PubMed Central

    Rew, Soo-Jung; Lee, Du-Hyeon; Park, Chang-Hwan; Jeon, Jin; Kim, Hyun-Soo; Choi, Sung-Kyu; Rew, Jong-Sun

    2016-01-01

    Background/Aims: Endoscopic retrograde biliary drainage (ERBD) has become a standard procedure in patients with a biliary obstruction. Intraductal ultrasonography (IDUS) has emerged as a new tool for managing extrahepatic biliary diseases. IDUS-directed ERBD can be performed without conventional cholangiography (CC). The goal of this study was to assess the effectiveness and safety of IDUS-directed ERBD compared to CC-directed ERBD in patients with an extrahepatic biliary obstruction. Methods: A total of 210 patients who had undergone IDUS-directed ERBD (IDUS-ERBD, n = 105) and CC-directed ERBD (CC-ERBD, n = 105) between October 2013 and April 2014 were analyzed retrospectively. The primary outcome measure was the procedural success rate. Secondary outcome measures included clinical outcomes, total procedure time, radiation exposure time, and overall complication rates. Results: The total technical success rate of ERBD was 100% (105/105) in the IDUS-ERBD and CC-ERBD groups. Mean procedure time was slightly prolonged in the IDUS-ERBD group than that in the CC-ERBD group (32.1 ± 9.9 minutes vs. 28.4 ± 11.6 minutes, p = 0.023). Mean radiation exposure time was one-third less in the IDUS-ERBD group than that in the CC-ERBD group (28.0 ± 49.3 seconds vs. 94.2 ± 57.3 seconds, p < 0.001). No significant differences in complication rates were detected between the groups. Conclusions: IDUS-ERBD was equally effective and safe as CC-ERBD in patients with an extrahepatic biliary obstruction. Although IDUS-ERBD increased total procedure time, it significantly decreased radiation exposure. PMID:27097771

  18. Limitations of Condensed Teaching Strategies to Develop Hand-Held Cardiac Ultrasonography Skills in Internal Medicine Residents.

    PubMed

    Wilkinson, Jeffrey S; Barake, Walid; Smith, Chris; Thakrar, Amar; Johri, Amer M

    2016-08-01

    Advances in ultrasonographic technology have allowed for hand-held cardiac ultrasonography (HHCU) units that fit into a physician's laboratory coat. Recently, studies to educate internal medicine residents have shown promise. The optimal duration and methodology for teaching HHCU skills has not been established. Over a 1-year period, internal medicine residents were recruited during their cardiology ward rotation into a single-centre nonblinded randomized trial. The 2 condensed teaching strategies were (1) a conventional ward-based program and (2) a technology-driven simulation-based strategy. Outcomes were evaluated by (1) an objective structured clinical examination (OSCE) to evaluate interpretation ability (assessing both type I and type II error rates) and (2) demonstration of HHCU skills graded by 2 level III echocardiographers. Twenty-four internal medicine residents were randomized. After teaching, the conventional teaching group had a significant absolute increase in the ability to make a singular correct diagnosis (20%; P < 0.001). In the technology arm, making a singular correct diagnosis increased 24% from baseline (P = 0.001). Interpretation skill was not significantly different between groups. The false-positive rate increased by an absolute 14% and 17% in the conventional and technology groups, respectively (P = 0.079 and P = 0.008). Our findings suggest that HHCU interpretation skills improve after either a conventional ward-based or a technology-driven approach. However, our study emphasizes the important limitations of both teaching programs, because we detected a trend toward an increase in the false-positive rate after both approaches. This suggests that a short duration of training may not be sufficient for HHCU to be performed in a safe manner.

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

    PubMed

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

    2014-09-01

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

  20. EULAR report on the use of ultrasonography in painful knee osteoarthritis. Part 1: Prevalence of inflammation in osteoarthritis

    PubMed Central

    D'Agostino, M; Conaghan, P; Le Bars, M; Baron, G; Grassi, W; Martin-Mola, E; Wakefield, R; Brasseur, J; So, A; Backhaus, M; Malaise, M; Burmester, G; Schmidely, N; Ravaud, P; Dougados, M; Emery, P

    2005-01-01

    Objectives: To assess the prevalence of inflammation in subjects with chronic painful knee osteoarthritis (OA), as determined by the presence of synovitis or joint effusion at ultrasonography (US); and to evaluate the correlation between synovitis, effusion, and clinical parameters. Methods: A cross sectional, multicentre, European study was conducted under the umbrella of EULAR-ESCISIT. Subjects had primary chronic knee OA (ACR criteria) with pain during physical activity ⩾30 mm for at least 48 hours. Clinical parameters were collected by a rheumatologist and an US examination of the painful knee was performed by a radiologist or rheumatologist within 72 hours of the clinical examination. Ultrasonographic synovitis was defined as synovial thickness ⩾4 mm and diffuse or nodular appearance, and a joint effusion was defined as effusion depth ⩾4 mm. Results: 600 patients with painful knee OA were analysed. At US 16 (2.7%) had synovitis alone, 85 (14.2%) had both synovitis and effusion, 177 (29.5%) had joint effusion alone, and 322 (53.7%) had no inflammation according to the definitions employed. Multivariate analysis showed that inflammation seen by US correlated statistically with advanced radiographic disease (Kellgren-Lawrence grade ⩾3; odds ratio (OR) = 2.20 and 1.91 for synovitis and joint effusion, respectively), and with clinical signs and symptoms suggestive of an inflammatory "flare", such as joint effusion on clinical examination (OR = 1.97 and 2.70 for synovitis and joint effusion, respectively) or sudden aggravation of knee pain (OR = 1.77 for joint effusion). Conclusion: US can detect synovial inflammation and effusion in painful knee OA, which correlate significantly with knee synovitis, effusion, and clinical parameters suggestive of an inflammatory "flare". PMID:15878903

  1. Assessment.

    ERIC Educational Resources Information Center

    Andrews, Theodore E., Ed.

    "The Role of the State in Performance-Based Teacher Education-Certification" by Robert Roth creates a context for viewing how state agencies are approaching performance education. Peter Airasian then explores the value questions that are at the heart of evaluation issues. Fred McDonald looks at "The State of the Art in Performance Assessment," and…

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

    ERIC Educational Resources Information Center

    Myowa-Yamakoshi, Masako; Takeshita, Hideko

    2006-01-01

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

  3. [Effects of Calorie Mate Jelly eating before abdominal ultrasonography on the diagnosis--an evaluation in healthy adults].

    PubMed

    Takizawa, Yoshinori; Suzuki, Kazutomo; Kawamura, Kenya; Shibazaki, Mitsuei; Haruki, Kosuke

    2011-03-01

    In transabdominal ultrasonography, the production of gas in the gastro-intestinal tract and contraction of the gallbladder have to be prevented to obtain clear observation images of any lesions. Therefore, patients avoid food and drink for many hours from the night before the examination. However, long-term fasting exacerbates energy homeostasis in patients with cirrhosis. Thus, it is necessary to develop a method of transabdominal ultrasonography allowing the shortening of the fasting time. In this study, subjects ingested Calorie Mate Jelly three hours before transabdominal ultrasonography. Then, we studied the effect of the Jelly on ultrasonographic images. Three hours after its consumption, imaging diagnosis involving the liver, in liver, gallbladder, pancreas, spleen, and kidney could be successfully carried out in all healthy adults. Thus, our observations indicated that the abdominal organs can be effectively observed by transabdominal ultrasonography if Calorie Mate Jelly is consumed up to three hours before the examination. Calorie Mate Jelly may help to prevent worsening energy homeostasis in patients who are required to fast for a prolonged period.

  4. Ultrasonography as a tool for monitoring the development and progression of cholangiocarcinoma in Opisthorchis viverrini/ dimethylnitrosamine-induced hamsters.

    PubMed

    Plengsuriyakarn, Tullayakorn; Eursitthichai, Veerachai; Labbunruang, Nipawan; Na-Bangchang, Kesara; Tesana, Smarn; Aumarm, Waraporn; Pongpradit, Ananya; Viyanant, Vithoon

    2012-01-01

    Cholangiocarcinoma (CCA) is the most common cancer in northeastern Thailand. At present, effective diagnosis of CCA either in humans or animals is not available. Monitoring the development and progression of CCA in animal models is essential for research and development of new promising chemotherapeutics. Ultrasonography has been widely used for screening of bile duct obstruction in CCA patients. In this study, we preliminarily investigated the applicability of ultrasonography to monitor the development and progression of CCA in Syrian golden hamsters (n=8) induced by Opisthorchis viverrini (OV)/dimethylnitrosamine (DMN) administration. Ultrasonography and histopathological examination of hamsters was performed at week 0, 20, 24 and 28 of OV infection or at the start of water/Tween-80 administration to controls. The ultrasonographic images of liver parenchyma and gallbladders of OV/DMN-induced CCA hamsters showed sediments in gallbladder, thickening of gallbladder wall, and hypoechogenicity of liver parenchyma cells. The ultrasonographic images of liver tissues were found to correlate well with histopathological examination. Although ultrasonography does not directly detect the occurrence of CCA, it reflects the thickening of bile ducts and abnormality of liver tissues. It may be applied as a reliable tool for monitoring the development and progression of CCA in animal models in research and development of new promising chemotherapeutics for CCA.

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  6. Contrast Agent Ultrasonography before and after HIFU Treatment of Parathyroid Glands

    NASA Astrophysics Data System (ADS)

    Kovatcheva, Roussanka; Arnaud, Françoise; Lacoste, François

    2010-03-01

    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.

  7. Iatrogenic water intoxication during pelvic ultrasonography in a patient with diabetes insipidus.

    PubMed

    Derinöz, Okşan; Emeksiz, Hamdi Cihan; Kalkan, Gökhan; Camurdan, Orhun

    2012-01-01

    Pelvic ultrasonography (US) is a simple and non-invasive radiologic test to evaluate the pelvic organs. It requires a full bladder for better visualization. Our case is a 14-year-old female with diabetes insipidus (DI) who admitted to the pediatric emergency service with the complaints of seizure and agitation after drinking 4 liters of water in one hour for a pelvic US examination due to work-up for delayed puberty. Her biochemical and clinical evaluation revealed water intoxication (WI). To our knowledge, this is the first WI case developed in a patient with DI. Here, we discuss the underlying factors leading to this complication and recommended an approach to obtain a better sonographic image without necessitating oral water intake to fill the urinary bladder.

  8. Gabor-based anisotropic diffusion for speckle noise reduction in medical ultrasonography.

    PubMed

    Zhang, Qi; Han, Hong; Ji, Chunhong; Yu, Jinhua; Wang, Yuanyuan; Wang, Wenping

    2014-06-01

    In ultrasound (US), optical coherence tomography, synthetic aperture radar, and other coherent imaging systems, images are corrupted by multiplicative speckle noise that obscures image interpretation. An anisotropic diffusion (AD) method based on the Gabor transform, named Gabor-based anisotropic diffusion (GAD), is presented to suppress speckle in medical ultrasonography. First, an edge detector using the Gabor transform is proposed to capture directionality of tissue edges and discriminate edges from noise. Then the edge detector is embedded into the partial differential equation of AD to guide the diffusion process and iteratively denoise images. To enhance GAD's adaptability, parameters controlling diffusion are determined from a fully formed speckle region that is automatically detected. We evaluate the GAD on synthetic US images simulated with three models and clinical images acquired in vivo. Compared with seven existing speckle reduction methods, the GAD is superior to other methods in terms of noise reduction and detail preservation.

  9. Transabdominal ultrasonography as a monitoring tool for pregnancy in Alpine marmots (Marmota marmota).

    PubMed

    Knauf, Sascha; Exner, Cornelia; Hospes, Rainer; Heldmaier, Gerhard; Wehrend, Axel

    2009-12-01

    In the wild, Alpine marmots (Marmota marmota) spend most of their time in underground burrows. Thus the observation of reproduction biology during mating season, gestation, and the early juvenile development is extremely challenging. An ultrasonographic follow-up of pregnancies in captive alpine marmots illustrates the characteristic findings of different gestational phases. The first ultrasonographic proof for a pregnancy was detected on day -25 (day 0 defined as partus). At day -18, first heartbeats were visualized, followed by spontaneous fetal movements on day -14. At day -7, the mineralization of the skeletal system was demonstrated. It was possible to evaluate and monitor the integrity of pregnancy. Ultrasonography is a noninvasive, alternative tool to the classical verification of pregnancy in marmots by progesterone measurement from serum samples.

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

    SciTech Connect

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

    1982-04-01

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

  11. Does the use of bedside ultrasonography reduce emergency department length of stay for patients with renal colic?: a pilot study

    PubMed Central

    Park, Yong Hoon; Jung, Ru Bi; Lee, Young Geun; Hong, Chong Kun; Ahn, Jung-Hwan; Shin, Tae Yong; Kim, Young Sik; Ha, Young Rock

    2016-01-01

    Objective The aim of this study was to evaluate the effect of adding bedside ultrasonography to the diagnostic algorithm for nephrolithiasis on emergency department (ED) length of stay. Methods A prospective, randomized, controlled pilot study was conducted from October 2014 to December 2014 with patients with acute flank pain. In the non-ultrasonography group (NUSG), non-contrast computed tomography was selected based on clinical features and hematuria in the urinalysis. In the ultrasonography group (USG), non-contrast computed tomography was selected based on clinical features and hydronephrosis on bedside ultrasonography. The primary outcome was ED length of stay. The secondary outcomes were radiation exposure, amount of analgesics, proportion of patients with diseases other than ureteral calculus, and proportion of patients with unexpected ED revisits within 7 days from the index visit. Results A total of 103 patients were enrolled (NUSG, 51; USG, 52). The ED length of stay for the USG (89.0 minutes) was significantly shorter than that for the NUSG (163.0 minutes, P<0.001). There were no significant differences between the two groups in the radiation exposure dose (5.29 and 5.08 mSv, respectively; P=0.392), amount of analgesics (P=0.341), proportion of patients with diseases other than ureteral calculus (13.0% and 6.8%, respectively; P=0.486), and proportion of patients with unexpected ED revisits within 7 days from the index visit (7.8% and 9.6%, respectively; P=1.000). Conclusion The use of early bedside ultrasonography for patients with acute flank pain could reduce the ED length of stay without increasing unexpected ED revisits. PMID:28168226

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

    PubMed

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

    2015-11-01

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

  13. Severe Portal Hypertension in Cirrhosis: Evaluation of Perfusion Parameters with Contrast-Enhanced Ultrasonography

    PubMed Central

    Sohn, Joo Hyun; Kim, Yongsoo; Kim, Jinoo

    2015-01-01

    Objective To investigate the role of contrast-enhanced ultrasonography (CEUS) and Doppler ultrasonography (DUS) in the diagnosis of severe portal hypertension (PH) in patients with liver cirrhosis (LC). Methods Patients with PH scheduled to receive hepatic venous pressure gradient (HVPG) measurement were recruited for this study. Hepatic DUS and CEUS were performed successively. Several Doppler and CEUS parameters were explored for correlation with HVPG values and their association with severe PH (≥ 12 mmHg of HVPG). Comparison of the parameters between the severe and non-severe PH groups and their correlation with HVPG values was evaluated. A receiver operating characteristic (ROC) curve analysis was also performed to investigate the performance in order to diagnose severe PH. Results Fifty-three consecutive patients were enrolled in this study. Among them, 43 patients did not have significant ascites. Compared with the non-severe PH group, portal venous velocity and intrahepatic transit time (ITT) were significantly reduced in the severe PH group (all p<0.05). Difference between inspiratory and expiratory hepatic venous damping indices (ΔHVDI), hepatic venous arrival time (HVAT) and ITT moderately correlated with HVPG (r = -0.358, -0.338, and -0.613, respectively). Areas under the curves for severe PH were 0.94 of ITT and 0.72 of HVAT, respectively (all p<0.05). ITT under 6 seconds indicated severe PH with a sensitivity of 92% and a specificity of 89%. Conclusions Hepatic CEUS may be more useful in estimating the HVPG value and determining the presence of severe PH compared to DUS, and ITT was the most accurate parameter to diagnose severe PH. PMID:25798930

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

    PubMed Central

    Lee, Jae Bok; Kim, Woo Young

    2015-01-01

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

  15. The value of magnetic resonance imaging and ultrasonography (MRI/US)-fusion biopsy platforms in prostate cancer detection: a systematic review.

    PubMed

    Gayet, Maudy; van der Aa, Anouk; Beerlage, Harrie P; Schrier, Bart Ph; Mulders, Peter F A; Wijkstra, Hessel

    2016-03-01

    Despite limitations considering the presence, staging and aggressiveness of prostate cancer, ultrasonography (US)-guided systematic biopsies (SBs) are still the 'gold standard' for the diagnosis of prostate cancer. Recently, promising results have been published for targeted prostate biopsies (TBs) using magnetic resonance imaging (MRI) and ultrasonography (MRI/US)-fusion platforms. Different platforms are USA Food and Drug Administration registered and have, mostly subjective, strengths and weaknesses. To our knowledge, no systematic review exists that objectively compares prostate cancer detection rates between the different platforms available. To assess the value of the different MRI/US-fusion platforms in prostate cancer detection, we compared platform-guided TB with SB, and other ways of MRI TB (cognitive fusion or in-bore MR fusion). We performed a systematic review of well-designed prospective randomised and non-randomised trials in the English language published between 1 January 2004 and 17 February 2015, using PubMed, Embase and Cochrane Library databases. Search terms included: 'prostate cancer', 'MR/ultrasound(US) fusion' and 'targeted biopsies'. Extraction of articles was performed by two authors (M.G. and A.A.) and were evaluated by the other authors. Randomised and non-randomised prospective clinical trials comparing TB using MRI/US-fusion platforms and SB, or other ways of TB (cognitive fusion or MR in-bore fusion) were included. In all, 11 of 1865 studies met the inclusion criteria, involving seven different fusion platforms and 2626 patients: 1119 biopsy naïve, 1433 with prior negative biopsy, 50 not mentioned (either biopsy naïve or with prior negative biopsy) and 24 on active surveillance (who were disregarded). The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess the quality of included articles. No clear advantage of MRI/US fusion-guided TBs was seen for cancer detection rates (CDRs) of all prostate

  16. High-Resolution Ultrasonography of the Superficial Peroneal Motor and Sural Sensory Nerves May Be a Non-invasive Approach to the Diagnosis of Vasculitic Neuropathy

    PubMed Central

    Üçeyler, Nurcan; Schäfer, Kristina A.; Mackenrodt, Daniel; Sommer, Claudia; Müllges, Wolfgang

    2016-01-01

    High-resolution ultrasonography (HRUS) is an emerging new tool in the investigation of peripheral nerves. We set out to assess the utility of HRUS performed at lower extremity nerves in peripheral neuropathies. Nerves of 26 patients with polyneuropathies of different etiologies and 26 controls were investigated using HRUS. Patients underwent clinical, laboratory, electrophysiological assessment, and a diagnostic sural nerve biopsy as part of the routine work-up. HRUS was performed at the sural, tibial, and the common, superficial, and deep peroneal nerves. The superficial peroneal nerve longitudinal diameter (LD) distinguished best between the groups: patients with immune-mediated neuropathies (n = 13, including six with histology-proven vasculitic neuropathy) had larger LD compared to patients with non-immune-mediated neuropathies (p < 0.05) and to controls (p < 0.001). Among all subgroups, patients with vasculitic neuropathy showed the largest superficial peroneal nerve LD (p < 0.001) and had a larger sural nerve cross-sectional area when compared with disease controls (p < 0.001). Enlargement of the superficial peroneal and sural nerves as detected by HRUS may be a useful additional finding in the differential diagnosis of vasculitic and other immune-mediated neuropathies. PMID:27064457

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

    PubMed

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

    2015-05-01

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

  18. High-Resolution Ultrasonography of the Superficial Peroneal Motor and Sural Sensory Nerves May Be a Non-invasive Approach to the Diagnosis of Vasculitic Neuropathy.

    PubMed

    Üçeyler, Nurcan; Schäfer, Kristina A; Mackenrodt, Daniel; Sommer, Claudia; Müllges, Wolfgang

    2016-01-01

    High-resolution ultrasonography (HRUS) is an emerging new tool in the investigation of peripheral nerves. We set out to assess the utility of HRUS performed at lower extremity nerves in peripheral neuropathies. Nerves of 26 patients with polyneuropathies of different etiologies and 26 controls were investigated using HRUS. Patients underwent clinical, laboratory, electrophysiological assessment, and a diagnostic sural nerve biopsy as part of the routine work-up. HRUS was performed at the sural, tibial, and the common, superficial, and deep peroneal nerves. The superficial peroneal nerve longitudinal diameter (LD) distinguished best between the groups: patients with immune-mediated neuropathies (n = 13, including six with histology-proven vasculitic neuropathy) had larger LD compared to patients with non-immune-mediated neuropathies (p < 0.05) and to controls (p < 0.001). Among all subgroups, patients with vasculitic neuropathy showed the largest superficial peroneal nerve LD (p < 0.001) and had a larger sural nerve cross-sectional area when compared with disease controls (p < 0.001). Enlargement of the superficial peroneal and sural nerves as detected by HRUS may be a useful additional finding in the differential diagnosis of vasculitic and other immune-mediated neuropathies.

  19. Early Detection of Fetal Malformation, a Long Distance Yet to Cover! Present Status and Potential of First Trimester Ultrasonography in Detection of Fetal Congenital Malformation in a Developing Country: Experience at a Tertiary Care Centre in India

    PubMed Central

    Kashyap, Namrata; Pradhan, Mandakini; Singh, Neeta; Yadav, Sangeeta

    2015-01-01

    Background. Early detection of malformation is tremendously improved with improvement in imaging technology. Yet in a developing country like India majority of pregnant women are not privileged to get timely diagnosis. Aims and Objectives. To assess the present status and potential of first trimester ultrasonography in detection of fetal congenital structural malformations. Methodology. This was a retrospective observational study conducted at Sanjay Gandhi Postgraduate Institute of Medical Sciences. All pregnant women had anomaly scan and women with fetal structural malformations were included. Results. Out of 4080 pregnant women undergoing ultrasound, 312 (7.6%) had fetal structural malformation. Out of 139 patients who were diagnosed after 20 weeks, 47 (33.8%) had fetal structural anomalies which could have been diagnosed before 12 weeks and 92 (66.1%) had fetal malformations which could have been diagnosed between 12 and 20 weeks. Conclusion. The first trimester ultrasonography could have identified 50% of major structural defects compared to 1.6% in the present scenario. This focuses on the immense need of the hour to gear up for early diagnosis and timely intervention in the field of prenatal detection of congenital malformation. PMID:26759727

  20. [Arteriovenous fistula of the spleen revealed by ascites and profuse diarrhea. A case report including ultrasonography and arteriography findings (author's transl)].

    PubMed

    Wenger, J J; Matter, D; Dupeyron, J P; Kretz, J G; Challan-Belval, P; Warter, P

    1981-05-01

    Abdominal pain, ascites and diarrhea revealed acute portal hypertension in a young woman. Ultrasonography and angiography demonstrated the causative congenital arterio-venous fistula of the splenic vessels. Surgery was successfully performed.

  1. Carotid bruits as predictor for carotid stenoses detected by ultrasonography: an observational study

    PubMed Central

    Johansson, Elias P; Wester, Per

    2008-01-01

    Background Carotid surgery in asymptomatic subjects with carotid stenosis is effective to prevent ischemic stroke. There is, however, uncertainty how to find such persons at risk, because mass screening with carotid artery ultrasonography (US) is not cost-effective. Signs of carotid bruits corresponding to the carotid arteries may serve as a tool to select subjects for further investigation. This study is thus aimed at determining the usefulness of carotid bruits in the screening of carotid stenoses. Methods 1555 consecutive carotid ultrasonography investigations from 1486 cases done between January 2004 and March 2006 at Norrlands University Hospital, Sweden, were examined. 356 subjects, medium age 69 (27–88) years, had a significant (≥ 50%) US-verified carotid stenosis uni- or bilaterally, 291 had been examined for signs of carotid bruits. The likelihood ratios for carotid bruits to predict US-verified carotid stenoses were calculated and expressed as likelihood percentages. Results Thirty-one out of 100 persons (31%) with carotid bruit as an indication to perform carotid US had a significant (≥ 50%) carotid stenosis. 281 of the 356 (79%) cases with significant carotid stenoses were found among patients with cerebrovascular disease (CVD). 145 of 226 (64%) CVD patients with a significant carotid stenosis had a carotid bruit. In patients with 50–99% carotid stenoses carotid bruits had an accuracy of 75% (436/582), a sensitivity of 71% (236/334), a specificity of 81% (200/248), a positive likelihood ratio at 3.65 and a negative likelihood at 0.36. Patients with 70–99% stenoses had the highest sensitivity at 77% (183/238). In patients with 100% carotid stenoses, carotid bruits had a sensitivity of 26% (15/57) and a specificity of 49% (256/525). Conclusion Although carotid bruits are not accurate to confirm or to exclude significant carotid stenoses, these signs are appropriate for directed screening for further investigation with carotid US if the patient

  2. Using Doppler ultrasonography on day 34 of pregnancy to predict pregnancy loss in lactating dairy cattle.

    PubMed

    Kelley, Dale E; Galvão, Klibs N; Mortensen, Christopher J; Risco, Carlos A; Ealy, Alan D

    2017-04-01

    The objective of this experiment was to determine whether uterine or ovarian vascular dynamics could be used to identify cows at risk for pregnancy loss. Our hypothesis was that cows that subsequently lose their pregnancy will have decreased corpus luteal (CL) perfusion, or an increased resistance index (RI; reduced blood flow), or both, at d 34 of pregnancy. Day 34 was chosen because it is a common time for dairy cattle to be checked for pregnancy. This experiment was performed in 2 replicates from November 2011 to April 2012 (n = 69) and from November 2012 to April 2013 (n = 53). Cows were bred via timed artificial insemination using Ovsynch-56 and checked for pregnancy on d 32 after artificial insemination. At d 34, cows confirmed pregnant were examined via transrectal Doppler ultrasonography. Blood samples collected via coccygeal vein were used to measure circulating plasma progesterone concentrations. Diameter of the corpus luteum and crown-rump length were measured. Color power Doppler ultrasonography was used to determine vascular perfusion to the CL, and RI was measured for the uterine arteries just after branching from the umbilical artery. Records were later examined to identify pregnancy status of cows after reconfirmation. Abortion rate did not differ between replicates (11.6% in replicate 1, 9.4% in replicate 2). Mean crown-rump length of embryos that were carried to term was greater on d 34 than that in cows that aborted (14.23 ± 0.27 vs. 13.21 ± 0.53 mm). Circulating progesterone concentration at d 34 was greater for cows that carried pregnancies to term than for those that aborted (9.1 ± 0.7 vs. 7.5 ± 1.0 ng/mL). The final logistic regression model consisted of crown-rump length, progesterone concentration, and RI of the uterine artery contralateral to pregnancy. Decreased crown-rump length and progesterone concentration tended to be associated with increased odds ratio for pregnancy loss, whereas CL perfusion and uterine blood flow were not

  3. Abnormal Development of the Femoral Head Epiphysis in an Infant with no Developmental Dysplasia of the Hip Apparent on Ultrasonography

    PubMed Central

    Atalar, Hakan; Gunay, Cuneyd; Aytekin, Mahmut Nedim

    2014-01-01

    Introduction: In the investigation of hip development in newborns and infants, ultrasonography and radiography are widely used, but their optimal roles in this setting remain controversial. Case Report: Here we describe an 8.5-month-old infant who had undergone hip radiography at a primary care facility and was referred to our hospital to be evaluated for developmental dysplasia of the hip. Ultrasonography showed no developmental dysplasia of the hip according to standard criteria, but developmental retardation of the femoral head was apparent on the radiograph. Conclusion: This patient's findings demonstrate that abnormalities in femoral head epiphysis development can go undetected during routine ultrasonographic evaluations for developmental dysplasia of the hip. PMID:27298982

  4. Ultrasonography-guided pulsed radiofrequency of sciatic nerve for the treatment of complex regional pain syndrome Type II

    PubMed Central

    Choi, Yi Hwa; Chang, Dong Jin; Hwang, Woon Suk; Chung, Jin Hwan

    2017-01-01

    Although the major mechanism of complex regional pain syndrome (CRPS) involves dysfunctional central or sympathetic nervous system activation, the peripheral nervous system also contributes significantly to its clinical manifestations. Pulsed radiofrequency (PRF) is a recently developed treatment option for neuropathic pain syndromes. Here, we report a case of CRPS Type II after a femur fracture and sciatic nerve injury, in which the pain was treated successfully with ultrasonography-guided selective sciatic nerve PRF application. PMID:28217060

  5. Point-of-care ultrasonography as a training milestone for internal medicine residents: the time is now

    PubMed Central

    Sabath, Bruce F.; Singh, Gurkeerat

    2016-01-01

    Point-of-care (POC) ultrasonography is considered fundamental in emergency medicine training and recently has become a milestone in critical care fellowship programs as well. Currently, there is no such standard requirement for internal medicine residency programs in the United States. We present a new case and briefly review another case at our institution – a community hospital – in which internal medicine house staff trained in ultrasonography were able to uncover unexpected and critical diagnoses that significantly changed patient care and outcomes. We also review the growing evidence of the application of ultrasound in the diagnosis of a myriad of conditions encountered in general internal medicine as well as the mounting data on the ability of internal medicine residents to apply this technology accurately at the bedside. We advocate that the literature has sufficiently established the role of POC ultrasonography in general internal medicine that there should no longer be any delay in giving this an official place in the development of internal medicine trainees. This may be particularly useful in the community hospital setting where 24-h echocardiography or other sonography may not be readily available. PMID:27802866

  6. Fetal neuroblastoma: ultrasonography and magnetic resonance imaging findings in the prenatal and postnatal IV-S stage

    PubMed Central

    Werner, Heron; Daltro, Pedro; Davaus, Taisa

    2016-01-01

    We report a case of a fetus with an ultrasonography diagnosis of a neuroblastoma during a routine third trimester fetal scan, which presented as a hyperechogenic nodule located above the right kidney. No other abnormalities were found in the ultrasonography scan; however, the follow-up ultrasonography during the 36th week of gestation revealed that the lesion had doubled in size. At the same time, magnetic resonance imaging demonstrated a round mass in the topography of the right adrenal gland with a low signal on T1-weighted images and slightly high signal on T2-weighted images, causing a slight inferior displacement of the kidney. The liver had enlarged and had heterogeneous signal intensity, predominantly hypointense on T2-weighted sequences. Based on these findings, a diagnosis of congenital adrenal neuroblastoma with liver metastases was suggested. A newborn male was delivered by cesarean section 2 weeks later. The physical examination of the neonate revealed abdominal distention and hepatomegaly. The infant had a clinical follow-up in which no surgical or medical intervention was required. At 5 months of age, the infant was asymptomatic with a normal physical examination. PMID:27668206

  7. Visibility of different foreign bodies in the maxillofacial region using plain radiography, CT, MRI and ultrasonography: an in vitro study

    PubMed Central

    Javadrashid, R; Fouladi, D F; Hajalioghli, P; Daghighi, M H; Shahmorady, Z; Niknejad, M T

    2015-01-01

    Objectives: To compare the usefulness of four imaging modalities in visualizing various foreign bodies of different sizes. Methods: Foreign bodies of four sizes (0.5, 1, 2 and 3 mm) including metal, tooth, wood, plastic, stone, glass and graphite were embedded in six fresh sheep heads on bone surface between the corpus mandible and muscle, and inside the tongue muscle. A human dry skull served as an air-filled space. Plain radiography, CT, MRI and ultrasonography were used, and four skilled radiologists rated the findings individually. Results: All embedded foreign bodies except wood were best visualized using CT. Wood could only be detected using ultrasonography, and then only when fragments were >0.5 mm in size. Plain radiography and CT were almost equally accurate in visualizing metal and graphite. MRI was the least useful imaging technique. Conclusions: In cases with suspected foreign bodies in the maxillofacial region, CT seems to be the optimal initial imaging study. Wood, however, could only be detected using ultrasonography. PMID:25426703

  8. Standardized approach for imaging and measuring Cesarean section scars using ultrasonography.

    PubMed

    Naji, O; Abdallah, Y; Bij De Vaate, A J; Smith, A; Pexsters, A; Stalder, C; McIndoe, A; Ghaem-Maghami, S; Lees, C; Brölmann, H A M; Huirne, J A F; Timmerman, D; Bourne, T

    2012-03-01

    Incomplete healing of the scar is a recognized sequel of Cesarean section (CS) and may be associated with complications in later pregnancies. These complications can include scar pregnancy, a morbidly adherent placenta, scar dehiscence or rupture. To date there is uncertainty relating to the factors that lead to poor scar healing and how to recognize it. In recent years, there has been an increase in studies using ultrasound that describe scars as deficient, or poorly, incompletely or inadequately healed with few data to associate the morphology of the scar with the functional integrity of the lower segment of the uterus. There have been multiple attempts to describe CS scars using ultrasonography. Different terminology, methods and results have been reported, yet there is still no consensus regarding the prevalence, clinical significance or most appropriate method to describe the appearances of these scars. Developing a test that can predict the likelihood of women having problems associated with a CS scar is becoming increasingly important. On the other hand, understanding whether the ultrasound appearances of the scar can tell us anything about its integrity is not well supported by the research evidence. In this article we present an overview of ultrasound-based definitions and methods used to describe CS scars. We also present information relating to the performance of alternative techniques used to evaluate CS scars. Having examined the current evidence we suggest a standardized approach to describe CS scars using ultrasound so that future studies can be meaningfully compared.

  9. Endoscopic ultrasonography-guided placement of a transhepatic portal vein stent in a live porcine model

    PubMed Central

    Park, Tae Young; Seo, Dong Wan; Kang, Hyeon-Ji; Cho, Min Keun; Song, Tae Jun; Park, Do Hyun; Lee, Sang Soo; Lee, Sung Koo; Kim, Myung-Hwan

    2016-01-01

    Background and Objectives: Percutaneous portal vein (PV) stent placement is used to manage PV occlusion or stenosis caused by malignancy. The use of endoscopic ultrasonography (EUS) has expanded to include vascular interventions. The aim of this study was to examine the technical feasibility and safety of EUS-guided transhepatic PV stent placement in a live porcine model. Materials and Methods: EUS-guided transhepatic PV stent placement was performed in six male miniature pigs under general anesthesia using forward-viewing echoendoscope. Under EUS guidance, the left intrahepatic PV was punctured with a 19-gauge fine-needle aspiration (FNA) needle and a 0.025 inch guidewire inserted through the needle and into the main PV. The FNA needle was then withdrawn and a needle-knife inserted to dilate the tract. Under EUS and fluoroscopic guidance, a noncovered metal stent was inserted over the guidewire and released into the main PV. Results: A PV stent was placed successfully in all six pigs with no technical problems or complications. The patency of the stent in the main PV was confirmed using color Doppler EUS and transhepatic portal venography. Necropsy of the first three animals revealed no evidence of bleeding and damage to intra-abdominal organs or vessels. No complications occurred in the remaining three animals during the 8 weeks observation period. Conclusions: EUS-guided transhepatic PV stent placement can be both technically feasible and safe in a live animal model. PMID:27803904

  10. Ultrasonography of the liver and kidneys of healthy camels (Camelus dromedarius)

    PubMed Central

    Tharwat, Mohamed; Al-Sobayil, Fahd; Ali, Ahmed; Buczinski, Sébastien

    2012-01-01

    This study describes the ultrasonography of the liver and kidneys of healthy camels (Camelus dromedarius). Images of the liver were obtained from the 11th to 5th intercostal spaces (ICSs). The distance between the dorsal liver margin and the midline of the back was shortest (39.1 ± 7.4 cm) at the 11th ICS and increased cranially to 5th ICS. The size of the liver was largest at the 9th ICS and smallest at the 5th ICS. In 6 camels the right kidney was visualized from the 10th and 11th ICSs and upper right flank and in the 10th and 11th ICSs in the remaining 16 camels. In all camels, the left kidney was imaged from the caudal left flank. In 21 camels, the differentiation between the renal cortex and medulla was clearly visible in the ultrasonograms. Ultrasonographic description of the liver and kidneys provides a basic reference for diagnosing hepatic and renal disorders in camels. PMID:23729824

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

    PubMed

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

    2015-11-01

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

  12. Common Carotid Artery Stump Syndrome Due to Mobile Thrombus Detected by Carotid Duplex Ultrasonography.

    PubMed

    Omoto, Shusaku; Hasegawa, Yuki; Sakai, Kenichiro; Matsuno, Hiromasa; Arai, Ayumi; Terasawa, Yuka; Mitsumura, Hidetaka; Iguchi, Yasuyuki

    2016-10-01

    Carotid stump syndrome is a cause of recurrent embolic stroke following occlusion of the ipsilateral internal carotid artery. The present report describes a case of recurrent cerebral embolism ipsilateral to a chronically occluded left common carotid artery (CCA), i.e., "CCA stump syndrome." Doppler color flow imaging showed anterograde flow in the left internal and external carotid arteries, which were supplied by collateral flow from the superior thyroid artery inflowing just proximal to the left carotid bifurcation. According to carotid duplex ultrasonography (CDU), a low-echoic mobile thrombus was noted at the distal stump of the occluded CCA, which presumably caused distal embolism. The low-echoic mobile thrombus dramatically changed to a homogenously high-echoic thrombus, and there was no recurrence of stroke after antiplatelet and anticoagulant therapy. This is the first report to demonstrate a CDU-verified temporal change in the thrombus at the stump in CCA stump syndrome. CDU is a noninvasive and useful technique to characterize hemodynamics, thrombus morphology, and the response to therapy.

  13. Diagnostic value of radionuclide scanning and ultrasonography in thyroid developmental anomaly imaging.

    PubMed

    Ruchała, Marek; Szczepanek, Ewelina; Sowiński, Jerzy

    2011-01-01

    Thyroid is particularly prone to morphogenetic variability. Developmental failure of the thyroid gland is in 85% of cases the underlying cause of congenital hypothyroidism, diagnosed at birth with a frequency of 1:3000-1:4000 newborns. However, the incidence of less severe developmental variants of the thyroid is much higher. Determination of the aetiology of congenital hypothyroidism is crucial for predicting its severity and outcome as well as impacts dose of L-thyroxine during substitution. Thyroid imaging is necessary to establish diagnosis, and it involves mainly thyroid ultrasound examination and scintiscan. Awareness of both the advantages and limitations of sonographic and scintigraphic imaging are central to the successful interpretation of their results and reasonable recommendation of these procedures for patients with thyroid developmental anomalies of different age and clinical picture. Hence, the aim of this review is to provide the most important and up-to-date information on the place of radionuclide scanning and ultrasonography in visualization of different thyroid developmental abnormalities.

  14. Ultrasonography and contrast-enhanced CT findings of tularemia in the neck

    PubMed Central

    Doğan, Serap; Ekinci, Afra; Demiraslan, Hayati; Kılıç, Ayşegül Ulu; Mavili, Ertuğrul; Öztürk, Mustafa; İmamoğlu, Hakan; Doğanay, Mehmet

    2016-01-01

    PURPOSE We aimed to evaluate the ultrasonography (US) and contrast-enhanced computed tomography (CECT) findings of tularemia in the neck. METHODS US and CECT findings of 58 patients with serologically proven tularemia were retrospectively evaluated. Forty-eight patients underwent US and 42 patients underwent CECT. Lymph node characteristics and parotid preauricular region involvement were analyzed using US and CECT. In addition, involvement of larynx, oropharynx, and retropharynx; presence of periorbital edema; and neck abscess formation were evaluated using CECT. Fine needle aspiration cytology (FNAC) results of enlarged lymph nodes were analyzed in 29 patients. RESULTS Hypoechoic pattern, round shape, absence of hilum, and cystic necrosis were seen in most of the lymph nodes especially at level 2 and 3 on US and CECT. Matting was more commonly observed than irregular nodal border on US and CECT. Parotid preauricular region involvement was seen in 20.8% of patients on US. Oropharyngeal, retropharyngeal, laryngeal and parotid preauricular region involvement and periorbital edema were seen in 52.4%, 19.1%, 4.8%, 31%, and 9.5% of tularemia patients, respectively. Neck abscess was found in 59.5% of patients on CECT. Suppurative inflammation was the most common finding of FNAC. CONCLUSION Tularemia should be considered in the presence of level 2 and 3 lymph nodes with cystic necrosis, matting, absence of calcification, oropharyngeal and retropharyngeal region involvement, and neck abscess, particularly in endemic areas. PMID:27498683

  15. Comparison of duplex ultrasonography and venography in the diagnosis of deep venous thrombosis.

    PubMed

    Mitchell, D C; Grasty, M S; Stebbings, W S; Nockler, I B; Lewars, M D; Levison, R A; Wood, R F

    1991-05-01

    Sixty-five patients with suspected deep venous thrombosis (DVT) in 68 limbs were entered consecutively into a study to compare venography with duplex ultrasonography scanning. Both tests were performed on 64 limbs, venography being contraindicated in four. Overall, duplex scanning correctly identified 86 per cent of DVTs diagnosed on venography and correctly excluded 80 per cent with negative venograms. Nearly all errors arose in the diagnosis of calf DVT. In the femoral vein duplex scanning had a specificity of 100 per cent and a sensitivity of 95 per cent. In addition, duplex scanning provided data on the limb not undergoing venography. Of 55 limbs that underwent bilateral duplex scanning, five had thrombus in the femoropopliteal segment and a negative contralateral venogram. In addition, three Baker's cysts were diagnosed. Duplex scanning can be used in patients in whom venography is contraindicated and may also provide information about the contralateral limb. We regard femoropopliteal duplex scanning as sufficiently accurate that treatment can be initiated on the basis of the scan. Duplex scanning should replace venography as the standard method of diagnosing femoropopliteal DVT; radiographic studies should now be required only when the scan result is in doubt.

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

    PubMed

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

    2015-10-01

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

  17. Determination of the fascicle length of the gastrocnemius muscle during calf raise exercise using ultrasonography

    PubMed Central

    Kudo, Shintarou; Hisada, Tomoyuki; Sato, Takanori

    2015-01-01

    [Purpose] The purpose of this study was to find a strength training protocol which maintains isometric contraction of the triceps surae during dorsal flexion of the ankle. [Subjects] The left feet of 22 young normal volunteers who did not have orthopedic injuries or lower limb pain participated in this study. [Methods] All subjects performed four sets of five repetitions of four sets calf-raise (CR) exercise at were (1) 60 bpm without a pedestal, (2) 60 bpm with a pedestal, (3) 90 bpm without a pedestal, and (4) 90 bpm with a pedestal. The fascicle length of the lateral head of the gastrocnemius and ankle angle were measured using ultrasonography and a video camera. The CR exercise was divided into two or three phases using the kinematics of the ankle. The average change in fascicle length over the five repetitions of each phase were compared. [Results] The change of the fascicle length during the hyper-dorsiflexion phase was significantly smaller than during the other two phases. [Conclusion] It is possible that eccentric CR exercises have progressed to motor learning of the isometric contraction during counter movement, and improved the release of elastic energy of the Achilles tendon during running, jumping, and other athletic activities. PMID:26834347

  18. Applicability of ultrasonography for evaluating trunk muscle size: a pilot study

    PubMed Central

    Wachi, Michio; Suga, Tadashi; Higuchi, Takatoshi; Misaki, Jun; Tsuchikane, Ryo; Tanaka, Daichi; Miyake, Yuto; Isaka, Tadao

    2017-01-01

    [Purpose] Ultrasonography (US) is widely applied to measure the muscle size in the limbs, as it has relatively high portability and is associated with low costs compared with large clinical devices such as magnetic resonance imaging (MRI). However, the applicability of US for evaluating trunk muscle size is poorly understood. This study aimed to examine whether US-measured muscle thickness (MT) in the trunk abdominal and back muscles correlated with MT and muscle cross-sectional area (MCSA) measured by MRI. [Subjects and Methods] Twenty-four healthy young males participated in this study. The MT and MCSA in the subjects were measured by US and MRI in a total of 10 sites, including the bilateral sides of the rectus abdominis (upper, central, and lower parts), abdominal wall, and multifidus lumborum. [Results] The interclass correlation coefficients of US-measured MT on the total 10 sites showed excellent values (n=12, 0.919 to 0.970). The US-measured MT significantly correlated with the MRI-measured MT (r=0.753 to 0.963) and MCSA (r=0.634 to 0.821). [Conclusion] US-measured MT could represent a surrogate for muscle size measured by MRI. The application of US for evaluating trunk muscle size may be a useful tool in the clinical setting. PMID:28265150

  19. Undergraduate student perceptions of the use of ultrasonography in the study of "living anatomy".

    PubMed

    Ivanusic, Jason; Cowie, Brian; Barrington, Michael

    2010-01-01

    Ultrasonography is a noninvasive imaging modality, and modern ultrasound machines are portable, inexpensive (relative to other imaging modalities), and user friendly. The aim of this study was to explore student perceptions of the use of ultrasound to teach "living anatomy". A module utilizing transthoracic echocardiography was developed and presented to undergraduate medical, science, and dental students at a time they were learning cardiac anatomy as part of their curriculum. Relevant cardiac anatomy was explored on a student volunteer and images were projected in real-time to all students via an AV projection system. Students were asked to complete a questionnaire about the learning experience and were given the opportunity to provide open feedback. The students' evaluations of this learning experience were very positive. They agreed or strongly agreed that it was an effective way to teach anatomy (90% medical; 77% dental; 100% science) and that it was incorporated in a way that promoted reinforcement of the lecture material (83% medical; 76% dental; 100% science). They agreed or strongly agreed with statements that the experience was innovative (93% medical; 92% dental; 100% science) and stimulated interest in the subject matter (86% medical; 75% dental; 96% science), and that they would like to see more modules, exploring other anatomical sites, incorporated into the curricula (83% medical; 72% dental; 100% science). We believe that ultrasound could be a useful tool, in conjunction with traditional teaching methods, to reinforce the learning of anatomy of a variety of different undergraduate student groups.

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

    PubMed

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

    2015-12-01

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

  1. [Possibilities of 4D ultrasonography in imaging of the pelvic floor structures].

    PubMed

    Dlouhá, K; Krofta, L

    2011-12-01

    Technological boom of the last decades brought urogynaecologists and other specialists new possibilities in imaging of the pelvic floor structures which may substantially add to search for etiology of pelvic floor dysfunction. Magnetic resonance imaging (MRI) is an expensive, less accessible method and may pose certain dyscomphort to the patient. 3D/4D ultrasonography overcomes these disadvantages and brings new possibilities especially in dynamic, real time imaging and consequently enables focus on functional anatomy of complex of muscles and fascial structures of the pelvic floor. With 3D/4D ultrasound we can visualise urethra and surrounding structures, levator ani and urogenital hiatus, its changes during muscle contraction and Valsalva manévre. This method has great potential in diagnostics of pelvic organ prolapse, it may bring new knowledge of factors contributing to loss of integrity of pelvic floor structures resulting in prolapse and incontinence. Studies exist which describe changes in urogenital hiatus after vaginal delivery, further studies of large numbers of patients during longer period of time are though necessary so that conclusions can be drawn for clinical praxis.

  2. Ultrasonography of the liver and kidneys of healthy camels (Camelus dromedarius).

    PubMed

    Tharwat, Mohamed; Al-Sobayil, Fahd; Ali, Ahmed; Buczinski, Sébastien

    2012-12-01

    This study describes the ultrasonography of the liver and kidneys of healthy camels (Camelus dromedarius). Images of the liver were obtained from the 11th to 5th intercostal spaces (ICSs). The distance between the dorsal liver margin and the midline of the back was shortest (39.1 ± 7.4 cm) at the 11th ICS and increased cranially to 5th ICS. The size of the liver was largest at the 9th ICS and smallest at the 5th ICS. In 6 camels the right kidney was visualized from the 10th and 11th ICSs and upper right flank and in the 10th and 11th ICSs in the remaining 16 camels. In all camels, the left kidney was imaged from the caudal left flank. In 21 camels, the differentiation between the renal cortex and medulla was clearly visible in the ultrasonograms. Ultrasonographic description of the liver and kidneys provides a basic reference for diagnosing hepatic and renal disorders in camels.

  3. UltraFast Doppler ultrasonography for hepatic vessels of liver recipients: preliminary experiences

    PubMed Central

    2015-01-01

    Purpose: The purpose of this study was to investigate the value of UltraFast Doppler ultrasonography (US) for evaluating hepatic vessels in liver recipients. Methods: Thirty-nine liver Doppler US sessions were conducted in 20 liver recipients. Each session consisted of UltraFast and conventional liver Doppler US in a random order. We compared the velocities and phasicities of the hepatic vessels, duration of each Doppler study, occurrence of technical failures, and differences in clinical decisions. Results: The velocities and resistive index values of hepatic vessels showed a strong positive correlation between the two Doppler studies (mean R=0.806; range, 0.710 to 0.924). The phasicities of the hepatic vessels were the same in both Doppler US exams. With respect to the duration of the Doppler US exam, there was no significant difference between the UltraFast (251±99 seconds) and conventional (231±117 seconds) Doppler studies (P=0.306). In five poor breath-holders, in whom the duration of conventional Doppler US was longer, UltraFast Doppler US (272±157 seconds) required a shorter time than conventional Doppler US (381±133 seconds; P=0.005). There was no difference between the two techniques with respect to technical failures and clinical decisions. Conclusion: UltraFast Doppler US is clinically equivalent to conventional Doppler US with advantages for poor breath-holders during the post-liver transplantation work-up. PMID:25409662

  4. Tissue harmonic imaging: is it useful in hepatobiliary and pancreatic ultrasonography?

    PubMed

    Spârchez, Zeno

    2003-09-01

    The introduction of tissue harmonic imaging (THI) could solve problems related to ultrasound in technically difficult patients by providing a marked improvement in image quality. Tissue harmonics are generated by tissue vibration while the transmitted pulse propagates through tissue and are multiples of the fundamental frequency. The harmonic image is obtained by separating the fundamental and harmonic frequencies, the second harmonic, or twice the fundamental frequency, being used for imaging. Through a better spatial resolution, less artifact and an increased visualization of the deep structures, tissue harmonic sonography improves the image quality. In hepatobiliary diseases THI improves the detection and characterisation of focal liver lesions, increases the conspicuity of gallbladder polyps and stones, choledocholithiasis and intrabiliary masses. Visualization of the pancreatic duct, pancreatic calcifications or duct stones is also more accurate with THI. The results with THI are better than those with conventional ultrasonography as the body mass index increases. The limitations of THI can be overcome by the use of the new pulse inversion harmonic imaging.

  5. Efficacy of Contrast-enhanced Harmonic Endoscopic Ultrasonography in the Diagnosis of Pancreatic Ductal Carcinoma

    PubMed Central

    Uekitani, Toshiyuki; Kaino, Seiji; Harima, Hirofumi; Suenaga, Shigeyuki; Sen-yo, Manabu; Sakaida, Isao

    2016-01-01

    Background/Aims: Distinguishing pancreatic ductal carcinoma (DC) from other pancreatic masses remains challenging. This study aims at evaluating the efficacy of contrast-enhanced harmonic endoscopic ultrasonography (CEH-EUS) in the diagnosis of DC. Patients and Methods: Forty-nine patients with solid pancreatic mass lesions underwent CEH-EUS. EUS (B-mode) was used to evaluate the inner echoes, distributions, and borders of the masses. The vascular patterns of the masses were evaluated with CEH-EUS at 30–50 s (early phase) and 70–90 s (late phase) after the administration of Sonazoid®. Results: The final diagnoses included DCs (37), mass-forming pancreatitis (6), endocrine neoplasms (3), a solid pseudopapillary neoplasm (1), a metastatic carcinoma (1), and an acinar cell carcinoma (1). The sensitivity, specificity, and accuracy of the diagnoses of DC in hypoechoic masses using EUS (B-mode) were 89.2%, 16.7%, and 71.4%, respectively. The sensitivity, specificity, and accuracy for the diagnosis of DC in hypovascular masses using CEH-EUS were 73.0%, 91.7%, and 77.6% in the early phase and 83.8%, 91.7%, and 85.7% in the late phase, respectively. Conclusions: CEH-EUS for the diagnosis of DC is superior to EUS. CEH-EUS in the late phase was particularly efficacious in the diagnosis of DC. PMID:27184637

  6. Vascular complications after adult living donor liver transplantation: Evaluation with ultrasonography

    PubMed Central

    Ma, Lin; Lu, Qiang; Luo, Yan

    2016-01-01

    Living donor liver transplantation (LDLT) has been widely used to treat end-stage liver disease with improvement in surgical technology and the application of new immunosuppressants. Vascular complications after liver transplantation remain a major threat to the survival of recipients. LDLT recipients are more likely to develop vascular complications because of their complex vascular reconstruction and the slender vessels. Early diagnosis and treatment are critical for the survival of graft and recipients. As a non-invasive, cost-effective and non-radioactive method with bedside availability, conventional gray-scale and Doppler ultrasonography play important roles in identifying vascular complications in the early postoperative period and during the follow-up. Recently, with the detailed vascular tracing and perfusion visualization, contrast-enhanced ultrasound (CEUS) has significantly improved the diagnosis of postoperative vascular complications. This review focuses on the role of conventional gray-scale ultrasound, Doppler ultrasound and CEUS for early diagnosis of vascular complications after adult LDLT. PMID:26819527

  7. Endoscopic ultrasonography: Transition towards the future of gastro-intestinal diseases

    PubMed Central

    De Lisi, Stefania; Giovannini, Marc

    2016-01-01

    Endoscopic ultrasonography (EUS) is a technique with an established role in the diagnosis and staging of gastro-intestinal tumors. In recent years, the spread of new devices dedicated to tissue sampling has improved the diagnostic accuracy of EUS fine-needle aspiration. The development of EUS-guided drainage of the bilio-pancreatic region and abdominal fluid collections has allowed EUS to evolve into an interventional tool that can replace more invasive procedures. Emerging techniques applying EUS in pancreatic cancer treatment and in celiac neurolysis have been described. Recently, confocal laser endomicroscopy has been applied to EUS as a promising technique for the in vivo histological diagnosis of gastro-intestinal, bilio-pancreatic and lymph node lesions. In this state-of-the-art review, we report the most recent data from the literature regarding EUS devices, interventional EUS, EUS-guided confocal laser endomicroscopy and EUS pancreatic cancer treatment, and we also provide an overview of their principles, clinical applications and limitations. PMID:26855537

  8. Is endoscopic ultrasonography essential for endoscopic resection of small rectal neuroendocrine tumors?

    PubMed Central

    Park, Su Bum; Kim, Dong Jun; Kim, Hyung Wook; Choi, Cheol Woong; Kang, Dae Hwan; Kim, Su Jin; Nam, Hyeong Seok

    2017-01-01

    AIM To evaluate the importance of endoscopic ultrasonography (EUS) for small (≤ 10 mm) rectal neuroendocrine tumor (NET) treatment. METHODS Patients in whom rectal NETs were diagnosed by endoscopic resection (ER) at the Pusan National University Yangsan Hospital between 2008 and 2014 were included in this study. A total of 120 small rectal NETs in 118 patients were included in this study. Histologic features and clinical outcomes were analyzed, and the findings of endoscopy, EUS and histology were compared. RESULTS The size measured by endoscopy was not significantly different from that measured by EUS and histology (r = 0.914 and r = 0.727 respectively). Accuracy for the depth of invasion was 92.5% with EUS. No patients showed invasion of the muscularis propria or metastasis to the regional lymph nodes. All rectal NETs were classified as grade 1 and demonstrated an L-cell phenotype. Mean follow-up duration was 407.54 ± 374.16 d. No patients had local or distant metastasis during the follow-up periods. CONCLUSION EUS is not essential for ER in the patient with small rectal NETs because of the prominent morphology and benign behavior. PMID:28373770

  9. Role of Endoscopic Ultrasonography in Guiding Treatment Plans for Upper Gastrointestinal Subepithelial Tumors.

    PubMed

    Moon, Jeong Seop

    2016-05-01

    Gastrointestinal (GI) subepithelial tumors (SETs) are usually observed incidentally by endoscopy and have diverse prognoses, varying from benign to potentially malignant. When a GI SET is suspected, endoscopic ultrasonography (EUS) is the most accurate diagnostic method to differentiate it from extraluminal compression. To determine the nature of GI SETs, EUS is also the most accurate diagnostic method, and reveals the precise sonographic nature of the lesion. There are some SETs with typical EUS findings of GI SETs, but most hypoechoic lesions are difficult to diagnose based on EUS images alone. EUS is also helpful to determine GI wall involvement in SETs and optimal treatment methods. For the diagnosis of GI SETs, obtaining a proper specimen is essential. EUS-guided cytology or biopsy methods such as fine-needle aspiration, Tru-Cut biopsy, and the newly introduced fine-needle biopsy (FNB) provide good results. To increase the diagnostic yield for GI SETs, cytology with immunocytochemical staining is used for cytological interpretation, resulting in good diagnostic yields. Recently, EUS-FNB using cheese slicer technology has been introduced, and has been reported to provide good diagnostic results for GI SETs.

  10. Unenhanced areas revealed by contrast-enhanced abdominal ultrasonography with Sonazoid™ potentially correspond to colorectal cancer

    PubMed Central

    Tomizawa, Minoru; Togashi, Mizuki; Shinozaki, Fuminobu; Hasegawa, Rumiko; Shirai, Yoshinori; Noritake, Midori; Matsuoka, Yukie; Kainuma, Hiroaki; Iwasaki, Yasuji; Fugo, Kazunori; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Kishimoto, Takashi; Ishige, Naoki

    2016-01-01

    The present study investigated the potential utility of contrast-enhanced abdominal ultrasonography (CEUS), using Sonazoid™, in colorectal cancer (CRC). Three patients were subjected to CEUS with Sonazoid™. Surgical specimens were immunostained for CD31. Numbers of blood vessels positive for CD31 were analyzed in each of five fields at ×400 magnification and averaged to determine blood vessel density. Blood vessel density was compared between non-tumorous and tumorous areas. Prior to the administration of Sonazoid™, CRC was illustrated as irregular-shaped wall thickening. One minute after the administration of Sonazoid™, the majority of the thickened wall was enhanced, while some parts of the thickened wall remained unenhanced. Blood vessel densities of non-tumorous and tumorous areas in patient two were 25.2±2.5 and 5.2±1.1 (P<0.0001). Blood vessel densities of non-tumorous and tumorous areas in patient three were 19.0±3.1 and 2.2±0.8 (P<0.0001). Tumorous areas of CRC were not enhanced 1 min after the administration of Sonazoid™. Blood vessel density was lower in tumorous areas compared with non-tumorous areas, as evidenced by immunohistochemistry for CD31. These findings suggest that CEUS may be useful for the determination of the extent of CRC. PMID:28105132

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

    NASA Astrophysics Data System (ADS)

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

    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.

  12. Antihypertensive treatment with cerebral hemodynamics monitoring by ultrasonography in elderly hypertensives without a history of stroke may prevent or slow down cognitive decline. A pending issue.

    PubMed

    Hadjiev, Dimiter I; Mineva, Petya P

    2011-03-01

    The role of the antihypertensive therapy in preventing cognitive disorders in elderly persons without a history of stroke is still a matter of debate. This article focuses on the pathogenesis of vascular cognitive disorders in hypertension and on the impact of antihypertensive treatment in their prevention. Cerebral white matter lesions, caused by small vessel disease and cerebral hypoperfusion, have been found in the majority of elderly hypertensives. They correlate with cognitive disorders, particularly impairments of attention and executive functions. Excessive blood pressure lowering in elderly patients with long-standing hypertension below a certain critical level, may increase the risk of further cerebral hypoperfusion because of disrupted cerebral blood flow autoregulation. As a result, worsening of the cognitive functions could occur, especially in cases with additional vascular risk factors. Five randomized, placebo-controlled trials have focused on the efficacy of antihypertensive treatments in preventing cognitive impairments in elderly patients without a prior cerebrovascular disease. Four of them have not found positive effects. We suggest that repeated neuropsychological assessments and ultrasonography for evaluation of carotid atherosclerosis, as well as cerebral hemodynamics monitoring could adjust the antihypertensive therapy with the aim to decrease the risk of cerebral hypoperfusion and prevent or slow down cognitive decline in elderly hypertensives. Prospective studies are needed to confirm such a treatment strategy.

  13. Which supplementary imaging modality should be used for breast ultrasonography? Comparison of the diagnostic performance of elastography and computer-aided diagnosis

    PubMed Central

    2017-01-01

    Purpose The aim of this study was to evaluate and compare the diagnostic performance of grayscale ultrasonography (US), US elastography, and US computer-aided diagnosis (US-CAD) in the differential diagnosis of breast masses. Methods A total of 193 breast masses in 175 consecutive women (mean age, 46.4 years) from June to August 2015 were included. US and elastography images were obtained and recorded. A US-CAD system was applied to the grayscale sonograms, which were automatically analyzed and visualized in order to generate a final assessment. The final assessments of breast masses were based on the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) categories, while elasticity scores were assigned using a 5-point scoring system. The diagnostic performance of grayscale US, elastography, and US-CAD was calculated and compared. Results Of the 193 breast masses, 120 (62.2%) were benign and 73 (37.8%) were malignant. Breast masses had significantly higher rates of malignancy in BI-RADS categories 4c and 5, elastography patterns 4 and 5, and when the US-CAD assessment was possibly malignant (all P<0.001). Elastography had higher specificity (40.8%, P=0.042) than grayscale US. US-CAD showed the highest specificity (67.5%), positive predictive value (PPV) (61.4%), accuracy (74.1%), and area under the curve (AUC) (0.762, all P<0.05) among the three diagnostic tools. Conclusion US-CAD had higher values for specificity, PPV, accuracy, and AUC than grayscale US or elastography. Computer-based analysis based on the morphologic features of US may be very useful in improving the diagnostic performance of breast US. PMID:27764908

  14. Diagnostic Accuracy of Hepatic Vein Arrival Time Performed with Contrast-Enhanced Ultrasonography for Cirrhosis: A Systematic Review and Meta-Analysis

    PubMed Central

    Kim, Gaeun; Shim, Kwang Yong; Baik, Soon Koo

    2017-01-01

    Background/Aims We identified reports in the literature regarding the diagnostic accuracy of hepatic vein arrival time (HVAT) measured by contrast-enhanced ultrasonography (CEUS) to assess hepatic fibrosis in cirrhosis. Methods The Ovid MEDLINE, Embase, and Cochrane databases were searched for all studies published up to 23 July 2015 that evaluated liver status using CEUS and liver biopsy (LB). The QUADAS-II (quality assessment of diagnostic accuracy studies-II) was applied to assess the internal validity of the diagnostic studies. Selected studies were subjected to a meta-analysis with MetaDisc 1.4 and RevMan 5.3. Results A total of 12 studies including 844 patients with chronic liver disease met our inclusion criteria. The overall summary sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of the HVAT measured by CEUS for the detection of cirrhosis compared to LB were 0.83 (95% confidence interval [CI], 0.77 to 0.89), 0.75 (95% CI, 0.69 to 0.79), 3.45 (95% CI, 1.60 to 7.43), and 0.28 (95% CI, 0.10 to 0.74), respectively. The summary diagnostic odds ratio (random effects model) was 15.23 (95% CI, 3.07 to 75.47), the summary receiver operator characteristics area under the curve was 0.74 (standard error [SE]=0.14), and the index Q was 0.69 (SE=0.11). Conclusions Based on a systematic review, the measurement of HVAT by CEUS exhibited an increased accuracy and correlation for the detection of cirrhosis. PMID:27538445

  15. Power Doppler ultrasonography of painful Achilles tendons and entheses in patients with and without spondyloarthropathy: a comparison with clinical examination and contrast-enhanced MRI.

    PubMed

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

    2013-03-01

    The objective of this study was to describe ultrasonography (US) and magnetic resonance imaging (MRI) findings at painful Achilles tendons and entheses in patients with and without spondyloarthropathy (SpA and non-SpA) and healthy control persons (CTRLs). Particularly, we aimed to investigate if any changes differentiate SpA from non-SpA. Finally, we investigated the reliability of US compared to clinical examination of Achilles tendinopathy, using MRI as gold standard reference. Twelve SpA patients and 15 non-SpA patients with pain and tenderness at at least one Achilles tendon and/or enthesis due to sports-related causes and 10 CTRLs were examined at the Achilles tendons and entheses with US, MRI and clinical assessment. Intratendinous changes, entheseal changes, bursitis and peritendonitis were assessed. An US interobserver substudy was performed in nine persons. US findings showed high agreement between observers (median 89 %, κ = 0.64) and with MRI (median 89 %, κ = 0.74). All inflammatory intratendinous changes were less frequent in SpA than non-SpA patients (p < 0.05). Entheseal changes and bursitis were found equally frequent in both patient groups except for enthesophytes, which were most common in the SpA group (p < 0.01). No findings were exclusively found in SpA. When MRI was considered gold standard, US showed higher sensitivity for intratendinous and entheseal changes than clinical examination (median sensitivity 0.83 versus 0.66). Especially, entheseal changes had higher sensitivity than clinical examination without loss of specificity. In conclusion, US performed by a trained operator can be a useful adjunct to clinical examination for improved assessment of Achilles tendons and entheses.

  16. Color Doppler Ultrasonography-Targeted Perforator Mapping and Angiosome-Based Flap Reconstruction.

    PubMed

    Gunnarsson, Gudjon Leifur; Tei, Troels; Thomsen, Jørn Bo

    2016-10-01

    Knowledge about perforators and angiosomes has inspired new and innovative flap designs for reconstruction of defects throughout the body. The purpose of this article is to share our experience using color Doppler ultrasonography (CDU)-targeted perforator mapping and angiosome-based flap reconstruction throughout the body. The CDU was used to identify the largest and best-located perforator adjacent to the defect to target the reconstruction. The cutaneous or fasciocutaneous flaps were raised, mobilized, and designed according to the reconstructive needs as rotation, advancement, or turnover flaps. We performed 148 reconstructions in 130 patients. Eleven facial reconstructions, 118 reconstructions in the body, 7 in the upper limbs, and 12 in the lower limbs. The propeller flap was used in 135 of 148 (91%) cases followed by the turnover design in 10 (7%) and the V to Y flap in 3 (2%) cases. The flaps were raised on 1 perforator in 98 (67%), 2 perforators in 48 (33%), and 3 perforators in 2 (1%) flaps. The reconstructive goal was achieved in 143 of 148 reconstructions (97%). In 5 cases, surgical revision was needed. No flaps were totally lost indicating a patent pedicle in all cases. We had 10 (7%) cases of major complications and 22 (15%) minor complications. The CDU-targeted perforator mapping and angiosome-based flap reconstruction are simple to perform, and we recommended its use for freestyle perforator flap reconstruction. All perforators selected by CDU was identified during surgery and used for reconstruction. The safe boundaries of angiosomes remain to be established.

  17. Serial ovarian ultrasonography in wild-caught wood bison (Bison bison athabascae).

    PubMed

    McCorkell, Robert B; Woodbury, Murray R; Adams, Gregg P

    2013-09-15

    The objectives of this study were to determine the feasibility of daily examination of wild-caught wood bison and to characterize the ovarian function using serial transrectal ultrasonography and blood hormone analysis. Ten 2-year-old wood bison heifers obtained from Elk Island National Park were placed in a corral adjacent to a handling system designed for restraining bison. The handling system was left open to the corral allowing the bison to explore it freely for 2 months. Active acclimation followed for a 2-week period, during which the bison were herded daily through the handling system and rewarded with whole oats. Finally, the bison were restrained in the handling system and rewarded with whole oats upon release. Once conditioned, daily transrectal examination of the ovaries was completed in 100% of attempts for 30 days (January-February) using a B-mode scanner with a 5 to 10-MHz linear array. Follicle size and numbers were recorded, and individual follicles were identified serially. Blood samples were collected daily and the serum was analyzed for FSH concentrations. Nonrandom changes were detected in the number of follicles ≥ 4 mm in diameter per day (P < 0.05). Each peak in follicle numbers was associated with the development of a single dominant follicle. The interval between the emergence of successive dominant follicles was 6.8 ± 0.6 days (mean ± SEM). The maximum diameter of the dominant follicle was 9.9 ± 0.4 mm. In conclusion, wild-caught wood bison were amenable to daily examination and blood sampling, and ovarian dynamics were characterized by wave-like development of anovulatory antral follicles. The demonstrated success of this approach to the study of ovarian function will be useful for characterizing the annual reproductive pattern in wood bison, which is necessary for the development of bison-specific protocols for controlling ovarian function for species conservation.

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

    PubMed

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

    2015-07-01

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

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

    SciTech Connect

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

    2012-05-01

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

  20. On the Role of Ultrasonography and CT Scan in the Diagnosis of Acute Appendicitis.

    PubMed

    Debnath, Jyotindu; Kumar, Rajesh; Mathur, Ankit; Sharma, Pawan; Kumar, Nikhilesh; Shridhar, Nagaraj; Shukla, Ashwani; Khanna, Shiv Pankaj

    2015-12-01

    The purposes of this study were to revisit the utility of ultrasonography (USG) as a primary imaging modality in acute appendicitis (AA) and to establish the role of CT scan as a second-line/problem-solving modality. All cases of suspected AA were referred for urgent USG. USG was done with standard protocol for appendicitis. Limited computed tomographic (CT) scan [NCCT ± CECT (IV contrast only)] was done for the lower abdomen and pelvis where sonographic findings were equivocal. One hundred and twenty-one patients were referred for USG for suspected appendicitis. Eight-four patients underwent surgery for AA based on clinical as well as imaging findings, of whom 76 had appendicitis confirmed at histopathology. Three patients were misdiagnosed (3.6 %) on USG as appendicitis. Of 76 patients of appendicitis confirmed histopathologically, 63 (82.8 %) had features of appendicitis on USG and did not require any additional imaging modality. Of 121 patients, 12 (10 %) needed CT scan because of atypical features on USG. Of these 12 patients, seven had retrocecal appendicitis, and three high-up paracolic appendicitis. USG alone had sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 81, 88, 92.6, 71.6, and 83 %, respectively. When combined with CT scan in select cases, the sensitivity, specificity, PPV, NPV, and accuracy of combined USG + CT scan were 96 % (P = 0.0014), 89 %, 93 %, 93.5 % (P = 0.0001), and 93 % (P = 0.0484), respectively. Twenty-eight (23 %) patients were given alternative diagnosis on USG. Dedicated appendiceal USG should be used as a primary imaging modality in diagnosing or excluding AA. Appendiceal CT can serve as a problem-solving modality.

  1. Crimean-Congo hemorrhagic fever: aid of abdominal ultrasonography in prediction of severity.

    PubMed

    Ziraman, Ipek; Celikbas, Aysel; Ergonul, Onder; Degirmenci, Tulin; Uyanik, Sadik Ahmet; Koparal, Suha; Dokuzoguz, Basak

    2014-11-01

    Crimean-Congo hemorrhagic fever (CCHF) is a fatal viral infection that involves multiple organs, and endothelium. We described abdominal sonographic findings of the patients infected with the Crimean-Congo hemorrhagic fever virus (CCHFV) in relation to the severity of the disease. This is a prospective study performed among hospitalized patients infected with CCHF between 2005 and 2011. A total of 210 hospitalized patients with confirmed CCHF infection were included in the study. The mean age was 47 and 49.5% of the patients were female. Patients were classified as mild, moderate, or severe disease according to their clinical and laboratory findings. The relationship between the clinical severity of CCHF and the abdominal sonographic findings was analyzed. Sonographic findings of abdomen included gallbladder wall thickening (GBWT) in 44 (21%), splenomegaly in 39 (19%), hepatomegaly in 52 (25%), decrease in echo of liver parenchyma in nine (4%), increase in echo liver parenchyma in 13 (6%), intra-abdominal fluid collection/ascites in 23 (11%), and enlarged periportal lymph nodes in seven (3%) cases. GBWT was detected in 3% of mild patients, 23% of moderate patients, and 61% of severe patients (p<0.001). In multivariate analysis to predict the severity, GBWT (odds ratio [OR] 5.4, confidence interval [CI] 1.76-16.49, p=0.003) and intra-abdominal fluid collection/ascites (OR 3.5, CI 1.07-12.61, p=0.049) were found to be significantly associated with disease severity. In conclusion, ultrasonography is a reliable, useful, and noninvasive diagnostic tool for evaluation of the abdominal findings of the patients with CCHFV infection. GBWT and intra-abdominal fluid collection/ascites were found to be predictors of severity.

  2. Ultrasonography in the diagnosis of nasal bone fractures: a comparison with conventional radiography and computed tomography.

    PubMed

    Lee, In Sook; Lee, Jung-Hoon; Woo, Chang-Ki; Kim, Hak Jin; Sol, Yu Li; Song, Jong Woon; Cho, Kyu-Sup

    2016-02-01

    The purpose of this study was to evaluate and compare the diagnostic efficacy of ultrasonography (US) with radiography and multi-detector computed tomography (CT) for the detection of nasal bone fractures. Forty-one patients with a nasal bone fracture who underwent prospective US examinations were included. Plain radiographs and CT images were obtained on the day of trauma. For US examinations, radiologist used a linear array transducer (L17-5 MHz) in 24 patients and hockey-stick probe (L15-7 MHz) in 17. The bony component of the nose was divided into three parts (right and left lateral nasal walls, and midline of nasal bone). Fracture detection by three modalities was subjected to analysis. Furthermore, findings made by each modality were compared with intraoperative findings. Nasal bone fractures were located in the right lateral wall (n = 28), midline of nasal bone (n = 31), or left lateral wall (n = 31). For right and left lateral nasal walls, CT had greater sensitivity and specificity than US or radiography, and better agreed with intraoperative findings. However, for midline fractures of nasal bone, US had higher specificity, positive predictive value, and negative predictive value than CT. Although two US evaluations showed good agreements at all three sites, US findings obtained by the hockey-stick probe showed closer agreement with intraoperative findings for both lateral nasal wall and midline of nasal bone. Although CT showed higher sensitivity and specificity than US or radiography, US found to be helpful for evaluating the midline of nasal bone. Furthermore, for US examinations of the nasal bone, a smaller probe and higher frequency may be required.

  3. Quantitative contrast-enhanced ultrasonography for the differential diagnosis of endometrial hyperplasia and endometrial neoplasms

    PubMed Central

    Liu, Ying; Xu, Yi; Cheng, Wen; Liu, Xinghan

    2016-01-01

    The present study aimed to investigate the feasibility of applying contrast-enhanced ultrasonography (CEUS) imaging technology for distinguishing between benign and malignant endometrial lesions, and to screen markers that could be correlated with the pathological results. In this study, endometrial diseases were diagnosed by biopsy under hysteroscopy and CEUS examinations. The intensity and time parameters of the time-intensity curve (TIC) were analyzed. The mean arrival time (AT), time-to-peak (TTP), rise time (RT), washout half-time and clearance half-time of malignant lesions were shorter than those of benign lesions (P<0.05), whereas the average peak intensity (PI) and enhancement intensity (EI) of malignant lesions were higher than those of benign lesions (P<0.05). The receiver operating characteristic curve showed the following cut-off values: PI, 29.2 dB; EI, 21.35 dB; AT, 12.75 sec; TTP, 26.75 sec; RT, 13.2 sec; clearance half-time, 89.3 sec; and washout half-time, 75.45 sec. The lesions with PI, an EI higher than that of the cut-off and lesions with an AT, TTP, RT, half clearing time and washout half-time shorter than the cut-off were considered malignant. The TTP, RT and half clearing time were negatively correlated with microvessel density (MVD), i.e., MVD was higher when the TTP, RT and half clearing time were shorter. Overall, changes in the enhancement and clearing of lesions could be quantitatively analyzed by CEUS TIC and further discriminate benign from malignant lesions. In the present study, CEUS appeared to indirectly reflect blood vessel changes inside the lesions and provided a pre-operative non-invasive fast imaging method for the diagnosis of endometrial disease. PMID:27895728

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

    PubMed Central

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

    2011-01-01

    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

  5. Ultrasonography as a guide during vascular access procedures and in the diagnosis of complications.

    PubMed

    Vezzani, A; Manca, T; Vercelli, A; Braghieri, A; Magnacavallo, A

    2013-10-29

    Vascular access used in the treatment of patients involves central and peripheral vein accesses and arterial accesses. Catheterization of central veins is widely used in clinical practice; it is a necessary part of the treatment of patients in various settings. The most commonly involved vessels are the internal jugular, subclavian, and femoral veins. The mechanical, infectious, and thrombotic complications of central venous catheterization are markedly reduced when the procedure is performed with real-time ultrasound guidance or (to a slightly lesser extent) ultrasound assistance. Ultrasound guidance is also used to create peripheral venous accesses, for catheterization of peripheral veins and for peripheral insertion of central venous catheters. In this setting, it increases the catheterization success rate, especially during difficult procedures (e.g., obese patients, children) and reduces complications such as catheter-related infections and venous thrombosis. Arterial cannulation is used for invasive monitoring of arterial pressure and for access during diagnostic or therapeutic procedures. Ultrasound guidance reduces the risk of catheterization failure and complications. It is especially useful for arterial catheterization procedures performed in the absence of a palpable pulse (e.g., patient in shock, ECMO). Imaging support is being used increasingly to facilitate the creation of vascular accesses under difficult conditions, in part because of the growing use of ultrasonography as a bedside procedure. In clinical settings where patients are becoming increasingly vulnerable as a result of advanced age and/or complex disease, the possibility to reduce the risks associated with these invasive procedures should motivate clinicians to acquire the technical skills needed for routine use of sonographic support during vascular access procedures.

  6. Parathyroid incidentalomas detected during thyroid ultrasonography and effect of chronic thyroiditis on false positive parathyroid lesions.

    PubMed

    Ozdemir, Didem; Arpaci, Dilek; Ucler, Rifki; Cuhaci, Neslihan; Ersoy, Reyhan; Cakir, Bekir

    2012-12-01

    We aimed to determine the prevalence of parathyroid incidentalomas in patients referred for thyroid ultrasonography (US) and investigate the role of chronic thyroiditis on false positive lesions. Patients suspected to have parathyroid lesions during thyroid US were recorded prospectively between August 2009 and January 2010. Patients referred for parathyroid US and patients with known high serum calcium or parathyroid hormone (PTH) levels were excluded. Suspected parathyroid lesions were defined as hypoechoic, homogeneous, solid lesions with regular margins located outside the thyroid lobe, most commonly inferior to the thyroid gland. Thyroid US was performed in 6,528 patients. There were 78 patients (1.19 %) (73 female and 5 male) with suspected parathyroid lesion. The diagnosis of a true parathyroid adenoma was confirmed in 6 (7.69 %) patients. In patients with true adenoma, mean serum calcium, phosphorus, and PTH levels were 10.57 ± 0.48 mg/dl, 3.03 ± 0.52 mg/dl, and 182.91 ± 46.62 pg/ml, respectively. Among 72 patients with false positive parathyroid lesion, antithyroid peroxidase antibody was positive in 50 (69.4 %), antithyroglobulin antibody was positive in 46 (63.9 %), and one of these antibodies were positive in 59 (81.9 %) patients. Also, 46 (63.9 %) of these patients had thyroid dysfunctions (43 hypothyroidism and 3 hyperthyroidism) and 59 (81.9 %) had chronic thyroiditis ultrasonographically. Parathyroid incidentaloma was detected in 0.09 % of patients referred for thyroid US. The presence of clinically or ultrasonographically chronic thyroiditis might cause inadvertent interpretation of a hypoechoic lesion as a parathyroid pathology during thyroid US.

  7. Ultrasonography is useful to detect subclinical synovitis in SLE patients without musculoskeletal involvement before symptoms appear.

    PubMed

    Yoon, Ho-Sung; Kim, Ki-Jo; Baek, In-Woon; Park, Yune-Jung; Kim, Wan-Uk; Yoon, Chong-Hyeon; Cho, Chul-Soo

    2014-03-01

    The purpose of this study is to investigate the frequency of the subclinical synovitis in hand or wrist joints of the SLE patients using ultrasonography (US) and to correlate them with clinical parameters. Forty-eight systemic lupus erythematosus (SLE) patients without musculoskeletal (MS) involvement were enrolled and underwent clinical and laboratory examinations. Gray-scale and power Doppler (PD) US was performed for imaging the wrist, second and third metacarpophalangeal (MCP) joints, and flexor tendons on non-dominant sides of the individuals. US synovitis index (USSI) and PD index were calculated as sum of the synovitis and PD semiquantitative scores, respectively, obtained from each joint. Subclinical synovitis was found by US in 28 (58.3%) out of 48 patients. US revealed synovitis of the wrist in 16 (33.3%) patients, of the second MCP joint in 14 (29.2%) and of the third MCP joint in 15 (31.3%). PD signals in three (6.3%) patients and tenosynovitis in two (4.2%) were also detected. USSI scores showed significant positive correlation with erythrocyte sedimentation rate (ESR) levels (r = 0.30, p < 0.05) or anti-dsDNA Ab titers (r = 0.34, p < 0.05). Within 6 months after US examination, new MS symptoms were developed in 11 (22.9%) patients. Older age at diagnosis (OR 1.283, 95% CI 1.029-1.601, p = 0.027) or higher USSI scores (OR 12.93, 95% CI 1.023-163.503, p = 0.048) were independently associated with development of new MS symptoms. Subclinical synovitis is common in SLE patients who do not suffer from MS symptoms. US is useful to detect joint abnormalities before symptoms appear in SLE patients.

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

    PubMed Central

    2014-01-01

    Background Endoscopic ultrasonography (EUS) is a valuable imaging tool for evaluating subepithelial lesions in the stomach. However, there are few studies on differentiation between gastrointestinal stromal tumors (GISTs) and benign mesenchymal tumors, such as leiomyoma or schwannoma, with the use of EUS. In addition, there are limitations in the analysis of the characteristic features of such tumors due to poor interobserver agreement as a result of subjective interpretation of EUS images. Therefore, the aim of this study was to evaluate the role of digital image analysis in distinguishing the features of GISTs from those of benign mesenchymal tumors on EUS. Methods We enrolled 65 patients with histopathologically proven gastric GIST, leiomyoma or schwannoma on surgically resected specimens who underwent EUS examination at our endoscopic unit from January 2007 to September 2010. After standardization of the EUS images, brightness values including the mean (Tmean), indicative of echogenicity, and the standard deviation (TSD), indicative of heterogeneity, in the tumors were analyzed. Results The Tmean and TSD were significantly higher in GIST than in leiomyoma and schwannoma (p < 0.001). However, there was no significant difference in the Tmean or TSD between benign and malignant GISTs. The sensitivity and specificity were almost optimized for differentiating GIST from leiomyoma or schwannoma when the critical values of Tmean and TSD were 65 and 75, respectively. The presence of at least 1 of these 2 findings in a given tumor resulted in a sensitivity of 94%, specificity of 80%, positive predictive value of 94%, negative predictive value of 80%, and accuracy of 90.8% for predicting GIST. Conclusions Digital image analysis provides objective information on EUS images; thus, it can be useful in diagnosing gastric mesenchymal tumors. PMID:24400772

  9. Contrast-Enhanced Ultrasonography in Differential Diagnosis of Benign and Malignant Ovarian Tumors

    PubMed Central

    Qiao, Jing-Jing; Yu, Jing; Yu, Zhe; Li, Na; Song, Chen; Li, Man

    2015-01-01

    Objective To evaluate the accuracy of contrast-enhanced ultrasonography (CEUS) in differential diagnosis of benign and malignant ovarian tumors. Methods The scientific literature databases PubMed, Cochrane Library and CNKI were comprehensively searched for studies relevant to the use of CEUS technique for differential diagnosis of benign and malignant ovarian cancer. Pooled summary statistics for specificity (Spe), sensitivity (Sen), positive and negative likelihood ratios (LR+/LR−), and diagnostic odds ratio (DOR) and their 95%CIs were calculated. Software for statistical analysis included STATA version 12.0 (Stata Corp, College Station, TX, USA) and Meta-Disc version 1.4 (Universidad Complutense, Madrid, Spain). Results Following a stringent selection process, seven high quality clinical trials were found suitable for inclusion in the present meta-analysis. The 7 studies contained a combined total of 375 ovarian cancer patients (198 malignant and 177 benign). Statistical analysis revealed that CEUS was associated with the following performance measures in differential diagnosis of ovarian tumors: pooled Sen was 0.96 (95%CI = 0.92∼0.98); the summary Spe was 0.91 (95%CI = 0.86∼0.94); the pooled LR+ was 10.63 (95%CI = 6.59∼17.17); the pooled LR− was 0.04 (95%CI = 0.02∼0.09); and the pooled DOR was 241.04 (95% CI = 92.61∼627.37). The area under the SROC curve was 0.98 (95% CI = 0.20∼1.00). Lastly, publication bias was not detected (t = −0.52, P = 0.626) in the meta-analysis. Conclusions Our results revealed the high clinical value of CEUS in differential diagnosis of benign and malignant ovarian tumors. Further, CEUS may also prove to be useful in differential diagnosis at early stages of this disease. PMID:25764442

  10. Implementation of a Process for Initial Transcranial Doppler Ultrasonography in Children With Sickle Cell Anemia

    PubMed Central

    Crosby, Lori E.; Joffe, Naomi E.; Davis, Blair; Quinn, Charles T.; Shook, Lisa; Morgan, Darice; Simmons, Kenya; Kalinyak, Karen A.

    2016-01-01

    Stroke, a devastating complication of sickle cell anemia (SCA), can cause irreversible brain injury with physical and cognitive deficits. Transcranial Doppler ultrasonography (TCD) is a non-invasive tool for identifying children with SCA at highest risk of stroke. National guidelines recommend that TCD screening begin at age 2 years, yet there is research to suggest less than half of young children undergo screening. The purpose of this project was to use quality improvement methods to improve the proportion of patients aged 24–27 months who successfully completed their initial TCD from 25% to 75% by December 31, 2013. Quality improvement methods (e.g., process mapping, simplified failure mode effect analysis, and plan–do–study–act cycles) were used to develop and test processes for identifying eligible patients, scheduling TCDs, preparing children and families for the first TCD, and monitoring outcomes (i.e., TCD protocol). Progress was tracked using a report of eligible patients and a chart showing the age in months for the first successful TCD (population metric). As of December 2013, 100% of eligible patients successfully completed their initial TCD screen; this improvement was maintained for the next 20 months. In November 2014, a Welch’s one-way ANOVA was conducted. Results showed a statistically significant difference between the average age of first TCD for eligible patients born in 2009 and eligible patients born during the intervention period (2010–2013; F[1,11.712]=16.03, p=0.002). Use of quality improvement methods to implement a TCD protocol was associated with improved TCD screening rates in young children with SCA. PMID:27320459

  11. Planning digital artery perforators using color Doppler ultrasonography: A preliminary report.

    PubMed

    Shintani, Kosuke; Takamatsu, Kiyohito; Uemura, Takuya; Onode, Ema; Okada, Mitsuhiro; Kazuki, Kenichi; Nakamura, Hiroaki

    2016-05-01

    Digital artery perforator (DAP) flaps have been applied for the coverage of finger soft tissue defects. Although an advantage of this method is that there is no scarification of the digital arteries, it is difficult to identify the location of the perforators during intraoperative elevation of the DAP flap. In this study, anatomically reliable locations of DAPs were confirmed using color Doppler ultrasonography (US) in healthy volunteers. A successful case using an adiposal-only DAP flap for the coverage of a released digital nerve using preoperative DAP mapping with color Doppler US is also described. A total of 40 digital arteries in 20 fingers of the right hands of five healthy volunteers (mean age: 32.2 years old) were evaluated. The DAPs were identified using color flow imaging based on the beat of the digital artery in the short axial view. In total, 133 perforators were detected, 76 (an average of 3.8 per finger) arising from the radial digital artery and 57 (an average of 2.9 per finger) arising from ulnar digital artery. Sixty-three perforators (an average of 3.2 per finger) in the middle phalanges and 70 (an average of 3.5 per finger) in the proximal phalanges were found. Overall, an average of 1.7 perforators from each digital artery was detected in the proximal or middle phalanges. Moreover, at least one DAP per phalanx was reliably confirmed using color Doppler US. Preoperative knowledge of DAP mapping could make elevating the DAP flap easier and safer.

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

    SciTech Connect

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

    2010-10-15

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

  13. Dynamic Contrast-Enhanced Magnetic Resonance Enterography and Dynamic Contrast-Enhanced Ultrasonography in Crohn’s Disease: An Observational Comparison Study

    PubMed Central

    Wilkens, Rune; Peters, David A.; Nielsen, Agnete H.; Hovgaard, Valeriya P.; Glerup, Henning; Krogh, Klaus

    2017-01-01

    Purpose e Cross-sectional imaging methods are important for objective evaluationof small intestinal inflammationinCrohn’sdisease(CD).The primary aim was to compare relative parameters of intestinal perfusion between contrast-enhanced ultrasonography (CEUS) and dynamic contrast-enhanced magnetic resonance enterography (DCE-MRE) in CD. Furthermore, we aimed at testing the repeatability of regions of interest (ROIs) for CEUS. Methods This prospective study included 25 patients: 12 females (age: 37, range: 19–66) with moderate to severe CD and a bowel wall thickness>3mm evaluated with DCE-MRE and CEUS. CEUS bolus injection was performed twice for repeatability and analyzed in VueBox®. Correlations between modalities were described with Spearman’s rho, limits of agreement(LoA) and intraclass correlation coefficient(ICC). ROIrepeatability for CEUS was assessed. Results s The correlation between modalities was good and very good for bowel wall thickness (ICC=0.71, P<0.001) and length of the inflamed segment (ICC=0.89, P<0.001). Moderate-weak correlations were found for the time-intensity curve parameters: peak intensity (r=0.59, P=0.006), maximum wash-in-rate (r=0.62, P=0.004), and wash-in perfusion index (r=0.47, P=0.036). Best CEUS repeatability for peak enhancement was a mean difference of 0.73 dB (95% CI: 0.17 to 1.28, P=0.01) and 95% LoA from −3.8 to 5.3 dB. Good quality of curve fit improved LoA to −2.3 to 2.8 dB. Conclusion The relative perfusion of small intestinal CD assessed with DCE-MRE and CEUS shows only a moderate correlation. Applying strict criteria for ROIs is important and allows for good CEUS repeatability PMID:28286879

  14. Field use of ultrasonography to characterize the reproductive tract and early pregnancy in a phocid, the Weddell seal (Leptonychotes weddellii).

    PubMed

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

    2015-12-01

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

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

    PubMed Central

    SHIMIZU, Satoru; MOCHIZUKI, Takahiro; OSAWA, Shigeyuki; KUMABE, Toshihiro

    2015-01-01

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

  16. Serum anti-Mullerian hormone levels after ovarian drilling for the second-line treatment of polycystic ovary syndrome: a pilot-randomized study comparing laparoscopy and transvaginal hydrolaparoscopy.

    PubMed

    Giampaolino, Pierluigi; Morra, Ilaria; Della Corte, Luigi; Sparice, Stefania; Di Carlo, Costantino; Nappi, Carmine; Bifulco, Giuseppe

    2017-01-01

    Aim of the study was to asses and compare serum anti-Mullerian harmone (AMH) levels after laparoscopic ovarian drilling (LOD) and transvaginal hydrolaparoscopy (THL) ovarian drilling in clomifene citrate (CC)-resistant polycystic ovary syndrome (PCOS) patients; secondary outcome was to evaluate postoperative pain to estimate the acceptability of procedures. A total of 246 patients with CC-resistant PCOS were randomized into two groups: 123 underwent LOD and 123 underwent THL ovarian drilling. AMH serum levels were evaluated before and after the procedure; moreover, women were asked to rate pain on a visual analog scale (VAS) from 0 (no pain, perfectly acceptable) to 10 (unbearable pain, completely unacceptable). In both groups, postoperative serum AMH levels were significantly reduced compared to preoperative levels (6.06 ± 1.18 and 5.84 ± 1.16 versus 5.00 ± 1.29 and 4.83 ± 1.10; p < 0.0001). Comparing postoperative serum AMH levels, no statistically significant difference was observed between the two surgical technique. After the procedure, mean pain VAS score was significantly higher for women who underwent LOD ovarian drilling in comparison to THL (3.26 ± 1.1 versus 1.11 ± 0.5; p < 0.0001). In conclusion, THL ovarian drilling is comparable to the LOD in terms of reduction in AMH, but it is preferred by patients in terms of acceptability. These results could support to use of THL ovarian drilling in the treatment of patients with CC- resistant PCOS.

  17. Chest ultrasonography in emergency Cesarean delivery in multi-valvular heart disease with pulmonary edema during spinal anesthesia.

    PubMed

    Samanta, Sukhen; Samanta, Sujay; Ghatak, Tanmoy; Grover, V K

    2014-05-01

    Valvular heart disease in a parturient presenting for Cesarean section is challenging. A 25 year old primigravida parturient with severe mitral stenosis, mild mitral regurgitation, mild aortic regurgitation, and mild pulmonary arterial hypertension required Cesarean delivery after developing pulmonary edema. Low-dose spinal with hyperbaric bupivacine 0.5% 1.8 mL plus 25 μg of fentanyl was used for anesthesia. Chest ultrasonography (US) and transthoracic echocardiography (TTE) were used for monitoring purposes. Spinal-induced preload reduction improved the pulmonary edema, as evidenced by chest US. Chest US and TTE helped in fluid management.

  18. Ultrasonography contribution to the detection and characterization of hepatic restructuring: is the "virtual biopsy" taken into consideration?

    PubMed

    Badea, Radu; Lupşor, Monica; Stefănescu, Horia; Nedevschi, Sergiu; Mitrea, Delia; Serban, Alexandru; Vasile, Tudor

    2006-06-01

    Generally, the evolution of diffuse liver diseases is variable but quite long. Even the severe types of chronic hepatitis have a slow progression which implies decades, often over 20-30 years. Cirrhosis is the principal long time complication of chronic hepatopathies. It represents a major risk factor for the development of hepatocellular carcinoma. Ultrasonography plays an important role among the methods used for detecting diffuse liver diseases, for placing them and identifying supplementary risk factors for carcinogenesis and of hepatocellular carcinoma itself. The two- and especially the three-dimensional exploration allow the characterization of hepatic texture and the identification of certain changes which may suggest hepatic restructuring.

  19. d-dimer testing as an adjunct to ultrasonography in patients with clinically suspected deep vein thrombosis: prospective cohort study

    PubMed Central

    Bernardi, Enrico; Prandoni, Paolo; Lensing, Anthonie W A; Agnelli, Giancarlo; Guazzaloca, Giuliana; Scannapieco, Gianluigi; Piovella, Franco; Verlato, Fabio; Tomasi, Cristina; Moia, Marco; Scarano, Luigi; Girolami, Antonio

    1998-01-01

    Objective To investigate the efficacy of using a rapid plasma d-dimer test as an adjunct to compression ultrasound for diagnosing clinically suspected deep vein thrombosis. Design d-dimer concentrations were determined in all patients with a normal ultrasonogram at presentation. Repeat ultrasonography was performed 1 week later only in patients with abnormal d-dimer test results. Main outcome measure Patients with normal ultrasonograms were not treated with anticoagulants and were followed for 3 months for thromboembolic complications. Setting University research and affiliated centres. Subjects 946 patients with clinically suspected deep vein thrombosis. Results Ultrasonograms were abnormal at presentation in 260 (27.5%) patients. Of the remaining 686 patients tested for d-dimer, 88 (12.8%) had abnormal concentrations. During follow up venous thromboembolic complications occurred in one of the 598 patients who were not treated with anticoagulants and who had an initial normal ultrasonogram and d-dimer concentration, whereas thromboembolic complications occurred in two of the 83 untreated patients who had abnormal d-dimer concentrations but a normal repeat ultrasonogram. The cumulative incidence of venous thromboembolic complications during follow up was 0.4% (95% confidence interval 0% to 0.9%). The rapid plasma d-dimer test used as an adjunct to compression ultrasonography resulted in a reduction in the mean number of repeat ultrasound examinations and additional hospital visits from 0.7 to 0.1 per patient. Conclusions Testing for d-dimer as an adjunct to a normal baseline ultrasound examination decreased the number of subsequent ultrasound examinations considerably without any increased risk of venous thromboembolic complications in patients not receiving anticoagulants. The use of ultrasound and testing for d-dimer enabled treatment decisions to be made at the time of presentation in most patients. Key messagesPatients with clinically suspected deep vein

  20. Major Salivary Gland Ultrasonography in the Diagnosis of Sjögren's Syndrome: A Place in the Diagnostic Criteria?

    PubMed

    Jonsson, Malin V; Baldini, Chiara

    2016-08-01

    Major salivary gland (SG) ultrasonography (US) represents a noninvasive, nonirradiating imaging modality for evaluation of the major SGs in the diagnosis and follow-up of primary and secondary Sjögren syndrome. Structural changes can be visualized as hyperechogenic and hypoechogenic areas, inhomogeneity, and altered echogenicity in general. The reliability of SG-US is poorly investigated, and the definition of US abnormalities varies in previously published studies. Recent studies have shown correlations between SG-US findings and focus score in the minor SGs; however further studies are needed to validate a US criterion in updated classification/diagnostic criteria.

  1. Localization and Retrieval of an Eyelid Metallic Foreign Body With an Oscillating Magnet and High-Resolution Ultrasonography.

    PubMed

    Yoo, Sylvia H; Rootman, Dan B; Goh, Alice; Savar, Aaron; Goldberg, Robert A

    2016-01-01

    A patient was found to have a metallic foreign body in the left anterior orbit on CT imaging, but the foreign body was not evident on clinical examination. On high-resolution ultrasonography, an object was identified in the left upper eyelid; however, the typical shadow with metallic foreign bodies was not seen. A high-power oscillating magnet was then applied to the eyelid, which revealed a subcutaneous metallic foreign body in the left upper eyelid. When used in conjunction, the high-resolution ultrasound and oscillating magnet successfully localized and facilitated retrieval of the metallic foreign body from the left upper eyelid.

  2. Charcoal-induced granuloma that mimicked a nodal metastasis on ultrasonography and FDG-PET/CT after neck dissection.

    PubMed

    Choi, Jin Woo; Moon, Won-Jin; Choi, Nami; Roh, Hong Gee; Kim, Mi Young; Kim, Na Ra; Moon, Sung Gyu; Chung, Hyun Woo; Lim, So Dug; Yang, Jung-Hyun

    2015-01-01

    Charcoal can be used for preoperative localization of metastatic lymph nodes in the neck. Charcoal remains stable without causing foreign body reactions during as hort period. However, foreign body reactions may develop if charcoal is left in situ for more than 6 months. We reported a case of charcoal granuloma mimicking local recurrence on fluorodeoxyglucose-positron emission tomography/computed tomography and ultrasonography in a 47-year-old woman who had cervical lymph node dissection due to metastatic invasive ductal carcinoma of the breast.

  3. Electrocautery vs non-electrocautery dilation catheters in endoscopic ultrasonography-guided pancreatic fluid collection drainage

    PubMed Central

    Kitamura, Katsuya; Yamamiya, Akira; Ishii, Yu; Nomoto, Tomohiro; Honma, Tadashi; Yoshida, Hitoshi

    2016-01-01

    AIM: To investigate the safety and utility of an electrocautery dilation catheter for endoscopic ultrasonography (EUS)-guided pancreatic fluid collection drainage. METHODS: A single-center, exploratory, retrospective study was conducted between August 2010 and August 2014. This study was approved by the Medical Ethics Committee of our institution. Informed, written consent was obtained from each patient prior to the procedure. The subjects included 28 consecutive patients who underwent EUS-guided transmural drainage (EUS-TD) for symptomatic pancreatic and peripancreatic fluid collections (PFCs) by fine needle aspiration using a 19-gauge needle. These patients were retrospectively divided into two groups based on the use of an electrocautery dilation catheter as a fistula dilation device; 15 patients were treated with an electrocautery dilation catheter (electrocautery group), and 13 patients were treated with a non-electrocautery dilation catheter (non-electrocautery group). We evaluated the technical and clinical successes and the adverse events associated with EUS-TD for the treatment of PFCs between the two groups. RESULTS: There were no significant differences in age, sex, type, location and diameter of PFCs between the groups. Thirteen patients (87%) in the electrocautery group and 10 patients (77%) in the non-electrocautery group presented with infected PFCs. The technical success rates of EUS-TD for the treatment of PFCs were 100% (15/15) and 100% (13/13) for the electrocautery and the non-electrocautery groups, respectively. The clinical success rates of EUS-TD for the treatment of PFCs were 67% (10/15) and 69% (9/13) for the electrocautery and the non-electrocautery groups, respectively (P = 0.794). The procedure time of EUS-TD for the treatment of PFCs in the electrocautery group was significantly shorter than that of the non-electrocautery group (mean ± SD: 30 ± 12 min vs 52 ± 20 min, P < 0.001). Adverse events associated with EUS-TD for the treatment

  4. Hyperglycemia effect on coronary disease in patients with metabolic syndrome evaluated by intracoronary ultrasonography

    PubMed Central

    Bonamichi, Beatriz Dal Santo Francisco; Parente, Erika Bezerra; Campos, Ana Carolina Noronha; Cury, Adriano Namo; Salles, João Eduardo Nunes

    2017-01-01

    Introduction Metabolic syndrome (MS) is characterized by dyslipidemia, central obesity, hypertension and hyperglycemia. However, type 2 diabetes mellitus (T2DM) may or may not be present in metabolic syndrome. MS and T2DM are considered important cardiovascular risk factors, but the role of hyperglycemia in coronary disease is still contested in the literature. Therefore, we decided to evaluate the effect of hyperglycemia on the severity of coronary disease in MS patients, with or without T2DM, submitted to coronary angiography (CA) and intravascular ultrasonography (IVUS). Materials and methods This is a cross sectional, observational study with 100 MS patients (50% with T2DM), 60% male. All of the patients had been referred for CA procedures. The obstruction was considered severe when stenosis was greater than 70% and moderate if it was between 50–69%. Patients detected with a moderate obstruction by CA were indicated to IVUS. A minimal luminal area of less than 4mm2 detected by IVUS was also considered severe. IDF criteria were used to define Metabolic Syndrome and T2DM diagnosis was defined according to the American Diabetes Association criteria. Student’s t-test and Pearson Chi-square were used for statistical analysis, considering p < 0.05 statistically significant. Results and discussion The majority of T2DM patients presented severe arterial lesions (74% vs 22%, p<0.001). Using CA procedure, 12% of T2DM had moderate obstructions, compared to 38% of the non-diabetic group (p< 0.05). 8% of patients with moderate lesions by CA were diagnosed with a luminal area less than 4mm2 using IVUS. This luminal area was significantly smaller in the T2DM group than in the control group (3.8mm2 ± 2.42. vs 4.6mm2 ± 2.58, p = 0.03). Conclusion Patients with MS and T2DM submitted to angiography and IVUS, had more severe coronary lesions compared to MS patients without diabetes. This finding suggests that beyond insulin resistance that is present in MS, hyperglycemia may

  5. Predicting Central Venous Pressure by Measuring Femoral Venous Diameter Using Ultrasonography

    PubMed Central

    Malik, Akram; Akhtar, Aftab; Mansoor, Salman

    2016-01-01

    Objectives The objective of this exploratory study was to find out the correlation of femoral vein diameter (FVD) to central venous pressure (CVP) measurements and to derive a prediction equation to help ascertain the fluid volume status in a critical patient. Patients and methods This was a single-centered prospective cohort study designed and conducted by the critical care department of Shifa International hospital in Islamabad, Pakistan. Patients were enrolled from the medical and surgical intensive care units. The inclusion criteria consisted of patients > 18 years of age, and an intrathoracic central venous catheterization (CVC) in place for producing CVP waveform through the transducer. Patients having contraindications to CVP placement and those unable to lie supine were excluded from the study. Critical Care fellows with sufficient training in performing venous ultrasonography measured the FVD. They were blinded to the CVP values of the same patients. Results The study included 108 patients. Among these 70/108 (64.8%) were males. Mean age was 53.85 (SD=16.74). The CVP and femoral vein diameter were measured in all patients. Mean CVP was 9.89 cmH2O (SD=3.46) and mean femoral vein diameter was 0.92 cm (SD=0.27). Multiple regression was used to generate a prediction model. FVD, age and sex of the patient were used as predictor variables to predict CVP diameter. The model was statistically significant with a p-value of < 0.000 and an F-value of 104.806. R-squared value for this model came out to be 0.744, thus the model was able to explain about 74.4% of the variance in the values observed for CVP. When controlled for age and sex, FVD was found highly correlated with CVP diameter with a p-value of < 0.000. A regression equation was derived that can be used to generate predicted values of CVP in millimeters of mercury with an R-square of 0.745 if FVD in centimeters is provided; CVP (cmH2O) = -0.039 + 10.718* FVD. Conclusions FVD was found highly correlated to

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

    PubMed Central

    Marques Jr., Wilson; Foss, Norma Tiraboschi

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  8. Routine application of lung ultrasonography in the neonatal intensive care unit

    PubMed Central

    Chen, Shui-Wen; Fu, Wei; Liu, Jing; Wang, Yan

    2017-01-01

    Abstract The aim of this study was to study the features of lung ultrasonography (LUS) in lung disease and to evaluate the usefulness of LUS in the neonatal intensive care unit (NICU). All of 3405 neonates included in this study underwent an LUS examination. Diagnoses were based on medical history, clinical manifestation, laboratory examination, and signs on chest radiography (CR) and/or computed tomography (CT). A single expert physician performed all LUS examinations. There were 2658 cases (78.9%) with lung disease and 747 cases (21.9%) without lung disease. The main signs of neonates with lung disease on LUS were as follows: absence of A-lines, pleural-line abnormalities, interstitial syndrome, lung consolidation, air bronchograms, pulmonary edema, and lung pulse. These abnormal signs were reduced or eliminated on LUS as patient conditions improved. There were 81 cases that could not be diagnosed as lung disease by CR but were discovered as pneumonia, respiratory distress syndrome (RDS), or transient tachypnea of newborn (TTN) on LUS. Likewise, 23 cases misdiagnosed as RDS by CR were diagnosed as TTN on LUS. Among 212 cases of long-term oxygen dependence (LTOD) that failed to yield signs of pulmonary edema and lung consolidation on CR, 103 cases showed abnormal signs on LUS. Among 747 cases without lung disease, B-lines of 713 neonates (95.4%) could be found within 3 days after birth, and 256 neonates (34.3%) could be observed from 3 days to 1 week after birth. B-lines of 19 cases could be detected from 1 to 2 weeks after birth. The longest time at which B-lines could still be observed was 19 days after birth. LUS has clinical value for the diagnosis of lung disease and the discrimination of causes of LTOP in premature infants, particularly for the diagnosis and identification of RDS and TTN. Moreover, LUS has additional advantages, including its lack of radiation exposure and its ability to noninvasively monitor treatment progress. Therefore, LUS should be

  9. Ultrasonography Evaluation of Vulnerable Vessels Around Cervical Nerve Roots During Selective Cervical Nerve Root Block

    PubMed Central

    2017-01-01

    Objective To evaluate the prevalence of vulnerable blood vessels around cervical nerve roots before cervical nerve root block in the clinical setting. Methods This retrospective study included 74 patients with cervical radiculopathy who received an ultrasonography-guided nerve block at an outpatient clinic from July 2012 to July 2014. Before actual injection of the steroid was performed, we evaluated the vulnerable blood vessels around each C5, C6, and C7 nerve root of each patient's painful side, with Doppler ultrasound. Results Out of 74 cases, the C5 level had 2 blood vessels (2.7%), the C6 level had 4 blood vessels (5.45%), and the C7 level had 6 blood vessels (8.11%) close to each targeted nerve root. Moreover, the C5 level had 2 blood vessels (2.7%), the C6 level 5 blood vessels (6.75%), and the C7 level had 4 blood vessels (5.45%) at the site of an imaginary needle's projected pathway to the targeted nerve root, as revealed by axial transverse ultrasound imaging with color Doppler imaging. In total, the C5 level had 4 blood vessels (5.45%), the C6 level 9 blood vessels (12.16%), and the C7 level 10 had blood vessels (13.51%) either at the targeted nerve root or at the site of the imaginary needle's projected pathway to the targeted nerve root. There was an unneglectable prevalence of vulnerable blood vessels either at the targeted nerve root or at the site of the needle' projected pathway to the nerve root. Also, it shows a higher prevalence of vulnerable blood vessels either at the targeted nerve root or at the site of an imaginary needle's projected pathway to the nerve root as the spinal nerve root level gets lower. Conclusion To prevent unexpected critical complications involving vulnerable blood vessel injury during cervical nerve root block, it is recommended to routinely evaluate for the presence of vulnerable blood vessels around each cervical nerve root using Doppler ultrasound imaging before the cervical nerve root block, especially for the lower

  10. Routine application of lung ultrasonography in the neonatal intensive care unit.

    PubMed

    Chen, Shui-Wen; Fu, Wei; Liu, Jing; Wang, Yan

    2017-01-01

    The aim of this study was to study the features of lung ultrasonography (LUS) in lung disease and to evaluate the usefulness of LUS in the neonatal intensive care unit (NICU).All of 3405 neonates included in this study underwent an LUS examination. Diagnoses were based on medical history, clinical manifestation, laboratory examination, and signs on chest radiography (CR) and/or computed tomography (CT). A single expert physician performed all LUS examinations.There were 2658 cases (78.9%) with lung disease and 747 cases (21.9%) without lung disease. The main signs of neonates with lung disease on LUS were as follows: absence of A-lines, pleural-line abnormalities, interstitial syndrome, lung consolidation, air bronchograms, pulmonary edema, and lung pulse. These abnormal signs were reduced or eliminated on LUS as patient conditions improved. There were 81 cases that could not be diagnosed as lung disease by CR but were discovered as pneumonia, respiratory distress syndrome (RDS), or transient tachypnea of newborn (TTN) on LUS. Likewise, 23 cases misdiagnosed as RDS by CR were diagnosed as TTN on LUS. Among 212 cases of long-term oxygen dependence (LTOD) that failed to yield signs of pulmonary edema and lung consolidation on CR, 103 cases showed abnormal signs on LUS. Among 747 cases without lung disease, B-lines of 713 neonates (95.4%) could be found within 3 days after birth, and 256 neonates (34.3%) could be observed from 3 days to 1 week after birth. B-lines of 19 cases could be detected from 1 to 2 weeks after birth. The longest time at which B-lines could still be observed was 19 days after birth.LUS has clinical value for the diagnosis of lung disease and the discrimination of causes of LTOP in premature infants, particularly for the diagnosis and identification of RDS and TTN. Moreover, LUS has additional advantages, including its lack of radiation exposure and its ability to noninvasively monitor treatment progress. Therefore, LUS should be routinely used

  11. Measurement of cerebral blood flow using phase contrast magnetic resonance imaging and duplex ultrasonography.

    PubMed

    Khan, Muhammad Ayaz; Liu, Jie; Tarumi, Takashi; Lawley, Justin Stevan; Liu, Peiying; Zhu, David C; Lu, Hanzhang; Zhang, Rong

    2017-02-01

    Phase contrast magnetic resonance imaging (PC-MRI) and color-coded duplex ultrasonography (CDUS) are commonly used for measuring cerebral blood flow in the internal carotid (ICA) and vertebral arteries. However, agreement between the two methods has been controversial. Recent development of high spatial and temporal resolution blood vessel wall edge-detection and wall-tracking methods with CDUS increased the accuracy and reliability of blood vessel diameter, hence cerebral blood flow measurement. The aim of this study was to compare the improved CDUS method with 3 T PC-MRI for cerebral blood flow measurements. We found that cerebral blood flow velocity measured in the ICA was lower using PC-MRI than CDUS (left ICA: PC-MRI, 18.0 ± 4.2 vs. CDUS, 25.6 ± 8.6 cm/s; right ICA: PC-MRI, 18.5 ± 4.8 vs. CDUS, 26.6 ± 6.7 cm/s, both p < 0.01). However, ICA diameters measured using PC-MRI were larger (left ICA: PC-MRI, 4.7 ± 0.50 vs. CDUS, 4.1 ± 0.46 mm; right ICA: PC-MRI, 4.5 ± 0.49 vs. CDUS, 4.0 ± 0.45 mm, both p < 0.01). Cerebral blood flow velocity measured in the left vertebral artery with PC-MRI was also lower than CDUS, but no differences in vertebral artery diameter were observed between the methods. Dynamic changes and/or intrinsic physiological fluctuations may have caused these differences in vessel diameter and velocity measurements between the methods. However, estimation of volumetric cerebral blood flow was similar and correlated between the methods despite the presence of large individual differences. These findings support the use of CDUS for cerebral blood flow measurements in the ICA and vertebral artery.

  12. Assessment of fetus during second trimester ultrasonography using HDlive software: What is its real application in the obstetrics clinical practice?

    PubMed Central

    Tonni, Gabriele; Grisolia, Gianpaolo; Santana, Eduardo Félix; Araujo Júnior, Edward

    2016-01-01

    AIM To show imaging results from application of four-dimensional (4D) ultrasound lightening technique (HDlive™) in clinical obstetrics practice. METHODS Normal and abnormal fetuses at second and third trimester of pregnancy undergoing routine scan with 4D HDlive™ (5DUS) in the rendering mode are described. Realistic features of fetal structures were provided by 5DUS in the rendering mode. Normal anatomy as well as pathology like cleft lip, hypoplastic face, micrognathia, low-set ears, corpus callosum, arthrogryposis, aortic arch, left congenital diaphragmatic hernia are highlighted in this study. Anatomical details of the fetuses were provided by 5DUS with higher quality imaging modality compared to those obtained using conventional 2D/3D ultrasound. RESULTS Realistic views of fetal anatomy details were displayed by means of 5DUS in the rendering mode, with high image quality obtained either in low-risk or in high-risk obstetrics population. Corpus callosum, esophagus, and aortic arch were obtained in normal fetuses. Cleft lip, cleft lip and palate, micrognathia, hypoplastic face, low-set ears, arthrogryposis, left congenital diaphragmatic hernia, exomphalos, and clitoris hypertrophy were clearly rendered by 5DUS application. CONCLUSION The use of 5DUS in the rendering mode, when clinical available, was diagnostic in a variety of congenital anomalies, aided understanding of the parents-to-be and improved prenatal counseling and perinatal management. PMID:28070244

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

    SciTech Connect

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

    2006-12-15

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

  14. Use of intra-arterial carbon-dioxide-enhanced ultrasonography for guidance of radiofrequency ablation and transcatheter arterial chemoembolization in hepatocellular carcinoma.

    PubMed

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

    2006-01-01

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

  15. Estimation of Muscle Mass by Ultrasonography Differs between Observers and Life States of Models in Small Birds.

    PubMed

    Royer-Boutin, Pascal; Cortés, Pablo A; Milbergue, Myriam; Petit, Magali; Vézina, François

    2015-01-01

    Ultrasonography has proven to be a valuable noninvasive method of measure of muscle size in birds, but validation of its use in birds as small as black-capped chickadees (Poecile atricapillus; 11 g) is scarce. The effect of observers and life state (dead or alive) of models used for calibration on measurement quality is also poorly documented. Using 31 dead and 22 live chickadees, linear regressions between ultrasound and dissection measurements of pectoral and thigh muscles were fitted and compared between five different observers. R(2) values varied greatly between observers and were generally weaker in live birds, ranging between 0.02 and 0.59, despite high repeatability of measurement. Using equations calculated from dead birds to estimate muscle mass of live birds yielded much higher measurement errors (9%-18%) than when using equations calculated from live birds (5%-8%). Our results suggest that with careful training and using only calibration from live birds, ultrasonography can be a useful but limited tool to estimate muscle size of birds as small as the black-capped chickadee.

  16. Ultrasound assessment of the elbow.

    PubMed

    Radunovic, Goran; Vlad, Violeta; Micu, Mihaela C; Nestorova, Rodina; Petranova, Tzvetanka; Porta, Francesco; Iagnocco, Annamaria

    2012-06-01

    Ultrasonography of the elbow is a very helpful and reliable diagnostic procedure for a broad spectrum of rheumatic and orthopedic conditions, representing a possible substitute to magnetic resonance imaging for evaluation of soft tissues of the elbow. Musculoskeletal ultrasound (US) shows many advantages over other imaging modalities, probably the most important being its capability to perform a dynamic assessment of musculoskeletal elements with patient's partnership and observation during examination. In addition, ultrasonography is cost effective, easy available, and has excellent and multiplanar capability to visualize superficial soft tissue structures. Among all imaging procedures, US is highly accepted by patients. US assessment of the elbow requires good operator experience in the assessment of normal anatomy, and suitable high-quality equipment. US of the elbow provides detailed information including joint effusions, medial and lateral epicondylitis, tears of the distal biceps and triceps tendons, radial and ulnar collateral ligament tears, ulnar nerve entrapment, cubital or olecranon bursitis and intra-articular loose bodies. The aim of this paper is to review the screening technique and the basic normal and pathological findings in elbow US.

  17. Spontaneous rupture of a middle colic artery aneurysm arising from superior mesenteric artery dissection: Diagnosis by color Doppler ultrasonography and CT angiography.

    PubMed

    Yoo, Bo Reum; Han, Hyun Young; Cho, Young Kwon; Park, Suk Jin

    2012-05-01

    Both middle colic artery (MCA) aneurysm and spontaneous dissection of the superior mesenteric artery (SMA) are rare. We report the first case of concomitancy of both conditions, diagnosed by ultrasonography and CT angiography. A 56-year-old man with abrupt abdominal pain and hypovolemic shock was diagnosed initially with ruptured MCA aneurysm by color Doppler ultrasonography. Computed tomography and angiography confirmed MCA aneurysm and showed that it was arising from the false lumen of an SMA dissection and was probably associated with segmental arterial mediolysis. The MCA aneurysm was treated successfully by transcatheter coil embolization, and the SMA dissection was treated conservatively.

  18. Intrapericardial extralobar pulmonary sequestration detected as an intrathoracic cystic mass by using prenatal ultrasonography: case report and review of the literature.

    PubMed

    Yanagisawa, Satohiko; Maeda, Kosaku; Tazuke, Yuko; Baba, Katsuhisa; Tuji, Yuki; Kawahara, Insu; Nakagami, Tomokazu

    2012-12-01

    Intrapericardial extralobar pulmonary sequestration is a very rare congenital lung anomaly. We report a case of this condition, detected as an intrathoracic cystic lesion by using prenatal ultrasonography. The neonate was born at 38 weeks of gestation with no progression of the lesion and no respiratory or cardiac symptoms. Ultrasonography and computed tomography (CT) revealed a 40 × 17 × 17-mm intrapericardial lesion, composed of cystic components and a solid component. Intrapericardial extrapulmonary sequestration was suspected largely because CT showed a vague aberrant artery. At the age of 3 months, elective surgery was performed, and the postoperative course was uneventful.

  19. Influence of the observer's level of experience on systolic and diastolic arterial blood pressure measurements using Doppler ultrasonography in healthy conscious cats.

    PubMed

    Gouni, Vassiliki; Tissier, Renaud; Misbach, Charlotte; Balouka, David; Bueno, Hanna; Pouchelon, Jean-Louis; Lefebvre, Hervé P; Chetboul, Valérie

    2015-02-01

    The objective of this study was to determine the influence of the observer's level of experience on within- and between-day variability, and the percentage of successful systolic (SAP) and diastolic arterial blood pressure (DAP) measurements obtained by Doppler ultrasonography (DU) in awake cats. For this purpose, six healthy conscious cats were used and four observers with different levels of training performed 144 SAP and DAP measurements on 4 days using DU. Measurements were recorded five consecutive times, and mean values were used for statistical analysis. Only the two most skilled observers - a PhD student in cardiology and a Dipl ECVIM-CA (cardiology) - had within- and between-day coefficients of variation (CVs) for SAP ⩽16% (13-16%). Conversely, the two less experienced observers - a fifth-year student and an assistant - had high between-day CVs (61% and 73%). For DAP, only the most experienced observer (Dipl ECVIM-CA) succeeded in 100% of the attempts, with within- and between-day CVs of 11% and 4%, respectively. Conversely, DAP could not be measured by the other three observers in 8%, 19% and 56% of attempts (from the highest to the lowest level of experience); therefore, the corresponding CV values could not be calculated. In conclusion, SAP may be assessed using DU in healthy awake cats with good repeatability and reproducibility by a well-trained observer. Measurement of DAP is more difficult than of SAP, and needs a longer training period, which represents one of the limitations of DU in cats.

  20. The Effects of Pioglitazone in Reducing Atherosclerosis Progression and Neointima Volume in Type 2 Diabetic Patients: Prospective Randomized Study With Volumetric Intravascular Ultrasonography Analysis

    PubMed Central

    You, Sung Hye; Kim, Beum Suk; Hong, Soon Jun; Ahn, Chul-Min

    2010-01-01

    Background and Objectives Pioglitazone has been known for its anti-atherogenic effects. We compared the effects of pioglitazone in reducing atherosclerosis progression and neointima volume in type 2 diabetic patients. Subjects and Methods This was a prospective, randomized single-blinded, 8-month follow-up study. Patients with significant coronary artery stenosis were randomly assigned to either pioglitazone (n=19) or placebo (n=18) following zotarolimus-eluting stent (ZES) implantation. Intravascular ultrasonography of the culprit vessel was performed from 20 mm distal and proximal to the stent at baseline. and at 8-month, and volumetric analysis was performed. Changes in inflammation markers, insulin resistance and lipid profile were compared. Results Changes in atherosclerosis progression from baseline in the pioglitazone group was significantly lower than that of the placebo group (0.06±0.73 vs. 1.16±1.41 mm3/mm, p=0.024, respectively), and neointima volume was significantly lower in the pioglitazone group compared to the placebo group (1.74±0.93 vs. 2.42±1.98 mm3/mm, p=0.007, respectively). Homeostatic model assessment-index, interleukin-6, and tumor necrosis factor-α levels were significantly lower in the pioglitazone group at 8 months. Adiponectin levels increased significantly only in the pioglitazone group. No significant differences in retinol binding protein-4 levels between the 2 groups were seen during the 8-month follow-up period. Conclusion Compared to placebo, pioglitazone was associated with significant reduction in atherosclerosis progression and neointima formation in type 2 diabetic patients with ZES implantation. PMID:21267384