Comparison of the use of scapular ultrasonography, physical examination, and measurement of serum biomarkers of bone turnover versus scintigraphy for detection of bone fragility syndrome in horses.

PubMed

Arens, Amanda M; Puchalski, Sarah M; Whitcomb, Mary Beth; Bell, Robin; Gardner, Ian A; Stover, Susan M

2013-01-01

To define scintigraphic, physical examination, and scapular ultrasonographic findings consistent with bone fragility syndrome (BFS) in horses; develop indices of BFS severity; and assess accuracy of physical examination, scapular ultrasonography, and serum biomarkers for BFS diagnosis. Prospective case-control study. 48 horses (20 horses with BFS and 28 control horses). Horses underwent forelimb scintigraphic evaluation, physical examination, scapular ultrasonography, and serum collection. Scintigraphy was used as a reference standard to which physical examination, scapular ultrasonography, and concentrations of serum biomarkers (carboxy-terminal telopeptide of collagen crosslinks and bone-specific alkaline phosphatase activity) were compared for assessing accuracy in BFS diagnosis. A diagnosis of BFS was strongly supported on scintigraphy by ≥ 2 regions of increased radiopharmaceutical uptake, including 1 region in the scapular spine and 1 region in the scapular body or ribs; on physical examination by lateral bowing of the scapulae; and on ultrasonography by widening of the scapular spine. None of the tests evaluated were accurate enough to replace scintigraphy for mild disease; however, physical examination and scapular ultrasonography were accurate in horses with moderate to severe BFS. Serum biomarkers were not accurate for BFS diagnosis. Scintigraphy remained the most informative diagnostic modality for BFS, providing insight into disease severity and distribution; however, physical examination and scapular ultrasonographic abnormalities were diagnostic in horses with moderate to severe disease. Proposed severity indices classified the spectrum of disease manifestations. Clearly defined criteria for interpretation of diagnostic tests aid in the detection of BFS. Severity indices may be useful for assessing disease progression and response to treatment.

Point-of-care ultrasonography by pediatric emergency physicians. Policy statement.

PubMed

Marin, Jennifer R; Lewiss, Resa E

2015-04-01

Point-of-care ultrasonography is increasingly being used to facilitate accurate and timely diagnoses and to guide procedures. It is important for pediatric emergency physicians caring for patients in the emergency department to receive adequate and continued point-of-care ultrasonography training for those indications used in their practice setting. Emergency departments should have credentialing and quality assurance programs. Pediatric emergency medicine fellowships should provide appropriate training to physician trainees. Hospitals should provide privileges to physicians who demonstrate competency in point-of-care ultrasonography. Ongoing research will provide the necessary measures to define the optimal training and competency assessment standards. Requirements for credentialing and hospital privileges will vary and will be specific to individual departments and hospitals. As more physicians are trained and more research is completed, there should be one national standard for credentialing and privileging in point-of-care ultrasonography for pediatric emergency physicians.

Endoscopic ultrasonography in chronic pancreatitis: a comparative prospective study with conventional ultrasonography, computed tomography, and ERCP.

PubMed

Buscail, L; Escourrou, J; Moreau, J; Delvaux, M; Louvel, D; Lapeyre, F; Tregant, P; Frexinos, J

1995-04-01

The usefulness and accuracy rate of endoscopic ultrasonography (EUS) in the diagnosis of chronic pancreatitis (CP) were prospectively evaluated in 81 patients with suspected pancreatic disease. All underwent EUS, abdominal ultrasonography (AUS), and computed tomography (CT), and endoscopic retrograde cholangiopancreatography (ERCP) was performed in 55 of the cases. The diagnosis of CP was established in 44 patients (CP group) including 24 with a calcified form. No pancreatic disease was observed in 18 patients (control group), and 19 patients had a pancreatic tumor. In the CP group AUS was less accurate than EUS in visualizing the pancreas, performances of CT scan being identical to EUS in this respect. A good correlation was observed between EUS and ERCP for visualization and measurement of the Wirsung duct. The most significant changes observed by EUS in the CP group were dilatation of the main pancreatic duct, heterogeneous echogenicity of the pancreatic parenchyma, and cysts < 20 mm in size even in noncalcified CP or with normal pancreatograms. Sensitivity of EUS for diagnosis of CP was 88% (AUS, 58%; ERCP, 74%; CT scan, 75%), the specificity being 100% for ERCP and EUS, 95% for CT scan, and 75% for AUS. The good performances of EUS allow early diagnosis of CP in symptomatic patients since heterogeneous echogenicity of the pancreatic parenchyma seems to be almost specifically associated with the disease.

A study of bedside ocular ultrasonography in the emergency department.

PubMed

Blaivas, Michael; Theodoro, Daniel; Sierzenski, Paul R

2002-08-01

The use of ocular ultrasonography for the evaluation of emergency patients has recently been described in the emergency medicine (EM) literature. There are a number of potential uses that may greatly aid the emergency physician (EP) and avoid lengthy consultation or other diagnostic tests. To examine the accuracy of bedside ultrasonography as performed by EPs for the evaluation of ocular pathology. This prospective, observational study took place in a high-volume, suburban community hospital with an EM residency program. All patients arriving with a history of eye trauma or acute change in vision were eligible to participate in the study. A 10-MHz linear-array transducer was used for imaging. All imaging was performed through a closed eyelid, using water-soluble ultrasound gel. Investigators filled out standardized data sheets and all examinations were taped for review. All ultrasound examinations were followed by orbital computed tomography or complete ophthalmologic evaluation from the ophthalmology service. Statistical analysis included sensitivity, specificity, and positive and negative predictive values. Sixty-one patients were enrolled in the study; 26 were found to have intraocular pathology on ultrasound. Of these, three had penetrating globe injuries, nine had retinal detachments, one had central retinal artery occlusion, and two had lens dislocations. The remaining pathology included vitreous hemorrhage and vitreous detachment. Emergency sonologists were in agreement with the criterion standard examination in 60 out of 61 cases. Emergency bedside ultrasound is highly accurate for ruling out and diagnosing ocular pathology in patients presenting to the emergency department. Further, it accurately differentiates between pathology that needs immediate ophthalmologic consultation and that which can be followed up on an outpatient basis.

Real-time tracheal ultrasonography for confirmation of endotracheal tube placement during cardiopulmonary resuscitation.

PubMed

Chou, Hao-Chang; Chong, Kah-Meng; Sim, Shyh-Shyong; Ma, Matthew Huei-Ming; Liu, Shih-Hung; Chen, Nai-Chuan; Wu, Meng-Che; Fu, Chia-Ming; Wang, Chih-Hung; Lee, Chien-Chang; Lien, Wan-Ching; Chen, Shyr-Chyr

2013-12-01

This study aimed to evaluate the accuracy of tracheal ultrasonography for assessing endotracheal tube position during cardiopulmonary resuscitation (CPR). We performed a prospective observational study of patients undergoing emergency intubation during CPR. Real-time tracheal ultrasonography was performed during the intubation with the transducer placed transversely just above the suprasternal notch, to assess for endotracheal tube positioning and exclude esophageal intubation. The position of trachea was identified by a hyperechoic air-mucosa (A-M) interface with posterior reverberation artifact (comet-tail artifact). The endotracheal tube position was defined as endotracheal if single A-M interface with comet-tail artifact was observed. Endotracheal tube position was defined as intraesophageal if a second A-M interface appeared, suggesting a false second airway (double tract sign). The gold standard of correct endotracheal intubation was the combination of clinical auscultation and quantitative waveform capnography. The main outcome was the accuracy of tracheal ultrasonography in assessing endotracheal tube position during CPR. Among the 89 patients enrolled, 7 (7.8%) had esophageal intubations. The sensitivity, specificity, positive predictive value, and negative predictive value of tracheal ultrasonography were 100% (95% confidence interval [CI]: 94.4-100%), 85.7% (95% CI: 42.0-99.2%), 98.8% (95% CI: 92.5-99.0%) and 100% (95% CI: 54.7-100%), respectively. Positive and negative likelihood ratios were 7.0 (95% CI: 1.1-43.0) and 0.0, respectively. Real-time tracheal ultrasonography is an accurate method for identifying endotracheal tube position during CPR without the need for interruption of chest compression. Tracheal ultrasonography in resuscitation management may serve as a powerful adjunct in trained hands. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Diagnostic Accuracy of Ultrasonography and Radiography in Initial Evaluation of Chest Trauma Patients.

PubMed

Vafaei, Ali; Hatamabadi, Hamid Reza; Heidary, Kamran; Alimohammadi, Hosein; Tarbiyat, Mohammad

2016-01-01

Application of chest radiography for all multiple trauma patients is associated with a significant increase in total costs, exposure to radiation, and overcrowding of the emergency department. Ultrasound has been introduced as an alternative diagnostic tool in this regard. The aim of the present study is to compare the diagnostic accuracy of chest ultrasonography and radiography in detection of traumatic intrathoracic injuries. In the present prospective cross-sectional study, patients with traumatic intrathoracic injuries, who were referred to the emergency department from December 2013 to December 2014, were assessed. The patients underwent bedside ultrasound, radiographic and computed tomography (CT) scan examinations based on ATLS recommendations. Screening performance characteristics of ultrasonography and radiography were compared using SPSS 21.0. Chest CT scan was considered as gold standard. 152 chest trauma patients with a mean age of 31.4 ± 13.8 years (range: 4 ‒ 67), were enrolled (77.6% male). Chest CT scan showed pulmonary contusion in 48 (31.6%) patients, hemothorax in 29 (19.1%), and pneumothorax in 55 (36.2%) cases. Area under the ROC curve of ultrasonography in detection of pneumothorax, hemothorax, and pulmonary contusion were 0.91 (95% CI: 0.86‒0.96), 0.86 (95% CI: 0.78‒0.94), and 0.80 (95% CI: 0.736‒0.88), respectively. Area under the ROC curve of radiography was 0.80 (95% CI: 0.736‒0.87) for detection of pneumothorax, 0.77 (95% CI: 0.68‒0.86) for hemothorax, and 0.58 (95% CI: 0.5‒0.67) for pulmonary contusion. Comparison of areas under the ROC curve declared the significant superiority of ultrasonography in detection of pneumothorax (p = 0.02) and pulmonary contusion (p < 0.001). However, the diagnostic value of the two tests was equal in detection of hemothorax (p = 0.08). The results of the present study showed that ultrasonography is preferable to radiography in the initial evaluation of patients with traumatic injuries to the

Prenatal Imaging: Ultrasonography and Magnetic Resonance Imaging

PubMed Central

Reddy, Uma M.; Filly, Roy A.; Copel, Joshua A.

2009-01-01

The Eunice Kennedy Shriver National Institute of Child Health and Human Development held a workshop on September 18–19, 2006, to summarize the available evidence on the role and performance of current fetal imaging technology and to establish a research agenda. Ultrasonography is the imaging modality of choice for pregnancy evaluation due to its relatively low cost, real-time capability, safety, and operator comfort and experience. First-trimester ultrasonography extends the available window for fetal observation and raises the possibility of performing an early anatomic survey. Three-dimensional ultrasonography has the potential to expand the clinical application of ultrasonography by permitting local acquisition of volumes and remote review and interpretation at specialized centers. New advances allow performance of fetal magnetic resonance imaging (MRI) without maternal or fetal sedation, with improved characterization and prediction of prognosis of certain fetal central nervous system anomalies such as ventriculomegaly when compared with ultrasonography. Fewer data exist on the usefulness of fetal MRI for non–central nervous system anomalies. PMID:18591320

The potential of ultrasonography in the evaluation of foot orthotics therapy.

PubMed

Petcu, Daniel; Mitrea, Delia Alexandrina; Bondor, Cosmina Ioana; Perciun, Elena Rodica

2017-11-29

Foot orthotics prescription is based on the foot functioning paradigms with tissue stress theory being in avant-garde. The main goal of orthotic therapy is to reduce the internal tissue's pathological stresses in the foot structures. Traditionally, ultrasound scanning technique depicts anatomic related data of both common and uncommon pathology encountered in the clinical practice, helping in diagnosing, treating and evaluating, which are equally important for the practitioners. Its accessibility, compared to biomechanical modelling, makes this technique a valuable tool in the field of foot and ankle disorders. Despite its user-dependent limitation, the ongoing technical progress improves the ability of ultrasonography as a highly advanced procedure in musculoskeletal imaging, being also a valuable searching tool for musculotendinous mechanics or morphological changes as a result of a conservative intervention. The aim of the present work was to perform a review of the state of the art concerning the usefulness of ultrasonography in the study of foot orthotic therapy and to analyze its effectiveness.

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. Copyright © 2015 by the American Academy of Pediatrics.

Value of ultrasonography for detecting chronic injury of the lateral ligaments of the ankle joint compared with ultrasonography findings.

PubMed

Cheng, Y; Cai, Y; Wang, Y

2014-01-01

The aim of this study was to assess the accuracy of ultrasonography in the diagnosis of chronic lateral ankle ligament injury. A total of 120 ankles in 120 patients with a clinical suspicion of chronic ankle ligament injury were examined by ultrasonography by using a 5- to 17-MHz linear array transducer before surgery. The results of ultrasonography were compared with the operative findings. There were 18 sprains and 24 partial and 52 complete tears of the anterior talofibular ligament (ATFL); 26 sprains, 27 partial and 12 complete tears of the calcaneofibular ligament (CFL); and 1 complete tear of the posterior talofibular ligament (PTFL) at arthroscopy and operation. Compared with operative findings, the sensitivity, specificity and accuracy of ultrasonography were 98.9%, 96.2% and 84.2%, respectively, for injury of the ATFL and 93.8%, 90.9% and 83.3%, respectively, for injury of the CFL. The PTFL tear was identified by ultrasonography. The accuracy of identification between acute-on-chronic and subacute-chronic patients did not differ. The accuracies of diagnosing three grades of ATFL injuries were almost the same as those of diagnosing CFL injuries. Ultrasonography provides useful information for the evaluation of patients presenting with chronic pain after ankle sprain. Intraoperative findings are the reference standard. We demonstrated that ultrasonography was highly sensitive and specific in detecting chronic lateral ligments injury of the ankle joint.

Role of endoscopic ultrasonography in evaluation of metastatic lesions to the pancreas: a tertiary cancer center experience.

PubMed

Atiq, Muslim; Bhutani, Manoop S; Ross, William A; Raju, Gottumukkala S; Gong, Yun; Tamm, Eric P; Javle, Milind; Wang, Xuemei; Lee, Jeffrey H

2013-04-01

Metastatic lesions to the pancreas pose diagnostic challenges with regards to their differentiation from primary pancreatic cancer. Data on the yield of endoscopic ultrasonography (EUS)-guided fine-needle aspiration in detection of these lesions are limited. This is a retrospective review of 23 patients referred to a tertiary referral center for further evaluation of suspected pancreatic metastases. Main outcome measures were diagnostic yield of endoscopic ultrasonography-guided fine-needle aspiration in evaluation of metastatic lesions to the pancreas. Of 644 patients, 23 (3.6%) undergoing EUS of the pancreas were diagnosed to have metastatic disease to the pancreas based on clinical, radiological, and cytological results. Mean (SD) age was 64.3 (11.7) years. Of the 23 patients, 18 (78.3%) were asymptomatic. Mean (SD) size of lesion on EUS was 39.1 (19.9) mm. A diagnosis of malignant lesion was made in 21 of 23 cases, with a diagnostic accuracy of 91.3%. Metastatic lesions to the pancreas present as incidental, solitary mass lesions on staging or surveillance imaging. Endoscopic ultrasonography-guided fine-needle aspiration is an important tool in the characterization and further differentiation of metastatic lesions to the pancreas from primary pancreatic cancer.

Assessment of ultrasonography and computed tomography for the evaluation of unilateral orbital disease in dogs.

PubMed

Boroffka, Susanne A E B; Verbruggen, Anne-Marie; Grinwis, Guy C M; Voorhout, George; Barthez, Paul Y

2007-03-01

To describe clinical, ultrasonographic, and computed tomographic (CT) features of confirmed neoplastic and nonneoplastic disease in dogs with unilateral orbital diseases, determine criteria to differentiate between the 2 conditions, and assess the relative value of ultrasonography and CT for the differential diagnosis of these 2 conditions. Prospective study. 29 dogs with unilateral neoplastic orbital disease and 16 dogs with unilateral nonneoplastic orbital disease. Clinical history and results of physical and ophthalmologic examinations were recorded. Ultrasonographic and CT images were evaluated, and discriminating factors were identified to differentiate neoplastic from nonneoplastic diseases. Diagnostic value of ultrasonography and CT was assessed. Dogs with neoplastic disease were significantly older; had clinical signs for a longer time before initial examination; had more progressive onset of clinical signs; and more frequently had protrusion of the nictitating membrane, fever, and anorexia. The most discriminating factor for both imaging modalities was delineation of the margins (odds ratio was 41.7 for ultrasonography and 45 for CT), with neoplastic lesions clearly delineated more often. Ultrasonographically, neoplastic lesions were more frequently hypoechoic and homogeneous, with indentation of the globe and bone involvement evident more frequently than for nonneoplastic lesions. Mineralization was detected only with neoplasia. Fluctuant fluid was seen more frequently in dogs with nonneoplastic disease. Computed tomography more frequently revealed extraorbital involvement. Diagnostic value was similar for both imaging modalities. Ultrasonography and CT are valuable imaging modalities to assist in differentiating neoplastic from nonneoplastic unilateral orbital disease in dogs.

The Efficacy of Thoracic Ultrasonography in Postoperative Newborn Patients after Cardiac Surgery

PubMed Central

Ozturk, Erkut; Tanidir, Ibrahim Cansaran; Yildiz, Okan; Ergul, Yakup; Guzeltas, Alper

2017-01-01

Objective In this study, the efficacy of thoracic ultrasonography during echocardiography was evaluated in newborns. Methods Sixty newborns who had undergone pediatric cardiac surgery were successively evaluated between March 1, 2015, and September 1, 2015. Patients were evaluated for effusion, pulmonary atelectasis, and pneumothorax by ultrasonography, and results were compared with X-ray findings. Results Sixty percent (n=42) of the cases were male, the median age was 14 days (2-30 days), and the median body weight was 3.3 kg (2.8-4.5 kg). The median RACHS-1 score was 4 (2-6). Atelectasis was demonstrated in 66% (n=40) of the cases. Five of them were determined solely by X-ray, 10 of them only by ultrasonography, and 25 of them by both ultrasonography and X-ray. Pneumothorax was determined in 20% (n=12) of the cases. Excluding one case determined by both methods, all of the 11 cases were diagnosed by X-ray. Pleural effusion was diagnosed in 26% (n=16) of the cases. Four of the cases were demonstrated solely by ultrasonography, three of them solely by X-ray, and nine of the cases by both methods. Pericardial effusion was demonstrated in 10% (n=6) of the cases. Except for one of the cases determined by both methods, five of the cases were diagnosed by ultrasonography. There was a moderate correlation when all pathologies evaluated together (k=0.51). Conclusion Thoracic ultrasonography might be a beneficial non-invasive method to evaluate postoperative respiratory problems in newborns who had congenital cardiac surgery. PMID:28977200

Value of ultrasonography for detecting chronic injury of the lateral ligaments of the ankle joint compared with ultrasonography findings

PubMed Central

Cheng, Y; Cai, Y

2014-01-01

Objective: The aim of this study was to assess the accuracy of ultrasonography in the diagnosis of chronic lateral ankle ligament injury. Methods: A total of 120 ankles in 120 patients with a clinical suspicion of chronic ankle ligament injury were examined by ultrasonography by using a 5- to 17-MHz linear array transducer before surgery. The results of ultrasonography were compared with the operative findings. Results: There were 18 sprains and 24 partial and 52 complete tears of the anterior talofibular ligament (ATFL); 26 sprains, 27 partial and 12 complete tears of the calcaneofibular ligament (CFL); and 1 complete tear of the posterior talofibular ligament (PTFL) at arthroscopy and operation. Compared with operative findings, the sensitivity, specificity and accuracy of ultrasonography were 98.9%, 96.2% and 84.2%, respectively, for injury of the ATFL and 93.8%, 90.9% and 83.3%, respectively, for injury of the CFL. The PTFL tear was identified by ultrasonography. The accuracy of identification between acute-on-chronic and subacute–chronic patients did not differ. The accuracies of diagnosing three grades of ATFL injuries were almost the same as those of diagnosing CFL injuries. Conclusion: Ultrasonography provides useful information for the evaluation of patients presenting with chronic pain after ankle sprain. Advances in knowledge: Intraoperative findings are the reference standard. We demonstrated that ultrasonography was highly sensitive and specific in detecting chronic lateral ligments injury of the ankle joint. PMID:24352708

Semi-closed reduction of tripod fractures of zygoma under intraoperative assessment using ultrasonography.

PubMed

Soejima, Kazutaka; Sakurai, Hiroyuki; Nozaki, Motohiro; Kitazawa, Yoshihiko; Takeuchi, Masaki; Yamaki, Takashi; Kono, Taro

2009-04-01

We conducted semi-closed reduction of isolated tripod fractures of the zygoma through only a brow incision under intraoperative assessment with ultrasonography. Twenty-three patients with unilateral, non-comminuted tripod fractures of zygoma were selected for application of this method at Tokyo Women's Medical University and Tokyo Metropolitan Hiroo General Hospital between April 2002 and April 2006. Patients with orbital floor blowout fractures were excluded. A skin incision was made only at the lateral brow region and the reduction was performed by inserting an elevator beneath the zygomatic arch. The bone alignment was intraoperatively assessed by ultrasonography. When the reduction was accurate, the frontozygomatic suture was immobilised with a mini-plate under direct visualisation and transmaler Kirshner wire fixation was performed. The accuracy of the reduction and postoperative movement were evaluated by computed tomography (CT) scans taken at 1 and 6 months. In five cases, the DICOM (Digital Imaging and Communication in Medicine) data from the CT were analysed with 3D imaging software (V-works, CyberMed Co., Korea). In all cases, accurate reduction was obtained. The analysis of the 3D imaging data revealed that postoperative movement of bone fragment was minimal. When the accurate reduction was obtained under intraoperative assessment, the semi-closed reduction and one-plate fixation with transmaler Kirshner wire is enough to treat the simple tripod fractures of zygoma. This method is minimally invasive and takes less operative time.

Evaluation of lymph node perfusion using continuous mode harmonic ultrasonography with a second-generation contrast agent.

PubMed

Rubaltelli, Leopoldo; Khadivi, Yeganeh; Tregnaghi, Alberto; Stramare, Roberto; Ferro, Federica; Borsato, Simonetta; Fiocco, Ugo; Adami, Fausto; Rossi, Carlo Riccardo

2004-06-01

To evaluate the contribution of continuous mode contrast-enhanced harmonic ultrasonography (CE-HUS) with a second-generation contrast agent to the characterization of superficial lymphadenopathies with respect to conventional ultrasonographic techniques (B-mode and power Doppler). Fifty-six lymph nodes from 45 patients were studied both by conventional techniques and by CE-HUS. The dimensions, intranodal architecture, margins, and location of vessels were evaluated. Subsequently, all the lymph nodes were examined by CE-HUS, and enhancement of echogenicity was evaluated. The diagnoses obtained by means of fine-needle aspiration cytologic examination, surgical biopsy, or both were compared with those obtained by ultrasonography. Of the lymph nodes examined, 30 were benign and 26 were malignant (18 metastases and 8 non-Hodgkin lymphomas). The study using CE-HUS showed intense homogeneous enhancement in 28 of 30 reactive lymph nodes; perfusion defects in 17, of which 15 were neoplastic and 2 were inflammatory; intense but inhomogeneous speckled enhancement in the early arterial phase in 5 cases of lymphoma; and, last, scarce or absent intranodal enhancement in 4 metastases. The specificity, sensitivity, and accuracy of conventional techniques in differentiation between benign and malignant lymph nodes were 76%, 80%, and 78% versus 93%, 92%, and 92.8% for CE-HUS. The increase in correct diagnoses was significant (P = .05) when conventional ultrasonography was tested against CE-HUS. Superficial lymph nodes can be characterized as being neoplastic or benign with a high degree of diagnostic accuracy on the basis of the perfusion characteristics evaluated by CE-HUS. This technique has been shown to afford a higher degree of accuracy than currently obtainable by any other ultrasonographic technique.

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…

[A Multimedia Tutorial to Train Ultrasonography of the Thyroid for Medical Students].

PubMed

Ritter, Julia; Wolfram, Maximilian; Schuler, Stefan; Guntinas-Lichius, Orlando

2017-11-01

Physicians in education often have poor experience in practice and assessment of ultrasonography on entering their profession, due to a deficiency of training offers during their study of medicine. Hence, a multimedia device for stepwise learning and training ultrasonography of the thyroid was developed. A software for a portable ultrasonography system was used to design a multimedia device for ultrasonography of the thyroid. It allows the user to illustrate texts and pictorial material simultaneously with ultrasound examination in order to compare own findings with examples from a database. The device was evaluated by 8 medical students and compared to a tutor-guided training. A structured, stepwise manual for ultrasonography of the thyroid with a large content of examples in different sectional images was designed for simultaneous reconstruction with the ultrasonography device. The informative content of the device and the replicability of the examination procedure were evaluated positively. Assessment respecting clarity, eligibility for users without experience and learning success was varying. The tutorial to learn and train ultrasonography of the thyroid is an instrument for self-learning and improving practical education in ultrasonography in medical education. In the next version, the manual for the examination will be structured in greater detail. © Georg Thieme Verlag KG Stuttgart · New York.

[The diagnostic value of ultrasonic elastography and ultrasonography comprehensive score in cervical lesions].

PubMed

Lu, R; Xiao, Y

2017-07-18

Objective: To evaluate the clinical value of ultrasonic elastography and ultrasonography comprehensive scoring method in the diagnosis of cervical lesions. Methods: A total of 116 patients were selected from the Department of Gynecology of the first hospital affiliated with Central South University from March 2014 to September 2015.All of the lesions were preoperatively examined by Doppler Ultrasound and elastography.The elasticity score was determined by a 5-point scoring method. Calculation of the strain ratio was based on a comparison of the average strain measured in the lesion with the adjacent tissue of the same depth, size, and shape.All these ultrasonic parameters were quantified, added, and arrived at ultrasonography comprehensive scores.To use surgical pathology as the gold standard, the sensitivity, specificity, accuracy of Doppler Ultrasound, elasticity score and strain ratio methods and ultrasonography comprehensive scoring method were comparatively analyzed. Results: (1) The sensitivity, specificity, and accuracy of Doppler Ultrasound in diagnosing cervical lesions were 82.89% (63/76), 85.0% (34/40), and 83.62% (97/116), respectively.(2) The sensitivity, specificity, and accuracy of the elasticity score method were 77.63% (59/76), 82.5% (33/40), and 79.31% (92/116), respectively; the sensitivity, specificity, and accuracy of the strain ratio measure method were 84.21% (64/76), 87.5% (35/40), and 85.34% (99/116), respectively.(3) The sensitivity, specificity, and accuracy of ultrasonography comprehensive scoring method were 90.79% (69/76), 92.5% (37/40), and 91.38% (106/116), respectively. Conclusion: (1) It was obvious that ultrasonic elastography had certain diagnostic value in cervical lesions. Strain ratio measurement can be more objective than elasticity score method.(2) The combined application of ultrasonography comprehensive scoring method, ultrasonic elastography and conventional sonography was more accurate than single parameter.

Learning curve of office-based ultrasonography for rotator cuff tendons tears.

PubMed

Ok, Ji-Hoon; Kim, Yang-Soo; Kim, Jung-Man; Yoo, Tae-Wook

2013-07-01

To compare the accuracy of ultrasonography and MR arthrography (MRA) imaging in detecting of rotator cuff tears with arthroscopic finding used as the reference standard. The ultrasonography and MRA findings of 51 shoulders that underwent the arthroscopic surgery were prospectively analysed. Two orthopaedic doctors independently performed ultrasonography and interpreted the findings at the office. The tear size measured at ultrasonography and MRA was compared with the size measured at surgery using Pearson correlation coefficients (r). The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and false-positive rate were calculated for a diagnosis of partial-and full-thickness rotator cuff tears. The kappa coefficient was calculated to verify the inter-observer agreement. The sensitivity of ultrasonography and MRA for detecting partial-thickness tears was 45.5 and 72.7 %, and that for full-thickness tears was 80.0 and 100 %, respectively. The accuracy of ultrasonograpy and MRA for detecting partial-thickness tears was 45.1 and 88.2 %, and that for full-thickness tears was 82.4 and 98 %, respectively. Tear size measured based on ultrasonography examination showed a poor correlation with the size measured at arthroscopic surgery (r = 0.21; p < 0.05). However, tear size estimated by MRA showed a strong correlation (r = 0.75; p < 0.05). The kappa coefficient was 0.47 between the two independent examiners. The accuracy of office-based ultrasonography for beginner orthopaedic surgeons to detect full-thickness rotator cuff tears was comparable to that of MRA but was less accurate for detecting partial-thickness tears and torn size measurement. Inter-observer agreement on the interpretation was fair. These results highlight the importance of the correct technique and experience in operation of ultrasonography in shoulder joint. Diagnostic study, Level II.

Transrectal contrast-enhanced ultrasonography, transrectal ultrasonography and retrograde cystography for the detection of vesicourethral anastomosis leakage after radical retropubic prostatectomy: a prospective comparative evaluation.

PubMed

Cantiello, Francesco; Cicione, Antonio; Autorino, Riccardo; De Nunzio, Cosimo; Tubaro, Andrea; Damiano, Rocco

2013-01-01

To evaluate the diagnostic accuracy of cystography (CG), transrectal ultrasonography (TRUS) and transrectal contrast-enhanced ultrasonography (CEUS) for the detection of vesicourethral extravasation (VE) after radical retropubic prostatectomy (RRP). In 80 consecutive patients who underwent RRP, the strength of the vesicourethral anastomosis (VUA) was assessed by CG, TRUS and transrectal CEUS. The investigation started with a conventional CG evaluated by an experienced uroradiologist. Following this, patients underwent TRUS which was performed by an experienced urologist who was blinded to the CG findings. The examination started with a conventional B-scan and, subsequently, a CEUS was performed by emptying and refilling the bladder with 90 ml of NaCl 0.9% + 10 ml suspension of 1:10 SonoVue and NaCl 0.9%. 26 patients (32.5%) presented urinary VE and 54 (67.5%) a watertight VUA. In 16 patients (61%) we observed a small leakage, 9 patients (35%) presented a moderate VE, and a large VE was detected in 1 patient (4%). No statistically significant difference in detection of VE was found among the three tests (p = 0.472). TRUS and CEUS are able to provide information about the integrity of the VUA that is comparable with that of CG. Copyright © 2013 S. Karger AG, Basel.

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

Screening ultrasonography of 2,204 patients with blunt abdominal trauma in the Wenchuan earthquake.

PubMed

Zhou, Jixiang; Huang, Jiwei; Wu, Hong; Jiang, Hui; Zhang, Heqing; Prasoon, Pankaj; Xu, Yinglong; Bai, Yannan; Qiu, Jianguo; Zeng, Yong

2012-10-01

Abdominal injuries constitute a small proportion of all earthquake-related traumas; however, it often resulted in fatal hemorrhage. Ultrasonography has been described as an effective triage tool in the evaluation of blunt abdominal trauma. We aimed to present an overview of the diagnostic accuracy of screening ultrasonography for patients with blunt abdominal trauma admitted to various hospitals during the Wenchuan earthquake in China. We retrospectively analyzed the patients with blunt abdominal trauma who underwent ultrasonography after admission to various hospitals. Ultrasonography findings were considered positive if evidence of free fluid or a parenchymal injury was identified. Ultrasonography findings were compared with the findings of computed tomography, diagnostic peritoneal lavage, repeated ultrasonography, cystography, operation, and/or the clinical course. Findings from 2,204 ultrasonographic examinations were evaluated. Findings of 199 ultrasonographic examinations (9.0%) were considered positive. Of the patients, 12 (0.5%) had a false-negative ultrasonographic findings; of this group, 3 (25%) required exploratory laparotomy. Ultrasonography had a sensitivity of 91.9%, specificity of 96.9%, and an accuracy of 96.6% for detection of abdominal injuries. Positive predictive value was 68.3%, and negative predictive value was 99.4%. Screening ultrasonography is highly reliable in the setting of blunt abdominal trauma after earthquake. It should be used as an initial diagnostic modality in the evaluation of most blunt abdominal trauma. Diagnostic study, level III.

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

[Technical specification for clinical application of critical ultrasonography].

PubMed

Yin, M G; Wang, X T; Liu, D W; Chao, Y G; Guan, X D; Kang, Y; Yan, J; Ma, X C; Tang, Y Q; Hu, Z J; Yu, K J; Chen, D C; Ai, Y H; Zhang, L N; Zhang, H M; Wu, J; Liu, L X; Zhu, R; He, W; Zhang, Q; Ding, X; Li, L; Li, Y; Liu, H T; Zeng, Q B; Si, X; Chen, H; Zhang, J W; Xu, Q H; Chen, W J; Chen, X K; Huang, D Z; Cai, S H; Shang, X L; Guan, J; Du, J; Zhao, L; Wang, M J; Cui, S; Wang, X M; Zhou, R; Zeng, X Y; Wang, Y P; Lyu, L W; Zhu, W H; Zhu, Y; Duan, J; Yang, J; Yang, H

2018-06-01

Critical ultrasonography(CUS) is different from the traditional diagnostic ultrasound, the examiner and interpreter of the image are critical care medicine physicians. The core content of CUS is to evaluate the pathophysiological changes of organs and systems and etiology changes. With the idea of critical care medicine as the soul, it can integrate the above information and clinical information, bedside real-time diagnosis and titration treatment, and evaluate the therapeutic effect so as to improve the outcome. CUS is a traditional technique which is applied as a new application method. The consensus of experts on critical ultrasonography in China released in 2016 put forward consensus suggestions on the concept, implementation and application of CUS. It should be further emphasized that the accurate and objective assessment and implementation of CUS requires the standardization of ultrasound image acquisition and the need to establish a CUS procedure. At the same time, the standardized training for CUS accepted by critical care medicine physicians requires the application of technical specifications, and the establishment of technical specifications is the basis for the quality control and continuous improvement of CUS. Chinese Critical Ultrasound Study Group and Critical Hemodynamic Therapy Collabration Group, based on the rich experience of clinical practice in critical care and research, combined with the essence of CUS, to learn the traditional ultrasonic essence, established the clinical application technical specifications of CUS, including in five parts: basic view and relevant indicators to obtain in CUS; basic norms for viscera organ assessment and special assessment; standardized processes and systematic inspection programs; examples of CUS applications; CUS training and the application of qualification certification. The establishment of applied technology standard is helpful for standardized training and clinical correct implementation. It is helpful

Validation of equations for pleural effusion volume estimation by ultrasonography.

PubMed

Hassan, Maged; Rizk, Rana; Essam, Hatem; Abouelnour, Ahmed

2017-12-01

To validate the accuracy of previously published equations that estimate pleural effusion volume using ultrasonography. Only equations using simple measurements were tested. Three measurements were taken at the posterior axillary line for each case with effusion: lateral height of effusion ( H ), distance between collapsed lung and chest wall ( C ) and distance between lung and diaphragm ( D ). Cases whose effusion was aspirated to dryness were included and drained volume was recorded. Intra-class correlation coefficient (ICC) was used to determine the predictive accuracy of five equations against the actual volume of aspirated effusion. 46 cases with effusion were included. The most accurate equation in predicting effusion volume was ( H  +  D ) × 70 (ICC 0.83). The simplest and yet accurate equation was H  × 100 (ICC 0.79). Pleural effusion height measured by ultrasonography gives a reasonable estimate of effusion volume. Incorporating distance between lung base and diaphragm into estimation improves accuracy from 79% with the first method to 83% with the latter.

[Analysis of eye ultrasonography in patients with trinitrotoluene cataract].

PubMed

Huang, Dongmei; Zhu, Linping; Yang, Jinping; Wu, Donping

2015-04-01

To evaluate the diagnostic value of ultrasonography for trinitrotoluene (TNT) cataract. The morphology and internal echoes of 90 lenses of 45 TNT cataract patients and 120 lenses of 60 healthy adults were observed and compared using ultrasonography and slit lamp, and the hemodynamic parameters of the post-ophthalmic artery were also measured. The findings of the slit-lamp microscope were regarded as diagnostic criteria, and the sensitivity, specificity, and accordance rate of ultrasonography in the diagnosis of TNT cataract were calculated. The sensitivity, specificity, and accordance rate of ultrasonography in the diagnosis of TNT cataract were 93.33%, 100.00%, and 97.14%, respectively; the positive and negative predictive values were 100% and 95.23%, respectively; the positive and negative likelihood ratios were 93.33 and 0.67, especuvey. With the progression TNT cataract, utrasonography showed that the lenses demonstrated morphological changes (spindle-shaped, spherical, and discoid morphologies), and the arc echoes of the posterior capsule were thickened and enhanced. The TNT cataract patients showed significantly lower peak systolic velocity and end-diastolic velocity of the ophthalmic artery (OA) and central retinal artery (P<0.01) and a significantly higher resistance index (P<0.05) than the healthy adults. The sensitivity of ultrasonography in the diagnosis of TNT cataract is similar to that of slit lamp. Ultrasonography can demonstrate objectively the shape, range, and degree of lens opacity in an efficient manner, which is conducive to the diagnosis and staging of TNT cataract by slit lamp, and can also provide hemodynamic information of the OA, thus providing new ideas for clinical physicians in evaluating the disease and clinical efficacy as well as exploring therapies.

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

Comparison of conventional ultrasonography and ultrasonography-computed tomography fusion imaging for target identification using digital/real hybrid phantoms: a preliminary study.

PubMed

Soyama, Takeshi; Sakuhara, Yusuke; Kudo, Kohsuke; Abo, Daisuke; Wang, Jeff; Ito, Yoichi M; Hasegawa, Yu; Shirato, Hiroki

2016-07-01

This preliminary study compared ultrasonography-computed tomography (US-CT) fusion imaging and conventional ultrasonography (US) for accuracy and time required for target identification using a combination of real phantoms and sets of digitally modified computed tomography (CT) images (digital/real hybrid phantoms). In this randomized prospective study, 27 spheres visible on B-mode US were placed at depths of 3.5, 8.5, and 13.5 cm (nine spheres each). All 27 spheres were digitally erased from the CT images, and a radiopaque sphere was digitally placed at each of the 27 locations to create 27 different sets of CT images. Twenty clinicians were instructed to identify the sphere target using US alone and fusion imaging. The accuracy of target identification of the two methods was compared using McNemar's test. The mean time required for target identification and error distances were compared using paired t tests. At all three depths, target identification was more accurate and the mean time required for target identification was significantly less with US-CT fusion imaging than with US alone, and the mean error distances were also shorter with US-CT fusion imaging. US-CT fusion imaging was superior to US alone in terms of accurate and rapid identification of target lesions.

[The role of ultrasonography exam in orbital-ocular tumors].

PubMed

Ciocâlteu, Alina Mihaela; Ardeleanu, S; Checheriţă, I A

2011-01-01

Ophthalmology is one of the specialties that have particularly benefited from the contribution of ultrasonography exam as a method of investigation. Ultrasonography is very much essential for diagnostic to complement other clinical and laboratory investigations, providing images in real time. The basic principle of diagnostic ultrasound is to study and to interpret the changes they undergo when crossing ultrasonic waves diverse biological properties different sound, and such injuries can be traced in the dynamics or can be documented on photographic paper and thus can diagnose correct certain eye diseases. The indications for performing ultrasound consist in: measurement of distances and volumes, examine difficult or inaccessible case of opaque media; ophthalmoscopic view of a mass lesion, examine the orbit or optic nerve. The advantages of ultrasound for orbital-ocular tumors are represented by the fact that ultrasound is a noninvasive method, safe, well tolerated, less expensive that the advantage of determining the position and distance from structures ocular tumor. High frequency ultrasound provides excellent resolution of 0-1 to 0.01 mm, and serial scans allow tracking progress and measuring lesion diameters tumor while allowing monitoring and evaluation of stereotactic radiation treatments applied to small tumors. In conclusion ultrasound allows not only early diagnosis of eye tumors, but accurate assessment of the proposed therapy and of the evolution of detected mass lesions or tumors.

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

PubMed

Nabavi, Seyed Saeed; Partovi, Parinaz

2017-01-01

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. 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. 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). 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.

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

Reliability, validity and feasibility of nail ultrasonography in psoriatic arthritis.

PubMed

Arbault, Anaïs; Devilliers, Hervé; Laroche, Davy; Cayot, Audrey; Vabres, Pierre; Maillefert, Jean-Francis; Ornetti, Paul

2016-10-01

To determine the feasibility, reliability and validity of nails ultrasonography in psoriatic arthritis as an outcome measure. Pilot prospective single-centre study of eight ultrasonography parameters in B mode and power Doppler concerning the distal interphalangeal (DIP) joint, the matrix, the bed and nail plate. Intra-observer and inter-observer reliability was evaluated for the seven quantitative parameters (ICC and kappa). Correlations between ultrasonography and clinical variables were searched to assess external validity. Feasibility was assessed by the time to carry out the examination and the percentage of missing data. Twenty-seven patients with psoriatic arthritis (age 55.0±16.2 years, disease duration 13.4±9.4 years) were included. Of these, 67% presented nail involvement on ultrasonography vs 37% on physical examination (P<0.05). Reliability was good (ICC and weighted kappa>0.75) for the seven quantitative parameters, except for synovitis of the DIP joint in B mode. The synovitis of the DIP joint revealed by ultrasonography correlated with the total number of clinical synovitis and Doppler US of the nail (matrix and bed). Doppler US of the matrix correlated with VAS pain but not with the ASDAS-CRP or with clinical enthesitis. No significant correlation was found with US nail thickness. The feasibility and reliability of ultrasonography of the nail in psoriatic arthritis appear to be satisfactory. Among the eight parameters evaluated, power Doppler of the matrix which correlated with local inflammation (DIP joint and bed) and with VAS pain could become an interesting outcome measure, provided that it is also sensitive to change. Copyright © 2015 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Fecal retention in childhood: Evaluation on ultrasonography.

PubMed

Hatori, Reiko; Tomomasa, Takeshi; Ishige, Takashi; Tatsuki, Maiko; Arakawa, Hirokazu

2017-04-01

To assess the usefulness of rectal diameter measurement on ultrasonography as a diagnostic tool for fecal retention in children. One hundred children (median age, 5.0 years), consisting of 80 with functional constipation and 20 without constipation, participated in the study. All patients underwent physical examination that included digital rectal examination. Forty-five children underwent ultrasonography in three differential planes: transection above the symphysis; under the ischial spine; and at the bladder neck. The measurement of the rectal diameter at the transection above the symphysis could most easily detect fecal retention and had the closest correlations with retention among the three planes. Rectal diameter was wider at all measuring points (35.2 vs 20.9 mm above the symphysis, P < 0.0001; 35.7 vs 24.0 mm under the ischial spine, P < 0.0001; and 19.4 vs 8.7 mm at the bladder neck, P < 0.0001) in children with fecal retention than in those with no fecal retention. With regard to presence of constipation, children with fecal retention had a wider rectal diameter above the symphysis than those with no fecal retention (children with functional constipation, 35.3 vs 20.0 mm, P < 0.0001; children without constipation: 32.6 vs 14.6 mm, P = 0.0026). The cut-off for the rectal diameter measured above the symphysis to identify fecal retention was 27 mm, with high sensitivity and specificity (95.5% and 94.1%, respectively). Ultrasound rectal diameter measurement can be used to detect fecal retention in children. © 2016 Japan Pediatric Society.

Evaluation of acute radiation optic neuropathy by B-scan ultrasonography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lovato, A.A.; Char, D.H.; Quivey, J.M.

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.more » 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.« less

Association between placentome size, measured using transrectal ultrasonography, and gestational age in cattle.

PubMed

Adeyinka, F D; Laven, R A; Lawrence, K E; van Den Bosch, M; Blankenvoorde, G; Parkinson, T J

2014-03-01

The aim of this study was to estimate whether fetal age could be accurately estimated using placentome size. Fifty-eight cows with confirmed conception dates in two herds were used for the study. The length of the long axis and cross-sectional area of placentomes close to the cervix were measured once every 10 days between approximately 60-130 days of gestation and once every 15 days between 130-160 days of gestation. Four to six placentomes were measured using transrectal ultrasonography in each uterine horn. A linear mixed model was used to establish the factors that were significantly associated with log mean placentome length and to create an equation to predict gestational age from mean placentome length. Limits of agreement analysis was then used to evaluate whether the predictions were sufficiently accurate for mean placentome length to be used, in practice, as a method of determining gestational age. Only age of gestation (p<0.001) and uterine horn (p=0.048) were found to have a significant effect on log mean placentome length. From the three models used to predict gestational age the one that used log mean placentome length of all placentomes, adjusting for the effect of horn, had the smallest 95% limits of agreement; ±33 days. That is, predicted gestational age had a 95% chance of being between 33 days greater and 33.7 days less than actual age. This is approximately twice that reported in studies using measurement of fetal size. Measurement of placentomes near to the cervix using transrectal ultrasonography was easily achieved. There was a significant association between placentome size and gestational age, but between-cow variation in placentome size and growth resulted in poor agreement between placentome size and gestational age. Although placentomes can be easily visualised during diagnosis of pregnancy using transrectal ultrasonography, mean placentome size should not be used to estimate gestational age.

Evaluation of diaphragmatic motion in normal and diaphragmatic paralyzed dogs using M-mode ultrasonography.

PubMed

Choi, Mihyun; Lee, Namsoon; Kim, Ahyoung; Keh, Seoyeon; Lee, Jinsoo; Kim, Hyunwook; Choi, Mincheol

2014-01-01

Diagnosis of unilateral diaphragmatic paralysis in dogs is currently based on fluoroscopic detection of unequal movement between the crura. Bilateral paralysis may be more difficult to confirm with fluoroscopy because diaphragmatic movement is sometimes produced by compensatory abdominal muscle contractions. The purpose of this study was to develop a new method to evaluate diaphragmatic movement using M-mode ultrasonography and to describe findings for normal and diaphragmatic paralyzed dogs. Fifty-five clinically normal dogs and two dogs with diaphragmatic paralysis were recruited. Thoracic radiographs were acquired for all dogs and fluoroscopy studies were also acquired for clinically affected dogs. Two observers independently measured diaphragmatic direction of motion and amplitude of excursion using M-mode ultrasonography for dogs meeting study inclusion criteria. Eight of the clinically normal dogs were excluded due to abnormal thoracic radiographic findings. For the remaining normal dogs, the lower limit values of diaphragmatic excursion were 2.85-2.98 mm during normal breathing. One dog with bilateral diaphragmatic paralysis showed paradoxical movement of both crura at the end of inspiration. One dog with unilateral diaphragmatic paralysis had diaphragmatic excursion values of 2.00 ± 0.42 mm on the left side and 4.05 ± 1.48 mm on the right side. The difference between left and right diaphragmatic excursion values was 55%. Findings indicated that M-mode ultrasonography is a relatively simple and objective method for measuring diaphragmatic movement in dogs. Future studies are needed in a larger number of dogs with diaphragmatic paralysis to determine the diagnostic sensitivity of this promising new technique. © 2013 American College of Veterinary Radiology.

Contrast-enhanced endoscopic ultrasonography in digestive diseases.

PubMed

Hirooka, Yoshiki; Itoh, Akihiro; Kawashima, Hiroki; Ohno, Eizaburo; Itoh, Yuya; Nakamura, Yosuke; Hiramatsu, Takeshi; Sugimoto, Hiroyuki; Sumi, Hajime; Hayashi, Daijiro; Ohmiya, Naoki; Miyahara, Ryoji; Nakamura, Masanao; Funasaka, Kohei; Ishigami, Masatoshi; Katano, Yoshiaki; Goto, Hidemi

2012-10-01

Contrast-enhanced endoscopic ultrasonography (CE-EUS) was introduced in the early 1990s. The concept of the injection of carbon dioxide microbubbles into the hepatic artery as a contrast material (enhanced ultrasonography) led to "endoscopic ultrasonographic angiography". After the arrival of the first-generation contrast agent, high-frequency (12 MHz) EUS brought about the enhancement of EUS images in the diagnosis of pancreatico-biliary diseases, upper gastrointestinal (GI) cancer, and submucosal tumors. The electronic scanning endosonoscope with both radial and linear probes enabled the use of high-end ultrasound machines and depicted the enhancement of both color/power Doppler flow-based imaging and harmonic-based imaging using second-generation contrast agents. Many reports have described the usefulness of the differential diagnosis of pancreatic diseases and other abdominal lesions. Quantitative evaluation of CE-EUS images was an objective method of diagnosis using the time-intensity curve (TIC), but it was limited to the region of interest. Recently developed Inflow Time Mapping™ can be generated from stored clips and used to display the pattern of signal enhancement with time after injection, offering temporal difference of contrast agents and improved tumor characterization. On the other hand, three-dimensional CE-EUS images added new information to the literature, but lacked positional information. Three-dimensional CE-EUS with accurate positional information is awaited. To date, most reports have been related to pancreatic lesions or lymph nodes. Hemodynamic analysis might be of use for diseases in other organs: upper GI cancer diagnosis, submucosal tumors, and biliary disorders, and it might also provide functional information. Studies of CE-EUS in diseases in many other organs will increase in the near future.

Endoscopic ultrasonography does not differentiate neoplastic from non-neoplastic small gallbladder polyps.

PubMed

Cheon, Young Koog; Cho, Won Young; Lee, Tae Hee; Cho, Young Deok; Moon, Jong Ho; Lee, Joon Seong; Shim, Chan Sup

2009-05-21

To assess the ability of endoscopic ultrasonography (EUS) to differentiate neoplastic from non-neoplastic polypoid lesions of the gallbladder (PLGs). The uses of EUS and transabdominal ultrasonography (US) were retrospectively analyzed in 94 surgical cases of gallbladder polyps less than 20 mm in diameter. The prevalence of neoplastic lesions with a diameter of 5-10 mm was 17.2% (10/58); 11-15 mm, 15.4% (4/26), and 16-20 mm, 50% (5/10). The overall diagnostic accuracies of EUS and US for small PLGs were 80.9% and 63.9% (P < 0.05), respectively. EUS correctly distinguished 12 (63.2%) of 19 neoplastic PLGs but was less accurate for polyps less than 1.0 cm (4/10, 40%) than for polyps greater than 1.0 cm (8/9, 88.9%) (P = 0.02). Although EUS was more accurate than US, its accuracy for differentiating neoplastic from non-neoplastic PLGs less than 1.0 cm was low. Thus, EUS alone is not sufficient for determining a treatment strategy for PLGs of less than 1.0 cm.

Endoscopic ultrasonography does not differentiate neoplastic from non-neoplastic small gallbladder polyps

PubMed Central

Cheon, Young Koog; Cho, Won Young; Lee, Tae Hee; Cho, Young Deok; Moon, Jong Ho; Lee, Joon Seong; Shim, Chan Sup

2009-01-01

AIM: To assess the ability of endoscopic ultrasonography (EUS) to differentiate neoplastic from non-neoplastic polypoid lesions of the gallbladder (PLGs). METHODS: The uses of EUS and transabdominal ultrasonography (US) were retrospectively analyzed in 94 surgical cases of gallbladder polyps less than 20 mm in diameter. RESULTS: The prevalence of neoplastic lesions with a diameter of 5-10 mm was 17.2% (10/58); 11-15 mm, 15.4% (4/26), and 16-20 mm, 50% (5/10). The overall diagnostic accuracies of EUS and US for small PLGs were 80.9% and 63.9% (P < 0.05), respectively. EUS correctly distinguished 12 (63.2%) of 19 neoplastic PLGs but was less accurate for polyps less than 1.0 cm (4/10, 40%) than for polyps greater than 1.0 cm (8/9, 88.9%) (P = 0.02). CONCLUSION: Although EUS was more accurate than US, its accuracy for differentiating neoplastic from non-neoplastic PLGs less than 1.0 cm was low. Thus, EUS alone is not sufficient for determining a treatment strategy for PLGs of less than 1.0 cm. PMID:19452579

Evaluation of the breeding soundness of male camels (Camelus dromedarius) via clinical examination, semen analysis, ultrasonography and testicular biopsy: a summary of 80 clinical cases.

PubMed

Waheed, M M; Ghoneim, I M; Hassieb, M M; Alsumait, A A

2014-10-01

Male camel infertility is a heterogeneous disorder. A variety of factors may adversely affect sperm production and function and impair fertility. This study was designed to evaluate the sensitivity and specificity of ultrasonography and testicular biopsy in the evaluation of the breeding soundness of male dromedaries compared with results obtained by clinical examination and semen analysis. Eighty-four male dromedary camels (5-15 years old) were used in this study during the rutting season (November-May). Four sexually mature male camels were used as controls. These animals were apparently healthy and had histories of normal fertility. Eighty infertile male camels were subjected to an algorithmic approach based on information collected during careful examinations of the camels' breeding histories, clinical examinations, testicular evaluations, testicular ultrasonographies, the results of the semen analyses and testicular biopsies to diagnose the camels' infertilities. The differences in the semen parameters between the control and infertile male camels were highly significant (p < 0.01). Regarding the diagnoses of male camel infertility, the results of testicular ultrasonographies and biopsies were compared with those from the semen analyses, and the accuracies of these tests were 92.5% and 90%, respectively. Additionally, the results of the testicular ultrasonographies were matched with those of the testicular biopsies of the infertile animals, and this comparison resulted in 85% accuracy. Testicular biopsy is a promising method that, along with a carefully performed history, clinical examination, an appropriate testicular ultrasonography procedure and semen analysis, can afford veterinarians the opportunity for more precise diagnosis and treatment of many dromedary infertility disorders. © 2014 Blackwell Verlag GmbH.

[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.

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

PubMed Central

Dupuis, Carolyn S.; Kim, Young H.

2015-01-01

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

Validation of ultrasonography for non-invasive assessment of diaphragm function in muscular dystrophy.

PubMed

Whitehead, Nicholas P; Bible, Kenneth L; Kim, Min Jeong; Odom, Guy L; Adams, Marvin E; Froehner, Stanley C

2016-12-15

Duchenne muscular dystrophy (DMD) is a severe, degenerative muscle disease that is commonly studied using the mdx mouse. The mdx diaphragm muscle closely mimics the pathophysiological changes in DMD muscles. mdx diaphragm force is commonly assessed ex vivo, precluding time course studies. Here we used ultrasonography to evaluate time-dependent changes in diaphragm function in vivo, by measuring diaphragm movement amplitude. In mdx mice, diaphragm amplitude decreased with age and values were much lower than for wild-type mice. Importantly, diaphragm amplitude strongly correlated with ex vivo specific force values. Micro-dystrophin administration increased mdx diaphragm amplitude by 26% after 4 weeks. Diaphragm amplitude correlated positively with ex vivo force values and negatively with diaphragm fibrosis, a major cause of DMD muscle weakness. These studies validate diaphragm ultrasonography as a reliable technique for assessing time-dependent changes in mdx diaphragm function in vivo. This technique will be valuable for testing potential therapies for DMD. Duchenne muscular dystrophy (DMD) is a severe, degenerative muscle disease caused by dystrophin mutations. The mdx mouse is a widely used animal model of DMD. The mdx diaphragm muscle most closely recapitulates key features of DMD muscles, including progressive fibrosis and considerable force loss. Diaphragm function in mdx mice is commonly evaluated by specific force measurements ex vivo. While useful, this method only measures force from a small muscle sample at one time point. Therefore, accurate assessment of diaphragm function in vivo would provide an important advance to study the time course of functional decline and treatment benefits. Here, we evaluated an ultrasonography technique for measuring time-dependent changes of diaphragm function in mdx mice. Diaphragm movement amplitude values for mdx mice were considerably lower than those for wild-type, decreased from 8 to 18 months of age, and correlated

Validation of ultrasonography for non‐invasive assessment of diaphragm function in muscular dystrophy

PubMed Central

Bible, Kenneth L.; Kim, Min Jeong; Odom, Guy L.; Adams, Marvin E.; Froehner, Stanley C.

2016-01-01

Key points Duchenne muscular dystrophy (DMD) is a severe, degenerative muscle disease that is commonly studied using the mdx mouse. The mdx diaphragm muscle closely mimics the pathophysiological changes in DMD muscles. mdx diaphragm force is commonly assessed ex vivo, precluding time course studies. Here we used ultrasonography to evaluate time‐dependent changes in diaphragm function in vivo, by measuring diaphragm movement amplitude.In mdx mice, diaphragm amplitude decreased with age and values were much lower than for wild‐type mice. Importantly, diaphragm amplitude strongly correlated with ex vivo specific force values.Micro‐dystrophin administration increased mdx diaphragm amplitude by 26% after 4 weeks. Diaphragm amplitude correlated positively with ex vivo force values and negatively with diaphragm fibrosis, a major cause of DMD muscle weakness.These studies validate diaphragm ultrasonography as a reliable technique for assessing time‐dependent changes in mdx diaphragm function in vivo. This technique will be valuable for testing potential therapies for DMD. Abstract Duchenne muscular dystrophy (DMD) is a severe, degenerative muscle disease caused by dystrophin mutations. The mdx mouse is a widely used animal model of DMD. The mdx diaphragm muscle most closely recapitulates key features of DMD muscles, including progressive fibrosis and considerable force loss. Diaphragm function in mdx mice is commonly evaluated by specific force measurements ex vivo. While useful, this method only measures force from a small muscle sample at one time point. Therefore, accurate assessment of diaphragm function in vivo would provide an important advance to study the time course of functional decline and treatment benefits. Here, we evaluated an ultrasonography technique for measuring time‐dependent changes of diaphragm function in mdx mice. Diaphragm movement amplitude values for mdx mice were considerably lower than those for wild‐type, decreased from 8 to 18�

Testicular volume measurement: comparison of ultrasonography, orchidometry, and water displacement.

PubMed

Sakamoto, Hideo; Saito, Katsuyuki; Oohta, Michiya; Inoue, Katuki; Ogawa, Yoshio; Yoshida, Hideki

2007-01-01

To determine the accuracy of orchidometry and ultrasonography for measuring the testicular volume by comparing the resultant measurements with the actual testicular volume in humans. The testicular volume of 40 testes from 20 patients with prostate cancer (mean age +/- SD 74.5 +/- 7.5 years) was measured using the Prader orchidometer and ultrasonography before therapeutic bilateral orchiectomy. The ultrasound measurements of testicular volume were calculated using three formulas: length (L) x width (W) x height (H) x 0.52, L x W2 x 0.52, and L x W x H x 0.71. The actual testicular volumes were determined by water displacement of the surgical specimen. The mean actual testicular volume of the 40 testes was 9.3 cm3 (range 2.5 to 23.0). A strong correlation was found between the testicular volume calculated by the three ultrasound formulas and the actual volume (r = 0.910 to 0.965, P <0.0001) and was stronger than the correlation with the Prader orchidometer (r = 0.818, P <0.0001). The smallest mean difference from the actual testicular volume was observed with the formula L x W x H x 0.71, which overestimated the actual volume by 0.80 cm3 (7.42%). The measurements using the Prader orchidometer correlated with the actual testicular volume and with the testicular volume calculated using the three ultrasound formulas (r = 0.801 to 0.816, P <0.0001). However, the orchidometer measurements had the largest mean difference from the actual testicular volume (6.68 cm3, 81.7%). The results of this study have shown that measuring the testicular volume by ultrasonography is more accurate than by the Prader orchidometer, and the formula L x W x H x 0.71 was the most accurate for calculating the testicular volume.

[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

Application value of biplane transrectal ultrasonography plus ultrasonic elastosonography and contrast-enhanced ultrasonography in preoperative T staging after neoadjuvant chemoradiotherapy for rectal cancer.

PubMed

Xiao, Ying; Xu, Dong; Ju, Haixing; Yang, Chen; Wang, Liping; Wang, Jinming; Hazle, John D; Wang, Dongguo

2018-07-01

To determine the accuracy of biplane transrectal ultrasonography (TRUS) plus ultrasonic elastosonography (UE) and contrast-enhanced ultrasonography (CEUS) in preoperative T staging after neoadjuvant chemoradiotherapy for rectal cancer. Fifty-three patients with advanced lower rectal cancer were examined before and after neoadjuvant chemoradiotherapy with use of TRUS plus UE and CEUS and were diagnosed as having T stage disease. We compared ultrasonic T stages before and after neoadjuvant chemoradiotherapy and analyzed any changes. Also, with postoperative pathological stages as the gold standard, we compared ultrasonic and pathological T stages and determined their consistency by the kappa statistic. For patients with rectal cancer, ultrasonic T stages were lower after neoadjuvant chemoradiotherapy than before, with a statistically significant difference (P < 0.05). The posttreatment downstaging rate was 39.6% (21/53). A total of 84.9% received correct staging with use of biplane TRUS plus UE and CEUS in the evaluation of preoperative T staging after neoadjuvant chemoradiotherapy for rectal cancer, which was highly consistent with that of pathological staging (κ = 0.768, P < 0.05). Its sensitivities were 80.0%, 50.0%, 75.0%, 96.3%, and 100% in the diagnoses of stages T0 to T4 rectal cancers, respectively; the specificities were 95.4%, 97.9%, 95.1%, 88.5%, and 100% at stages T0 to T4, respectively. Biplane TRUS plus UE and CEUS can be used to accurately perform preoperative T staging in rectal cancer after neoadjuvant chemoradiotherapy; in addition, this procedure well reflects changes in depth of rectal cancer invasion into the intestinal wall before and after neoadjuvant chemoradiotherapy. It is of great value in clinically evaluating the efficacy of neoadjuvant chemoradiotherapy, in selecting therapeutic regimens, and in avoiding overtreatment. Copyright © 2018 Elsevier B.V. All rights reserved.

Evaluation of the Causes of Erectile Dysfunction in Patients Undergoing Penile Doppler Ultrasonography in Pakistan

PubMed Central

Khanzada, Usman; Khan, Sohail Ahmed; Hussain, Munawar; Adel, Hatem; Masood, Kamran; Manohar, Murli

2017-01-01

Purpose In patients with erectile dysfunction, it is important to differentiate psychogenic from organic causes. Penile Doppler ultrasonography is a relatively inexpensive and minimally invasive tool for this purpose. This study was conducted to evaluate the causes of erectile dysfunction in an adult male population, using penile Doppler ultrasonography. Materials and Methods A retrospective study was conducted in a single center. All patients who presented with complaints of erectile dysfunction and underwent penile Doppler ultrasonography between July 2014 and June 2016 were included in this study. All examinations were performed using GE Voluson S6 and GE Logiq P5 devices. Following baseline scans, an intracavernosal injection of 20 µg of prostaglandin E1 was given. Peak systolic and end diastolic velocities were measured in each cavernosal artery. Patients with a peak systolic velocity of <25 cm/s were considered to have arterial insufficiency, while an end diastolic velocity of >5 cm/s was considered to indicate venous incompetence. Results Out of 97 patients (mean age, 37.09±11.59 years; range, 19~69 years), 50 patients (51.5%) had normal findings, 24 patients (24.7%) had arterial insufficiency, 15 patients (15.5%) had a venous leak, and 8 patients (8.2%) patients had arterial insufficiency with a venous leak. Psychogenic erectile dysfunction was significantly higher among patients aged ≤40 years, while arterial insufficiency with or without a venous leak was significantly higher among patients aged >40 years (p=0.022). Conclusions A majority of the studied individuals demonstrated no organic cause of erectile dysfunction, thus confirming a high prevalence of the psychogenic etiology, particularly in relatively young individuals. PMID:28459144

Use of ultrasonography to make management decisions

USDA-ARS?s Scientific Manuscript database

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...

Portable ultrasonography in mass casualty incidents: The CAVEAT examination.

PubMed

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

2010-11-18

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.

Endoanal ultrasonography in fecal incontinence: Current and future perspectives.

PubMed

Albuquerque, Andreia

2015-06-10

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

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.

Clinical utility of colour flow Doppler ultrasonography in planning anterolateral thigh flap harvest.

PubMed

Patel, Rajan S; Higgins, Kevin M; Enepekides, Danny J; Hamilton, Paul A

2010-10-01

The anatomic variability of cutaneous perforators contributes to the technical challenges of anterolateral thigh (ALT) free flap harvest. The objective of this study was to assess the accuracy and clinical utility of preoperative colour flow Doppler (CFD) ultrasonography in evaluating planned ALT flap donor sites. A prospective study of the infrainguinal vasculature (profunda femoris and lateral circumflex femoral arteries) in 16 consecutive patients scheduled for ALT free flap transfer for reconstruction of head and neck surgical defects was undertaken. All patients underwent CFD ultrasonography. The location of perforators and the thigh thickness determined by CFD ultrasonography were correlated with the actual intraoperative findings using a scatter plot and paired t-test. Two patients were diagnosed with bilateral silent infrainguinal claudication, which precluded safe use of the ALT donor site. In two other patients, the planned ALT donor site ipsilateral to the defect was not used because of silent infrainguinal claudication diagnosed by CFD ultrasonography. In the 14 patients who underwent ALT flap harvest, CFD ultrasonography identified 48 perforators, which coincided with 43 actual perforators found intraoperatively. CFD ultrasonography demonstrated a statistically significant correlation with the actual perforator locations (Spearman coefficient .76; p = .55). Although CFD ultrasonography tended to underestimate flap thickness, there was a statistically significant correlation (Spearman coefficient .94; p ≤ .0001) with the actual flap thickness. CFD ultrasonography has clinical utility in facilitating decision making and planning ALT flap harvest.

Role of ultrasonography in the differential diagnosis of thyrotoxicosis: a noninvasive, cost-effective, and widely available but underutilized diagnostic tool.

PubMed

Alzahrani, Ali S; Ceresini, Graziano; Aldasouqi, Saleh A

2012-01-01

To explore the use of ultrasonography as a diagnostic alternative to the traditional "gold standard" imaging study of nuclear scintigraphy in the evaluation of thyrotoxicosis. We review the relevant literature and share our own experience to highlight the promising role of ultrasonography in thyrotoxicosis. In addition, we present a diagnostic algorithm suggesting liberal use of ultrasonography in the evaluation of thyrotoxicosis. Ultrasonography has proved effective not only in the differentiation of Graves disease from other types and causes of thyrotoxicosis but also in the detection of subtle thyroid nodules. The latter role is emphasized in light of the recent observation of an increased risk of occurrence of papillary thyroid carcinoma in patients with Graves disease. Ultrasonography is a cost-effective, noninvasive, portable, and safe imaging modality in the evaluation of thyrotoxicosis, both for physiologic assessment and for detection of nonpalpable thyroid cancers that may elude identification on physical examination and nuclear imaging studies. Although thyroid scintigraphy remains a standard radiologic study, thyroid ultrasonography can be a practical alternative in many cases and the primary imaging modality in some situations such as during pregnancy and lactation and for evaluation and management of amiodarone-induced thyrotoxicosis.

Reversible Causes in Cardiovascular Collapse at the Emergency Department Using Ultrasonography (REVIVE-US).

PubMed

Chua, Mui Teng; Chan, Gene Wh; Kuan, Win Sen

2017-08-01

Ultrasonographic evaluation of patients in cardiac arrest is currently not protocolised in the advanced cardiac life support (ACLS) algorithm. Potentially reversible causes may be identified using bedside ultrasonography that is ubiquitous in most emergency departments (EDs). This study aimed to evaluate the incidence of sonographically detectable reversible causes of cardiac arrest by incorporating an ultrasonography protocol into the ACLS algorithm. Secondary objectives include rates of survival to hospital admission, hospital discharge, and 30-day mortality. We conducted a prospective study using bedside ultrasonography to evaluate for potentially reversible causes in patients with cardiac arrest at the ED of National University Hospital, Singapore, regardless of the initial electrocardiogram rhythm. A standardised ultrasonography protocol was performed during the 10-second pulse check window. Between June 2015 and April 2016, 104 patients were recruited, corresponding to 65% of all out-of-hospital cardiac arrest patients conveyed to the ED. Median age was 71 years (interquartile range, 55 to 80) and 71 (68.3%) patients were male. The most common rhythm on arrival was asystole (45.2%). Four (3.8%) patients had ultrasonographic findings suggestive of massive pulmonary embolism while 1 received intravenous thrombolysis and survived until discharge. Pericardial effusion without tamponade was detected in 4 (3.8%) patients and 6 (5.8%) patients had intra-abdominal free fluid. Twenty (19.2%) patients survived until admission, 2 of whom (1.9%) survived to discharge and beyond 30 days. Bedside ultrasonography can be safely incorporated into the ACLS protocol. Detection of any reversible causes may alter management and improve survival in selected patients.

Ultrasonography versus computed tomography for suspected nephrolithiasis.

PubMed

Smith-Bindman, Rebecca; Aubin, Chandra; Bailitz, John; Bengiamin, Rimon N; Camargo, Carlos A; Corbo, Jill; Dean, Anthony J; Goldstein, Ruth B; Griffey, Richard T; Jay, Gregory D; Kang, Tarina L; Kriesel, Dana R; Ma, O John; Mallin, Michael; Manson, William; Melnikow, Joy; Miglioretti, Diana L; Miller, Sara K; Mills, Lisa D; Miner, James R; Moghadassi, Michelle; Noble, Vicki E; Press, Gregory M; Stoller, Marshall L; Valencia, Victoria E; Wang, Jessica; Wang, Ralph C; Cummings, Steven R

2014-09-18

There is a lack of consensus about whether the initial imaging method for patients with suspected nephrolithiasis should be computed tomography (CT) or ultrasonography. In this multicenter, pragmatic, comparative effectiveness trial, we randomly assigned patients 18 to 76 years of age who presented to the emergency department with suspected nephrolithiasis to undergo initial diagnostic ultrasonography performed by an emergency physician (point-of-care ultrasonography), ultrasonography performed by a radiologist (radiology ultrasonography), or abdominal CT. Subsequent management, including additional imaging, was at the discretion of the physician. We compared the three groups with respect to the 30-day incidence of high-risk diagnoses with complications that could be related to missed or delayed diagnosis and the 6-month cumulative radiation exposure. Secondary outcomes were serious adverse events, related serious adverse events (deemed attributable to study participation), pain (assessed on an 11-point visual-analogue scale, with higher scores indicating more severe pain), return emergency department visits, hospitalizations, and diagnostic accuracy. A total of 2759 patients underwent randomization: 908 to point-of-care ultrasonography, 893 to radiology ultrasonography, and 958 to CT. The incidence of high-risk diagnoses with complications in the first 30 days was low (0.4%) and did not vary according to imaging method. The mean 6-month cumulative radiation exposure was significantly lower in the ultrasonography groups than in the CT group (P<0.001). Serious adverse events occurred in 12.4% of the patients assigned to point-of-care ultrasonography, 10.8% of those assigned to radiology ultrasonography, and 11.2% of those assigned to CT (P=0.50). Related adverse events were infrequent (incidence, 0.4%) and similar across groups. By 7 days, the average pain score was 2.0 in each group (P=0.84). Return emergency department visits, hospitalizations, and diagnostic

Linear array ultrasonography to stage rectal neoplasias suitable for local treatment.

PubMed

Ravizza, Davide; Tamayo, Darina; Fiori, Giancarla; Trovato, Cristina; De Roberto, Giuseppe; de Leone, Annalisa; Crosta, Cristiano

2011-08-01

Because of the many therapeutic options available, a reliable staging is crucial for rectal neoplasia management. Adenomas and cancers limited to the submucosa without lymph node involvement may be treated locally. The aim of this study is to evaluate the diagnostic accuracy of endorectal ultrasonography in the staging of neoplasias suitable for local treatment. We considered all patients who underwent endorectal ultrasonography between 2001 and 2010. The study population consisted of 92 patients with 92 neoplasias (68 adenocarcinomas and 24 adenomas). A 5 and 7.5MHz linear array echoendoscope was used. The postoperative histopathologic result was compared with the preoperative staging defined by endorectal ultrasonography. Adenomas and cancers limited to the submucosa were considered together (pT0-1). The sensitivity, specificity, overall accuracy rate, positive predictive value, and negative predictive value of endorectal ultrasonography for pT0-1 were 86%, 95.6%, 91.3%, 94.9% and 88.7%. Those for nodal involvement were 45.4%, 95.5%, 83%, 76.9% and 84%, with 3 false positive results and 12 false negative. For combined pT0-1 and pN0, endorectal ultrasonography showed an 87.5% sensitivity, 95.9% specificity, 92% overall accuracy rate, 94.9% positive predictive value and 90.2% negative predictive value. Endorectal linear array ultrasonography is a reliable tool to detect rectal neoplasias suitable for local treatment. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Use of ultrasonography to make reproductive management decisions

USDA-ARS?s Scientific Manuscript database

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...

Performance of physical examination versus ultrasonography to detect stenosis in haemodialysis arteriovenous fistula.

PubMed

Maldonado-Cárceles, Ana B; García-Medina, José; Torres-Cantero, Alberto M

2017-01-18

The overall purpose of this study is to compare the accuracy of physical examination (PE) versus ultrasonography (US) in people with arteriovenous fistula (AVF). This is a cross-sectional study with a total of 99 patients attended by the vascular radiology unit for AVF evaluation during January - March 2015. PE and ultrasonography were blinded performed by different radiologists. For complete and individual signs of PE, sensitivity, specificity, predictive positive (PPV) and negative (PNV) value, likelihood ratios (LR) and Cohen's κ value were measured. According to ultrasonography, the presence of stenosis was identified in 57 (58%) patients, and 61 (62%) by PE. The accuracy of PE for the diagnosis of AVF was sensitivity 82%, specificity 67%, PPV 77%, NPV 74%, LR 2.74 and 0.26. There was a moderate agreement beyond chance between PE and ultrasonography (κ = 0.5). PE has shown a moderate accuracy to detect stenosis. With non-ultrasonography availability Haemodialysis Units can get benefit to optimize VA survival and professionals should improve its basic skills.

Is intravenous urography required when ultrasonography and KUB evidence a ureteroscopy plan?

PubMed

Aghamir, Seyed Mohammad Kazem; Modaresi, Seyed Saeed; Salavati, Alborz; Aloosh, Mehdi; Meysami, Ali Pasha

2012-01-01

To determine whether pre-ureteroscopic stone extraction (USE) evaluation by intravenous urography (IVU) can change the clinical decision made on the basis of a plain X-ray of the kidneys, ureters, and bladder (KUB) plus an ultrasonography in the case of ureteral calculi. From October 2005 to November 2007, 139 USE candidates were selected based on ultrasonography and KUB, and were randomly divided into two groups. Each group was assessed by an expert urologist to decide about the treatment plans. Thereafter, all the patients underwent an IVU pre-operatively and were evaluated for the second time by the other urologist considering IVU. Presence of a hydronephrotic kidney on the ultrasonography, existence of a density in the probable tract of the ureter on KUB, and previous episodes of renal colic were considered as inclusion criteria. Exclusion criteria were non-opaque stones on KUB, hypersensitivity to contrast media, and serum creatinine > 1.5 mg/dL. On the basis of ultrasonography and KUB assessment, all of the patients were identified candidate for USE. According to secondary IVU-based planning, of 139 patients, 127 (91.3%) required USE, 10 (7.1%) ureteroscopy, and 2 (1.4%) non-operative treatment. About 8.7% of treatment plans was changed by IVU, which was not statistically significant (P = .35). Positive predictive value of ultrasonography plus KUB to diagnose a ureteral stone which needed USE was 92.8% while IVU is the gold standard (95% confidence interval: 92.38 to 93.22). Intravenous urography is not useful enough to be performed routinely before entire USEs.

Incremental cancer detection using breast ultrasonography versus breast magnetic resonance imaging in the evaluation of newly diagnosed breast cancer patients.

PubMed

He, Hongying; Plaxco, Jeri S; Wei, Wei; Huo, Lei; Candelaria, Rosalind P; Kuerer, Henry M; Yang, Wei T

2016-09-01

To compare the incremental cancer detection rate (ICDR) using bilateral whole-breast ultrasonography (BWBUS) vs dynamic contrast-enhanced MRI in patients with primary breast cancer. A retrospective database search in a single institution identified 259 patients with breast cancer diagnosed from January 2011 to August 2014 who underwent mammography, BWBUS and MRI before surgery. Patient characteristics, tumour characteristics and lesions seen on each imaging modality were recorded. The sensitivity, specificity and accuracy for each modality were calculated. ICDRs according to index tumour histology and receptor status were also evaluated. The effect of additional cancer detection on surgical planning was obtained from the medical records. A total of 266 additional lesions beyond 273 index malignancies were seen on at least 1 modality, of which 121 (45%) lesions were malignant and 145 (55%) lesions were benign. MRI was significantly more sensitive than BWBUS (p = 0.01), while BWBUS was significantly more accurate and specific than MRI (p < 0.0001). Compared with mammography, the ICDRs using BWBUS and MRI were significantly higher for oestrogen receptor-positive and triple-negative cancers, but not for human epidermal growth factor receptor 2-positive cancers. 22 additional malignant lesions in 18 patients were seen on MRI only. Surgical planning remained unchanged in 8 (44%) of those 18 patients. MRI was more sensitive than BWBUS, while BWBUS was more accurate and specific than MRI. MRI-detected additional malignant lesions did not change surgical planning in almost half of these patients. BWBUS may be a cost-effective and practical tool in breast cancer staging.

Assessment of Oropharyngeal Dysphagia in Patients With Parkinson Disease: Use of Ultrasonography.

PubMed

Oh, Eun Hyun; Seo, Jin Seok; Kang, Hyo Jung

2016-04-01

To compare tongue thickness, the shortest hyoid-thyroid approximation (distance between the hyoid bone and thyroid cartilage), and the time interval between the initiation of tongue movement and the time of the shortest hyoid-thyroid approximation, by using ultrasonography in healthy controls and patients with Parkinson disease (PD). Healthy controls and PD patients with dysphagia were compared. Ultrasonography was performed 3 times for the evaluation of tongue thickness, the shortest hyoid-thyroid approximation, and the time between the initiation of tongue movement and the shortest hyoid-thyroid approximation. A total of 24 healthy controls and 24 PD patients with dysphagia were enrolled. No significant differences were demonstrated between the two groups for the shortest hyoid-thyroid approximation (controls, 1.19±0.34 cm; PD patients, 1.37±0.5 cm; p=0.15) and tongue thickness (controls, 4.42±0.46 cm; PD patients, 4.27±0.51 cm; p=0.3). In contrast, the time to the shortest hyoid-thyroid approximation was significantly different between the two groups (controls, 1.53±0.87 ms; PD patients, 2.4±1.4 ms, p=0.048). Ultrasonography can be useful in evaluating dysphagia in patients with PD by direct visualization and measurement of the hyoid bone. Moreover, ultrasonography might contribute to a greater understanding of the pathophysiology of dysphagia in PD.

How useful is abdominal ultrasonography in dogs with diarrhoea?

PubMed

Mapletoft, E K; Allenspach, K; Lamb, C R

2018-01-01

To assess the utility of abdominal ultrasonography in the diagnostic work-up of dogs with diarrhoea. Retrospective cross-sectional study based on a referral population of dogs with diarrhoea. Associations between the clinical signs, use of abdominal ultrasonography, results of abdominal ultrasonography and subsequent work-up were examined. The utility of abdominal ultrasonography was scored as high, moderate, none or counterproductive based on review of medical records. Medical records of 269 dogs were reviewed, of which 149 (55%) had abdominal ultrasonography. The most frequent result was no ultrasonographic abnormalities affecting the intestine in 65 (44%) dogs. Ultrasonography results were associated with subsequent work-up as follows: (1) no detected abnormalities and dietary trial; (2) focal thickening of the intestinal wall, loss of intestinal wall layers or enlarged abdominal lymph nodes and ultrasound-guided fine-needle aspirates; (3) diffuse thickening of the intestinal wall or hyperechoic striations in the small intestinal mucosa and endoscopy; and (4) small intestinal foreign body and coeliotomy. Abdominal ultrasonography was considered to be diagnostic without further testing in only four (3%) dogs: two had a portosystemic shunt identified ultrasonographically, one had a linear foreign body and one had a perforated pyloric ulcer. Abdominal ultrasonography had moderate utility in 56 (38%) dogs and no utility in 79 (53%) dogs. Abdominal ultrasonography was considered counterproductive in 10 (7%) dogs because results were either falsely negative or falsely positive. These results should prompt clinicians to reconsider routine use of abdominal ultrasonography in dogs with diarrhoea. © 2017 British Small Animal Veterinary Association.

Role of ultrasonography in detecting mammographically occult breast carcinoma in women with dense breasts.

PubMed

Corsetti, V; Ferrari, A; Ghirardi, M; Bergonzini, R; Bellarosa, S; Angelini, O; Bani, C; Ciatto, S

2006-04-01

The purpose of this study was to assess the usefulness of routine ultrasonography in women with negative mammography and dense breasts [Breast Imaging Reporting and Data System (BIRADS D3-4)]. We applied a protocol involving routine ultrasonography in a consecutive series of subjects with negative mammography and dense breasts. After evaluation by internal and external reviewers of cancers detected by ultrasonography performed to confirm negative mammography, we determined the additional cancer detection rate of ultrasonography and the cost of the protocol. Out of 17,883 total mammographies, 167 cancers were diagnosed (detection rate: 0.93%). Out of 257 suspicious mammographies, 138 cancers were detected. Out of 17,626 negative mammographies, 6,449 (36.5%) were classified as "dense breast" and underwent ultrasonography: 29 cancers were detected (detection rate: 0.44%, or 17.3% of total cancers). Out of 25 cancer cases reviewed, negative mammography and asymptomatic status was confirmed in 15 (detection rate 0.23%, or 8.9% of total cancers). The cancer detection rate was 0.11%, 0.22%, 0.32% and 0.14% for age groups <40, 40-49, 50-59 and >59, respectively. The cost per additional carcinoma detected by ultrasonography alone was euro 25,847.85 whereas that per examined woman was euro 21.68. The study confirms the possibility that ultrasonography can detect mammographically occult breast carcinoma in dense breasts. The evidence is insufficient to recommend this policy in routine screening practice but suggests that, at least in current clinical practice, adding ultrasonography in dense breasts may be useful despite the substantial costs.

Accuracy of Physical Examination, Ultrasonography, and Mammography in Predicting Residual Pathologic Tumor Size in Patients Treated With Neoadjuvant Chemotherapy

PubMed Central

Chagpar, Anees B.; Middleton, Lavinia P.; Sahin, Aysegul A.; Dempsey, Peter; Buzdar, Aman U.; Mirza, Attiqa N.; Ames, Fredrick C.; Babiera, Gildy V.; Feig, Barry W.; Hunt, Kelly K.; Kuerer, Henry M.; Meric-Bernstam, Funda; Ross, Merrick I.; Singletary, S Eva

2006-01-01

Objective: To assess the accuracy of physical examination, ultrasonography, and mammography in predicting residual size of breast tumors following neoadjuvant chemotherapy. Background: Neoadjuvant chemotherapy is an accepted part of the management of stage II and III breast cancer. Accurate prediction of residual pathologic tumor size after neoadjuvant chemotherapy is critical in guiding surgical therapy. Although physical examination, ultrasonography, and mammography have all been used to predict residual tumor size, there have been conflicting reports about the accuracy of these methods in the neoadjuvant setting. Methods: We reviewed the records of 189 patients who participated in 1 of 2 protocols using doxorubicin-containing neoadjuvant chemotherapy, and who had assessment by physical examination, ultrasonography, and/or mammography no more than 60 days before their surgical resection. Size correlations were performed using Spearman rho analysis. Clinical and pathologic measurements were also compared categorically using the weighted kappa statistic. Results: Size estimates by physical examination, ultrasonography, and mammography were only moderately correlated with residual pathologic tumor size after neoadjuvant chemotherapy (correlation coefficients: 0.42, 0.42, and 0.41, respectively), with an accuracy of ±1 cm in 66% of patients by physical examination, 75% by ultrasonography, and 70% by mammography. Kappa values (0.24–0.35) indicated poor agreement between clinical and pathologic measurements. Conclusion: Physical examination, ultrasonography, and mammography were only moderately useful for predicting residual pathologic tumor size after neoadjuvant chemotherapy. PMID:16432360

Ultrasonography in determining pubertal growth and bone age.

PubMed

Torenek Ağırman, Kubra; Bilge, Osman Murat; Miloğlu, Özkan

2018-05-02

The purpose of this study is to evaluate the compatibility of ultrasonographic data with hand-wrist radiographs taken to determine the extent of pubertal growth and bone age in patients and investigate the usability of ionizing radiation-free ultrasonography instead of conventional radiography. In this study, a total of 120 children from 10 to 17 years old (mean age was 168 months ± 27.5 months) were treated with routine radiographs before orthodontic treatment, and ultrasonographic imaging was performed on the wrists the same day. Researchers examined the phalanges, sesamoid bone, and radial bone distal epiphysis-diaphysis comparatively in each patient by both imaging methods and statistical evaluation. There was no statistically significant difference between conventional radiography and ultrasonography values at 13 points except for PP1 (proximal phalanges of the first finger), PP2 (proximal phalanges of the second finger), and radial epiphysis (p > 0.05). PP1, PP2, and radial epiphysis showed a statistically significant difference (p < 0.05). The CBA (bone age obtained from conventional radiographs) of the females was found to be larger than their CA (chronological age) and their UBA (ultrasonographic bone age). For males; the means of the CBA, UBA and CA values close to each other. In females and males; there was a strong correlation between the CA, the UBA and the CBA (p < 0.01). Ultrasonography gives detailed information about epiphyseal diaphysis relations. It can be used as an alternative to conventional radiography in the detection of bone age and pubertal growth, owing to the absence of ionizing radiation.

Ultrasonography in gastroenterology.

PubMed

Ødegaard, Svein; Nesje, Lars B; Hausken, Trygve; Gilja, Odd Helge

2015-06-01

Ultrasonography (US) is a safe and available real-time, high-resolution imaging method, which during the last decades has been increasingly integrated as a clinical tool in gastroenterology. New US applications have emerged with enforced data software and new technical solutions, including strain evaluation, three-dimensional imaging and use of ultrasound contrast agents. Specific gastroenterologic applications have been developed by combining US with other diagnostic or therapeutic methods, such as endoscopy, manometry, puncture needles, diathermy and stents. US provides detailed structural information about visceral organs without hazard to the patients and can play an important clinical role by reducing the need for invasive procedures. This paper presents different aspects of US in gastroenterology, with a special emphasis on the contribution from Nordic scientists in developing clinical applications.

Evaluation of gastrointestinal activity patterns in healthy horses using B mode and Doppler ultrasonography

PubMed Central

2005-01-01

Abstract Healthy adult horses were examined by using transabdominal ultrasonography to quantitatively and qualitatively evaluate activity of the jejunum, cecum, and colon with B mode and Doppler techniques. Doppler ultrasound was used to assess jejunal peristaltic activity. Examinations were performed on multiple occasions under imposed colic evaluation conditions, including fasting, nasogastric intubation, and xylazine sedation. In fasted horses, jejunal visibility was increased and jejunal, cecal, and colonic activity was decreased. The stomach was displaced ventrally and was visualized ventral to the costochondral junction. Xylazine sedation in fed horses had minimal effects; however, in fasted horses, xylazine significantly decreased jejunal and cecal activity. Nasogastric intubation in fasted horses had no observable effects on activity, but moved the stomach dorsally. B mode and Doppler jejunal activity were strongly correlated. Prior feeding and sedation status need to be considered when interpreting the results of equine abdominal ultrasound examinations. Doppler techniques may be useful for assessing jejunal activity. PMID:15825515

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

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

PubMed

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

2017-01-01

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. 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. 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. 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.

The use of ultrasonography and digital mammography in women under 40 years with symptomatic breast cancer: a 7-year Irish experience.

PubMed

Redmond, C E; Healy, G M; Murphy, C F; O'Doherty, A; Foster, A

2017-02-01

Breast cancer in women under 40 years of age is rare and typically presents symptomatically. The optimal imaging modality for this patient group is controversial. Most women undergo ultrasonography with/without mammography. Young women typically have dense breasts, which can obscure the features of malignancy on film mammography, however, initial studies have suggested that digital mammography may have a more accurate diagnostic performance in younger women. Ultrasound generally performs well in this age group, although it is poor at detecting carcinoma in situ (DCIS). To evaluate the comparative diagnostic performance of ultrasonography and digital mammography in the initial diagnostic evaluation of women under 40 years of age with symptomatic breast cancer. Retrospective review of all women under the age of 40 years managed at our symptomatic breast cancer unit from January 2009 to December 2015. There were 120 patients that met the inclusion criteria for this study. The sensitivity of ultrasonography and digital mammography for breast cancer in this patient group was 95.8 and 87.5 %, respectively. The patients with a false negative mammographic examination were more likely to have dense breasts (p < 0.01). Five patients had a false negative ultrasonographic examination, withal of whom were diagnosed with DCIS detected by mammography. This study demonstrates the superior sensitivity of ultrasound for breast cancer in women under the age of 40 years, however, the results show that digital mammography has an important complimentary role in the comprehensive assessment of these patients, particularly in the diagnosis of DCIS.

Ultrasonography of the equine shoulder: technique and normal appearance.

PubMed

Tnibar, M A; Auer, J A; Bakkali, S

1999-01-01

This study was intended to document normal ultrasonographic appearance of the equine shoulder and anatomic landmarks useful in clinical imaging. Both forelimbs of five equine cadavers and both forelimbs of six live adult horses were used. To facilitate understanding of the images, a zoning system assigned to the biceps brachii and to the infraspinatus tendon was developed. Ultrasonography was performed with a real-time B-mode semiportable sector scanner using 7.5- and 5-MHz transducers. On one cadaver limb, magnetic resonance imaging (MRI) was performed using a system at 1.5 Tesla, T1-weighted spin-echo sequence. Ultrasonography images were compared to frozen specimens and MRI images to correlate the ultrasonographic findings to the gross anatomy of the shoulder. Ultrasonography allowed easy evaluation of the biceps brachii and the infraspinatus tendon and their bursae, the supraspinatus muscle and tendons, the superficial muscles of the shoulder, and the underlying humerus and scapula. Only the lateral and, partially, the caudal aspects of the humeral head could be visualized with ultrasound. Ultrasonographic appearance, orientation, and anatomic relationships of these structures are described. Ultrasonographic findings correlated well with MRI images and with gross anatomy in the cadavers' limbs.

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

Early quantitative evaluation of a tumor vasculature disruptive agent AVE8062 using dynamic contrast-enhanced ultrasonography.

PubMed

Lavisse, Sonia; Lejeune, Pascale; Rouffiac, Valérie; Elie, Nicolas; Bribes, Estelle; Demers, Brigitte; Vrignaud, Patricia; Bissery, Marie-Christine; Brulé, Aude; Koscielny, Serge; Péronneau, Pierre; Lassau, Nathalie

2008-02-01

To evaluate the early tumor vasculature disrupting effects of the AVE8062 molecule and the feasibility of dynamic contrast-enhanced ultrasonography (DCE-US) in the quantitative assessment of these effects. AVE8062 was administered at a single dose (41 mg/kg) to 40 melanoma-bearing nude mice, which were all imaged before and after drug administration (5 + 15 minutes, 1, 6, and 24 hours). Using an ultrasound scanner (Aplio, Toshiba), intratumor vessels were counted in power Doppler mode and tumor microvasculature was assessed in a specific harmonic mode associated with a perfusion and quantification software for contrast-uptake quantification (Sonovue, Bracco). The peak intensity (PI), time-to-PI (T PI), and full-width at half maximum (FWHM) were extracted from the time-intensity curves expressed as linear raw data. Histologic analysis evaluated microvessel density (MVD) and necrosis at each time point studied. Statistical significance was estimated (paired sum rank and Mann-Whitney tests) to evaluate drug activity and to compare its efficacy at the different time points. In power Doppler mode, intratumoral vessels depletion started 15 minutes postinjection (32%, P = 0.004) and the decrease was maximal at 6 hours (51%, P = 0.002). PI decreased by 3.5- and 45.7-fold at 1 and 6 hours, respectively, compared with preinjection values (P = 0.016 and P = 0.008). The decrease at 6 hours was significantly different from the variation at 1 hour (P = 0.0012) and at 24 hours (P = 0.0008). T PI and FWHM showed a significant increase exclusively at 6 hours (P = 0.0034, P = 0.0039). Histology revealed significantly decreased MVD and increased necrosis at 24 hours (P < 0.01). DCE-US allowed quantitative in vivo evaluation of the functional effects of AVE8062, which was found most effective on tumoral microvasculature 6 hours after its administration. A clinical phase-1 study of AVE8062 is ongoing using the same ultrasonography methodology before and 6 and 24 hours

Follow-up of renal and mesenteric artery revascularization with duplex ultrasonography

PubMed Central

Taylor, David C.; Houston, Gordon T.M.; Anderson, Caroline; Jameson, Margot; Popatia, Shelley

1996-01-01

Objective To evaluate the long-term anatomic results of renal revascularization procedures using duplex ultrasonography. Design A case series. Setting A university-affiliated hospital. Patients Twenty-five patients who had undergone renal percutaneous transluminal angioplasty (PTA) (18 arteries), renal bypass (10 arteries) and mesenteric bypass (6 arteries). The mean follow-up was 22 months (range from 3 to 48 months) for those who underwent renal PTA, 23 months (range from 1.5 to 70 months) for those who underwent renal bypass and 34 months (range from 8 to 144 months) for those who underwent mesenteric bypass. Main Outcome Measures Patency rates for the three procedures as assessed by duplex ultrasonography. Results Duplex ultrasonography demonstrated patency without stenosis after renal and mesenteric artery revascularization in 14 arteries subjected to renal PTA, 9 arteries subjected to renal bypass and 6 arteries subjected to mesenteric bypass. Three arteries that had renal PTA had recurrent vessel stenosis and one had occlusion. One artery that had renal bypass showed occlusion. Conclusions Renal PTA, renal bypass and mesenteric bypass are durable procedures at 2 years of follow-up, and duplex ultrasonography is a valuable method for assessing the patency of arteries after renal and mesenteric revascularization. PMID:8599785

Characterization of the biliary tract by virtual ultrasonography constructed by gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging.

PubMed

Koizumi, Yohei; Hirooka, Masashi; Ochi, Hironori; Tokumoto, Yoshio; Takechi, Megumi; Hiraoka, Atsushi; Ikeda, Yoshio; Kumagi, Teru; Matsuura, Bunzo; Abe, Masanori; Hiasa, Yoichi

2015-04-01

This study aimed at prospectively evaluating bile duct anatomy on ultrasonography and evaluating the safety and utility of radiofrequency ablation (RFA) assisted by virtual ultrasonography from gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI). The institutional review board approved this study, and patients provided written informed consent prior to entry into the study. Bile duct anatomy was assessed in 201 patients who underwent Gd-EOB-DTPA-enhanced MRI for the evaluation of hepatic tumor. Eighty-one of these patients subsequently underwent RFA assisted by ultrasound imaging. In 23 patients, the tumor was located within 5 mm of the central bile duct, as demonstrated by MRI. Virtual ultrasonography constructed by Gd-EOB-enhanced MRI was able to visualize the common bile duct, left hepatic duct, and right hepatic duct in 96.5, 94.0, and 89.6 % of cases, respectively. The target hepatic tumor nodule and biliary duct could be detected with virtual ultrasonography in all patients, and no severe complications occurred. The running pattern of the bile ducts could be recognized on conventional ultrasound by referencing virtual ultrasonography constructed by Gd-EOB-DTPA-enhanced MRI. RFA assisted by this imaging strategy did not result in bile duct injury.

Comparison of radiography and ultrasonography for diagnosing small-intestinal mechanical obstruction in vomiting dogs.

PubMed

Sharma, Ajay; Thompson, Margret S; Scrivani, Peter V; Dykes, Nathan L; Yeager, Amy E; Freer, Sean R; Erb, Hollis N

2011-01-01

A cross-sectional study was performed on acutely vomiting dogs to compare the accuracy of radiography and ultrasonography for the diagnosis of small-intestinal mechanical obstruction and to describe several radiographic and ultrasonographic signs to identify their contribution to the final diagnosis. The sample population consisted of 82 adult dogs and small-intestinal obstruction by foreign body was confirmed in 27/82 (33%) dogs by surgery or necropsy. Radiography produced a definitive result (obstructed or not obstructed) in 58/82 (70%) of dogs; ultrasonography produced a definitive result in 80/82 (97%) of dogs. On radiographs, a diagnosis of obstruction was based on detection of segmental small-intestinal dilatation, plication, or detection of a foreign body. Approximately 30% (8/27) of obstructed dogs did not have radiographic signs of segmental small-intestinal dilatation, of which 50% (4/8) were due to linear foreign bodies. The ultrasonographic diagnosis of small-intestinal obstruction was based on detection of an obstructive lesion, sonographic signs of plication or segmental, small-intestinal dilatation. The ultrasonographic presence or absence of moderate-to-severe intestinal diameter enlargement (due to lumen dilatation) of the jejunum (>1.5 cm) was a useful discriminatory finding and, when present, should prompt a thorough search for a cause of small-intestinal obstruction. In conclusion, both abdominal radiography and abdominal ultrasonography are accurate for diagnosing small-intestinal obstruction in vomiting dogs and either may be used depending on availability and examiner choice. Abdominal ultrasonography had greater accuracy, fewer equivocal results and provided greater diagnostic confidence compared with radiography. © 2010 Veterinary Radiology & Ultrasound.

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.

Histogram-based quantitative evaluation of endobronchial ultrasonography images of peripheral pulmonary lesion.

PubMed

Morikawa, Kei; Kurimoto, Noriaki; Inoue, Takeo; Mineshita, Masamichi; Miyazawa, Teruomi

2015-01-01

Endobronchial ultrasonography using a guide sheath (EBUS-GS) is an increasingly common bronchoscopic technique, but currently, no methods have been established to quantitatively evaluate EBUS images of peripheral pulmonary lesions. The purpose of this study was to evaluate whether histogram data collected from EBUS-GS images can contribute to the diagnosis of lung cancer. Histogram-based analyses focusing on the brightness of EBUS images were retrospectively conducted: 60 patients (38 lung cancer; 22 inflammatory diseases), with clear EBUS images were included. For each patient, a 400-pixel region of interest was selected, typically located at a 3- to 5-mm radius from the probe, from recorded EBUS images during bronchoscopy. Histogram height, width, height/width ratio, standard deviation, kurtosis and skewness were investigated as diagnostic indicators. Median histogram height, width, height/width ratio and standard deviation were significantly different between lung cancer and benign lesions (all p < 0.01). With a cutoff value for standard deviation of 10.5, lung cancer could be diagnosed with an accuracy of 81.7%. Other characteristics investigated were inferior when compared to histogram standard deviation. Histogram standard deviation appears to be the most useful characteristic for diagnosing lung cancer using EBUS images. © 2015 S. Karger AG, Basel.

Point-of-care ultrasonography as a training milestone for internal medicine residents: the time is now.

PubMed

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.

Role of ultrasonography in the management of twin gestation.

PubMed

Smith, Jessica; Treadwell, Marjorie C; Berman, Deborah R

2018-06-01

Twins represent 1%-2% of all pregnancies, yet continue to account for a disproportionate share of neonatal adverse events including neonatal intensive care admission, morbidity, and mortality. Ultrasonography is central to the proper diagnosis of the type of twinning. Ideally, ultrasonography is performed before 14 weeks of gestation to determine chorionicity and amnionicity. Correct identification of the chorionicity in a twin pregnancy facilitates proper counseling and management of the gestation, including ultrasonography follow-up. Herein, the different types of twinning are reviewed, together with the implications for ultrasonography monitoring of each specific type of twin gestation. © 2018 International Federation of Gynecology and Obstetrics.

Point-of-Care Ultrasonography for Evaluation of Acute Dyspnea in the ED.

PubMed

Zanobetti, Maurizio; Scorpiniti, Margherita; Gigli, Chiara; Nazerian, Peiman; Vanni, Simone; Innocenti, Francesca; Stefanone, Valerio T; Savinelli, Caterina; Coppa, Alessandro; Bigiarini, Sofia; Caldi, Francesca; Tassinari, Irene; Conti, Alberto; Grifoni, Stefano; Pini, Riccardo

2017-06-01

Acute dyspnea is a common symptom in the ED. The standard approach to dyspnea often relies on radiologic and laboratory results, causing excessive delay before adequate therapy is started. Use of an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis, while maintaining an acceptable safety profile. Consecutive adult patients presenting with dyspnea and admitted after ED evaluation were prospectively enrolled. The gold standard was the final diagnosis assessed by two expert reviewers. Two physicians independently evaluated the patient; a sonographer performed an ultrasound evaluation of the lung, heart, and inferior vena cava, while the treating physician requested traditional tests as needed. Time needed to formulate the ultrasound and the ED diagnoses was recorded and compared. Accuracy and concordance of the ultrasound and the ED diagnoses were calculated. A total of 2,683 patients were enrolled. The average time needed to formulate the ultrasound diagnosis was significantly lower than that required for ED diagnosis (24 ± 10 min vs 186 ± 72 min; P = .025). The ultrasound and the ED diagnoses showed good overall concordance (κ = 0.71). There were no statistically significant differences in the accuracy of PoCUS and the standard ED evaluation for the diagnosis of acute coronary syndrome, pneumonia, pleural effusion, pericardial effusion, pneumothorax, and dyspnea from other causes. PoCUS was significantly more sensitive for the diagnosis of heart failure, whereas a standard ED evaluation performed better in the diagnosis of COPD/asthma and pulmonary embolism. PoCUS represents a feasible and reliable diagnostic approach to the patient with dyspnea, allowing a reduction in time to diagnosis. This protocol could help to stratify patients who should undergo a more detailed evaluation. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Usefulness of intraoperative ultrasonography in liver resections due to colon cancer metastasis.

PubMed

Lucchese, Angélica Maria; Kalil, Antônio Nocchi; Schwengber, Alex; Suwa, Eiji; Rolim de Moura, Gabriel Garcia

2015-08-01

Intraoperative ultrasonography (IOUS) of the liver has been used both as an aid for intraoperative anatomical definition and for the detection of new lesions. The present study aimed to evaluate the impact of IOUS and to identify factors that can predict the detection of new lesions intraoperatively. In this observational and prospective study, with a cross-sectional design, patients with colorectal cancer metastases who underwent hepatectomy were selected. Abdominal computed tomography, magnetic resonance imaging, and positron emission tomography were the preoperative evaluation tests. All patients underwent IOUS performed by the same surgeon. The intraoperative findings were compared with the preoperative tests results. In total, 56 hepatectomies were evaluated. Half of the patients were men, with a mean age of 57 (30-85) years. New lesions were found intraoperatively in 12 patients (21.4% of cases) and were detected on both palpation and ultrasonography in 11 of these patients. Ultrasonography helped to revise the surgical plans by providing additional information in 35.7% of cases. On multivariate analysis, the presence of more than 4 preoperative nodules was predictive of the intraoperative occurrence of new lesions. IOUS remains the only way to evaluate the relationships between tumors, liver vascular structures, and bile ducts intraoperatively. Alone, IOUS was not useful for identifying new lesions intraoperatively, as all new lesions were also detected on palpation. The number of lesions diagnosed on preoperative tests influenced the probability of identifying new lesions intraoperatively. There may be additional influential factors. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Role of endoscopic ultrasonography in the staging and follow-up of esophageal cancer.

PubMed

Lightdale, Charles J; Kulkarni, Ketan G

2005-07-10

To evaluate the role of endoscopic ultrasonography (EUS) in the initial staging and follow-up of esophageal cancer on the basis of a review of the published literature. Articles published from 1985 to 2005 were searched and reviewed using the following keywords: "esophageal cancer staging," "endoscopic ultrasound," and "endoscopic ultrasonography." For initial anatomic staging, EUS results have consistently shown more than 80% accuracy compared with surgical pathology for depth of tumor invasion (T). Accuracy increased with higher stage, and was >90% for T3 cancer. EUS results have shown accuracy in the range of 75% for initial staging of regional lymph nodes (N). EUS has been invariably more accurate than computed tomography for T and N staging. EUS is limited for staging distant metastases (M), and therefore EUS is usually performed after a body imaging modality such as computed tomography or positron emission tomography. Pathologic staging can be achieved at EUS using fine-needle aspiration (FNA) to obtain cytology from suspect Ns. FNA has had greatest efficacy in confirming celiac axis lymph node metastases with more than 90% accuracy. EUS is inaccurate for staging after radiation and chemotherapy because of inability to distinguish inflammation and fibrosis from residual cancer, but a more than 50% decrease in tumor cross-sectional area or diameter has been found to correlate with treatment response. EUS has a central role in the initial anatomic staging of esophageal cancer because of its high accuracy in determining the extent of locoregional disease. EUS is inaccurate for staging after radiation therapy and chemotherapy, but can be useful in assessing treatment response.

A quantitative method for evaluating inferior glenohumeral joint stiffness using ultrasonography.

PubMed

Tsai, Wen-Wei; Lee, Ming-Yih; Yeh, Wen-Lin; Cheng, Shih-Chung; Soon, Kok-Soon; Lei, Kin Fong; Lin, Wen-Yen

2013-02-01

Subluxation of the affected shoulder in post-stroke patients is associated with nerve disorders and muscle fatigue. Clinicians must be able to accurately and reliably measure inferior glenohumeral subluxation in patients to provide appropriate treatment. However, quantitative methods for evaluating the laxity and stiffness of the glenohumeral joint (GHJ) are still being developed. The aim of this study was to develop a new protocol for evaluating the laxity and stiffness of the inferior GHJ using ultrasonography under optimal testing conditions and to investigate changes in the GHJ from a commercially available humerus brace and shoulder brace. Multistage inferior displacement forces were applied to create a glide between the most cephalad point on the visible anterosuperior surface of the humeral head and coracoid process in seven healthy volunteers. GHJ stiffness was defined as the slope of the linear regression line between the glides and different testing loads. The testing conditions were defined by different test loading mechanisms (n=2), shoulder constraining conditions (n=2), and loading modes (n=4). The optimal testing condition was defined as the condition with the least residual variance of measured laxity to the calculated stiffness under different testing loads. A paired t-test was used to compare the laxity and stiffness of the inferior GHJ using different braces. No significant difference was identified between the two test loading mechanisms (t=0.218, p=0.831) and two shoulder constraining conditions (t=-0.235, p=0.818). We concluded that ultrasonographic laxity measurements performed using a pulley set loading mechanism was as reliable as direct loading. Additionally, constraining the unloaded shoulder was proposed due to the lower mean residual variance value. Moreover, pulling the elbow downward with loading on the upper arm was suggested, as pulling the elbow downward with the elbow flexed and loading on the forearm may overestimate stiffness

Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta.

PubMed

Riteau, Anne-Sophie; Tassin, Mikael; Chambon, Guillemette; Le Vaillant, Claudine; de Laveaucoupet, Jocelyne; Quéré, Marie-Pierre; Joubert, Madeleine; Prevot, Sophie; Philippe, Henri-Jean; Benachi, Alexandra

2014-01-01

To evaluate the accuracy of ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of placenta accreta and to define the most relevant specific ultrasound and MRI features that may predict placental invasion. This study was approved by the institutional review board of the French College of Obstetricians and Gynecologists. We retrospectively reviewed the medical records of all patients referred for suspected placenta accreta to two university hospitals from 01/2001 to 05/2012. Our study population included 42 pregnant women who had been investigated by both ultrasonography and MRI. Ultrasound images and MRI were blindly reassessed for each case by 2 raters in order to score features that predict abnormal placental invasion. Sensitivity in the diagnosis of placenta accreta was 100% with ultrasound and 76.9% for MRI (P = 0.03). Specificity was 37.5% with ultrasonography and 50% for MRI (P = 0.6). The features of greatest sensitivity on ultrasonography were intraplacental lacunae and loss of the normal retroplacental clear space. Increased vascularization in the uterine serosa-bladder wall interface and vascularization perpendicular to the uterine wall had the best positive predictive value (92%). At MRI, uterine bulging had the best positive predictive value (85%) and its combination with the presence of dark intraplacental bands on T2-weighted images improved the predictive value to 90%. Ultrasound imaging is the mainstay of screening for placenta accreta. MRI appears to be complementary to ultrasonography, especially when there are few ultrasound signs.

Use of high-frequency ultrasonography for evaluation of skin thickness in relation to hydration status and fluid distribution at various cutaneous sites in dogs.

PubMed

Diana, Alessia; Guglielmini, Carlo; Fracassi, Federico; Pietra, Marco; Balletti, Erika; Cipone, Mario

2008-09-01

To assess the usefulness of high-frequency diagnostic ultrasonography for evaluation of changes of skin thickness in relation to hydration status and fluid distribution at various cutaneous sites in dogs. 10 clinically normal adult dogs (6 males and 4 females) of various breeds. Ultrasonographic examination of the skin was performed before and after hydration via IV administration of an isotonic crystalloid solution (30 mL/kg/h for 30 minutes). A 13-MHz linear-array transducer was used to obtain series of ultrasonographic images at 4 different cutaneous sites (the frontal, sacral, flank, and metatarsal regions). Weight and various clinicopathologic variables (PCV; serum osmolality; and serum total protein, albumin, and sodium concentrations) were determined before and after the infusion. These variables and ultrasonographic measurements of skin thickness before and after hydration were compared. Among the 10 dogs, mean preinfusion skin thickness ranged from 2,211 microm (metatarsal region) to 3,249 microm (sacral region). Compared with preinfusion values, weight was significantly increased, whereas PCV; serum osmolality; and serum total protein, albumin, and sodium concentrations were significantly decreased after infusion. After infusion, dermal echogenicity decreased and skin thickness increased significantly by 21%, 14%, 15%, and 13% in the frontal, sacral, flank, and metatarsal regions, respectively. Cutaneous site and hydration were correlated with cutaneous characteristics and skin thickness determined by use of high-frequency ultrasonography in dogs. Thus, diagnostic ultrasonography may be a useful tool for the noninvasive evaluation of skin hydration in healthy dogs and in dogs with skin edema.

Diagnostic accuracy of oblique chest radiograph for occult pneumothorax: comparison with ultrasonography.

PubMed

Matsumoto, Shokei; Sekine, Kazuhiko; Funabiki, Tomohiro; Orita, Tomohiko; Shimizu, Masayuki; Hayashida, Kei; Kazamaki, Taku; Suzuki, Tatsuya; Kishikawa, Masanobu; Yamazaki, Motoyasu; Kitano, Mitsuhide

2016-01-01

An occult pneumothorax is a pneumothorax that is not seen on a supine chest X-ray but is detected by computed tomography scanning. However, critical patients are difficult to transport to the computed tomography suite. We previously reported a method to detect occult pneumothorax using oblique chest radiography (OXR). Several authors have also reported that ultrasonography is an effective technique for detecting occult pneumothorax. The aim of this study was to evaluate the usefulness of OXR in the diagnosis of the occult pneumothorax and to compare OXR with ultrasonography. All consecutive blunt chest trauma patients with clinically suspected pneumothorax on arrival at the emergency department were prospectively included at our tertiary-care center. The patients underwent OXR and ultrasonography, and underwent computed tomography scans as the gold standard. Occult pneumothorax size on computed tomography was classified as minuscule, anterior, or anterolateral. One hundred and fifty-nine patients were enrolled. Of the 70 occult pneumothoraces found in the 318 thoraces, 19 were minuscule, 32 were anterior, and 19 were anterolateral. The sensitivity and specificity of OXR for detecting occult pneumothorax was 61.4 % and 99.2 %, respectively. The sensitivity and specificity of lung ultrasonography was 62.9 % and 98.8 %, respectively. Among 27 occult pneumothoraces that could not be detected by OXR, 16 were minuscule and 21 could be conservatively managed without thoracostomy. OXR appears to be as good method as lung ultrasonography in the detection of large occult pneumothorax. In trauma patients who are difficult to transfer to computed tomography scan, OXR may be effective at detecting occult pneumothorax with a risk of progression.

Renal blood flow measurement with contrast-enhanced harmonic ultrasonography: evaluation of dopamine-induced changes in renal cortical perfusion in humans.

PubMed

Kishimoto, N; Mori, Y; Nishiue, T; Shibasaki, Y; Iba, O; Nose, A; Uchiyama-Tanaka, Y; Masaki, H; Matsubara, H; Iwasaka, T

2003-06-01

An accessible non-invasive method for evaluating renal regional blood flow in real time is highly desirable in the clinical setting. Recent progress in ultrasonography with microbubble contrast has allowed quantification of regional blood flow in animal models. Goal ofthis study was to establish a convenient contrast--enhanced harmonic ultrasonography (CEHU) method for evaluating renal cortical blood flow in humans. We carried out intermittent second harmonic imaging in 9 healthy volunteers. Pulse interval was progressively decreased from 4 s - 0.2 s during continuous venous infusion of the microbubble contrast agent. Pulse interval versus CEHU-derived acoustic intensity plots provided microbubble velocity (MV) and fractional vascular volume (FVV) during renal cortical perfusion in humans. Low-dose dopamine infusion (2 microg/min/kg) resulted in a significant increase in MV which correlated well with the increase in total renal blood flow (RBF) determined by a conventional study of p-aminohippurate clearance (C(PAH)) (r = 0.956, p < 0.0001). Although FVV was not significantly increased, alterations in CEHU-derived renal cortical blood flow calculated by the products of MV and FVV were also correlated with alterations in total RBF (r = 0.969, p < 0.0001). Thus, low-dose dopamine infusion increases renal cortical blood flow observed in CEHU, mainly by increasing MV. The present study shows that renal cortical blood flow in humans can be measured non-invasively by CEHU and that CEHU can be used for quantitatively evaluating changes induced by a therapeutic agent such as dopamine in flow velocity and in FVV.

[The role of ultrasonography in the investigation of male infertility].

PubMed

Fejes, Zsuzsanna; Pásztor, Norbert; Karczagi, Lilla; Brzózka, Ádám; Király, István; Morvay, Zita; Palkó, András

2018-05-01

Unintended childlessness affects approximately 9-15% of couples in the reproductive age. It is known that a remarkable proportion of infertility is caused by the disorders of the male reproductive functions. Diagnostic imaging methods and especially ultrasonography play a crucial role in the infertility work-up, the ultrasound examination has become the method of choice for imaging in diseases affecting the testis. With the development of high resolution transducers and technology using colour Doppler, pulsed Doppler, share wave elastography and strain elastography, it is now possible to make accurate diagnoses. However, the place of the new imaging methods in the algorithm of infertility check-up should be clearly defined. Orv Hetil. 2018; 159(21): 815-822.

Electrophysiological examination and high frequency ultrasonography for diagnosis of radial nerve torsion and compression

PubMed Central

Shi, Miao; Qi, Hengtao; Ding, Hongyu; Chen, Feng; Xin, Zhaoqin; Zhao, Qinghua; Guan, Shibing; Shi, Hao

2018-01-01

Abstract This study aims to evaluate the value of electrophysiological examination and high frequency ultrasonography in the differential diagnosis of radial nerve torsion and radial nerve compression. Patients with radial nerve torsion (n = 14) and radial nerve compression (n = 14) were enrolled. The results of neurophysiological and high frequency ultrasonography were compared. Electrophysiological examination and high-frequency ultrasonography had a high diagnostic rate for both diseases with consistent results. Of the 28 patients, 23 were positive for electrophysiological examination, showing decreased amplitude and decreased conduction velocity of radial nerve; however, electrophysiological examination cannot distinguish torsion from compression. A total of 27 cases showed positive in ultrasound examinations among all 28 cases. On ultrasound images, the nerve was thinned at torsion site whereas thickened at the distal ends of torsion. The diameter and cross-sectional area of torsion or compression determined the nerve damage, and ultrasound could locate the nerve injury site and measure the length of the nerve. Electrophysiological examination and high-frequency ultrasonography can diagnose radial neuropathy, with electrophysiological examination reflecting the neurological function, and high-frequency ultrasound differentiating nerve torsion from compression. PMID:29480857

Accuracy of Ultrasonography and Magnetic Resonance Imaging in the Diagnosis of Placenta Accreta

PubMed Central

Riteau, Anne-Sophie; Tassin, Mikael; Chambon, Guillemette; Le Vaillant, Claudine; de Laveaucoupet, Jocelyne; Quéré, Marie-Pierre; Joubert, Madeleine; Prevot, Sophie; Philippe, Henri-Jean; Benachi, Alexandra

2014-01-01

Purpose To evaluate the accuracy of ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of placenta accreta and to define the most relevant specific ultrasound and MRI features that may predict placental invasion. Material and Methods This study was approved by the institutional review board of the French College of Obstetricians and Gynecologists. We retrospectively reviewed the medical records of all patients referred for suspected placenta accreta to two university hospitals from 01/2001 to 05/2012. Our study population included 42 pregnant women who had been investigated by both ultrasonography and MRI. Ultrasound images and MRI were blindly reassessed for each case by 2 raters in order to score features that predict abnormal placental invasion. Results Sensitivity in the diagnosis of placenta accreta was 100% with ultrasound and 76.9% for MRI (P = 0.03). Specificity was 37.5% with ultrasonography and 50% for MRI (P = 0.6). The features of greatest sensitivity on ultrasonography were intraplacental lacunae and loss of the normal retroplacental clear space. Increased vascularization in the uterine serosa-bladder wall interface and vascularization perpendicular to the uterine wall had the best positive predictive value (92%). At MRI, uterine bulging had the best positive predictive value (85%) and its combination with the presence of dark intraplacental bands on T2-weighted images improved the predictive value to 90%. Conclusion Ultrasound imaging is the mainstay of screening for placenta accreta. MRI appears to be complementary to ultrasonography, especially when there are few ultrasound signs. PMID:24733409

The role of transvaginal ultrasonography for detecting ovarian cancer in an asymptomatic screening population: a systematic review.

PubMed

Buhling, Kai J; Lezon, S; Eulenburg, C; Schmalfeldt, B

2017-05-01

The purpose of this study was to systematically analyze the effect of transvaginal ultrasonography in an asymptomatic female population as an annual screening procedure with regard to mortality data. Studies were evaluated descriptively on their strengths and weaknesses considering the methods and results. We evaluated 632 international studies by selecting only randomized controlled trials (RCTs). Three RCTs concerning transvaginal ultrasonography were found, performed in Japan, the USA, and Great Britain. Currently, no clear recommendation for the screening for ovarian cancer in an asymptomatic population can be given based on these three studies. The authors could not show a change in mortality using transvaginal ultrasonography for annual screening. An annual palpation does not offer a beneficial effect. The development of new ultrasound machines with higher image resolution in combination with a well-standardized algorithm for ovarian cancer in upcoming years might provide an improvement regarding mortality. The current studies do not show a benefit in screening an asymptomatic population annually with transvaginal ultrasonography, but the most recent publication showed a trend toward lower mortality in patients who underwent screening after 7-14 years of follow-up. Nevertheless, all three heterogeneous RCTs had weaknesses in their methods and therefore they neither contradict the general recommendation for screening in an asymptomatic population nor do they support it.

Postnatal Brain Growth Assessed by Sequential Cranial Ultrasonography in Infants Born <30 Weeks' Gestational Age.

PubMed

Cuzzilla, R; Spittle, A J; Lee, K J; Rogerson, S; Cowan, F M; Doyle, L W; Cheong, J L Y

2018-06-01

Brain growth in the early postnatal period following preterm birth has not been well described. This study of infants born at <30 weeks' gestational age and without major brain injury aimed to accomplish the following: 1) assess the reproducibility of linear measures made from cranial ultrasonography, 2) evaluate brain growth using sequential cranial ultrasonography linear measures from birth to term-equivalent age, and 3) explore perinatal predictors of postnatal brain growth. Participants comprised 144 infants born at <30 weeks' gestational age at a single center between January 2011 and December 2013. Infants with major brain injury seen on cranial ultrasonography or congenital or chromosomal abnormalities were excluded. Brain tissue and fluid spaces were measured from cranial ultrasonography performed as part of routine clinical care. Brain growth was assessed in 3 time intervals: <7, 7-27, and >27 days' postnatal age. Data were analyzed using intraclass correlation coefficients and mixed-effects regression. A total of 429 scans were assessed for 144 infants. Several linear measures showed excellent reproducibility. All measures of brain tissue increased with postnatal age, except for the biparietal diameter, which decreased within the first postnatal week and increased thereafter. Gestational age of ≥28 weeks at birth was associated with slower growth of the biparietal diameter and ventricular width compared with gestational age of <28 weeks. Postnatal corticosteroid administration was associated with slower growth of the corpus callosum length, transcerebellar diameter, and vermis height. Sepsis and necrotizing enterocolitis were associated with slower growth of the transcerebellar diameter. Postnatal brain growth in infants born at <30 weeks' gestational age can be evaluated using sequential linear measures made from routine cranial ultrasonography and is associated with perinatal predictors of long-term development. © 2018 by American Journal of

Bedside ultrasonography for diagnosis of pneumothorax

PubMed Central

Chen, Lin

2015-01-01

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

MRI versus ultrasonography to assess meniscal abnormalities in acute knees.

PubMed

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

2014-08-01

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

Transabdominal ultrasonography as a screening test for second-trimester placenta previa.

PubMed

Quant, Hayley S; Friedman, Alexander M; Wang, Eileen; Parry, Samuel; Schwartz, Nadav

2014-03-01

To determine the test characteristics of transabdominal ultrasonography as a screening test for second-trimester placenta previa. This secondary analysis of a prospective cohort study evaluated the distance from the placental edge to the internal os (placenta-cervix distance) through both transabdominal and transvaginal ultrasonography during the anatomic survey. Patients were recruited in the Maternal-Fetal Medicine Ultrasound Unit at the Hospital of the University of Pennsylvania, an urban tertiary care center. Transabdominal placenta-cervix distance cutoffs with high sensitivity for detection of previa and low-lying placenta were identified, and test characteristics were calculated. Follow-up ultrasound data, pregnancy, and delivery outcomes for those with second-trimester previa or low-lying placenta were obtained. One thousand two hundred fourteen women were included in the analysis. A transabdominal placenta-cervix distance cutoff of 4.2 cm was 93.3% sensitive and 76.7% specific for detection of previa with a 99.8% negative predictive value at a screen-positive rate of 25.0%. A cutoff of 2.8 cm was 86.7% sensitive and 90.5% specific with a 99.6% negative predictive value at a screen-positive rate of 11.4%. Only 9.8% (four of 41) of previas and low-lying placentas persisted through delivery. Transabdominal ultrasonography is an effective screening test for second-trimester placenta previa. At centers not performing universal transvaginal ultrasonography at the time of the anatomic survey, evidence-based transabdominal placenta-cervix distance cutoffs can optimize the identification of patients who require further surveillance for previa.

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

PubMed Central

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

2008-01-01

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

[Diagnostic utility of endoscopic ultrasonography elastography and contrast-enhanced harmonic endoscopic ultrasonography in a patient with type 2 autoimmune pancreatitis].

PubMed

Yokode, Masataka; Shiomi, Hideyuki; Itai, Ryosuke; Mikami, Sakae; Yamashita, Yukimasa; Nakano, Ryota; Ezaki, Takeshi; Masuda, Atsuhiro; Zen, Yoh

2018-01-01

A referring hospital diagnosed a 57-year-old man with a pancreatic head mass. The initial endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) was inconclusive because of the small sample size. Endoscopic ultrasonography elastography (EUS-EG) and contrast-enhanced harmonic endoscopic ultrasonography (CE-EUS), conducted at our institute, raised the possibility of mass-forming pancreatitis or autoimmune pancreatitis (AIP). A repeat EUS-FNA revealed inflammatory changes, including a neutrophilic duct injury suggestive of type 2 AIP. The pancreatic lesion responded well to the steroid therapy. The present case suggests that EUS-EG and CE-EUS may be useful for diagnostic exclusion of pancreatic cancers, and the combined use of EUS-EG and CE-EUS, with EUS-FNA, may help characterize inflammatory pancreatic lesions.

Cardiovascular ultrasonography detection of embolic sources in trauma.

PubMed

Saranteas, Theodosios; Mavrogenis, Andreas F; Poularas, John; Kostroglou, Andreas; Mandila, Christina; Panou, Fotios

2018-06-01

Venous thromboembolism (deep vein thrombosis and pulmonary embolism) and bone cement implantation syndrome are major sources of embolic events in trauma patients. In these patients, embolic events due to venous thromboembolism and bone cement implantation syndrome have been detected with cardiac and vascular ultrasonography in the emergency setting, during the perioperative period, and in the intensive care unit. This article discusses the ultrasonography modalities and imaging findings of embolic events related to venous thromboembolism and bone cement implantation syndrome. The aim is to present a short review with exceptional illustrations that can enable physicians to identify sources of emboli in trauma patients with cardiovascular ultrasonography. Copyright © 2018 Elsevier Inc. All rights reserved.

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. © 2015 The Authors. Digestive Endoscopy © 2015 Japan Gastroenterological Endoscopy Society.

Transperineal ultrasonography: First level exam in IBD patients with perianal disease.

PubMed

Terracciano, Fulvia; Scalisi, Giuseppe; Bossa, Fabrizio; Scimeca, Daniela; Biscaglia, Giuseppe; Mangiacotti, Michele; Valvano, Maria Rosa; Perri, Francesco; Simeone, Anna; Andriulli, Angelo

2016-08-01

A pelvic magnetic resonance imaging (MRI) represents the front-line method for evaluating perianal disease in patients with inflammatory bowel disease (IBD). Recently, transperineal ultrasonography (TPUS) has been proposed as a simple, safe, time-sparing and useful diagnostic technique to assess different pathological conditions of the pelvic floor. The aim of this prospective single centre study was to evaluate the accuracy of TPUS versus MRI for the detection and classification of perineal disease in IBD patients. From November 2013 to November 2014, 28 IBD patients underwent either TPUS or MRI. Fistulae and abscesses were classified according to Parks' and AGA's classification methods. A concordance was assessed by k statistics. Overall, 33 fistulae and 8 abscesses were recognized by TPUS (30 and 7 by MRI, respectively). The agreement between TPUS and MRI was 75% according to Parks' classification (k=0.67) and 86% according to AGA classification (k=0.83), while it was 36% (k=0.34) for classifying abscesses. TPUS proved to be as accurate as MRI for detecting superficial and small abscesses and for classifying perianal disease. Both examinations may be performed at the initial presentation of the patient, but TPUS is a cheaper, time-sparing procedure. The optimal use of TPUS might be in follow-up patients. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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. Copyright 2010 Elsevier Inc. All rights reserved.

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

Comparison of ultrasonography and physical examination in the diagnosis of incisional hernia in a prospective study.

PubMed

Bloemen, A; van Dooren, P; Huizinga, B F; Hoofwijk, A G M

2012-02-01

Incisional hernia is a frequent complication of abdominal surgery (incidence 2-20%). Diagnosis by physical examination is sometimes difficult, especially in small incisional hernias or in obese patients. The additional diagnostic value of standardized ultrasonography was evaluated in this prospective study. A total of 456 patients participating in a randomized trial comparing two suture materials for closure of the abdominal fascia underwent physical examination and ultrasonography at 6-month intervals. Wound complaints and treatment of incisional hernia were also noted. Statistical analysis was performed using the Chi-squared and Fisher's exact tests (SPSS). Interest variability analysis was performed. During a median follow-up of 31 months, 103 incisional hernias were found. A total of 82 incisional hernias were found by physical examination and an additional 21 with ultrasonography. Six of these additional hernias were symptomatic and only one of the additional hernias received operative treatment. The false-negative rates for physical examination and ultrasonography were 25.3 and 24.4%, respectively. Interest variability was low, with a Kappa of 0.697 (P < 0.001). There are no clear diagnostic criteria for incisional hernia available in the literature. Standardized combination of ultrasonography with physical examination during follow-up yields a significant number of, mostly asymptomatic, hernias, which would not be found using physical examination alone. This is especially relevant in research settings.

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

3D ultrasonography is as accurate as low-dose CT in thyroid volumetry.

PubMed

Licht, K; Darr, A; Opfermann, T; Winkens, T; Freesmeyer, M

2014-01-01

The purpose of this study was to compare thyroid volumetry by three-dimensional mechanically swept ultrasonography (3DmsUS) and low-dose computed tomography (ldCT). 30 subjects referred for radioiodine therapy of benign thyroid diseases were subjected to 3DmsUS and ldCT. A prerequisite of 3DmsUS analyses was that the scans had to capture the entire thyroid, excluding therefore cases with a very large volume or retrosternal portions. The 3DmsUS data were transformed into a DICOM format, and volumetry calculations were performed via a multimodal workstation equipped with standard software for cross-sectional imaging. Volume was calculated applying both the ellipsoid model and a manually tracing method. Statistical analyses included 95% confidence intervals (CI) of the means and limits of agreement according to Bland and Altman, the latter including 95% of all expected values. Volumetric measurements by 3DmsUS and ldCT resulted in very high, significant correlation coefficients, r = 0.997 using the ellipsoid model and r = 0.993 with the manually tracing method. The mean relative differences of the two imaging modalities proved very small (-1.2±4.0% [95% CI -2.62; 0.28] using the ellipsoid model; -1.1±5.2% [95% CI -2.93; 0.80] using the manually tracing method) and the limits of agreement sufficiently narrow (-9.1% to 6.8%; -11.3% to 9.2%, respectively). For moderately enlarged thyroids, volumetry with 3DmsUS proved comparable to that of ldCT, irrespective of whether the ellipsoid model or the manually tracing method was applied. Thus, 3DmsUS qualifies as a potential alternative to ldCT, provided that the organ is completely accessible. The use of a standard workstation for cross-sectional imaging with routine software did not prove problematic.

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.

Contrast-enhanced ultrasonography for the evaluation of liver fibrosis after biliary obstruction.

PubMed

Shin, Hyun Joo; Chang, Eun Young; Lee, Hye Sun; Hong, Jung Hwa; Park, Gyuri; Kim, Hyun Gi; Kim, Myung-Joon; Lee, Mi-Jung

2015-03-07

To investigate perfusion change in contrast-enhanced ultrasonography (CEUS) to evaluate liver fibrosis based on biliary obstruction using an animal model. New Zealand white rabbits (3-4 kg) underwent bile duct ligation to form a biliary obstruction model. We performed liver CEUS and laboratory tests on the day before the operation (day 0) and every 7 postoperative days until the rabbits were sacrificed. After CEUS, signal intensity of liver parenchyma with a time-intensity curve was analyzed. Perfusion parameters were automatically calculated from region-of-interests, including peak signal intensity, mean transit time, area under the curve and time to peak. Histological grades of liver fibrosis were assessed according to the Metavir score system immediately after sacrifice. Generalized estimating equations were used to analyze the association between liver fibrosis grades and perfusion parameters for statistical analysis. The perfusion parameters were measured on the last day and the difference between day 0 and the last day were evaluated. From the nine rabbits, histological grades of liver fibrosis were grade 1 in one rabbit, grade 2 and 3 in three rabbits each, and grade 4 in two rabbits. Among the four CEUS parameters, only the peak signal intensity measured on the last day demonstrated a significant association with liver fibrosis grades (OR = 1.392, 95%CI: 1.114-1.741, P = 0.004). The difference in peak signal intensity between day 0 and the last day also demonstrated an association with liver fibrosis (OR = 1.191, 95%CI: 0.999-1.419, P = 0.051). The other parameters tested, including mean transit time, area under the curve, and time to peak, showed no significant correlation with liver fibrosis grades. This animal study demonstrates that CEUS can be used to evaluate liver fibrosis from biliary obstruction using peak signal intensity as a parameter.

Diagnostic accuracy of transabdominal ultrasonography for gallbladder polyps: systematic review.

PubMed

Martin, Erin; Gill, Richdeep; Debru, Estifanos

2018-06-01

Previous research has shown variable but generally poor accuracy of transabdominal ultrasonography in the diagnosis of gallbladder polyps. We performed a systematic review of the literature with the aim of helping surgeons interpret and apply these findings in the preoperative assessment and counselling of their patients. We searched PubMed, MEDLINE and the Cochrane database using the keywords "gallbladder," "polyp," "ultrasound," "pathology" and "diagnosis" for English-language articles published after 1990 with the full-text article available through our institutional subscriptions. Polyps were defined as immobile features that on transabdominal ultrasonography appear to arise from the mucosa and that lack an acoustic shadow, and pseudopolyps were defined as features such as inflammation, hyperplasia, cholesterolosis and adenomyomatosis that convey no risk of malignant transformation. The search returned 1816 articles, which were narrowed down to 14 primary sources involving 15 497 (range 23-13 703) patients who had preoperative transabdominal ultrasonography, underwent cholecystectomy and had postoperative pathology results available. Among the 1259 patients in whom a gallbladder polyp was diagnosed on ultrasonography, 188 polyps were confirmed as true polyps on pathologic examination, and 81 of these were found to be malignant. Of the 14 238 patients for whom a polyp was not seen on ultrasonography, 38 had a true polyp on pathologic examination, none of which were malignant. For true gallbladder polyps, transabdominal ultrasonography had a sensitivity of 83.1%, specificity of 96.3%, positive predictive value of 14.9% (7.0% for malignant polyps) and negative predictive value of 99.7%. Transabdominal ultrasonography has a high false-positive rate (85.1%) for the diagnosis of gallbladder polyps. Further study of alternative imaging modalities and reevaluation of existing management guidelines are warranted.

Impact of vocal cord ultrasonography on endocrine surgery practices.

PubMed

Carneiro-Pla, Denise; Solorzano, Carmen C; Wilhelm, Scott M

2016-01-01

It is common practice to perform flexible laryngoscopy (FL) to ensure true vocal cord (TVC) mobility in patients with previous neck operations or patients with suspected VC dysfunction. Vocal cord ultrasonography (VCUS) is accurate in identifying TVC paralysis. The goal of this study is to evaluate the impact of VCUS as the initial study to confirm TVC mobility in patients requiring preoperative FL. A total of 194 consecutive patients with indications for preoperative FL underwent VCUS. In group 1, 52 patients had FL regardless of the results of VCUS, whereas in group 2, 142 patients had VCUS followed by FL only when VCUS was unsatisfactory. VCUS visualized TVC/arytenoids in 164 of 194 (85%) patients. TVC visualization was more common in women (95%) and in patients without thyroid cartilage calcification (92%) (P < .0005). VCUS predicted all paralyzed TVC. In group 2, 76% of patients had adequate VCUS and avoided preoperative FL. Among 24% of patients in whom VCUS was inadequate, 16 had preoperative FL attributable to a lack of TVC visualization, 6 had abnormal TVC mobility, 11 needed additional confirmations, and 2 had previous FL for another reason. VCUS changed surgeon practices by avoiding the need for preoperative FL in the majority of patients. This noninvasive and sensitive method demonstrates TVC mobility and safely precludes preoperative FL in most patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluation of Abdominal Ultrasonography Mass Screening for Hepatocellular Carcinoma in Taiwan

PubMed Central

Yeh, Yen-Po; Hu, Tsung-Hui; Cho, Po-Yuan; Chen, Hsiu-Hsi; Yen, Amy Ming-Fang; Chen, Sam Li-Sheng; Chiu, Sherry Yueh-Hsia; Fann, Jean Ching-Yuan; Su, Wei-Wen; Fang, Yi-Jen; Chen, Shih-Tien; San, Hsiao-Ching; Chen, Hung-Pin; Liao, Chao-Sheng

2014-01-01

Mass screening with abdominal ultrasonography (AUS) has been suggested as a tool to control adult hepatocellular carcinoma (HCC) in individuals, but its efficacy in reducing HCC mortality has never been demonstrated. This study aimed to assess the effectiveness of reducing HCC mortality by mass AUS screening for HCC based on a program designed and implemented in the Changhua Community-based Integrated Screening (CHCIS) program with an efficient invitation scheme guided by the risk score. We invited 11,114 (27.0%) of 41,219 eligible Taiwanese subjects between 45 and 69 years of age who resided in an HCC high-incidence area to attend a risk score-guided mass AUS screening between 2008 and 2010. The efficacy of reducing HCC mortality was estimated. Of the 8,962 AUS screening attendees (with an 80.6% attendance rate), a total of 16 confirmed HCC cases were identified through community-based ultrasonography screening. Among the 16 screen-detected HCC cases, only two died from HCC, indicating a favorable survival. The cumulative mortality due to HCC (per 100,000) was considerably lower in the invited AUS group (17.26) compared with the uninvited AUS group (42.87) and the historical control group (47.51), yielding age- and gender-adjusted relative mortality rates of 0.69 (95% confidence interval [CI]: 0.56-0.84) and 0.63 (95% CI: 0.52-0.77), respectively. Conclusion: The residents invited to community-based AUS screening for HCC, compared with those who were not invited, showed a reduction in HCC mortality by ∼31% among subjects aged 45-69 years who had not been included in the nationwide vaccination program against hepatitis B virus infection. (Hepatology 2014;59:1840–1849) PMID:24002724

Sensitivity and specificity of ultrasonography and low-field magnetic resonance imaging for diagnosing arthritis.

PubMed

Broll, Matthias; Albrecht, Katinka; Tarner, Ingo; Müller-Ladner, Ulf; Strunk, Johannes

2012-01-01

To evaluate the value of grey-scale ultrasonography (US) including power Doppler ultrasonography (PDUS) and low-field magnetic resonance imaging (MRI) for the diagnosis of arthritis in a diagnostic phase III study. Fifty consecutive patients with suspected arthritis were included in the study. Following a standardised protocol, US of the carpus and the metacarpophalangeal (MCP) joints of the dominant hand was performed. Subsequently, low-field MRI was done using standard sequences, with contrast agent (Gadolinium DTPA) administered to 29 patients. In 32 out of 50 patients a clinical diagnosis of arthritis was established. In grey-scale ultrasonography including PDUS, sensitivity and specificity were determined as 0.94 and 0.5, respectively, for synovitis (effusion and hypertrophy), 0.72 and 0.94, respectively, for Doppler signals, and 0.38 and 1.0, respectively, for bone erosions. In low-field MRI, sensitivity and specificity values were 0.77 and 0.75, respectively, for synovitis (when using contrast agent), 0.48 and 0.78, respectively, for bone marrow oedema, and 0.58 and 0.83, respectively, for bone erosion. Both grey-scale ultrasonography including PDUS and low-field MRI are suitable imaging methods for diagnosing arthritis at an early stage. However, PDUS displays a higher specificity and almost the same sensitivity as compared to contrast-enhanced MRI, while being a much simpler and less costly procedure.

Advances in diagnostic ultrasonography.

PubMed

Reef, V B

1991-08-01

A wide variety of ultrasonographic equipment currently is available for use in equine practice, but no one machine is optimal for every type of imaging. Image quality is the most important factor in equipment selection once the needs of the practitioner are ascertained. The transducer frequencies available, transducer footprints, depth of field displayed, frame rate, gray scale, simultaneous electrocardiography, Doppler, and functions to modify the image are all important considerations. The ability to make measurements off of videocassette recorder playback and future upgradability should be evaluated. Linear array and sector technology are the backbone of equine ultrasonography today. Linear array technology is most useful for a high-volume broodmare practice, whereas sector technology is ideal for a more general equine practice. The curved or convex linear scanner has more applications than the standard linear array and is equipped with the linear array rectal probe, which provides the equine practitioner with a more versatile unit for equine ultrasonographic evaluations. The annular array and phased array systems have improved image quality, but each has its own limitations. The new sector scanners still provide the most versatile affordable equipment for equine general practice.

Imaging evaluation of non-alcoholic fatty liver disease: focused on quantification.

PubMed

Lee, Dong Ho

2017-12-01

Non-alcoholic fatty liver disease (NAFLD) has been an emerging major health problem, and the most common cause of chronic liver disease in Western countries. Traditionally, liver biopsy has been gold standard method for quantification of hepatic steatosis. However, its invasive nature with potential complication as well as measurement variability are major problem. Thus, various imaging studies have been used for evaluation of hepatic steatosis. Ultrasonography provides fairly good accuracy to detect moderate-to-severe degree hepatic steatosis, but limited accuracy for mild steatosis. Operator-dependency and subjective/qualitative nature of examination are another major drawbacks of ultrasonography. Computed tomography can be considered as an unsuitable imaging modality for evaluation of NAFLD due to potential risk of radiation exposure and limited accuracy in detecting mild steatosis. Both magnetic resonance spectroscopy and magnetic resonance imaging using chemical shift technique provide highly accurate and reproducible diagnostic performance for evaluating NAFLD, and therefore, have been used in many clinical trials as a non-invasive reference of standard method.

Imaging evaluation of non-alcoholic fatty liver disease: focused on quantification

PubMed Central

2017-01-01

Non-alcoholic fatty liver disease (NAFLD) has been an emerging major health problem, and the most common cause of chronic liver disease in Western countries. Traditionally, liver biopsy has been gold standard method for quantification of hepatic steatosis. However, its invasive nature with potential complication as well as measurement variability are major problem. Thus, various imaging studies have been used for evaluation of hepatic steatosis. Ultrasonography provides fairly good accuracy to detect moderate-to-severe degree hepatic steatosis, but limited accuracy for mild steatosis. Operator-dependency and subjective/qualitative nature of examination are another major drawbacks of ultrasonography. Computed tomography can be considered as an unsuitable imaging modality for evaluation of NAFLD due to potential risk of radiation exposure and limited accuracy in detecting mild steatosis. Both magnetic resonance spectroscopy and magnetic resonance imaging using chemical shift technique provide highly accurate and reproducible diagnostic performance for evaluating NAFLD, and therefore, have been used in many clinical trials as a non-invasive reference of standard method. PMID:28994271

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

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.

B-Flow Imaging in Lower Limb Peripheral Arterial Disease and Bypass Graft Ultrasonography.

PubMed

D'Abate, Fabrizio; Ramachandran, Veni; Young, Mark A; Farrah, John; Ahmed, Mudasar H; Jones, Keith; Hinchliffe, Robert J

2016-09-01

Doppler ultrasonography plays a key role in the diagnosis of peripheral arterial disease, but is often limited by pitfalls that may be overcome by B-flow imaging. Thus far, there is little information on B-flow imaging for the assessment of peripheral arterial disease and bypass grafts in lower limbs. This article describes the authors' early experience with B-flow in the lower extremities. Sixty patients were included among a large cohort of patients routinely referred to the vascular laboratory for peripheral arterial disease and bypass graft assessments. Two experienced vascular sonographers performed all scans, comparing color Doppler ultrasonography with B-flow imaging. All scans were performed using a combination of the 9 L linear and C2-9 curvilinear transducers with the LOGIQ E9 system (GE Healthcare, Waukesha, WI, USA). Our experience indicates that this relatively unexplored technology has the potential to significantly improve peripheral blood flow evaluation. Nevertheless, B-flow imaging is not exempt from limitations and should be considered complementary to color Doppler ultrasonography. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Intrarater reliability of measuring the patella position by ultrasonography in weight-bearing condition.

PubMed

Chen, Chia Lin; Lo, Chu Ling; Huang, Kai Chu; Huang, Chen Fu

2017-10-01

[Purpose] The aim of this study was to determine the intrarater reliability of using ultrasonography as a measurement tool to assess the patella position in a weight-bearing condition. [Subjects and Methods] Ten healthy adults participated in this study. Ultrasonography was used to assess the patella position during step down with the loading knee in flexion (0° and 20°). The distance between the patella and lateral condyle was measured to represent the patella position on the condylar groove. Two measurements were obtained on the first day and the day after 1 week by the same investigator. [Results] Excellent intrarater reliability, ranging from 0.83 to 0.93, was shown in both conditions. Standard errors of the measurements were 0.5 mm in the straight knee and 0.7 mm in the knee flexion at 20°. Minimal differences in knee flexion at 0° and knee flexion at 20° were 1.5 mm and 1.9 mm, respectively. [Conclusion] Ultrasonography is a reliable assessment tool for evaluating the positional changes of the patella in weight-bearing activities, and it can be easily used by practitioners in the clinical setting.

Robot-assisted laparoscopic ultrasonography for hepatic surgery.

PubMed

Schneider, Caitlin M; Peng, Peter D; Taylor, Russell H; Dachs, Gregory W; Hasser, Christopher J; DiMaio, Simon P; Choti, Michael A

2012-05-01

This study describes and evaluates a novel, robot-assisted laparoscopic ultrasonographic device for hepatic surgery. Laparoscopic liver surgery is being performed with increasing frequency. One major drawback of this approach is the limited capability of intraoperative ultrasonography (IOUS) using standard laparoscopic devices. Robotic surgery systems offer the opportunity to develop new tools to improve techniques in minimally invasive surgery. This study evaluates a new integrated ultrasonography (US) device with the da Vinci Surgical System for laparoscopic visualization, comparing it with conventional handheld laparoscopic IOUS for performing key tasks in hepatic surgery. A prototype laparoscopic IOUS instrument was developed for the da Vinci Surgical System and compared with a conventional laparoscopic US device in simulation tasks: (1) In vivo porcine hepatic visualization and probe manipulation, (2) lesion detection accuracy, and (3) biopsy precision. Usability was queried by poststudy questionnaire. The robotic US proved better than conventional laparoscopic US in liver surface exploration (85% success vs 73%; P = .030) and tool manipulation (79% vs 57%; P = .028), whereas no difference was detected in lesion identification (63 vs 58; P = .41) and needle biopsy tasks (57 vs 48; P = .11). Subjects found the robotic US to facilitate better probe positioning (80%), decrease fatigue (90%), and be more useful overall (90%) on the post-task questionnaire. We found this robot-assisted IOUS system to be practical and useful in the performance of important tasks required for hepatic surgery, outperforming free-hand laparoscopic IOUS for certain tasks, and was more subjectively usable to the surgeon. Systems such as this may expand the use of robotic surgery for complex operative procedures requiring IOUS. Copyright © 2012 Mosby, Inc. All rights reserved.

Clinical utility of magnetic resonance imaging and ultrasonography for diagnosis of polycystic ovary syndrome in adolescent girls.

PubMed

Kenigsberg, Lisa E; Agarwal, Chhavi; Sin, Sanghun; Shifteh, Keivan; Isasi, Carmen R; Crespi, Rebecca; Ivanova, Janeta; Coupey, Susan M; Heptulla, Rubina A; Arens, Raanan

2015-11-01

To evaluate ovarian morphology using three-dimensional magnetic resonance imaging (MRI) in adolescent girls with and without polycystic ovary syndrome (PCOS). Also compare the utility of MRI versus ultrasonography (US) for diagnosis of PCOS. Cross-sectional study. Urban academic tertiary-care children's hospital. Thirty-nine adolescent girls with untreated PCOS and 22 age/body mass index (BMI)-matched controls. Magnetic resonance imaging and/or transvaginal/transabdominal US. Ovarian volume (OV); follicle number per section (FNPS); correlation between OV on MRI and US; proportion of subjects with features of polycystic ovaries (PCOs) on MRI and US. Magnetic resonance imaging demonstrated larger OV and higher FNPS in subjects with PCOS compared with controls. Within the PCOS group, median OV was 11.9 (7.7) cm(3) by MRI compared with 8.8 (7.8) cm(3) by US. Correlation coefficient between OV by MRI and US was 0.701. Due to poor resolution, FNPS could not be determined by US or compared with MRI. The receiver operating characteristic curve analysis for MRI demonstrated that increasing volume cutoffs for PCOs from 10-14 cm(3) increased specificity from 77%-95%. For FNPS on MRI, specificity increased from 82%-98% by increasing cutoffs from ≥ 12 to ≥ 17. Using Rotterdam cutoffs, 91% of subjects with PCOS met PCO criteria on MRI, whereas only 52% met criteria by US. Ultrasonography measures smaller OV than MRI, cannot accurately detect follicle number, and is a poor imaging modality for characterizing PCOs in adolescents with suspected PCOS. For adolescents in whom diagnosis of PCOS remains uncertain after clinical and laboratory evaluation, MRI should be considered as a diagnostic imaging modality. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Radiologic evaluation of nonalcoholic fatty liver disease

PubMed Central

Lee, Seung Soo; Park, Seong Ho

2014-01-01

Nonalcoholic fatty liver disease (NAFLD) is a frequent cause of chronic liver diseases, ranging from simple steatosis to nonalcoholic steatohepatitis (NASH)-related liver cirrhosis. Although liver biopsy is still the gold standard for the diagnosis of NAFLD, especially for the diagnosis of NASH, imaging methods have been increasingly accepted as noninvasive alternatives to liver biopsy. Ultrasonography is a well-established and cost-effective imaging technique for the diagnosis of hepatic steatosis, especially for screening a large population at risk of NAFLD. Ultrasonography has a reasonable accuracy in detecting moderate-to-severe hepatic steatosis although it is less accurate for detecting mild hepatic steatosis, operator-dependent, and rather qualitative. Computed tomography is not appropriate for general population assessment of hepatic steatosis given its inaccuracy in detecting mild hepatic steatosis and potential radiation hazard. However, computed tomography may be effective in specific clinical situations, such as evaluation of donor candidates for hepatic transplantation. Magnetic resonance spectroscopy and magnetic resonance imaging are now regarded as the most accurate practical methods of measuring liver fat in clinical practice, especially for longitudinal follow-up of patients with NAFLD. Ultrasound elastography and magnetic resonance elastography are increasingly used to evaluate the degree of liver fibrosis in patients with NAFLD and to differentiate NASH from simple steatosis. This article will review current imaging methods used to evaluate hepatic steatosis, including the diagnostic accuracy, limitations, and practical applicability of each method. It will also briefly describe the potential role of elastography techniques in the evaluation of patients with NAFLD. PMID:24966609

Assessment of the effect of pelvic floor exercises on pelvic floor muscle strength using ultrasonography in patients with urinary incontinence: a prospective randomized controlled trial

PubMed Central

Tosun, Ozge Celiker; Solmaz, Ulas; Ekin, Atalay; Tosun, Gokhan; Gezer, Cenk; Ergenoglu, Ahmet Mete; Yeniel, Ahmet Ozgur; Mat, Emre; Malkoc, Mehtap; Askar, Niyazi

2016-01-01

[Purpose] The aim of this study was to evaluate whether the effect of pelvic floor exercises on pelvic floor muscle strength could be detected via ultrasonography in patients with urinary incontinence. [Subjects and Methods] Of 282 incontinent patients, 116 participated in the study and were randomly divided into a pelvic floor muscle training (n=65) group or control group (n=51). The pelvic floor muscle training group was given pelvic floor exercise training for 12 weeks. Both groups were evaluated at the beginning of the study and after 12 weeks. Abdominal ultrasonography measurements in transverse and longitudinal planes, the PERFECT scheme, perineometric evaluation, the stop test, the stress test, and the pad test were used to assess pelvic floor muscle strength in all cases. [Results] After training, the PERFECT, perineometry and transabdominal ultrasonography measurements were found to be significantly improved, and the stop test and pad test results were significantly decreased in the pelvic floor muscle training group, whereas no difference was observed in the control group. There was a positive correlation between the PERFECT force measurement scale and ultrasonography force measurement scale before and after the intervention in the control and pelvic floor muscle training groups (r=0.632 and r=0.642, respectively). [Conclusion] Ultrasonography can be used as a noninvasive method to identify the change in pelvic floor muscle strength with exercise training. PMID:27065519

Contrast-enhanced ultrasonography (CEUS) vs. MRI of the small bowel in the evaluation of Crohn's disease activity.

PubMed

Malagò, R; D'Onofrio, M; Mantovani, W; D'Alpaos, G; Foti, G; Pezzato, A; Caliari, G; Cusumano, D; Benini, L; Pozzi Mucelli, R

2012-03-01

The presence of disease activity in Crohn's disease (CD) is one of the main parameters used to establish whether optimal therapy should be drug therapy or surgery. However, a major problem in monitoring CD is the common mismatch between the patient's symptoms and imaging objective signs of disease activity. Bowel ultrasonography (US) has emerged as a low-cost, noninvasive technique in the diagnosis and follow-up of patients with CD. Accordingly, the use of contrast-enhanced US (CEUS) has made possible an evaluation of the vascular enhancement pattern, similar to the use of magnetic resonance imaging (MRI). The aim of our study was to evaluate the role of CEUS in comparison with small-bowel MRI for assessing Crohn's disease activity. We prospectively enrolled 30 consecutive patients with known CD. Clinical and laboratory data were compared with imaging findings obtained from MRI and CEUS of the small bowel. MRI was performed with a 1.5-T system using phased-array coils and biphasic orally administered contrast agent prior to and after gadolinium chelate administration. We performed US with a 7.5-MHz linear-array probe and a second-generation contrast agent. The parameters analysed in both techniques were the following: lesion length, wall thickness, layered wall appearance, comb sign, fibroadipose proliferation, presence of enlarged lymph nodes and stenosis. We classified parietal enhancement curves into two types in relation to the contrast pattern obtained with the time-intensity curves at MRI and CEUS: (1) quick washin, quick washout, (2) slow washin, plateau with a slow washout. Comparison between Crohn's disease activity index (CDAI) and MRI showed a low correlation, with an rho=0.398; correlation between CDAI-laboratory data and CEUS activity was low, with rho=0.354; correlation between MRI activity and CEUS activity was good, with rho = 0.791; high correlation was found between CEUS and MRI of the small bowel when assessing wall-thickness, lymph nodes and

Diagnostic utility of abdominal ultrasonography in dogs with chronic diarrhea.

PubMed

Leib, M S; Larson, M M; Grant, D C; Monroe, W E; Troy, G C; Panciera, D L; Rossmeisl, J H; Werre, S R

2012-01-01

Chronic diarrhea is common in dogs and has many causes. Ultrasonographic descriptions of many gastrointestinal diseases have been published, but the diagnostic utility of ultrasonography in dogs with chronic diarrhea has not been investigated. Diagnostic utility of abdominal ultrasound will be highest in dogs with GI neoplasia and lowest in those with inflammatory disorders. 87 pet dogs with chronic diarrhea. Prospective study in which medical records were reviewed and contribution of abdominal ultrasound toward making diagnosis was scored. In 57/87 (66%) of dogs, the same diagnosis would have been reached without ultrasonography. In 13/87 (15%) of dogs, the ultrasound examination was vital or beneficial to making the diagnosis. Univariable analysis identified that increased diagnostic utility was associated with weight loss (P = .0086), palpation of an abdominal or rectal mass (P = .0031), diseases that commonly have mass lesions visible on ultrasound examination (P < .0001), and a final diagnosis of GI neoplasia. Multivariable regression indicated that utility of abdominal ultrasonography would be 30 times more likely to be high in dogs in which an abdominal or rectal mass was palpated (odds ratio 30.5, 95% CI 5.5-169.6) (P < .0001) versus dogs without a palpable mass. In 15/87 (17%) of dogs, additional benefits of ultrasonography to case management, independent of the contribution to the diagnosis of diarrhea, were identified. Overall, the diagnostic utility of abdominal ultrasonography was low in dogs with chronic diarrhea. Identification of factors associated with high diagnostic utility is an indication to perform abdominal ultrasonography in dogs with chronic diarrhea. Copyright © 2012 by the American College of Veterinary Internal Medicine.

Retrospective comparison of abdominal ultrasonography and radiography in the investigation of feline abdominal disease

PubMed Central

Won, Wylen Wade; Sharma, Ajay; Wu, Wenbo

2015-01-01

Abdominal radiography and ultrasonography are commonly used as part of the initial diagnostic plan for cats with nonspecific signs of abdominal disease. This retrospective study compared the clinical usefulness of abdominal radiography and ultrasonography in 105 feline patients with signs of abdominal disease. The final diagnosis was determined more commonly with ultrasonography (59%) compared to radiography (25.7%). Ultrasonography was also able to provide additional clinically relevant information in 76% of cases, and changed or refined the diagnosis in 47% of cases. Based on these findings, ultrasonography may be sufficient as an initial diagnostic test for the investigation of feline abdominal disease. PMID:26483582

Teaching of clinical ultrasonography to undergraduates: students as mentors.

PubMed

García de Casasola Sánchez, G; González Peinado, D; Sánchez Gollarte, A; Muñoz Aceituno, E; Peña Vázquez, I; Torres Macho, J

2015-05-01

Ultrasonography is a highly useful diagnostic technique that supplements traditional physical examinations. To demonstrate that students previously trained in clinical ultrasonography are capable of instructing other students in a similar manner in a short period of time ("peer mentoring"). Five medical students in their 5th year, trained in abdominal and cardiac ultrasonography by physicians with experience, instructed 24 other students in the same procedure. The training consisted of an online theoretical course and practical training lasting about 12hours, in which each student had to perform 6 basic abdominal planes and 4 basic cardiac planes on 20 healthy volunteers. Subsequently, the students underwent an objective assessment test on healthy models performed by expert physicians in clinical ultrasonography. The students managed to correctly identify 90.2% of the basic abdominal planes, except for the left coronal (spleen and left kidney) and subcostal (gallbladder) planes, with slightly lower success rates of 82.5% and 80%, respectively. Due to the greater difficulty of obtaining cardiac planes, the success rate was lower: 70.3%, in the subxiphoid, short parasternal and four chamber planes. The cardiac plane with the fewest errors in identification was the parasternal long plane (90% success). We observed no statistically significant differences between the results (teaching capacity) of the various mentors. Medical students are capable of instructing other colleagues (peer mentoring) on the basic aspects of abdominal and cardiac ultrasonography after a relatively short training period. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Dynamic Ultrasonography of the Deep External Rotator Musculature of the Hip: A Descriptive Study.

PubMed

Battaglia, Patrick J; Mattox, Ross; Haun, Daniel W; Welk, Aaron B; Kettner, Norman W

2016-07-01

No detailed reports exist describing the methodology of ultrasound image acquisition of the deep external rotator muscles of the hip. Because gluteal pain and sciatica are common, ultrasound may be a useful dynamic imaging adjunct in the evaluation of these patients. To describe dynamic ultrasonography of the deep external rotator muscles of the hip for diagnostic purposes. Descriptive. University radiology department. Participants (n = 25; 14 male) without gluteal pain or sciatica were enrolled (mean age 27.6 ± 4.7 years; mean body mass index 26.0 ± 4.1 kg/m(2)). Ultrasonographic cine clips oriented to the long axis of each deep external rotator muscle were captured. In addition, cine clips of the piriformis tendon and obturator internus tendon were obtained. Cine clips were analyzed approximately 1 week after completion of image acquisition independently by 2 blinded raters. A 5-point Likert scale to evaluate the diagnostic utility of the ultrasound image. The modal Likert scores for rater 1 were as follows: piriformis muscle = 4; piriformis tendon = 4; superior gemellus muscle = 3; obturator internus muscle = 4; obturator internus tendon = 4; inferior gemellus muscle = 4; quadratus femoris muscle = 4. The modal scores for rater 2 were: piriformis muscle = 4; piriformis tendon = 3; superior gemellus muscle = 4; obturator internus muscle = 3; obturator internus tendon = 4; inferior gemellus muscle = 3; quadratus femoris muscle = 4. Dynamic ultrasonography may be useful to image the hip deep external rotator musculature for diagnostic purposes and therefore aid in the evaluation of gluteal pain and sciatica. Future work should investigate the reliability and validity of ultrasonography in the evaluation of pathology of these muscles. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Changes in ultrasonography indicators of abnormally invasive placenta during pregnancy.

PubMed

Calì, Giuseppe; Timor-Trisch, Ilan E; Palacios-Jaraquemada, Josè; Monteaugudo, Ana; Forlani, Francesco; Minneci, Gabriella; Foti, Francesca; Buca, Danilo; Familiari, Alessandra; Scambia, Giovanni; Liberati, Marco; D'Antonio, Francesco

2018-03-01

To ascertain whether the prevalence of ultrasonography signs of abnormally invasive placenta (AIP) changes during pregnancy. The present retrospective analysis included women with a prenatal diagnosis of AIP that was confirmed at delivery between January 1, 2007, and April 30, 2017, at the Department of Obstetrics and Gynaecology, Arnas Civico Hospital, Palermo, Italy. Ultrasonography signs of AIP were recorded at four different intervals during pregnancy: early first (6-9 weeks), first (11-14 weeks), second (15-24 weeks), and third trimester (25-36 weeks). There were 105 pregnancies included. Low implantation of the gestational sac was present on all ultrasonography images from the early first trimester compared with on 23 of 83 (27.7%) images from 11-14 weeks of pregnancy. The identification of loss of the clear space, placental lacunae, bladder wall interruption, and uterovesical hypervascularity all increased (all P<0.001) from the early first trimester onwards; these could all be identified in a majority of patients at 11-14 weeks of pregnancy. The prevalence of ultrasonography signs suggestive of AIP varied throughout pregnancy. During the early first trimester, indicators of AIP were similar to those of a cesarean scar pregnancy; classical ultrasonography signs of AIP were already present at 11-14 weeks of pregnancy for most patients. © 2017 International Federation of Gynecology and Obstetrics.

Ultrasonography and C-reactive protein can predict the outcomes of voiding cystography after the first urinary tract infection.

PubMed

Kido, Jun; Yoshida, Fuminori; Sakaguchi, Katsuya; Ueno, Yasushi; Yanai, Masaaki

2015-05-01

This study evaluated whether sex, clinical variables, laboratory variables or ultrasonography predicted the presence of vesicoureteric reflux during the first episode of urinary tract infection in paediatric patients. We also aimed to define the criteria that indicated the need for voiding cystography testing. We used voiding cystography to investigate 200 patients who experienced their first urinary tract infection at our institution between 2004 and 2013 and retrospectively analysed the data by reviewing their medical records. Sex (p = 0.001), peak blood C-reactive protein levels (p < 0.001), the duration of fever after antibiotic administration (p = 0.007) and the ultrasonography findings grade (p < 0.001) were significantly different between patients with and without vesicoureteric reflux. Grade IV-V ultrasonography findings and C-reactive protein levels of ≥80 mg/L predicted vesicoureteric reflux with a sensitivity, specificity and odds ratio of 47.8%, 87.8% and 6.59 (95% confidence interval = 3.26-13.33), respectively (p < 0.001). Voiding cystography should be performed for patients with C-reactive protein levels of ≥80 mg/L and grade IV-V ultrasonography findings, but is not necessary in patients with C-reactive protein levels of <80 mg/L and grade I-III ultrasonography findings. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Evaluation of arterial digital blood flow using Doppler ultrasonography in healthy dairy cows.

PubMed

Müller, H; Heinrich, M; Mielenz, N; Reese, S; Steiner, A; Starke, A

2017-06-06

Local circulatory disturbances have been implicated in the development of foot disorders in cattle. The goals of this study were to evaluate the suitability of the interdigital artery in the pastern region in both hind limbs using pulsed-wave (PW) Doppler ultrasonography and to investigate quantitative arterial blood flow variables at that site in dairy cows. An Esaote MyLabOne ultrasound machine with a 10-MHz linear transducer was used to assess blood flow in the interdigital artery in the pastern region in both hind limbs of 22 healthy German Holstein cows. The cows originated from three commercial farms and were restrained in a standing hoof trimming chute without sedation. A PW Doppler signal suitable for analysis was obtained in 17 of 22 cows. The blood flow profiles were categorised into four curve types, and the following quantitative variables were measured in three uniform cardiac cycles: vessel diameter, pulse rate, maximum systolic velocity, maximum diastolic velocity, end-diastolic velocity, reverse velocity, maximum time-averaged mean velocity, blood flow rate, resistance index and persistence index. The measurements did not differ among cows from the three farms. Maximum systolic velocity, vessel diameter and pulse rate did not differ but other variables differed significantly among blood flow profiles. Differences in weight-bearing are thought to be responsible for the normal variability of blood flow profiles in healthy cows. The scanning technique used in this report for evaluation of blood flow in the interdigital artery appears suitable for further investigations in healthy and in lame cows.

Endoscopic Ultrasonography in the Diagnosis and Treatment Strategy Choice of Esophageal Leiomyoma.

PubMed

Sun, Ling-Jia; Chen, Xin; Dai, Yi-Ning; Xu, Cheng-Fu; Ji, Feng; Chen, Li-Hua; Chen, Hong-Tan; Chen, Chun-Xiao

2017-04-01

Esophageal leiomyoma is the most common benign tumor of the esophagus, and it originates from mesenchymal tissue. This study analyzed the clinicopathological characteristics of esophageal leiomyoma and aimed to evaluate the role of endoscopic ultrasonography in the diagnosis and treatment selection for these lesions. Two hundred and twenty-five patients who had suspected esophageal leiomyomas in endoscopic ultrasonography were enrolled at the Endoscopy Center of The First Affiliated Hospital, Zhejiang University from January 1st, 2009 to May 31th, 2015. The main outcomes included the demographic and morphological characteristics, symptoms, comparisons of diagnosis and treatment methods, adverse events, and prognosis. One hundred and sixty-seven patients were diagnosed as having an esophageal leiomyoma by pathological examination. The mean patient age was 50.57±9.983 years. In total, 62.9% of the lesions originated from the muscularis mucosa, and the others originated from the muscularis propria. The median distance to the incisors was 30±12 cm. The median diameter was 0.72±0.99 cm. As determined by endoscopic ultrasonography, most existing leiomyomas were homogeneous, endophytic, and spherical. The leiomyomas from the muscularis mucosa were smaller than those from the muscularis propria and much closer to the incisors (p<0.05). SMA (smooth muscle antibody) (97.2%) and desmin (94.5%) were positive in the majority of patients. In terms of treatments, patients preferred endoscopic therapies, which led to less adverse events (e.g., intraoperative bleeding, local infection, pleural effusion) than surgical operations (p<0.05). The superficial leiomyomas presented less adverse events and better recovery (p<0.05) than deep leiomyomas. Endoscopic ultrasonography has demonstrated high accuracy in the diagnosis of esophageal leiomyomas and provides great support in selecting treatments; however, EUS cannot completely avoid misdiagnosis, so combining it with other

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tercan, Fahri; Oguzkurt, Levent; Ozkan, Ugur

2008-05-15

The purpose of this study was to compare the technical success and complication rates of ultrasonography-guided central venous catheterization between adult and pediatric patients which have not been reported previously. In a 4-year period, 859 ultrasonography-guided central vein catheterizations in 688 adult patients and 247 catheterizations in 156 pediatric patients were retrospectively evaluated. Mean age was 56.3 years (range, 18 to 95 years) for adults and 3.3 years (range, 0.1 to 16.3 years) for children. The preferred catheterization site was internal jugular vein in 97% of adults and 85% of children. The technical success rate, mean number of punctures, andmore » 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.« less

Enteral nutrition tube placement assisted by ultrasonography in patients with severe acute pancreatitis

PubMed Central

Li, Gang; Pan, Yiyuan; Zhou, Jing; Tong, Zhihui; Ke, Lu; Li, Weiqin

2017-01-01

Abstract To evaluate the effect of a novel procedure using real-time ultrasonography to assist nasojejunal tube placement at bedside in patients with severe acute pancreatitis (SAP). Single center, prospective descriptive study in a 15-bed surgery intensive care unit of a university hospital. Thirty SAP patients were enrolled. The whole procedure of placing nasojejunal tube was performed by a single physician, who places nasojejunal tube at the bedside and performs ultrasonography to guide the tube positioning. The final nasojejunal tube position was confirmed by abdominal radiograph. The successful rate of the procedure as well as the time it took, the time from the decision of enteral feeding to commencement of feeding, and complications were recorded. Thirty-six intubations were performed in 30 patients by using ultrasonography-assisted method at bedside. Nasojejunal tubes were successful placed in 28 of 30 patients (93.3%). The average time of successful placement was 22.07 ± 5.78 minutes. The median time between physician's decision for tube placement and feeding initiation was 5.5 (2, 24) hours. No adverse events occurred in all of patients. This novel method of nasojejunal tube placement under ultrasound guidance is practical, less time consuming and reliable. PMID:29137035

Accurate evaluation of exchange fields in finite element micromagnetic solvers

NASA Astrophysics Data System (ADS)

Chang, R.; Escobar, M. A.; Li, S.; Lubarda, M. V.; Lomakin, V.

2012-04-01

Quadratic basis functions (QBFs) are implemented for solving the Landau-Lifshitz-Gilbert equation via the finite element method. This involves the introduction of a set of special testing functions compatible with the QBFs for evaluating the Laplacian operator. The results by using QBFs are significantly more accurate than those via linear basis functions. QBF approach leads to significantly more accurate results than conventionally used approaches based on linear basis functions. Importantly QBFs allow reducing the error of computing the exchange field by increasing the mesh density for structured and unstructured meshes. Numerical examples demonstrate the feasibility of the method.

Diagnostic utility of abdominal ultrasonography in dogs with chronic vomiting.

PubMed

Leib, M S; Larson, M M; Panciera, D L; Troy, G C; Monroe, W E; Rossmeisl, J H; Forrester, S D; Herring, E S

2010-01-01

Chronic vomiting is a common problem in dogs that has many causes. Ultrasonographic descriptions of many gastrointestinal (GI) diseases have been published. However, diagnostic utility of ultrasonography in dogs with chronic vomiting has not been investigated. Diagnostic utility of abdominal ultrasound will be highest in dogs with GI neoplasia and lowest in those with inflammatory disorders. Eighty-nine pet dogs with chronic vomiting. Medical records were reviewed and the contribution of abdominal ultrasound to the clinical diagnosis was subjectively scored. In 68.5% of dogs, the reviewers thought that the same diagnosis would have been reached without performing ultrasonography. In 22.5% of dogs, the ultrasound examination was considered to be vital or beneficial to the diagnosis. Univariable analysis identified that increased diagnostic utility was associated with increasing age, a greater number of vomiting episodes per week, presence of weight loss, a greater percentage of lost body weight, and a final diagnosis of GI lymphoma or gastric adenocarcinoma. However, multivariate analysis only identified increasing age and a final diagnosis of gastric adenocarcinoma or GI lymphoma to be associated with increased diagnostic utility. In 12.4% of dogs, additional benefits of ultrasonography to case management, excluding the contribution to the vomiting problem, were identified. The diagnostic utility of abdominal ultrasonography was high in 27% of dogs. The presence of factors that are associated with high diagnostic utility is an indication to perform abdominal ultrasonography in dogs with chronic vomiting.

Evaluation of phrenic nerve and diaphragm function with peripheral nerve stimulation and M-mode ultrasonography in potential pediatric phrenic nerve or diaphragm pacing candidates.

PubMed

Skalsky, Andrew J; Lesser, Daniel J; McDonald, Craig M

2015-02-01

Assessing phrenic nerve function in the setting of diaphragmatic paralysis in diaphragm pacing candidates can be challenging. Traditional imaging modalities and electrodiagnostic evaluations are technically difficult. Either modality alone is not a direct measure of the function of the phrenic nerve and diaphragm unit. In this article, the authors present their method for evaluating phrenic nerve function and the resulting diaphragm function. Stimulating the phrenic nerve with transcutaneous stimulation and directly observing the resulting movement of the hemidiaphragm with M-mode ultrasonography provides quantitative data for predicting the success of advancing technologies such as phrenic nerve pacing and diaphragm pacing. Copyright © 2015 Elsevier Inc. All rights reserved.

Use of dynamic 3-dimensional transvaginal and transrectal ultrasonography to assess posterior pelvic floor dysfunction related to obstructed defecation.

PubMed

Murad-Regadas, Sthela M; Regadas Filho, Francisco Sergio Pinheiro; Regadas, Francisco Sergio Pinheiro; Rodrigues, Lusmar Veras; de J R Pereira, Jacyara; da S Fernandes, Graziela Olivia; Dealcanfreitas, Iris Daiana; Mendonca Filho, Jose Jader

2014-02-01

New ultrasound techniques may complement current diagnostic tools, and combined techniques may help to overcome the limitations of individual techniques for the diagnosis of anorectal dysfunction. A high degree of agreement has been demonstrated between echodefecography (dynamic 3-dimensional anorectal ultrasonography) and conventional defecography. Our aim was to evaluate the ability of a combined approach consisting of dynamic 3-dimensional transvaginal and transrectal ultrasonography by using a 3-dimensional biplane endoprobe to assess posterior pelvic floor dysfunctions related to obstructed defecation syndrome in comparison with echodefecography. This was a prospective, observational cohort study conducted at a tertiary-care hospital. Consecutive female patients with symptoms of obstructed defecation were eligible. Each patient underwent assessment of posterior pelvic floor dysfunctions with a combination of dynamic 3-dimensional transvaginal and transrectal ultrasonography by using a biplane transducer and with echodefecography. Kappa (κ) was calculated as an index of agreement between the techniques. Diagnostic accuracy (sensitivity, specificity, and positive and negative predictive values) of the combined technique in detection of posterior dysfunctions was assessed with echodefecography as the standard for comparison. A total of 33 women were evaluated. Substantial agreement was observed regarding normal relaxation and anismus. In detecting the absence or presence of rectocele, the 2 methods agreed in all cases. Near-perfect agreement was found for rectocele grade I, grade II, and grade III. Perfect agreement was found for entero/sigmoidocele, with near-perfect agreement for rectal intussusception. Using echodefecography as the standard for comparison, we found high diagnostic accuracy of transvaginal and transrectal ultrasonography in the detection of posterior dysfunctions. This combined technique should be compared with other dynamic techniques and

Imaging of juvenile spondyloarthritis. Part II: Ultrasonography and magnetic resonance imaging

PubMed Central

Znajdek, Michał; Gietka, Piotr; Vasilevska-Nikodinovska, Violeta; Patrovic, Lukas; Salapura, Vladka

2017-01-01

Juvenile spondyloarthropathies are mainly manifested by symptoms of peripheral arthritis and enthesitis. Early involvement of sacroiliac joints and spine is exceptionally rare in children; this usually happens in adulthood. Conventional radiographs visualize late inflammatory lesions. Early diagnosis is possible with the use of ultrasonography and magnetic resonance imaging. The first part of the article presented classifications and radiographic presentation of juvenile spondyloarthropathies. This part discusses changes seen on ultrasonography and magnetic resonance imaging. In patients with juvenile spondyloarthropathies, these examinations are conducted to diagnose inflammatory lesions in peripheral joints, tendon sheaths, tendons and bursae. Moreover, magnetic resonance also shows subchondral bone marrow edema, which is considered an early sign of inflammation. Ultrasonography and magnetic resonance imaging do not show specific lesions for any rheumatic disease. Nevertheless, they are conducted for early diagnosis, treatment monitoring and identifying complications. This article presents a spectrum of inflammatory changes and discusses the diagnostic value of ultrasonography and magnetic resonance imaging. PMID:29075522

The value of ultrasonography alone in screening surveys of cystic echinococcosis in children in Turkey.

PubMed

Kilimcioğlu, Ali A; Ozkol, Mine; Bayindir, Petek; Girginkardeşler, Nogay; Ostan, Ipek; Ok, Ulgen Z

2006-12-01

A total of 1,205 primary school children were examined for cystic echinococcosis in five villages of Manisa, Turkey, to evaluate the efficacy of diagnostic methods of this infection in community-based screening surveys. Six hundred and thirty children from three villages, examined by a portable ultrasound scanner, chest microfilm and serological methods (ELISA, indirect hemagglutination) in our previous study, were designated as Study Group 1; and 575 children, from two adjacent villages, examined by ultrasonography alone in the present study, were designated as Study Group 2. In Study Group 1, hepatic cystic echinococcosis was detected in two cases (0.3%) by ultrasonography, while 43 (8.9%) and 49 (10.1%) cases were found to be positive for cystic echinococcosis by ELISA and indirect hemagglutination, respectively. Three of 575 children (0.5%) were diagnosed with cystic echinococcosis (two hepatic and one renal involvement) by ultrasonography alone in Study Group 2; and lung lesions were later detected in both cases with liver involvement by chest radiography. Our results suggested that serological tests may be beneficial in suspected cases for confirmation and differential diagnosis, but have some drawbacks, such as discrepancy in results and high false seropositivity rates. Chest microfilm is not easy in field studies and exposure to X-ray is undesirable. As a reliable, simple, inexpensive and rapid technique, ultrasonography alone is recommended to be used in community-based screening surveys for cystic echinococcosis with confirmatory tests for suspected cases found during the screening program.

Feasibility and Safety of Substituting Lung Ultrasonography for Chest Radiography When Diagnosing Pneumonia in Children: A Randomized Controlled Trial.

PubMed

Jones, Brittany Pardue; Tay, Ee Tein; Elikashvili, Inna; Sanders, Jennifer E; Paul, Audrey Z; Nelson, Bret P; Spina, Louis A; Tsung, James W

2016-07-01

Chest radiography (CXR) is the test of choice for diagnosing pneumonia. Lung ultrasonography (LUS) has been shown to be accurate for diagnosing pneumonia in children and may be an alternative to CXR. Our objective was to determine the feasibility and safety of substituting LUS for CXR when evaluating children suspected of having pneumonia. We conducted a randomized control trial comparing LUS with CXR in 191 children from birth to 21 years of age suspected of having pneumonia in an ED. Patients in the investigational arm underwent LUS. If there was clinical uncertainty after ultrasonography, physicians had the option to perform CXR. Patients in the control arm underwent sequential imaging with CXR followed by LUS. The primary outcome was the rate of CXR reduction; secondary outcomes were missed pneumonia, subsequent unscheduled health-care visits, and adverse events between the investigational and control arms. There was a 38.8% reduction (95% CI, 30.0%-48.9%) in CXR among investigational subjects compared with no reduction (95% CI, 0.0%-3.6%) in the control group. Novice and experienced physician-sonologists achieved 30.0% and 60.6% reduction in CXR use, respectively. There were no cases of missed pneumonia among all study participants (investigational arm, 0.0%: 95% CI, 0.0%-2.9%; control arm, 0.0%: 95% CI, 0.0%-3.0%), or differences in adverse events, or subsequent unscheduled health-care visits between arms. It may be feasible and safe to substitute LUS for CXR when evaluating children suspected of having pneumonia with no missed cases of pneumonia or increase in rates of adverse events. ClinicalTrials.gov; No.: NCT01654887; URL: www.clinicaltrials.gov. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Shear-wave elastography in breast ultrasonography: the state of the art

PubMed Central

2017-01-01

Shear-wave elastography (SWE) is a recently developed ultrasound technique that can visualize and measure tissue elasticity. In breast ultrasonography, SWE has been shown to be useful for differentiating benign breast lesions from malignant breast lesions, and it has been suggested that SWE enhances the diagnostic performance of ultrasonography, potentially improving the specificity of conventional ultrasonography using the Breast Imaging Reporting and Data System criteria. More recently, not only has SWE been proven useful for the diagnosis of breast cancer, but has also been shown to provide valuable information that can be used as a preoperative predictor of the prognosis or response to chemotherapy. PMID:28513127

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

[Ultrasonography of the lower urethra in male sheep lambs].

PubMed

AlLugami, Ammar; von Pückler, Kerstin; Sickinger, Marlene

2018-06-01

In male small ruminants, voiding disturbances are not uncommon. A precise knowledge of the underlying disease is essential for prognostic evaluation as well as for a decision concerning the therapeutic approach. Common reasons for voiding disturbances in the male small ruminant are obstructive urolithiasis, traumata of the penis or inflammatory processes within the urethra or urinary bladder. The diagnostic method of choice - in addition to clinical examination - is diagnostic imaging. Because radiology is not always possible under field conditions, the aim of this article is a detailed presentation of ultrasonography of the distal urethra of the male lamb. Schattauer GmbH.

Ultrasonography and magnetic resonance imaging in the diagnosis of Morton's neuroma.

PubMed

Fazal, Muhammad Ali; Khan, Ishrat; Thomas, Cherian

2012-01-01

Magnetic resonance imaging (MRI) and ultrasonography are used widely for the diagnosis of Morton's neuroma. The aim of this study was to assess the accuracy of these two modalities as diagnostic tools in Morton's neuroma. Fifty feet of 47 consecutive patients (39 women and 8 men; mean age, 46 years; age range, 36-64 years) who presented between January 1, 2005, and June 30, 2008, were included in the study. Twenty-five feet were investigated with ultrasonography and 25 with MRI. Morton's neuroma was confirmed surgically and histologically in all of the patients. A Student unpaired t test was applied. Twenty-two MRIs were diagnostic (sensitivity, 88%). Three patients with negative MRI findings underwent ultrasonography and were found to have a neuroma smaller than 5 mm. Twenty-four ultrasound scans demonstrated the neuroma (sensitivity, 96%), with five neuromas being smaller than 5 mm. Ultrasonography has a slightly higher sensitivity in the diagnosis of Morton's neuroma, particularly of neuromas smaller than 5 mm, and should be the preferred imaging modality in suspected cases, and MRI should be reserved for cases with equivocal diagnosis.

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

PubMed Central

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

2010-01-01

The present study was conducted on 101 animals suffering from thoracoabdominal disorders; out of which twenty seven animals (twenty six buffaloes and one cow) were diagnosed with diaphragmatic hernia based on clinical signs, radiography, ultrasonography, and left flank laparorumenotomy. Radiography alone confirmed diaphragmatic hernia in 18 cases (66.67%) with a sac-like structure cranial to the diaphragm. In 15 animals the sac contained metallic densities while in three cases a sac-like structure with no metallic densities was present. Ultrasonography was helpful in confirming diaphragmatic hernia in 23 cases (85.18%) and ultrasonographically reticular motility was evident at the level of 4th/5th intercostal space in all the animals. B+M mode ultrasonography was used for the first time for diagnosis of diaphragmatic hernia in bovines and the results suggested that ultrasonography was a reliable diagnostic modality for diaphragmatic hernia in bovines. PMID:20445795

Comparison of the diagnostic value of ultrasonography and standing radiography for pelvic-femoral disorders in horses.

PubMed

Geburek, Florian; Rötting, Anna K; Stadler, Peter M

2009-04-01

To assess agreement between ultrasonography (transcutaneous and transrectal) and standing radiography in horses with fractures in the pelvic region and disorders of the coxofemoral joint. Case series. Warmblood horses (n=23) and 2 ponies. Medical records (1999-2008) of equids with pelvic or coxofemoral disorders that had pelvic radiography and ultrasonography were retrieved and results of both techniques compared. Radiography and ultrasonography each identified equal numbers of fractures of the tuber coxa (n=4), ilial shaft (2), ischium (3), femoral neck (2), and osteoarthritis/osis of the coxofemoral joint (6). Fractures of the ilial wing (4) were only identified by ultrasonography not by standing radiography. Of 9 acetabular fractures, 3 were identified on radiographs only, 5 were identified with both modalities. One pubic fracture was identified using ultrasonography and radiography. One acetabular and 1 pubic fracture were only diagnosed on necropsy. We found reasonable agreement (73%; 24/33) between ultrasonography and standing radiography for diagnosis of pelvic-femoral disorders. Ultrasonography was more useful for ilial wing fractures and radiography for acetabular fractures. Ultrasonography is a rapid, safe imaging technique for detecting disorders of the pelvic region with a high diagnostic yield and is a preferred initial approach in horses with severe hindlimb lameness.

Age, tumor size, and in-office ultrasonography are predictive parameters of malignancy in follicular neoplasms of the thyroid.

PubMed

Paramo, Juan C; Mesko, Thomas

2008-01-01

To identify clinical predictors of malignancy in patients with intraoperative frozen-section diagnosis of follicular neoplasm of the thyroid. We performed a retrospective cross-sectional study of 71 patients with intraoperative frozen-section diagnosis of follicular neoplasm who underwent thyroidectomy between January 1992 and December 2000. Age, sex, tumor size, and in-office ultrasonography characteristics of the lesions were assessed. These clinical factors were compared between cases that had benign definitive pathologic findings and those that were found to be carcinomas on permanent sections. Nine (13%) of the 71 follicular neoplasms were found to be carcinomas after definitive pathologic evaluation. The incidence of malignancy was 13% (2/16) in men and 13% (7/55) in women (P>.5). Patients younger than 45 years had a 27% (8/30) incidence of malignancy compared with 2% (1/41) in patients 45 years or older (P<.01). Of tumors smaller than 4 cm, 7% (4/55) were ultimately diagnosed as carcinomas compared with 31% (5/16) of those 4 cm or larger (P = .05). When the in-office ultrasonography findings were interpreted as benign, only 7% (3/46) of cases were malignant compared with 40% (4/10) when the ultrasonography findings were suspicious (P = .02). Age and tumor size are predictive parameters of malignancy in follicular neoplasm of the thyroid. Suspicious ultrasonography findings also have an important predictive role. Total thyroidectomy is reasonable in patients with follicular neoplasm on frozen section if they are young (<45 years old), with large (>4 cm) tumors or if there are suspicious findings on in-office ultrasonography.

Mobile kidney pain provocation ultrasonography before surgery for symptomatic mobile kidney: A prospective study of 43 consecutive patients.

PubMed

Arnerlöv, Conny; Söderström, Minette; Öhberg, Lars

2016-01-01

The aim of this study was to evaluate whether mobile kidney pain provocation ultrasonography together with intravenous pyelography in supine and standing positions and a full medical history can confirm the diagnosis of the clinical condition of symptomatic mobile kidney and aid the selection of patients for surgical treatment. In a consecutive study, 43 patients with the clinical picture of symptomatic mobile kidney, a positive mobile kidney pain provocation ultrasonography and a renal descent of at least 2 lumbar vertebral heights on intravenous pyelography in the standing position, were operated on with nephropexy. Patients' pain relief after nephropexy was evaluated by clinical follow-up, a questionnaire and visual analogue scale (VAS) scoring. Reduction of pain after nephropexy was associated with a significant decrease in VAS scoring from a median of 8 (range 4-10) preoperatively to a median of 0 (range 0-7) postoperatively (p < 0.001). Thirty-four patients (79%) were cured of their pain and seven patients (16%) experienced substantial relief from their pain symptoms. In two patients (5%) the symptoms were unchanged. The results indicate that mobile kidney pain provocation ultrasonography and intravenous pyelography in supine and standing positions can verify the diagnosis of symptomatic mobile kidney and aid the selection of patients who will benefit from nephropexy.

Evaluation of joint effusion in rabbits by color Doppler, power Doppler, and contrast-enhanced power Doppler ultrasonography.

PubMed

Lim, Gye-Yeon; Im, Soo Ah; Jung, Won Sang; Lee, Jae Mun; Lee, Ah Won

2005-09-01

The aim of this prospective study was to evaluate the diagnostic value of power Doppler ultrasonography (PDUS) and contrast-enhanced PDUS (CEPDUS) in the depiction and characterization of experimentally induced arthritis in the rabbit. Thirty rabbits were divided into three groups consisting of one control group (saline injection group) and two experimental groups: a suppurative arthritis group and a chemically induced synovitis group. The same amount (1 ml) of each agent was directly injected into the right hip joint. Serial color Doppler ultrasound (CDUS), PDUS, and CEPDUS images were obtained before and after injection. We observed that all of the infected knees in the suppurative arthritis group with Staphylococcus aureus demonstrated an increased signal on PDUS after inoculation. A minimal power Doppler signal was presented in the chemically induced synovitis group with talc injection, but none of the control knees demonstrated any increased signals. CEPDUS was the most sensitive imaging modality for evaluating the increase of blood flows in suppurative arthritis and was subsequently followed by PDUS and CDUS. The increased signals obtained with PDUS represent increased local blood flows; therefore, this technique can be used for evaluating the degree of inflammation. Furthermore, using the contrast agent enhances the sensitivity of PDUS, and it can even be useful for differentiating borderline cases. Copyright 2005 Wiley Periodicals, Inc

Correlation Between Echodefecography and 3-Dimensional Vaginal Ultrasonography in the Detection of Perineal Descent in Women With Constipation Symptoms.

PubMed

Murad-Regadas, Sthela M; Pinheiro Regadas, Francisco Sergio; Rodrigues, Lusmar V; da Silva Vilarinho, Adjra; Buchen, Guilherme; Borges, Livia Olinda; Veras, Lara B; da Cruz, Mariana Murad

2016-12-01

Defecography is an established method of evaluating dynamic anorectal dysfunction, but conventional defecography does not allow for visualization of anatomic structures. The purpose of this study was to describe the use of dynamic 3-dimensional endovaginal ultrasonography for evaluating perineal descent in comparison with echodefecography (3-dimensional anorectal ultrasonography) and to study the relationship between perineal descent and symptoms and anatomic/functional abnormalities of the pelvic floor. This was a prospective study. The study was conducted at a large university tertiary care hospital. Consecutive female patients were eligible if they had pelvic floor dysfunction, obstructed defecation symptoms, and a score >6 on the Cleveland Clinic Florida Constipation Scale. Each patient underwent both echodefecography and dynamic 3-dimensional endovaginal ultrasonography to evaluate posterior pelvic floor dysfunction. Normal perineal descent was defined on echodefecography as puborectalis muscle displacement ≤2.5 cm; excessive perineal descent was defined as displacement >2.5 cm. Of 61 women, 29 (48%) had normal perineal descent; 32 (52%) had excessive perineal descent. Endovaginal ultrasonography identified 27 of the 29 patients in the normal group as having anorectal junction displacement ≤1 cm (mean = 0.6 cm; range, 0.1-1.0 cm) and a mean anorectal junction position of 0.6 cm (range, 0-2.3 cm) above the symphysis pubis during the Valsalva maneuver and correctly identified 30 of the 32 patients in the excessive perineal descent group. The κ statistic showed almost perfect agreement (κ = 0.86) between the 2 methods for categorization into the normal and excessive perineal descent groups. Perineal descent was not related to fecal or urinary incontinence or anatomic and functional factors (sphincter defects, pubovisceral muscle defects, levator hiatus area, grade II or III rectocele, intussusception, or anismus). The study did not include a

[Technique of abdominal ultrasonography in newborn foals and normal findings].

PubMed

Behn, C; Bostedt, H

2000-09-01

Under field conditions, the diagnosis of foal's diseases relies almost exclusively on the physical examination. As the signs of illness in the equine neonate are frequently vage and non-localizing, the diagnosis of diseases may be problematic. This often causes misinterpretations and leads to ineffective prophylaxis and treatment. The purpose of this study was to evaluate the usefulness of diagnostic ultrasonography of the foal's abdomen under field conditions to provide an optimized technique and to describe the normal findings. Diagnostic ultrasonography of the abdomen was performed after obtaining clinical history and passing the physical examination of 25 foals without signs of abdominal problems. The foals were scanned in a stable box, being restrained by three persons in semi-lateral recumbency. Usually, sedation was not necessary. The ventral abdominal wall was clipped, a generous amount of ultrasound coupling gel was applied and massaged on the skin surface. The ultrasonographic examination was carried out using a portable sector scanner ("Microimager 2000", Ausonics) with 5.0 and 7.5-MHz transducers or a combined 5.0 and 7.5-MHz transrectal linear-array scanner ("450 Enhanced", Pie Medical). Employing the 5.0-MHz sector scanner first, the abdomen was explored from caudal to cranial in left and right semi-lateral recumbency. The 7.5-MHz scanner was used to attain higher resolution of certain structures. The sector scanner turned out to be suitable under field conditions and adequate to examine the abdominal organs. The transrectal linear-array scanner also provided the most important informations, although it was difficult to maintain a good contact area of the scan head. By ultrasonography it was possible to identify the urinary bladder, kidneys, spleen, liver and part of the gastrointestinal tract. Thus, application of ultrasound could successfully be performed on newborn foals under field conditions.

Chest ultrasonography for the emergency diagnosis of traumatic pneumothorax and haemothorax: A systematic review and meta-analysis.

PubMed

Staub, Leonardo Jönck; Biscaro, Roberta Rodolfo Mazzali; Kaszubowski, Erikson; Maurici, Rosemeri

2018-03-01

haemothorax, with a sensitivity of 0.60 (95%CI, 0.31-0.86), specificity of 0.98 (95%CI, 0.94-0.99), LR+ of 37.5 (95%CI, 5.26-207.5), LR- of 0.40 (95%CI, 0.17-0.72) and AUC of 0.953. Notwithstanding the limitations of the included studies, this systematic review and meta-analysis suggested that chest ultrasonography is an accurate tool for the diagnostic assessment of traumatic pneumothorax and haemothorax in adults. Copyright © 2018 Elsevier Ltd. All rights reserved.

Clinical usefulness of endoscopic ultrasonography for the evaluation of ulcerative colitis-associated tumors

PubMed Central

Kobayashi, Kiyonori; Kawagishi, Kana; Ooka, Shouhei; Yokoyama, Kaoru; Sada, Miwa; Koizumi, Wasaburo

2015-01-01

AIM: To evaluate the clinical usefulness of endoscopic ultrasonography (EUS) for the diagnosis of the invasion depth of ulcerative colitis-associated tumors. METHODS: The study group comprised 13 patients with 16 ulcerative colitis (UC)-associated tumors for which the depth of invasion was preoperatively estimated by EUS. The lesions were then resected endoscopically or by surgical colectomy and were examined histopathologically. The mean age of the subjects was 48.2 ± 17.1 years, and the mean duration of UC was 15.8 ± 8.3 years. Two lesions were treated by endoscopic resection and the other 14 lesions by surgical colectomy. The depth of invasion of UC-associated tumors was estimated by EUS using an ultrasonic probe and was evaluated on the basis of the deepest layer with narrowing or rupture of the colonic wall. RESULTS: The diagnosis of UC-associated tumors by EUS was carcinoma for 13 lesions and dysplasia for 3 lesions. The invasion depth of the carcinomas was intramucosal for 8 lesions, submucosal for 2, the muscularis propria for 2, and subserosal for 1. Eleven (69%) of the 16 lesions arose in the rectum. The macroscopic appearance was the laterally spreading tumor-non-granular type for 4 lesions, sessile type for 4, laterally spreading tumor-granular type for 3, semi-pedunculated type (Isp) for 2, type 1 for 2, and type 3 for 1. The depth of invasion was correctly estimated by EUS for 15 lesions (94%) but was misdiagnosed as intramucosal for 1 carcinoma with high-grade submucosal invasion. The 2 lesions treated by endoscopic resection were intramucosal carcinoma and dysplasia, and both were diagnosed as intramucosal lesions by EUS. CONCLUSION: EUS provides a good estimation of the invasion depth of UC-associated tumors and may thus facilitate the selection of treatment. PMID:25759538

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

Application of Ultrasonography and Radiography in Detection of Hemothorax; a Systematic Review and Meta-Analysis.

PubMed

Rahimi-Movaghar, Vafa; Yousefifard, Mahmoud; Ghelichkhani, Parisa; Baikpour, Masoud; Tafakhori, Abbas; Asady, Hadi; Faridaalaee, Gholamreza; Hosseini, Mostafa; Safari, Saeed

2016-01-01

Hemothorax is one of the most prevalent injuries caused by thoracic traumas. Early detection and treatment of this injury is of utmost importance in prognosis of the patient, but there are still controversial debates on the diagnostic value of imaging techniques in detection of hemothorax. Therefore, the present study aimed to evaluate the diagnostic value of chest ultrasonography and radiography in detection of hemothorax through a systematic review and meta-analysis. Two independent reviewers performed an extended systematic search in databases of Medline, EMBASE, ISI Web of Knowledge, Scopus, Cochrane Library, and ProQuest. Data were extract and quality of the relevant studies were assessed. The number of true positive, false positive, true negative and false negative cases were extracted and screening performance characteristics of two imaging techniques were calculated using a mixed-effects binary regression model. Data from 12 studies were extracted and included in the meta-analysis (7361 patients, 77.1% male). Pooled sensitivity and specificity of ultrasonography in detection of hemothorax were 0.67 (95% CI: 0.41-0.86; I2= 68.38, p<0.001) and 0.99 (95% CI: 0.95-1.0; I2= 88.16, p<0.001), respectively. These measures for radiography were 0.54 (95% CI: 0.33-0.75; I2= 92.85, p<0.001) and 0.99 (95% CI: 0.94-1.0; I2= 99.22, p<0.001), respectively. Subgroup analysis found operator of the ultrasonography device, frequency of the transducer and sample size to be important sources of heterogeneity of included studies. The results of this study showed that although the sensitivity of ultrasonography in detection of hemothorax is relatively higher than radiography, but it is still at a moderate level (0.67%). The specificity of both imaging modalities were found to be at an excellent level in this regard. The screening characteristics of ultrasonography was found to be influenced of the operator and frequency of transducer.

Application of Ultrasonography and Radiography in Detection of Hemothorax; a Systematic Review and Meta-Analysis

PubMed Central

Rahimi-Movaghar, Vafa; Yousefifard, Mahmoud; Ghelichkhani, Parisa; Baikpour, Masoud; Tafakhori, Abbas; Asady, Hadi; Faridaalaee, Gholamreza; Hosseini, Mostafa; Safari, Saeed

2016-01-01

Introduction: Hemothorax is one of the most prevalent injuries caused by thoracic traumas. Early detection and treatment of this injury is of utmost importance in prognosis of the patient, but there are still controversial debates on the diagnostic value of imaging techniques in detection of hemothorax. Therefore, the present study aimed to evaluate the diagnostic value of chest ultrasonography and radiography in detection of hemothorax through a systematic review and meta-analysis. Methods: Two independent reviewers performed an extended systematic search in databases of Medline, EMBASE, ISI Web of Knowledge, Scopus, Cochrane Library, and ProQuest. Data were extract and quality of the relevant studies were assessed. The number of true positive, false positive, true negative and false negative cases were extracted and screening performance characteristics of two imaging techniques were calculated using a mixed-effects binary regression model. Results: Data from 12 studies were extracted and included in the meta-analysis (7361 patients, 77.1% male). Pooled sensitivity and specificity of ultrasonography in detection of hemothorax were 0.67 (95% CI: 0.41-0.86; I2= 68.38, p<0.001) and 0.99 (95% CI: 0.95-1.0; I2= 88.16, p<0.001), respectively. These measures for radiography were 0.54 (95% CI: 0.33-0.75; I2= 92.85, p<0.001) and 0.99 (95% CI: 0.94-1.0; I2= 99.22, p<0.001), respectively. Subgroup analysis found operator of the ultrasonography device, frequency of the transducer and sample size to be important sources of heterogeneity of included studies. Conclusion: The results of this study showed that although the sensitivity of ultrasonography in detection of hemothorax is relatively higher than radiography, but it is still at a moderate level (0.67%). The specificity of both imaging modalities were found to be at an excellent level in this regard. The screening characteristics of ultrasonography was found to be influenced of the operator and frequency of transducer

Medical auditing of whole-breast screening ultrasonography

PubMed Central

2017-01-01

Since breast ultrasonography (US) has been used as an adjunctive screening modality in women with dense breasts, the need has arisen to evaluate and monitor its possible harm and benefits in comparison with other screening modalities such as mammography. Recently, the fifth edition of the Breast Imaging Reporting and Data System published by the American College of Radiology has suggested auditing methods for screening breast US. However, the method proposed therein is slightly different from how diagnostic performance was calculated in previous studies on screening breast US. In this article, the background and core aspects of medical audits of breast cancer screening will be reviewed to provide an introduction to the medical auditing of screening breast US, with the goal of helping radiologists to understand and identify potential ways to improve outcomes. PMID:28322034

Medical auditing of whole-breast screening ultrasonography.

PubMed

Kim, Min Jung

2017-07-01

Since breast ultrasonography (US) has been used as an adjunctive screening modality in women with dense breasts, the need has arisen to evaluate and monitor its possible harm and benefits in comparison with other screening modalities such as mammography. Recently, the fifth edition of the Breast Imaging Reporting and Data System published by the American College of Radiology has suggested auditing methods for screening breast US. However, the method proposed therein is slightly different from how diagnostic performance was calculated in previous studies on screening breast US. In this article, the background and core aspects of medical audits of breast cancer screening will be reviewed to provide an introduction to the medical auditing of screening breast US, with the goal of helping radiologists to understand and identify potential ways to improve outcomes.

Transvaginal duplex ultrasonography appears to be the gold standard investigation for the haemodynamic evaluation of pelvic venous reflux in the ovarian and internal iliac veins in women.

PubMed

Whiteley, M S; Dos Santos, S J; Harrison, C C; Holdstock, J M; Lopez, A J

2015-12-01

To assess the suitability of transvaginal duplex ultrasonography to identify pathological reflux in the ovarian and internal iliac veins in women. A retrospective study of patients treated in 2011 and 2012 was performed in a specialised vein clinic. Diagnostic transvaginal duplex ultrasonography in women presenting with symptoms or signs of pelvic vein reflux were compared with the outcomes of treatment from pelvic vein embolisation. A repeat transvaginal duplex ultrasonography was performed 6 weeks later by a blinded observer and any residual reflux was identified. Results from 100 sequential patients were analysed. Mean age 44.2 years (32-69) with mode average parity of 3 (0-5 deliveries). Pre-treatment, 289/400 veins were refluxing (ovarian - 29 right, 81 left; internal iliac - 93 right, 86 left). Coil embolisation was successful in 86/100 patients and failed partially in 14/100 - 5 due to failure to cannulate the target vein. One false-positive diagnosis was made. Currently there is no accepted gold standard for pelvic vein incompetence. Comparing transvaginal duplex ultrasonography with the outcome from selectively treating the veins identified as having pathological reflux with coil embolisation, there were no false-negative diagnoses and only one false-positive. This study suggests that transvaginal duplex ultrasonography could be the gold standard in assessing pelvic vein reflux. © The Author(s) 2014.

Intraoral ultrasonography: development of a specific high-frequency probe and clinical pilot study.

PubMed

Salmon, Benjamin; Le Denmat, Dominique

2012-04-01

Although ultrasonography is a non-invasive, inexpensive and painless diagnostic tool for soft tissue imaging, this technique is not currently used for oral exploration. Therefore, we developed a 25-MHz high-frequency ultrasound probe, specially designed for intraoral applications. This paper aims to present clinical intraoral ultrasound images actually interpretable, in order to identify the relevant applications of this novel tool and to design future oral studies. Two independent radiologists performed ultrasound examinations on three healthy volunteers. All the teeth were explored on the lingual and buccal sides (162 samples) to evaluate the ergonomics of the system and the visualisation of anatomic structures. Osseointegrated dental implants and a mucocele were also scanned. At the gingivodental junction of the maxillary and mandibular teeth, the device clearly identifies the tooth surfaces, the alveolar bone reflection with its surrounding subepithelial connective tissue of the gingiva and the gingival epithelia. The bone level and the thickness of soft tissue around the implant are measurable on the buccal and lingual sides. Therefore, intraoral ultrasonography provides additional morphological information that is not accessible by conventional dental x-rays. We propose a novel diagnostic tool that explores the biological width and is able to define the thin or thick nature of the gums. Moreover, intraoral ultrasonography may help to monitor precancerous lesions. This promising device requires large-scale clinical studies to determine whether it should remain a research tool or be used as a diagnostic tool for daily dental practice.

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

Doppler ultrasonography and single-fiber laser Doppler flowmetry for measurement of hind limb blood flow in anesthetized horses.

PubMed

Raisis, A L; Young, L E; Taylor, P M; Walsh, K P; Lekeux, P

2000-03-01

To use Doppler ultrasonography and single-fiber laser Doppler flowmetry (LDF) to evaluate blood flow in the dependent and nondependent hind limbs of anesthetized horses and to evaluate changes in femoral arterial blood flow and microvascular skeletal muscle perfusion in response to administration of phenylephrine hydrochloride or dobutamine hydrochloride. 6 healthy adult horses. Horses were anesthetized and positioned in left lateral recumbency. Doppler ultrasonography was used to measure velocity and volumetric flow in the femoral vessels. Single-fiber LDF was used to measure relative microvascular perfusion at a single site in the semimembranosus muscles. Phenylephrine or dobutamine was then administered to decrease or increase femoral arterial blood flow, and changes in blood flow and microvascular perfusion were recorded. Administration of phenylephrine resulted in significant decreases in femoral arterial and venous blood flows and cardiac output and significant increases in mean aortic blood pressure, systemic vascular resistance, and PCV. Administration of dobutamine resulted in significant increases in femoral arterial blood flow, mean aortic blood pressure, and PCV. Significant changes in microvascular perfusion were not detected. Results suggest that Doppler ultrasonography and single-fiber LDF can be used to study blood flows in the hind limbs of anesthetized horses. However, further studies are required to determine why changes in femoral arterial blood flows were not associated with changes in microvascular perfusion.

The Wagner-Nelson method can generate an accurate gastric emptying flow curve from CO2 data obtained by a 13C-labeled substrate breath test.

PubMed

Sanaka, Masaki; Yamamoto, Takatsugu; Ishii, Tarou; Kuyama, Yasushi

2004-01-01

In pharmacokinetics, the Wagner-Nelson (W-N) method can accurately estimate the rate of drug absorption from its urinary elimination rate. A stable isotope (13C) breath test attempts to estimate the rate of absorption of 13C, as an index of gastric emptying rate, from the rate of pulmonary elimination of 13CO2. The time-gastric emptying curve determined by the breath test is quite different from that determined by scintigraphy or ultrasonography. In this report, we have shown that the W-N method can adjust the difference. The W-N equation to estimate gastric emptying from breath data is as follows: the fractional cumulative amount of gastric contents emptied by time t = Abreath (t)/Abreath (infinity) + (1/0.65).d[Abreath (t)/Abreath (infinity) ]/dt, where Abreath (t) = the cumulative recovery of 13CO2 in breath by time t and Abreath ( infinity ) = the ultimate cumulative 13CO2 recovery. The emptying flow curve generated by ultrasonography was compared with that generated by the W-N method-adjusted breath test in 6 volunteers. The emptying curves by the W-N method were almost identical to those by ultrasound. The W-N method can generate an accurate emptying flow curve from 13CO2 data, and it can adjust the difference between ultrasonography and the breath test. Copyright 2004 S. Karger AG, Basel

Toward Accurate Measurement of Participation: Rethinking the Conceptualization and Operationalization of Participatory Evaluation

ERIC Educational Resources Information Center

Daigneault, Pierre-Marc; Jacob, Steve

2009-01-01

While participatory evaluation (PE) constitutes an important trend in the field of evaluation, its ontology has not been systematically analyzed. As a result, the concept of PE is ambiguous and inadequately theorized. Furthermore, no existing instrument accurately measures stakeholder participation. First, this article attempts to overcome these…

Doppler ultrasonography combined with transient elastography improves the non-invasive assessment of fibrosis in patients with chronic liver diseases.

PubMed

Alempijevic, Tamara; Zec, Simon; Nikolic, Vladimir; Veljkovic, Aleksandar; Stojanovic, Zoran; Matovic, Vera; Milosavljevic, Tomica

2017-01-31

Accurate clinical assessment of liver fibrosis is essential and the aim of our study was to compare and combine hemodynamic Doppler ultrasonography, liver stiffness by transient elastography, and non-invasive serum biomarkers with the degree of fibrosis confirmed by liver biopsy, and thereby to determine the value of combining non-invasive method in the prediction significant liver fibrosis. We included 102 patients with chronic liver disease of various etiology. Each patient was evaluated using Doppler ultrasonography measurements of the velocity and flow pattern at portal trunk, hepatic and splenic artery, serum fibrosis biomarkers, and transient elastography. These parameters were then input into a multilayer perceptron artificial neural network with two hidden layers, and used to create models for predicting significant fibrosis. According to METAVIR score, clinically significant fibrosis (≥F2) was detected in 57.8% of patients. A model based only on Doppler parameters (hepatic artery diameter, hepatic artery systolic and diastolic velocity, splenic artery systolic velocity and splenic artery Resistance Index), predicted significant liver fibrosis with a sensitivity and specificity of75.0% and 60.0%. The addition of unrelated non-invasive tests improved the diagnostic accuracy of Doppler examination. The best model for prediction of significant fibrosis was obtained by combining Doppler parameters, non-invasive markers (APRI, ASPRI, and FIB-4) and transient elastography, with a sensitivity and specificity of 88.9% and 100%. Doppler parameters alone predict the presence of ≥F2 fibrosis with fair accuracy. Better prediction rates are achieved by combining Doppler variables with non-invasive markers and liver stiffness by transient elastography.

Laparoscopy-guided intracorporeal ultrasound accurately delineates hepatobiliary anatomy.

PubMed

Yamamoto, M; Stiegmann, G V; Durham, J; Berguer, R; Oba, Y; Fujiyama, Y; McIntyre, R C

1993-01-01

The purpose of this study was to develop a technique and assess the ability of a laparoscopic ultrasound probe to delineate biliary antomy and to determine the presence or absence of duct stones. Five pigs had ultrasonography of biliary structures and liver at laparoscopy followed by cholangiograms and anatomical dissection. Five patients had ultrasonography of the biliary tract at laparoscopic cholecystectomy. All animals had adequate visualization of important hepatobiliary structure, and an optimal method of accessing these structures at laparoscopy was established. Patients had ultrasonography which used methods developed in the animal trial. All had adequate visualization of the entire common bile duct confirmed by cholangiography. Limitations in demonstrating the relationship of the cystic duct to the common duct were technical and can be corrected. Laparoscopic ultrasonography has significant potential for delineation of biliary anatomy and determination of presence or absence of duct calculi. Clinical implementation could minimize the risk of iatrogenic duct injury and the need for operative cholangiography.

The inter-observer agreement in the assessment of carotid plaque neovascularization by contrast-enhanced ultrasonography: The impact of plaque thickness.

PubMed

Chen, Jian; Zhang, Yan-Ming; Song, Ze-Zhou; Fu, Yan-Fei; Geng, Yu

2018-04-10

The interobserver agreement in the assessment of the grade of carotid plaque neovascularization by contrast-enhanced ultrasonography is poorly established. We examined 140 carotid plaques in 66 patients (all patients had bilateral plaques, and 8 patients had 2 plaques on one side). We performed conventional and contrast-enhanced ultrasonography to analyze the presence of carotid plaque neovascularization, which was graded by two independent observers whose interobserver agreement (κ) was evaluated according to the thickness of carotid plaque. For all carotid plaques, the mean κ was 0.689 (95% confidence interval 0.604-0.774). It was 0.689 (0.569-0.808), 0.637 (0.487-0.787), and 0.740 (0.585-0.896), respectively for carotid plaques with maximal thickness <2 mm, from 2 mm to 3 mm, and >3 mm. The interobserver agreement for assessing carotid plaque neovascularization by using contrast-enhanced ultrasonography is substantial and acceptable for research purposes, regardless of the maximal thickness of the plaque. © 2018 Wiley Periodicals, Inc.

Validation of ultrasonography of the thyroid gland for epidemiological purposes.

PubMed

Knudsen, N; Bols, B; Bülow, I; Jørgensen, T; Perrild, H; Ovesen, L; Laurberg, P

1999-11-01

Ultrasonography of the thyroid is often used in epidemiological surveys, thus thorough characterization of the interobserver variation of the different parameters obtained is important. Various methods have been used for measuring thyroid volume, and different formulas have been used for calculation of thyroid volume from the measured dimensions. In this article, two principles of thyroid volume measurement are described in detail: the wellknown method based on the three axes of each lobe and a new principle based on planimetry in two planes. The interobserver variation of the examination and the measuring procedure in itself were tested on 25 participants in a population study. A comparison of postmortem ultrasonography of the thyroid and results of an autopsy was performed. Good correlation and agreement between observers was found for thyroid volume (r = 0.98) and prevalence of thyroid nodules (kappa = 0.72), whereas echogenecity and echopattern showed little agreement. The correlation of thyroid volume by ultrasonography to autopsy results was satisfactory (r = 0.93), but the volume tended to be slightly underestimated even when using the formula pi/6(= 0.52)*length*width*depth. No major differences were found between the performance of the two principles of volume calculation. We conclude that when the measuring procedure is well defined, results of ultrasonography are comparable between observers for thyroid volume and prevalence of thyroid nodules, but not for echogenecity or echopattern. The formula of length*depth*width*pi/6 is suitable for thyroid volume measurement.

[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%. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Ultrasonography of ovarian hyperandrogenemia

NASA Astrophysics Data System (ADS)

Kuzmina, Svetlana A.; Zharkin, Nikolay A.

2001-05-01

The method of ultrasonography is high informative and widely used in diagnostics of ovarian hyperandrogenaemia. The majority of authors consider that a hyperplasia of a stroma is the main pathognomonic marker of polycystic ovaries (PCO). Still recently swell of a stroma was valued visually, that had subjective nature. We offer for the first time a way of diagnostics of stromal hyperplasia grounded on measurement of a volume of a stroma and ovary with ultrasound method, calculation of the ratio of a volume of the ovary to a volume of a stroma for every patient.

Circulating Magnetic Microbubbles for Localized Real-Time Control of Drug Delivery by Ultrasonography-Guided Magnetic Targeting and Ultrasound

PubMed Central

Chertok, Beata; Langer, Robert

2018-01-01

Image-guided and target-selective modulation of drug delivery by external physical triggers at the site of pathology has the potential to enable tailored control of drug targeting. Magnetic microbubbles that are responsive to magnetic and acoustic modulation and visible to ultrasonography have been proposed as a means to realize this drug targeting strategy. To comply with this strategy in vivo, magnetic microbubbles must circulate systemically and evade deposition in pulmonary capillaries, while also preserving magnetic and acoustic activities in circulation over time. Unfortunately, challenges in fabricating magnetic microbubbles with such characteristics have limited progress in this field. In this report, we develop magnetic microbubbles (MagMB) that display strong magnetic and acoustic activities, while also preserving the ability to circulate systemically and evade pulmonary entrapment. Methods: We systematically evaluated the characteristics of MagMB including their pharmacokinetics, biodistribution, visibility to ultrasonography and amenability to magneto-acoustic modulation in tumor-bearing mice. We further assessed the applicability of MagMB for ultrasonography-guided control of drug targeting. Results: Following intravenous injection, MagMB exhibited a 17- to 90-fold lower pulmonary entrapment compared to previously reported magnetic microbubbles and mimicked circulation persistence of the clinically utilized Definity microbubbles (>10 min). In addition, MagMB could be accumulated in tumor vasculature by magnetic targeting, monitored by ultrasonography and collapsed by focused ultrasound on demand to activate drug deposition at the target. Furthermore, drug delivery to target tumors could be enhanced by adjusting the magneto-acoustic modulation based on ultrasonographic monitoring of MagMB in real-time. Conclusions: Circulating MagMB in conjunction with ultrasonography-guided magneto-acoustic modulation may provide a strategy for tailored minimally

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

PubMed

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

2015-01-01

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

Carotid artery Doppler ultrasonography in retinal macroaneurysms.

PubMed

Thurairajan, G; Potamitis, T; Naylor, G; Gibson, J

1998-01-01

It is postulated that retinal arterial macroaneurysms (RAMs) occur at the site of incomplete embolic occlusion of a branch retinal artery. Embolic events of the retinal vessels are related to the state of the carotid artery tree and therefore Doppler ultrasonography of the carotid arteries in these patients is of particular interest. We have examined 13 patients with retinal artery macroaneurysms with carotid artery Doppler ultrasonography (CADU). Eight of these patients (61.5%) exhibited atheromatous plaques on the same side as the RAM with a moderate degree of arterial narrowing. Although our group of patients did not show advanced carotid artery disease, alterations of the arterial wall found at the level of the carotid artery were higher than expected in a similar hypertensive population. To our knowledge this is the first study of the carotid arterial tree in these patients. Our results support the theory that RAMs may be of embolic origin. Furthermore they demonstrate that CADU is a useful investigation in patients with RAMs.

Correlation of brain ultrasonography scans to the neuromotor outcome of very-low-birth-weight infants during the first year of life.

PubMed

Karagianni, Paraskevi; Rallis, Dimitrios; Kyriakidou, Maria; Tsakalidis, Christos; Pratsiou, Paraskevi; Nikolaidis, Nikolaos

2014-11-01

To evaluate the consistency of the Hammersmith Infant Neurological Examination scores of very-low-birth-weight infants at 6 and 12 months of age and its correlation to cranial ultrasonography findings, we designed a prospective study between January 2005 and January 2008, in the tertiary Neonatal Unit of Aristotle University of Thessaloniki, Greece. All infants enrolled had a cranial ultrasonography performed at term. Preterm infants born at <32 weeks gestation with a birth weight <1500 g were eligible for the study. One hundred seventy-four infants were finally enrolled; out of those, 46 (26%) had an optimal score at 6 and 76 (44%) at 12 months of age. Mean global scores were 61 and 69 at 6 and 12 months, respectively. The Hammersmith Infant Neurological Examination score significantly increased between 6 and 12 months, equally in all ultrasonography groups. The presence of cystic periventricular leukomalacia was associated to lower scores and neurologic impairment. © The Author(s) 2013.

Creation and Validation of a Simulator for Neonatal Brain Ultrasonography: A Pilot Study.

PubMed

Tsai, Andy; Barnewolt, Carol E; Prahbu, Sanjay P; Yonekura, Reimi; Hosmer, Andrew; Schulz, Noah E; Weinstock, Peter H

2017-01-01

Historically, skills training in performing brain ultrasonography has been limited to hours of scanning infants for lack of adequate synthetic models or alternatives. The aim of this study was to create a simulator and determine its utility as an educational tool in teaching the skills that can be used in performing brain ultrasonography on infants. A brain ultrasonography simulator was created using a combination of multi-modality imaging, three-dimensional printing, material and acoustic engineering, and sculpting and molding. Radiology residents participated prior to their pediatric rotation. The study included (1) an initial questionnaire and resident creation of three coronal images using the simulator; (2) brain ultrasonography lecture; (3) hands-on simulator practice; and (4) a follow-up questionnaire and re-creation of the same three coronal images on the simulator. A blinded radiologist scored the quality of the pre- and post-training images using metrics including symmetry of the images and inclusion of predetermined landmarks. Wilcoxon rank-sum test was used to compare pre- and post-training questionnaire rankings and image quality scores. Ten residents participated in the study. Analysis of pre- and post-training rankings showed improvements in technical knowledge and confidence, and reduction in anxiety in performing brain ultrasonography. Objective measures of image quality likewise improved. Mean reported value score for simulator training was high across participants who reported perceived improvements in scanning skills and enjoyment from simulator use, with interest in additional practice on the simulator and recommendations for its use. This pilot study supports the use of a simulator in teaching radiology residents the skills that can be used to perform brain ultrasonography. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Applications of diagnostic ultrasonography in small ruminant reproductive management.

PubMed

Scott, P R

2012-02-01

Modern portable ultrasound machines provide the veterinary clinician with an inexpensive and non-invasive method to further examine the reproductive tract of both male and female sheep on farm which should take no more than 5 min with the results available immediately. Unlike cattle, ultrasound examination of the ovaries is not undertaken because failure to cycle during the normal season is rare in sheep and there are no common ovarian conditions causing acyclicity. Accurate diagnosis of foetal number has greatly improved the nutritional management of late gestation ewes over the past 30 years. Late gestation nutritional supply in response to foetal demand greatly reduces perinatal lamb mortality by ensuring lamb birthweight and ewe colostrum accumulation. The contents of vaginal prolapse have been determined using ultrasonography which has led to an improved method for correction. A retained foetus when second stage labour is considered to have been completed, and uterine torsion, can be identified during ultrasound examination allowing timely correction. Ultrasonographic examination of palpable scrotal abnormalities can provide much useful information particularly in the diagnosis of epididymitis, orchitis and testicular atrophy. Copyright © 2012 Elsevier B.V. All rights reserved.

[Color Doppler ultrasonography--a new imaging procedure in maxillofacial surgery].

PubMed

Reinert, S; Lentrodt, J

1991-01-01

Colour Doppler ultrasonography shows blood flow in real time and colour by combining the features of real time B mode ultrasound and Doppler. At each point in the image the returning signal is interrogated for both amplitude and frequency information. The resulting image shows all non-moving structures in shades of gray and moving structures in shades of red or blue depending on direction and velocity. The technique of colour Doppler ultrasonography and our experiences in 63 examinations are described. The clinical application of this new simple non-invasive method in maxillo-facial surgery is discussed.

Evaluation of sorafenib for advanced hepatocellular carcinoma with low α-fetoprotein in arrival time parametric imaging using contrast-enhanced ultrasonography.

PubMed

Shiozawa, Kazue; Watanabe, Manabu; Ikehara, Takashi; Shimizu, Ryo; Shinohara, Mie; Igarashi, Yoshinori; Sumino, Yasukiyo

2017-01-01

To determine the usefulness of arrival time parametric imaging (AtPI) using contrast-enhanced ultrasonography (CEUS) with Sonazoid in evaluating early response to sorafenib for hepatocellular carcinoma (HCC). Twenty-one advanced HCC patients with low α-fetoprotein (AFP) levels (≤35 ng/ml) who received sorafenib for at least 4 weeks were enrolled in this study. CEUS was performed before and 2 weeks after treatment, and the images of the target lesion in the arterial phase were analyzed by AtPI. In the color mapping images obtained by AtPI, the mean arrival time of the contrast agent in the target lesion from the reference point (mean time: MT) was calculated. In each patient, differences between MT before and MT 2 weeks after treatment were compared. MT (+) and MT (-) groups were defined as difference of 0 s or greater and less than 0 s, respectively. Overall survival was evaluated between the two groups. In the MT (+) (11 patients) and MT (-) (10 patients) groups, the median survival time was 792 and 403 days, respectively, which was statistically significant. The results suggested that AtPI was useful for evaluating early response to sorafenib for advanced HCC with low AFP level.

A comparative study of two-dimensional and three-dimensional ultrasonography in evaluation of gastric affections in dogs

PubMed Central

Pal, Madan; Singh, Prem; Tayal, Rishi; Dehmiwal, Dinesh; Behl, S. M.; Kumar, Sarvan; Chandolia, R. K

2015-01-01

Aim: The objective of the study was to obtain and compare the two-dimensional (2D) and three-dimensional (3D) ultrasonographic images of pathological conditions of the stomach in dogs in clinical cases. Materials and Methods: In our study, 12 clinical conditions of the stomach were recorded using ultrasonography. The ultrasound machine used for this study was 3D ultrasound machine (Nemio-XG: Toshiba, Japan) having four-dimensional volumetric transducer. Results: Present study was done to compare 2D and 3D ultrasonographic images in different gastric affections in dogs. In case of uremic gastropathy due to inflammatory response, the wall of the stomach was 0.6 cm thick and hyperechoic and gastric folds were also hyperechoic indicative of gastritis. In second, third, and fourth case of gastritis the wall of the stomach was 0.7, 0.6, and 0.55 cm, respectively thick and hyperechoic. In fifth and sixth case of gastritis, inflammatory response due to ingestion of polythene and sand led to gastritis and ultrasonographically, the wall of the stomach was 0.6 cm and 0.7 cm thick, respectively, and hyperechoic. In case of gastric ulcer, ultrasonographically, there was a disruption of gastric mucosal layer. In cases of gastric dilatation, anechoic content indicating fluid was seen in stomach area and due to dilatation boundary of the stomach was not clear and the increase in the lumen of the stomach was observed. In case of foreign body, ultrasonographically the wall of the stomach was 0.55 cm thick and hyperechoic. In the middle of the stomach, multiple hyperechoic shadows of the foreign bodies i.e. leather and bunch of straw of grass were observed. In case of pyloric stenosis ultrasonographically, anechoic lumen of the pylorus surrounded by 0.5 cm hypoechoic thickened muscle. In some cases, 3D ultrasonography was not diagnostic i.e. gastric foreign bodies and gastric dilatation. These conditions were better visualized on the 2D sonogram. Conclusion: The appearance of

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.

Comparison between high-frequency ultrasonography and histological assessment reveals weak correlation for measurements of scar tissue thickness.

PubMed

Agabalyan, Natacha A; Su, Samuel; Sinha, Sarthak; Gabriel, Vincent

2017-05-01

Current methods for evaluating scar tissue volume following burns have shortcomings. The Vancouver Burn Scar scale is subjective, leading to a high variability in assessment. Although histological assessment via punch biopsy can discriminate between the different layers of skin, such an approach is invasive, inefficient, and detrimental to patient experience and wound healing. This study investigates the accuracy of high-frequency ultrasonography, a non-invasive alternative to histology, for measuring dermal and epidermal thickness in scar tissue. Scar thicknesses of 10 patients following burns were assessed using a 2-D high-frequency ultrasound probe. The scars were then biopsied using a circular 4mm punch biopsy for histological assessment. Dermal, epidermal, and total thickness of the scar tissue was measured using ultrasound and histology, and correlations between the two measurements were calculated. There was not a strong correlation between ultrasound measurement and histological analysis for epidermal, dermal, and total thickness (Spearman's rank correlation of -0.1223, -0.6242, and -0.6242) of scar tissue. Measurements of scar thickness using high-frequency ultrasonography did not recapitulate the in vivo dermal, epidermal and total thickness. Based on these findings, strategies for further optimization of 2-D ultrasonography is discussed before clinical and research use. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Prenatal diagnosis of placenta accreta by colour Doppler ultrasonography: 5-year review.

PubMed

Pongrojpaw, Densak; Chanthasenanont, Athita; Nanthakomon, Tongta; Suwannarurk, Komsun

2014-08-01

To determine the accuracy of colour Doppler ultrasonography to diagnose placenta accreta. The authors reviewed cases of placenta accreta between January, 2008 and December, 2012. Ultrasonographic images consistent with signs ofplacenta accreta (numerous vascular lacunae, loss ofsubplacentalsonolucent space, absent lower uterine segment between bladder-placenta, turbulent or complicated blood flow at the uteroplacental interface) were correlated with findings at the time of surgery and pathologic examination. Over 60 months, 12 cases (0.48/1,000 deliveries) with suspected placenta accreta by ultrasonography were studied. The median gestational age atfirst diagnosis was 24 weeks. All cases had at least one previous cesarean delivery. At surgery, all cases had an adherent placenta requiring hysterectomy (five accreta, three increta, andfourpercreta). Four cases (33%) had accidental tear of urinary bladder Nine cases (75%) required blood transfusions. Colour Doppler ultrasonography appears useful in antenatal diagnosis ofplacenta accreta.

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

A novel method for the accurate evaluation of Poisson's ratio of soft polymer materials.

PubMed

Lee, Jae-Hoon; Lee, Sang-Soo; Chang, Jun-Dong; Thompson, Mark S; Kang, Dong-Joong; Park, Sungchan; Park, Seonghun

2013-01-01

A new method with a simple algorithm was developed to accurately measure Poisson's ratio of soft materials such as polyvinyl alcohol hydrogel (PVA-H) with a custom experimental apparatus consisting of a tension device, a micro X-Y stage, an optical microscope, and a charge-coupled device camera. In the proposed method, the initial positions of the four vertices of an arbitrarily selected quadrilateral from the sample surface were first measured to generate a 2D 1st-order 4-node quadrilateral element for finite element numerical analysis. Next, minimum and maximum principal strains were calculated from differences between the initial and deformed shapes of the quadrilateral under tension. Finally, Poisson's ratio of PVA-H was determined by the ratio of minimum principal strain to maximum principal strain. This novel method has an advantage in the accurate evaluation of Poisson's ratio despite misalignment between specimens and experimental devices. In this study, Poisson's ratio of PVA-H was 0.44 ± 0.025 (n = 6) for 2.6-47.0% elongations with a tendency to decrease with increasing elongation. The current evaluation method of Poisson's ratio with a simple measurement system can be employed to a real-time automated vision-tracking system which is used to accurately evaluate the material properties of various soft materials.

[Abdominal ultrasonography in patients with diabetes mellitus. Part 1: Liver].

PubMed

Jenssen, C; Pietsch, C; Gottschalk, U; Barreiros, A P; Teufel, A; Cui, X W; Dietrich, C F

2015-04-01

In patients with diabetes mellitus, abdominal ultrasonography is the appropriate diagnostic technique to detect and to follow-up secondary and accompanying diseases of the liver, the kidneys, the pancreas, the gastrointestinal tract and of abdominal vessels. Moreover, pancreatic and hepatic diseases may be realized which are of etiological importance for diabetes mellitus. Based on a systematic survey of the published literature, this review in 3 parts will describe the value of abdominal ultrasonography in patients with diabetes mellitus. Part 1 deals with the diagnostic relevance and particular findings of ultrasonographic methods in hepatic manifestations and complications of diabetes mellitus. © Georg Thieme Verlag KG Stuttgart · New York.

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

USDA-ARS?s Scientific Manuscript database

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...

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.

Duplex Ultrasonography Has Limited Utility in Detection of Postoperative DVT After Primary Total Joint Arthroplasty.

PubMed

Vira, Shaleen; Ramme, Austin J; Alaia, Michael J; Steiger, David; Vigdorchik, Jonathan M; Jaffe, Frederick

2016-07-01

Duplex ultrasound is routinely used to evaluate suspected deep venous thrombosis after total joint arthroplasty. When there is a clinical suspicion for a pulmonary embolism, a chest angiogram (chest CTA) is concomitantly obtained. Two questions were addressed: First, for the population of patients who receive duplex ultrasound after total joint arthroplasty, what is the rate of positive results? Second, for these patients, how many of these also undergo chest CTA for clinical suspicion of pulmonary embolus and how many of these tests are positive? Furthermore, what is the correlation between duplex ultrasound results and chest CTA results? A retrospective chart review was conducted of total joint replacement patients in 2011 at a single institution. Inclusion criteria were adult patients who underwent a postoperative duplex ultrasonography for clinical suspicion of deep venous thrombosis (DVT). Demographic data, result of duplex scan, clinical indications for obtaining the duplex scan, and DVT prophylaxis used were recorded. Additionally, if a chest CTA was obtained for clinical suspicion for pulmonary embolus, results and clinical indication for obtaining the test were recorded. The rate of positive results for duplex ultrasonography and chest CTA was computed and correlated based on clinical indications. Two hundred ninety-five patients underwent duplex ultrasonography of which only 0.7% were positive for a DVT. One hundred three patients underwent a chest CTA for clinical suspicion of a pulmonary embolism (PE) of which 26 revealed a pulmonary embolus, none of which had a positive duplex ultrasound. Postoperative duplex scans have a low rate of positive results. A substantial number of patients with negative duplex results subsequently underwent chest CTA for clinical suspicion for which a pulmonary embolus was found, presumably resulting from a DVT despite negative duplex ultrasound result. A negative duplex ultrasonography should not rule out the presence of a

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bakhshandeh, Mohsen; Hashemi, Bijan, E-mail: bhashemi@modares.ac.ir; Mahdavi, Seyed Rabie

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 frommore » 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

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

PubMed

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

2013-01-01

Anatomical understanding is critical to medical education. With reduced teaching time and limited cadaver availability, it is important to investigate how best to utilize in vivo imaging to supplement anatomical understanding and better prepare medical graduates for the proliferation of point-of-care imaging in the future. To investigate whether using short sessions of in vivo imaging using ultrasonography could benefit students' anatomical knowledge and clinical application, we conducted a 2-hour session on abdominal anatomy using ultrasonography in small groups of five to six students, for both first- and second-year student cohorts. Individual feedback was collected to assess student perceptions. To measure retention and understanding, a short examination containing ultrasound images and questions and performance of a clinical skill (gastrointestinal' tract examination) were assessed. Ultrasonography sessions were highly valued by the students, with 90% of the students reporting their understanding was improved, and over 70% reporting increased confidence in their anatomical knowledge. However, the assessments showed no appreciable impact on skills or understanding related to abdominal anatomy and examination. We conclude that the risk associated with limited exposure increasing confidence without increasing skills remains real and that in vivo imaging is not effective when used as a short adjunct teaching tool. The widespread use of ultrasonography means finding the best way to incorporate ultrasound into medical education remains important. To this end, we are currently implementing an extended program including echocardiography and multiple anatomical sessions that will determine if frequency and repetition of use can positively impact on student performance and understanding. Copyright © 2012 American Association of Anatomists.

[The diagnostic performance of color Doppler ultrasonography for newborn four cases of midgut volvulus accompanied by intestinal malrotation].

PubMed

Ikeshima, Yukari; Hisano, Katsuya; Morisawa, Takeshi; Inoue, Kozue; Shimamoto, Masahiro; Koujitani, Toshiaki; Yonetani, Masahiko; Yasufuku, Masao

2014-03-01

Midgut volvulus accompanied by intestinal malrotation is classified as a surgical emergency disease of the newborn, which emerges with the bilious vomiting or melena. This report presents four patients of this disease in our hospital, evaluated by color Doppler ultrasonography before surgical operation. All four patients were presented by bilious vomiting at the onset. By color Doppler ultrasonography method, the whirlpool sign which is the view of intestine and superior mesenteric vein rotated around with the axis of superior mesenteric artery, were shown in all cases. This whirlpool sign led to the diagnosis of midgut volvulus accompanied by intestinal malrotation. Intestinal contrast imaging was tested in three patients for the purpose of confirming the diagnosis. Repair of the volvulus and a ladd operation was performed in all four patients, without the excision of intestine because of no intestinal ischemic change. The clinical courses of four cases were good, and all patients were discharged within 17 days. Early diagnosis and timely surgical operation are essential for decreasing the possibility of occurring intestinal ischemic changes and improving clinical outcome after surgical operation. We propose that color Doppler ultrasonography is the powerful tool for the diagnosis of this disease, especially for the newborn, for whom the available diagnostic tests are limited.

Indices of diagnostic abdominal ultrasonography in acute appendicitis: influence of gender and physical constitution, time evolution of the disease and experience of radiologist.

PubMed

Peixoto, Rodrigo de Oliveira; Nunes, Tarcizo Afonso; Gomes, Carlos Augusto

2011-01-01

To assess the value of abdominal ultrasonography in the diagnosis of acute appendicitis and the influence of gender, physical constitution, experience of the radiologist and the time evolution of the disease on the results of diagnostic indices. We prospectively evaluated 156 patients with clinical diagnosis of acute appendicitis who underwent laparoscopic appendectomy and abdominal ultrasonography, together with pathology of the excised appendices. Patients were allocated in relation to BMI in both groups (below or above 25 kg/m²) and radiologists, in three groups according to their professional experience (less than five years, between five and 10 years and more than 10 years). The survey also assessed the influence of gender and time of disease progression using the median of 36 hours. The sensitivity and specificity of abdominal ultrasonography for diagnosing appendicitis were 64.9 and 72% respectively. Gender, body mass index, length of experience of the radiologists in the three groups and time of onset of symptoms showed no significant differences in the establishment of sonographic diagnosis of acute appendicitis. The abdominal ultrasonography showed low sensitivity and specificity and little contribution to the diagnosis of acute appendicitis. Gender, physical constitution, the experience of the radiologist and time of onset of symptoms did not affect the outcome of the sonography.

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

PubMed Central

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

2011-01-01

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

Ultrasonography of the male breast.

PubMed

Draghi, F; Tarantino, C C; Madonia, L; Ferrozzi, G

2011-09-01

The male breast has been insufficiently explored in the medical literature, particularly that dealing with ultrasonography, although this topic is almost as vast and varied as that of the female breast. The purpose of this article is to provide a schematic review of the most frequent breast lesions encountered in males and their sonographic appearances. After a brief introduction on the anatomy of the male breast, the authors review the non-neoplastic (gynecomastia, pseudogynecomastia, cysts, inflammatory diseases, and Mondor disease) and neoplastic (benign and malignant) lesions encountered in this organ.

Ultrasonography of the male breast

PubMed Central

Draghi, F.; Tarantino, C.C.; Madonia, L.; Ferrozzi, G.

2011-01-01

The male breast has been insufficiently explored in the medical literature, particularly that dealing with ultrasonography, although this topic is almost as vast and varied as that of the female breast. The purpose of this article is to provide a schematic review of the most frequent breast lesions encountered in males and their sonographic appearances. After a brief introduction on the anatomy of the male breast, the authors review the non-neoplastic (gynecomastia, pseudogynecomastia, cysts, inflammatory diseases, and Mondor disease) and neoplastic (benign and malignant) lesions encountered in this organ. PMID:23397020

Vascular access: the impact of ultrasonography

PubMed Central

de Almeida, Carlos Eduardo Saldanha

2016-01-01

ABSTRACT 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. PMID:28076607

Value of doppler ultrasonography in the study of hemodialysis peripheral vascular access dysfunction.

PubMed

Moreno Sánchez, T; Martín Hervás, C; Sola Martínez, E; Moreno Rodríguez, F

2014-01-01

The main objectives of this study were to evaluate the sensitivity and specificity of duplex Doppler ultrasonography in the study of hemodialysis peripheral vascular access dysfunction and to analyze the resistance index and flow in the afferent artery. We prospectively studied 178 patients with 178 peripheral vascular accesses that were dysfunctional in at least three consecutive hemodialysis sessions. Patients underwent duplex Doppler ultrasonography and clinical and laboratory follow-up for three months (provided angiography findings were negative). We calculated the sensitivity, specificity, predictive values, and coefficients of probability. We studied the morphology of the afferent artery, the arteriovenous anastomosis, and the efferent vein, and we measured the resistance index and the flow of the afferent artery, the diameter of the anastomosis, and the flow and peak systolic velocity in the efferent vein. The final sample consisted of 159 patients. The sensitivity, specificity, positive and negative predictive values, and positive and negative coefficients of probability were 0,98 (95% CI: 0,88-1.00), 0,74 (95% CI: 0,66-0,81), 0,96, 0,82, 3.7, and 0,03, respectively. The resistance index was less than 0,5 in 78.5% of the peripheral vascular accesses with normal function and greater than 0,5 in 86.1% of the dysfunctional peripheral vascular accesses. We found aneurysms in 19 of the native peripheral vascular accesses and pseudoaneurysms in 7 of the prosthetic grafts. Inverted flow was seen in 57 peripheral vascular accesses. Duplex Doppler ultrasonography is an efficacious method for detecting and characterizing stenosis and thrombosis in peripheral vascular accesses, and it provides information about the morphology and hemodynamics. Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.

Use of contrast ultrasonography in the diagnosis of metastatic feline visceral haemangiosarcoma.

PubMed

Webster, Natalie; Holloway, Andrew

2008-08-01

A 12-year-old cat was presented for investigation of weight loss and inappetence. Radiography and conventional grey-scale ultrasonography showed a large mid-body splenic mass. Contrast enhanced ultrasonography of the liver demonstrated a hypoechoic left lateral lobe nodular mass during the peak and late portal-phases of liver enhancement. Histopathology of the splenic mass and hepatic nodular mass confirmed haemangiosarcoma. The use of ultrasound microbubble contrast media in the diagnosis of hepatic metastasis in the cat has not been previously reported in the cat.

Evaluation of abdominal fat index by ultrasonography and its relationship with psoriasis and metabolic syndrome.

PubMed

Gönül, Müzeyyen; Tatar, İdil; Canpolat, Filiz; Işıl Kurmus, Gökçe; Ergin, Can; Hekimoğlu, Baki

2017-10-01

Accumulating evidence indicates that psoriasis is associated with obesity and metabolic syndrome. Psoriasis and obesity share similar inflammatory mediators, and obesity may potentiate some inflammatory cytokines seen in psoriasis. Body fat distribution, particularly visceral adipose tissue (VAT), is an important factor in metabolic syndrome and atherosclerotic diseases. An association has been demonstrated between psoriasis and abdominal VAT measured by computed tomography (CT). To measure abdominal VAT noninvasively by ultrasonography (USG) in patients with psoriasis and investigated its relation to psoriasis and metabolic syndrome. The study population consisted of 41 psoriasis patients and 41 control subjects matched for age, sex, and body mass index. The maximal preperitoneal fat thickness (Pmax) at the anterior surface of the liver and the minimal subcutaneous fat thickness (Smin) of the abdomen were measured by USG. The abdominal fat index (AFI = Pmax/Smin ratio) was calculated and the results were compared between groups. The rate of metabolic syndrome was significantly higher in psoriasis patients ( p = 0.0018). The mean AFI was similar in both groups. AFI was not associated with psoriasis in subjects with metabolic syndrome ( p = 0.495) or with Psoriasis Area and Severity Index ( r = 0.123, p = 0.443). This is the first study to evaluate abdominal VAT by USG. Computed tomography may be more reliable than USG, but its high cost and radiation exposure are major disadvantages. Further studies are required to determine the relationships between psoriasis and VAT.

Effect of Provider Experience on Clinician-Performed Ultrasonography for Hydronephrosis in Patients With Suspected Renal Colic

PubMed Central

Herbst, Meghan K.; Rosenberg, Graeme; Daniels, Brock; Gross, Cary P.; Singh, Dinesh; Molinaro, Annette M.; Luty, Seth; Moore, Christopher L.

2016-01-01

Study objective Hydronephrosis is readily visible on ultrasonography and is a strong predictor of ureteral stones, but ultrasonography is a user-dependent technology and the test characteristics of clinician-performed ultrasonography for hydronephrosis are incompletely characterized, as is the effect of ultrasound fellowship training on predictive accuracy. We seek to determine the test characteristics of ultrasonography for detecting hydronephrosis when performed by clinicians with a wide range of experience under conditions of direct patient care. Methods This was a prospective study of patients presenting to an academic medical center emergency department with suspected renal colic. Before computed tomography (CT) results, an emergency clinician performed bedside ultrasonography, recording the presence and degree of hydronephrosis. CT data were abstracted from the dictated radiology report by an investigator blinded to the bedside ultrasonographic results. Test characteristics of bedside ultrasonography for hydronephrosis were calculated with the CT scan as the reference standard, with test characteristics compared by clinician experience stratified into 4 levels: attending physicians with emergency ultrasound fellowship training, attending physicians without emergency ultrasound fellowship training, ultrasound experienced non–attending physician clinicians (at least 2 weeks of ultrasound training), and ultrasound inexperienced non–attending physician clinicians (physician assistants, nurse practitioners, off-service rotators, and first-year emergency medicine residents with fewer than 2 weeks of ultrasound training). Results There were 670 interpretable bedside ultrasonographic tests performed by 144 unique clinicians, 80.9% of which were performed by clinicians directly involved in the care of the patient. On CT, 47.5% of all subjects had hydronephrosis and 47.0% had a ureteral stone. Among all clinicians, ultrasonography had a sensitivity of 72.6% (95

Effect of provider experience on clinician-performed ultrasonography for hydronephrosis in patients with suspected renal colic.

PubMed

Herbst, Meghan K; Rosenberg, Graeme; Daniels, Brock; Gross, Cary P; Singh, Dinesh; Molinaro, Annette M; Luty, Seth; Moore, Christopher L

2014-09-01

Hydronephrosis is readily visible on ultrasonography and is a strong predictor of ureteral stones, but ultrasonography is a user-dependent technology and the test characteristics of clinician-performed ultrasonography for hydronephrosis are incompletely characterized, as is the effect of ultrasound fellowship training on predictive accuracy. We seek to determine the test characteristics of ultrasonography for detecting hydronephrosis when performed by clinicians with a wide range of experience under conditions of direct patient care. This was a prospective study of patients presenting to an academic medical center emergency department with suspected renal colic. Before computed tomography (CT) results, an emergency clinician performed bedside ultrasonography, recording the presence and degree of hydronephrosis. CT data were abstracted from the dictated radiology report by an investigator blinded to the bedside ultrasonographic results. Test characteristics of bedside ultrasonography for hydronephrosis were calculated with the CT scan as the reference standard, with test characteristics compared by clinician experience stratified into 4 levels: attending physicians with emergency ultrasound fellowship training, attending physicians without emergency ultrasound fellowship training, ultrasound experienced non-attending physician clinicians (at least 2 weeks of ultrasound training), and ultrasound inexperienced non-attending physician clinicians (physician assistants, nurse practitioners, off-service rotators, and first-year emergency medicine residents with fewer than 2 weeks of ultrasound training). There were 670 interpretable bedside ultrasonographic tests performed by 144 unique clinicians, 80.9% of which were performed by clinicians directly involved in the care of the patient. On CT, 47.5% of all subjects had hydronephrosis and 47.0% had a ureteral stone. Among all clinicians, ultrasonography had a sensitivity of 72.6% (95% confidence interval [CI] 65.4% to 78

Usefulness of abdominal ultrasonography in the analysis of endoscopic activity in patients with Crohn's disease: changes following treatment with immunomodulators and/or anti-TNF antibodies.

PubMed

Moreno, Nadia; Ripollés, Tomás; Paredes, José María; Ortiz, Inmaculada; Martínez, María Jesús; López, Antonio; Delgado, Fructuoso; Moreno-Osset, Eduardo

2014-09-01

The objective of this study was to analyze the accuracy of abdominal ultrasonography (AUS) in the assessment of mucosal healing in patients with Crohn's disease (CD) receiving immunomodulators and/or biological treatment, with ileocolonoscopy as the reference standard. Thirty patients were included in a prospective longitudinal study. All patients underwent ileocolonoscopy and AUS before and after a minimum of one year of treatment. The Crohn's Disease Endoscopic Inflammatory Index of Severity (CDEIS) was used for endoscopic assessment whereas AUS was analyzed by means of bowel wall thickness, color Doppler grade and percentage of increase of parietal enhancement after contrast injection. In the segmental analysis, endoscopic healing was found in 71.2% of the segments and AUS findings were normalized in 62.8%, with a significant correlation between the two techniques (κ=0.76, p<0.001). In the overall assessment performed after treatment, 18 (60%) patients exhibited endoscopic remission (CDEIS <6 points); of these patients, 15 (83.3%) had normalized sonographic findings, with a good correlation between endoscopic remission and sonographic normalization (κ=0.73, p<0.001). Of the three variables assessed by AUS, parietal thickness was the best variable to predict mucosal healing in both analyses, segmental and global. Abdominal ultrasonography is a useful and reliable technique for the assessment of the endoscopic response to treatment with immunomodulators and/or biological drugs in Crohn's disease. AUS is a highly accurate technique for evaluating the healing of the intestinal mucosa. Copyright © 2014 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Intravenous and Intracavitary Use of Contrast-Enhanced Ultrasound in the Evaluation and Management of Complicated Pediatric Pneumonia.

PubMed

Deganello, Annamaria; Rafailidis, Vasileios; Sellars, Maria E; Ntoulia, Aikaterini; Kalogerakou, Kleanthi; Ruiz, Gary; Cosgrove, David O; Sidhu, Paul S

2017-09-01

Pediatric pneumonia can be complicated by necrotizing pneumonia or a parapneumonic effusion either in the form of an empyema or a clear effusion. Ultrasonography (US) and computed tomography represent well-established modalities for evaluation of complicated pediatric pneumonia. Contrast-enhanced ultrasound (CEUS) was recently introduced and is gaining increasing acceptance in pediatric imaging. In this case series, we present our initial experience with both intravenous and intracavitary use of CEUS in children with complicated pneumonia. Intravenous CEUS accurately and confidently showed necrotizing pneumonia and delineated pleural effusions, whereas intracavitary CEUS accurately identified the chest catheter location and patency and showed the presence of loculations, suggesting the use of fibrinolytics. © 2017 by the American Institute of Ultrasound in Medicine.

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.

Surveillance Duplex Ultrasonography of Stent Grafts for Popliteal Aneurysms.

PubMed

Pineda, Danielle M; Troutman, Douglas A; Dougherty, Matthew J; Calligaro, Keith D

2016-05-01

Stent grafts, also known as covered stents, have become an increasingly acceptable treatment for popliteal artery aneurysms. However, endovascular exclusion confers lower primary patency compared to traditional open bypass and exclusion. The purpose of this study was to evaluate whether duplex ultrasonography (DU) can reliably diagnose failing stent grafts placed for popliteal artery aneurysms prior to occlusion. Between June 5, 2007, and March 11, 2014, 21 stent grafts (Viabahn; Gore, Flagstaff, Arizona) were placed in 19 patients for popliteal artery aneurysms. All patients had at least 1 follow-up duplex scan postoperatively. Mean follow-up was 28.9 months (9-93 months). Postoperative DU surveillance was performed in our Intersocietal Accreditation Commission noninvasive vascular laboratory at 1 week postprocedure and every 6 months thereafter. Duplex ultrasonography measured peak systolic velocities (PSVs) and ratio of adjacent PSVs (Vr) every 5 cm within the stent graft and adjacent arteries. We retrospectively classified the following factors as "abnormal DU findings": focal PSV > 300 cm/s, uniform PSVs < 50 cm/s throughout the graft, and Vr > 3.0. These DU criteria were derived from laboratory-specific data that we previously published on failing stent grafts placed for lower extremity occlusive disease. Four of the 21 stent grafts presented with symptomatic graft thrombosis within 6 months of a normal DU. Three of these 4 patients presented with rest pain and underwent thrombectomy (2) or vein bypass (1), and 1 elected for nonintervention for claudication. Our results suggest that surveillance DU using criteria established for grafts placed for occlusive disease may not be useful for predicting stent graft failure in popliteal artery aneurysms. © The Author(s) 2016.

The Clinical Accuracy of Endoscopic Ultrasonography and White Light Imaging in Gastric Endoscopic Submucosal Dissection

PubMed Central

Park, Soon Hong; Sung, Sang Hun; Lee, Seung Jun; Jung, Min Kyu; Kim, Sung Kook

2012-01-01

Purpose Gastric mucosal neoplastic lesions should have characteristic endoscopic features for successful endoscopic submucosal dissection. Materials and Methods Out of the 1,010 endoscopic submucosal dissection, we enrolled 62 patients that had the procedure cancelled. Retrospectively, whether the reasons for cancelling the endoscopic submucosal dissection were consistent with the indications for an endoscopic submucosal dissection were assessed by analyzing the clinical outcomes of the patients that had the surgery. Results The cases were divided into two groups; the under-diagnosed group (30 cases; unable to perform an endoscopic submucosal dissection) and the over-diagnosed group (32 cases; unnecessary to perform an endoscopic submucosal dissection), according to the second endoscopic findings, compared with the index conventional white light image. There were six cases in the under-diagnosed group with advanced gastric cancer on the second conventional white light image endoscopy, 17 cases with submucosal invasion on endoscopic ultrasonography findings, 5 cases with a size greater than 3 cm and ulcer, 1 case with diffuse infiltrative endoscopic features, and 1 case with lymph node involvement on computed tomography. A total of 25 patients underwent a gastrectomy to remove a gastric adenocarcinoma. The overall accuracy of the decision to cancel the endoscopic submucosal dissection was 40% (10/25) in the subgroup that had the surgery. Conclusions The accuracy of the decision to cancel the endoscopic submucosal dissection, after conventional white light image and endoscopic ultrasonography, was low in this study. Other diagnostic options are needed to arrive at an accurate decision on whether to perform a gastric endoscopic submucosal dissection. PMID:22792522

An unanticipated diagnosis with bedside ultrasonography in patients with acute abdominal pain: rectus hematoma.

PubMed

Ünlüer, Erden Erol; Kaykısız, Eylem Kuday

2017-01-01

Although abdominal pain is a common presentation in emergency departments, rectus sheath hematoma (RSH) is among the rarest diagnosis. Here we present 2 cases of RSH likely caused by coughing due to upper respiratory tract infection. The two described cases were diagnosed by bedside ultrasonography and confirmed as RSH by computed tomography. Review of patient history and use of ultrasonography are important to avoid misdiagnosisof RSH.

Failure of pre-natal ultrasonography to prevent urinary infection associated with underlying urological abnormalities.

PubMed

Lakhoo, K; Thomas, D F; Fuenfer, M; D'Cruz, A J

1996-06-01

To analyse the reasons underlying the failure of routine pre-natal ultrasonography to prevent the subsequent development of urinary tract infection (UTI) in children with predisposing urological abnormalities. This retrospective study comprised 39 children (22 females and 17 males) who had at least one documented UTI, the presence of an anatomical anomaly of the urinary tract recognized as predisposing to UTI and had undergone ultrasonography of the urinary tract undertaken in fetal life as part of routine maternal ante-natal ultrasonography. Four categories of patients were defined: Group A, those with normal findings on pre-natal ultrasonography and no urological abnormality detected; Group B, those with a urological abnormality detected but where there was a subsequent failure of communication among clinicians; Group C, those with a urological abnormality but who received inappropriate or sub-optimal post-natal management and; Group D, those with a urological abnormality but who had a UTI despite appropriate post-natal management. In each case, the most severe documented episode of UTI was categorized as: Grade I, asymptomatic bacteriuria; Grade II, mild/moderate symptomatic UTI and; Grade III, severe symptomatic UTI necessitating hospital admission. Group A comprised 22 (56%), Group B three (9%), Group C two (5%) and Group D 12 children (31%). Of the 22 children in Group A, nine experienced a UTI of sufficient severity to necessitate hospital admission. Of the 12 children in Group D only one required hospital admission. The failure of pre-natal ultrasonography to identify the underlying predisposing urological abnormality was the most important factor contributing to subsequent UTI in post-natal life. Failure of communication and inappropriate post-natal management were numerically unimportant. In some children, UTI occurred despite pre-natal detection of their underlying anomaly and appropriate post-natal management. However, in this group the UTI was less

Comparative Study of Three Regimens of Bowel Preparation Before Transabdominal Ultrasonography of the Colon.

PubMed

Fan, Xiu-Ping; Zhu, Qiang; Zhou, Ya-Jing; Ma, Teng; Xia, Chun-Xia; Huang, Hui-Lian

2016-09-01

The objective of the study was to compare the efficacy of three bowel preparation regimens for transabdominal colon ultrasonography. A total of 192 consecutive patients were given one of three regimens (senna, magnesium sulfate or polyethylene glycol electrolyte powder) before ultrasonographic examinations. The cleaning grade (I = emptying; II = filled or filled + empty; III = I or II with some retention; and IV = retention [grades I and II were termed "qualified"]) and cleaning range (A = all seven colon sections were qualified; B = four to six sections were qualified; C = three or less sections were qualified) were evaluated retrospectively. Senna was found more effective than polyethylene glycol in terms of cleaning grade (p < 0.001), qualified rate (p < 0.001) and cleaning range (p = 0.003). Senna was better than magnesium sulfate in cleaning grade (p < 0.001). Our results suggest that senna seems to be the preferred regimen for bowel preparation before transabdominal colonic ultrasonography. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Differential diagnosis between gallbladder adenomas and cholesterol polyps on contrast-enhanced harmonic endoscopic ultrasonography.

PubMed

Park, Chan Hyuk; Chung, Moon Jae; Oh, Tak Geun; Park, Jeong Youp; Bang, Seungmin; Park, Seung Woo; Kim, Hyunki; Hwang, Ho Kyoung; Lee, Woo Jung; Song, Si Young

2013-04-01

Differential diagnosis between gallbladder (GB) adenomas and cholesterol polyps based on ultrasonography or endoscopic ultrasonography (EUS) is challenging because they have similar echogenicity and morphology. We evaluated the usefulness of contrast-enhanced harmonic EUS (CEH-EUS) for differentiating between GB adenomas and cholesterol polyps. Between June 2010 and December 2011, a total of 87 patients with GB polyps who underwent a CEH-EUS were reviewed retrospectively. Of the 87 patients, 57 had a cholecystectomy. Of these, 34 patients were diagnosed with adenoma, cholesterol polyp, adenocarcinoma, or adenomyomatosis pathology. The remaining 23 patients were not diagnosed with GB polyps because their lesions separated from the GB mucosal layer during pathological sampling. On CEH-EUS, homogeneous and heterogeneous enhancement was shown in 6 and 2 patients with adenoma and in 4 and 8 patients with cholesterol polyps, respectively. Sensitivity and specificity of CEH-EUS for differential diagnosis of GB adenomas from cholesterol polyps based on the enhancement pattern were 75.0 and 66.6 %, respectively. CEH-EUS might be useful for distinguishing GB adenomas and cholesterol polyps based on enhancement patterns. However, an additional technique such as quantitative perfusion analysis is necessary because visual assessment of CEH-EUS images is subjective.

The identification of complete domains within protein sequences using accurate E-values for semi-global alignment

PubMed Central

Kann, Maricel G.; Sheetlin, Sergey L.; Park, Yonil; Bryant, Stephen H.; Spouge, John L.

2007-01-01

The sequencing of complete genomes has created a pressing need for automated annotation of gene function. Because domains are the basic units of protein function and evolution, a gene can be annotated from a domain database by aligning domains to the corresponding protein sequence. Ideally, complete domains are aligned to protein subsequences, in a ‘semi-global alignment’. Local alignment, which aligns pieces of domains to subsequences, is common in high-throughput annotation applications, however. It is a mature technique, with the heuristics and accurate E-values required for screening large databases and evaluating the screening results. Hidden Markov models (HMMs) provide an alternative theoretical framework for semi-global alignment, but their use is limited because they lack heuristic acceleration and accurate E-values. Our new tool, GLOBAL, overcomes some limitations of previous semi-global HMMs: it has accurate E-values and the possibility of the heuristic acceleration required for high-throughput applications. Moreover, according to a standard of truth based on protein structure, two semi-global HMM alignment tools (GLOBAL and HMMer) had comparable performance in identifying complete domains, but distinctly outperformed two tools based on local alignment. When searching for complete protein domains, therefore, GLOBAL avoids disadvantages commonly associated with HMMs, yet maintains their superior retrieval performance. PMID:17596268

Is dynamic two-dimensional anal ultrasonography useful in the assessment of anismus? A comparison with manometry.

PubMed

Murad-Regadas, Sthela Maria; Regadas, Francisco Sérgio P; Barreto, Rosilma Gorete Lima; Rodrigues, Lusmar Veras; Fernandes, Graziela Olivia da Silva; Lima, Doryane Maria dos Reis

2010-01-01

Anismus is a prevalent functional cause of outlet delay. It is characterized by symptoms of obstructed defecation associated with paradoxical contraction of the pelvic floor muscles. To evaluate the ability of two dimensional anal ultrasonography to identify anismus patients with paradoxical contraction or normal relaxation, comparing findings with manometric measurements. Forty-nine women presenting with outlet delay and a mean validated Wexner constipation score of 13.5 were included in a prospective study. Following screening with anal manometry, the patients were assigned to one of two groups: G-I -with normal relaxation and G-II -patients with anismus. Dynamic anorectal ultrasonography was used to quantifier the movement of the puborectalis muscle and to measure changes in the angle between two converging lines drawn from the 3 o'clock and the 9 o'clock positions of the endoprobe circumference to the internal border of the puborectalis muscle. The angle decreases during straining in patients with normal relaxation, but increases in patients with anismus. The agreement between the two techniques was verified with the Kappa index. In manometry, during straining the anal canal pressure decreased by 41.3% in G-I and increased by 168.6% in G-II, indicating a diagnosis of anismus for the second group. In US, during straining, the angle produced by the movement of the puborectalis muscle decreased from 63 ± 1.31 to 58 ± 1.509 degrees (P = 0.0135) in 23 of the 30 patients in G-I, indicating normal relaxation, and increased from 66 ± 0.972 to 72 ± 0.897 degrees (P = 0.0001) in 16 of the 19 patients in G-II, indicating anismus. The index of agreement between manometry and two dimensional anal ultrasonography was moderate: 77% (23/30) for G-I and 84% (16/19) for G-II. Two-dimensional dynamic anal ultrasonography showed similar results previously suggested by anal manometry at identifying patients with normal relaxation or paradoxical contraction.

Accurate Evaluation Method of Molecular Binding Affinity from Fluctuation Frequency

NASA Astrophysics Data System (ADS)

Hoshino, Tyuji; Iwamoto, Koji; Ode, Hirotaka; Ohdomari, Iwao

2008-05-01

Exact estimation of the molecular binding affinity is significantly important for drug discovery. The energy calculation is a direct method to compute the strength of the interaction between two molecules. This energetic approach is, however, not accurate enough to evaluate a slight difference in binding affinity when distinguishing a prospective substance from dozens of candidates for medicine. Hence more accurate estimation of drug efficacy in a computer is currently demanded. Previously we proposed a concept of estimating molecular binding affinity, focusing on the fluctuation at an interface between two molecules. The aim of this paper is to demonstrate the compatibility between the proposed computational technique and experimental measurements, through several examples for computer simulations of an association of human immunodeficiency virus type-1 (HIV-1) protease and its inhibitor (an example for a drug-enzyme binding), a complexation of an antigen and its antibody (an example for a protein-protein binding), and a combination of estrogen receptor and its ligand chemicals (an example for a ligand-receptor binding). The proposed affinity estimation has proven to be a promising technique in the advanced stage of the discovery and the design of drugs.

Ultrasonography and progesterone concentration at a single time point for the detection of puberty in dairy heifers.

PubMed

Archbold, H; Buckley, F; Pierce, K M; Begley, N; Mee, J F

2012-06-01

Data were available from 1657 heifers across 48 dairy farms which were visited once, on average 9 days (± 5.2) prior to the mating start date (23 April, ± 12.6). Blood samples were collected via coccygeal venepuncture for progesterone (P4) analysis, and animals were scanned for the presence or absence of corpora lutea (CL), to determine the luteal status. A comparison of luteal status between ultrasound (CL identified) and P4 (≥ 1 ng/ml), based on a single measurement point, showed poor agreement (K = 0.32). The majority of animals were classified as luteal (76%) using both ultrasonography and P4. There was excellent agreement between luteal status detected by ultrasonography alone and luteal status assigned by a combination of ultrasonography and P4 (K = 0.93). The agreement between luteal status assigned by P4 and luteal status assigned by the combination of ultrasonography and P4 was poor (K = 0.37). These results indicate that at a single examination, ultrasonography is the preferred modality to determine the luteal status of maiden heifers. © 2011 Blackwell Verlag GmbH.

An unanticipated diagnosis with bedside ultrasonography in patients with acute abdominal pain: rectus hematoma

PubMed Central

Ünlüer, Erden Erol; Kaykısız, Eylem Kuday

2017-01-01

Although abdominal pain is a common presentation in emergency departments, rectus sheath hematoma (RSH) is among the rarest diagnosis. Here we present 2 cases of RSH likely caused by coughing due to upper respiratory tract infection. The two described cases were diagnosed by bedside ultrasonography and confirmed as RSH by computed tomography. Review of patient history and use of ultrasonography are important to avoid misdiagnosisof RSH. PMID:28748020

High-resolution ultrasonography in assessment of nail-related disorders.

PubMed

Singh, R; Bryson, D; Singh, H P; Jeyapalan, K; Dias, J J

2012-09-01

Disorders of the nail can pose a diagnostic challenge, and non-invasive imaging is frequently required to clarify diagnosis and delineate anatomy pre-operatively. We explored the use of high-resolution ultrasonography in the assessment of patients with nail disorders attending orthopaedic hand clinics. A search of a university teaching hospital musculoskeletal radiology database identified 36 patients (mean age 54.2 years) where ultrasonography was used to assess nail-related disorders between April 2003 and January 2007. Clinical, surgical and histological findings were correlated in these cases with ultrasound reports. Ultrasound findings correlated with the provisional diagnosis in 20 (61%) of 33 patients and provided a diagnosis in 3 patients where a provisional diagnosis was unavailable. In 7 of the 13 cases where the clinical diagnosis differed from ultrasound findings, a lump originally diagnosed as cystic in origin was shown to be solid on ultrasound. Different nail pathologies showed different characteristics on ultrasonography, including differences in vascularity, echogenicity, changes in nail structure/shape and extension into the nail bed, matrix, fold or evidence of bony erosion. The ultrasound findings correlated with histological analysis and intra-operative assessment in 10 of 15 patients who underwent operative treatment. Ultrasound provides important information on the anatomy of the nail apparatus and can differentiate solid and cystic lesions. It can be used as a diagnostic tool and can therefore help in pre-operative planning of nail-related disorders. In our series ultrasound supported or improved upon the clinical diagnosis in 31 (86%) out of the 36 patients presenting with nail-related disorders.

Transthoracic ultrasonography for the immunocompromised patient. A pilot project that introduces transthoracic ultrasonography for the follow-up of hematological patients in Romania.

PubMed

Frinc, Ioana; Ilies, Petru; Zaharie, Florin; Dima, Delia; Tanase, Alina; Petrov, Ljubomir; Irimie, Alexandru; Berce, Cristian; Lisencu, Cosmin; Berindan-Neagoe, Ioana; Tomuleasa, Ciprian; Bojan, Anca

2017-06-01

In the past decade, there has been significant progress in clinical hematology with the discovery of targeted molecules and thus the achievement of both hematologic and molecular responses. Nevertheless, chemotherapy remains the treatment of choice for many types of hematological malignancies. Aggressive chemotherapy leads to immunosuppression, accompanied by a high rate of infections and an increased rate of treatment-related mortality. Invasive fungal infections as well as more common bacterial and viral infections are frequent in immunocompromised patients as they are difficult to diagnose and treat. Pleuropulmonary infections in immunocompromised patients are diagnosed using clinical examination, imaging and laboratory tests. Many laboratory tests are run for several days before a final result is given and are expensive. Computer tomography is a reliable technique, but it is encumbered by high irradiation and high cost, and can assess lesions larger than 1 cm. Transthoracic ultrasound is a modern method, used in the diagnostic algorithm of pleuropulmonary pathology. It allows the diagnosis of small lesions, can be performed at the patients' bedside, with acceptable costs and no irradiation. A fast, informed and accurate medical decision is essential for a favorable outcome in immunosuppressed patients with an adjacent infection. In the current case series we present the implementation of a new protocol for the follow-up of immunocompromised patients using transthoracic ultrasonography, of great potential use in the clinic.

Technical description of endoscopic ultrasonography with fine-needle aspiration for the staging of lung cancer.

PubMed

Kramer, Henk; van Putten, John W G; Douma, W Rob; Smidt, Alie A; van Dullemen, Hendrik M; Groen, Harry J M

2005-02-01

Endoscopic ultrasonography (EUS) is a novel method for staging of the mediastinum in lung cancer patients. The recent development of linear scanners enables safe and accurate fine-needle aspiration (FNA) of mediastinal and upper abdominal structures under real-time ultrasound guidance. However, various methods and equipment for mediastinal EUS-FNA are being used throughout the world, and a detailed description of the procedures is lacking. A thorough description of linear EUS-FNA is needed. A step-by-step description of the linear EUS-FNA procedure as performed in our hospital will be provided. Ultrasonographic landmarks will be shown on images. The procedure will be related to published literature, with a systematic literature search. EUS-FNA is an outpatient procedure under conscious sedation. The typical linear EUS-FNA procedure starts with examination of the retroperitoneal area. After this, systematic scanning of the mediastinum is performed at intervals of 1-2cm. Abnormalities are noted, and FNA of the abnormalities can be performed. Specimens are assessed for cellularity on-site. The entire procedure takes 45-60 min. EUS-FNA is minimally invasive, accurate, and fast. Anatomical areas can be reached that are inaccessible for cervical mediastinoscopy. EUS-FNA is useful for the staging of lung cancer or the assessment and diagnosis of abnormalities in the posterior mediastinum.

In-utero diagnosis of Norrie disease by ultrasonography.

PubMed

Redmond, R M; Vaughan, J I; Jay, M; Jay, B

1993-03-01

Obstetric ultrasonography of an obligate Norrie disease carrier revealed bilateral retinal detachments in a third trimester male fetus. Postnatal examination confirmed the diagnosis of Norrie disease. DNA linkage analysis with the markers L1.28 and MAO had been uninformative for this family. This report suggests that retinal detachment occurs late in the gestation of the affected fetus.

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.

Accurate evaluation and analysis of functional genomics data and methods

PubMed Central

Greene, Casey S.; Troyanskaya, Olga G.

2016-01-01

The development of technology capable of inexpensively performing large-scale measurements of biological systems has generated a wealth of data. Integrative analysis of these data holds the promise of uncovering gene function, regulation, and, in the longer run, understanding complex disease. However, their analysis has proved very challenging, as it is difficult to quickly and effectively assess the relevance and accuracy of these data for individual biological questions. Here, we identify biases that present challenges for the assessment of functional genomics data and methods. We then discuss evaluation methods that, taken together, begin to address these issues. We also argue that the funding of systematic data-driven experiments and of high-quality curation efforts will further improve evaluation metrics so that they more-accurately assess functional genomics data and methods. Such metrics will allow researchers in the field of functional genomics to continue to answer important biological questions in a data-driven manner. PMID:22268703

Cost-effectiveness analysis of ultrasonography screening for nonalcoholic fatty liver disease in metabolic syndrome patients.

PubMed

Phisalprapa, Pochamana; Supakankunti, Siripen; Charatcharoenwitthaya, Phunchai; Apisarnthanarak, Piyaporn; Charoensak, Aphinya; Washirasaksiri, Chaiwat; Srivanichakorn, Weerachai; Chaiyakunapruk, Nathorn

2017-04-01

Nonalcoholic fatty liver disease (NAFLD) can be diagnosed early by noninvasive ultrasonography; however, the cost-effectiveness of ultrasonography screening with intensive weight reduction program in metabolic syndrome patients is not clear. This study aims to estimate economic and clinical outcomes of ultrasonography in Thailand. Cost-effectiveness analysis used decision tree and Markov models to estimate lifetime costs and health benefits from societal perspective, based on a cohort of 509 metabolic syndrome patients in Thailand. Data were obtained from published literatures and Thai database. Results were reported as incremental cost-effectiveness ratios (ICERs) in 2014 US dollars (USD) per quality-adjusted life year (QALY) gained with discount rate of 3%. Sensitivity analyses were performed to assess the influence of parameter uncertainty on the results. The ICER of ultrasonography screening of 50-year-old metabolic syndrome patients with intensive weight reduction program was 958 USD/QALY gained when compared with no screening. The probability of being cost-effective was 67% using willingness-to-pay threshold in Thailand (4848 USD/QALY gained). Screening before 45 years was cost saving while screening at 45 to 64 years was cost-effective. For patients with metabolic syndromes, ultrasonography screening for NAFLD with intensive weight reduction program is a cost-effective program in Thailand. Study can be used as part of evidence-informed decision making. Findings could contribute to changes of NAFLD diagnosis practice in settings where economic evidence is used as part of decision-making process. Furthermore, study design, model structure, and input parameters could also be used for future research addressing similar questions.

Magnetic resonance imaging, ultrasonography and histology of the suspensory ligament origin: a comparative study of normal anatomy of warmblood horses.

PubMed

Bischofberger, A S; Konar, M; Ohlerth, S; Geyer, H; Lang, J; Ueltschi, G; Lischer, C J

2006-11-01

The diagnosis of lameness caused by proximal metacarpal and metatarsal pain can be challenging. Magnetic resonance imaging (MRI) offers the possibility for further diagnosis but there have been no studies on the normal MRI appearance of the origin of the suspensory ligament (OSL) in conjunction with ultrasonography and histology. To describe the MRI appearance of the OSL in fore- and hindlimbs of sound horses and compare it to the ultrasonographic and histological appearance. The findings can be used as reference values to recognise pathology in the OSL. The OSL in the fore- and hindlimbs of 6 sound horses was examined by ultrasonography prior to death, and MRI and histology post mortem. Qualitative evaluation and morphometry of the OSL were performed and results of all modalities compared. Muscular tissue, artefacts, variable SL size and shape complicated ultrasonographic interpretation. In MRI and histology the forelimb OSL consisted of 2 portions, the lateral being significantly thicker than medial. The hindlimb SL had a single large area of origin. In fore- and hindlimbs, the amount of muscular tissue was significantly larger laterally than medially. Overall SL measurements using MRI were significantly higher than using histology and ultrasonography and histological higher than ultrasonographic measurements. Morphologically, there was a good correlation between MRI and histology. MRI provides more detailed information than ultrasonography regarding muscle fibre detection and OSL dimension and correlates morphologically well with histology. Therefore, ultrasonographic results should be regarded with caution. MRI may be a diagnostic aid when other modalities fail to identify clearly the cause of proximal metacarpal and metatarsal pain; and may improve selection of adequate therapy and prognosis for injuries in this region.

“Nodule in Nodule” on Thyroid Ultrasonography: Possibility of Follicular Carcinoma Transformed from Benign Thyroid Tumor

PubMed Central

Kobayashi, Kaoru; Ota, Hisashi; Hirokawa, Mitsuyoshi; Yabuta, Tomonori; Fukushima, Mitsuhiro; Masuoka, Hiroo; Higashiyama, Takuya; Kihara, Minoru; Ito, Yasuhiro; Miya, Akihiro; Miyauchi, Akira

2017-01-01

Background It is generally considered impossible to differentiate follicular carcinomas from follicular adenomas by means of ultrasonography or cytology before surgery. Therefore, follicular carcinoma is histopathologically diagnosed by verifying capsular and/or vascular invasion after surgery. However, ultrasonography may play an important role in diagnosing follicular carcinoma preoperatively in a small number of cases. Case Description Four cases of follicular carcinoma or follicular neoplasm that transformed from a benign thyroid tumor and demonstrated a “nodule in nodule” appearance on ultrasonography are presented in this report. Characteristic ultrasound features of such patients are: (1) a “nodule in nodule” appearance, (2) a well-defined boundary line between the nodules, and (3) separate distribution of blood signals within each nodule. Conclusion A small number of patients with follicular carcinomas or follicular neoplasms may present with a “nodule in nodule” appearance on ultrasonography. It was suggested a long time ago that follicular carcinomas may develop from benign thyroid tumors. The fact that follicular carcinomas appear within benign tumors may be evidence of thyroid tumorigenesis. PMID:28589092

The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center

PubMed Central

2012-01-01

Background This study was designed to compare the effectiveness of using auscultation, pH measurements of gastric aspirates, and ultrasonography as physical examination methods to verify nasogastric tube(NGT) placement in emergency room patients with low consciousness who require NGT insertion. Methods The study included 47 patients who were all over 18 years of age. In all patients, tube placement was verified by chest X-rays. Auscultation, pH analysis of gastric aspirates, and ultrasonography were conducted on each patient in random order. The mean patient age was 57.62 ± 17.24 years, and 28 males (59.6%) and 19 females (40.4%) were included. The NGT was inserted by an emergency room resident. For pH testing, gastric aspirates were dropped onto litmus paper, and the resulting color of the paper was compared with a reference table. Ultrasonography was performed by an emergency medicine specialist, and the chest X-ray examination was interpreted by a different emergency medicine specialist who did not conduct the ultrasonography test. The results of the auscultation, gastric aspirate pH, and ultrasonography examinations were compared with the results of the chest x-ray examination. Results The sensitivity and specificity were 100% and 33.3%, respectively, for auscultation and 86.4% and 66.7%, respectively, for ultrasonography. Kappa values were the highest for auscultation at 0.484 compared to chest x-rays, followed by 0.299 for ultrasonography and 0.444 for pH analysis of the gastric aspirate. The ultrasonography has a positive predictive value of 97.4% and a negative predictive value of 25%. Conclusions Ultrasonography is useful for confirming the results of auscultation after NGT insertion among patients with low consciousness at an emergency center. When ultrasound findings suggest that the NGT placement is not gastric, additional chest X-ray should be performed. PMID:22691418

The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center.

PubMed

Kim, Hyung Min; So, Byung Hak; Jeong, Won Jung; Choi, Se Min; Park, Kyu Nam

2012-06-12

This study was designed to compare the effectiveness of using auscultation, pH measurements of gastric aspirates, and ultrasonography as physical examination methods to verify nasogastric tube(NGT) placement in emergency room patients with low consciousness who require NGT insertion. The study included 47 patients who were all over 18 years of age. In all patients, tube placement was verified by chest X-rays. Auscultation, pH analysis of gastric aspirates, and ultrasonography were conducted on each patient in random order. The mean patient age was 57.62 ± 17.24 years, and 28 males (59.6%) and 19 females (40.4%) were included. The NGT was inserted by an emergency room resident. For pH testing, gastric aspirates were dropped onto litmus paper, and the resulting color of the paper was compared with a reference table. Ultrasonography was performed by an emergency medicine specialist, and the chest X-ray examination was interpreted by a different emergency medicine specialist who did not conduct the ultrasonography test. The results of the auscultation, gastric aspirate pH, and ultrasonography examinations were compared with the results of the chest x-ray examination. The sensitivity and specificity were 100% and 33.3%, respectively, for auscultation and 86.4% and 66.7%, respectively, for ultrasonography. Kappa values were the highest for auscultation at 0.484 compared to chest x-rays, followed by 0.299 for ultrasonography and 0.444 for pH analysis of the gastric aspirate. The ultrasonography has a positive predictive value of 97.4% and a negative predictive value of 25%. Ultrasonography is useful for confirming the results of auscultation after NGT insertion among patients with low consciousness at an emergency center. When ultrasound findings suggest that the NGT placement is not gastric, additional chest X-ray should be performed.

Ultrasonography of the biliary tract - up to date. The importance of correlation between imaging methods and patients' signs and symptoms.

PubMed

Badea, Radu; Zaro, Răzvan; Tanțău, Marcel; Chiorean, Liliana

2015-09-01

Ultrasonography is generally accepted and performed as a first choice imaging technique in patients with jaundice. The method allows the discrimination between cholestatic and mechanical jaundice. The existing procedures are multiple: gray scale, Doppler, i.v. contrast enhancement, elastography, tridimensional ultrasonography, each of these with different contribution to the positive and differential diagnosis regarding the nature of the jaundice. The final diagnosis is a multimodal one and the efficiency is dependent on the level of the available technology, the examiner's experience, the degree and modality of integration of the data within the clinical context, as well as on the portfolio of available imaging procedures. This review shows the main ultrasonographic methods consecrated in the evaluation of the biliary tree. It also underlines the integrated character of the procedures, as well as the necessity to correlate with other imaging methods and the clinical situation.

Return to contact sports following infectious mononucleosis: the role of serial ultrasonography.

PubMed

O'Connor, Tony E; Skinner, Liam J; Kiely, Patrick; Fenton, John E

2011-08-01

Splenic rupture is a rare but potentially fatal complication of infectious mononucleosis. Athletes returning to contact sports following infectious mononucleosis are at potential risk of splenic rupture secondary to abdominal trauma. No clear consensus exists as to when it is safe to allow these athletes to return to contact sports. Suggested periods of abstinence have ranged from 2 weeks to 6 months. We outline our experiences with the use of abdominal ultrasonography at 1 month after the diagnosis of infectious mononucleosis as a means of determining when athletes can safely return to contact sports. Our study group was made up of 19 such patients (mean age: 16.7 yr). We found that 16 of these patients (84%) had normal splenic dimensions on ultrasonography 1 month after diagnosis, and they were therefore allowed to return to contact sports. While the remaining 3 patients had an enlarged spleen at 1 month, their splenic dimensions had all returned to normal when ultrasonographic examination was repeated at 2 months postdiagnosis. We conclude that serial abdominal ultrasonography allows for informed decision making in determining when athletes can safely return to contact sports following infectious mononucleosis.

Evaluation of postoperative anal functions using endoanal ultrasonography and anorectal manometry in children with congenital anorectal malformations.

PubMed

Wang, Zhichao; Hu, Lijun; Jin, Xianqing; Li, Xiaoqing; Xu, Lixia

2016-03-01

The aim of this study was to assess the postoperative anorectal anatomy and function in children with congenital anorectal malformations (ARM) using endoanal ultrasonography (EUS) and anorectal manometry. This study included 47 children who had undergone posterior sagittal anorectoplasty (PSARP) or transperineal anorectoplasty for the repair of an ARM. Children were grouped according to symptoms of defecation disorder, including normal defecation, fecal soiling, fecal incontinence, and constipation. Ten children with no history of anal or rectal diseases served as healthy controls. A well-established scoring system was used for the evaluation of anal function and defecation disorder. EUS showed significant differences in the thickness of the interior sphincter between the ARM patients and the healthy controls (P<0.05). However, no significant difference was found in the thickness of the interior sphincters between the PSARP group and transperineal anorectoplasty group (P>0.05). Anorectal manometry showed that the balloon volumes were significantly different between the surgical group and the control group (P<0.01), and between the low defect group and the intermediate-high defect group (P=0.022). Balloon volume was significantly correlated with anal function scores (r=-0.30, P<0.05). EUS and anorectal manometry can provide objective assessment of postoperative anorectal anatomy and function in children with ARM. Copyright © 2016 Elsevier Inc. All rights reserved.

Quantitative Muscle Ultrasonography in Carpal Tunnel Syndrome.

PubMed

Lee, Hyewon; Jee, Sungju; Park, Soo Ho; Ahn, Seung-Chan; Im, Juneho; Sohn, Min Kyun

2016-12-01

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. 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. 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). 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.

High-resolution ultrasonography in assessing temporomandibular joint disc position.

PubMed

Talmaceanu, Daniel; Lenghel, Lavinia Manuela; Bolog, Nicolae; Popa Stanila, Roxana; Buduru, Smaranda; Leucuta, Daniel Corneliu; Rotar, Horatiu; Baciut, Mihaela; Baciut, Grigore

2018-02-04

The purpose of this study was to determine the diagnostic value of high-resolution ultrasonography (US) in temporomandibular joint (TMJ) disc displacements. A number of 74 patients (148 TMJs) with signs and symptoms of TMJ disorders, according to the Research Diagnostic Criteria for Temporomandibular Disorders, were included in this study. All patients received US and magnetic resonance imaging (MRI) of both TMJs 1 to 5 days after the clinical examination. MRI examinations were performed using 1.5 T MRI equipment (Siemens Avanto, Siemens, Erlangen). Ultrasonographic examination was performed on a Hitachi EUB 8500 (Hitachi Medical Corp., Tokyo, Japan) scanner with L 54 M6.5-13 MHz linear transducer. MRI depicted 68 (45.95%) normal joints, 47 (31.76%) with disc displacement with reduction, 33 (22.3%) with disc displacement without reduction and 34 (22.97%) with degenerative changes. US detected 78 (52.7%) normal joints, 37 (25%) with disc displacement with reduction, 33 (22.3%) with disc displacement without reduction and 21 (14.19%) with degenerative changes. Compared to MRI, US showed a sensitivity of 93.1%, specificity of 87.88%, accuracy of 90.32%, a positive predictive value of 87.1% and a negative predictive value of 93.55% for overall diagnosis of disc displacement. The Youden index was 0.81. Based on our results, high-resolution ultrasonography showed high sensitivity, specificity and accuracy in the diagnosis of TMJ disc displacement. It could be a valuable imaging technique in assessing TMJ disc position. The diagnostic value of high-resolution ultrasonography depends strictly on the examiner's skills and on the equipment used.

Doppler ultrasonography of the pectinis oculi artery in harpy eagles (Harpia harpyja)

PubMed Central

de Moraes, Wanderlei; Ferreira, Thiago A.C.; Somma, André T.; Cubas, Zalmir S.; Moore, Bret A.; Montiani-Ferreira, Fabiano

2017-01-01

Twenty harpy eagles (Harpia harpyja) without systemic or ocular diseases were examined to measure blood velocity parameters of the pectinis oculi artery using Doppler ultrasonography. Pectinate artery resistive index (RI) and pulsatility index (PI) were investigated using ocular Doppler ultrasonography. The mean RI and PI values across all eyes were 0.44±0.10 and 0.62±0.20 respectively. Low RI and PI values found in the harpy eagle´s pectinis oculi artery compared with the American pekin ducks one and other tissue suggest indeed a high metabolic activity in pecten oculi and corroborates the hypothesis of a nutritional function and/or intraocular pressure regulation. PMID:28540254

Preoperative evaluation of patients with squamous cell carcinoma of the oral cavity: fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography and ultrasonography versus histopathology.

PubMed

Sugawara, Chieko; Takahashi, Akira; Kubo, Michiko; Otsuka, Hideki; Ishimaru, Naozumi; Miyamoto, Youji; Honda, Eiichi

2012-10-01

The purpose of this retrospective study was to compare fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and ultrasonography (US) in the staging of patients with squamous cell carcinoma of the oral cavity. We compared preoperative evaluations regarding lymph nodes using PET/CT, US, and both methods. The cutoff for the maximum standardized uptake value (SUV(max)) in PET/CT was set at 2.7 by a receiver operating characteristic analysis that was based on the histopathological diagnosis. US was used to examine internal structural changes on B-mode and hilar vascularity on power Doppler. The performance of PET/CT and US in combination was better than that of each modality separately. However, there were histopathological changes that could not be detected on PET/CT or US. PET/CT could not detect nodes with necrotic or cystic changes. US could not detect lymph nodes that did not have abnormal structures. PET/CT and US are complementary tools to evaluate preoperative patients. Copyright © 2012 Elsevier Inc. All rights reserved.

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

Ultrasonographic Evaluation of Zone II Partial Flexor Tendon Lacerations of the Fingers: A Cadaveric Study.

PubMed

Kazmers, Nikolas H; Gordon, Joshua A; Buterbaugh, Kristen L; Bozentka, David J; Steinberg, David R; Khoury, Viviane

2018-04-01

Accurate assessment of zone II partial flexor tendon lacerations in the finger is clinically important. Surgical repair is recommended for lacerations of greater than 50% to 60%. Our goal was to evaluate ultrasonographic test characteristics and accuracy in identifying partial flexor tendon lacerations in a cadaveric model. From fresh-frozen above-elbow human cadaveric specimens, 32 flexor digitorum profundus tendons were randomly selected to remain intact or receive low- or high-grade lacerations involving 10% to 40% and 60% to 90% of the radioulnar width within Verdan Zone II, respectively. Static and dynamic ultrasonography using a linear array 14-MHz transducer was performed by a blinded musculoskeletal radiologist. Sensitivities, specificities, and other standard test performance metrics were calculated. Actual and measured percentages of tendon laceration were compared by the paired t test. After randomization, 24 tendons were lacerated (12 low- and 12 high-grade), whereas 8 remained intact. The sensitivity and specificity in detecting the presence versus absence of a partial laceration were 0.54 and 0.75, respectively, with positive and negative likelihood ratio values of 2.17 and 0.61. For low-grade lacerations, the sensitivity and specificity were 0.25 and 0.85, compared to 0.83 and 0.85 for high-grade lacerations. Ultrasonography underestimated the percentage of tendon involvement by a mean of 18.1% for the study population as a whole (95% confidence interval, 9.0% to 27.2%; P < .001) but accurately determined the extent for correctly diagnosed high-grade lacerations (-6.7%; 95% confidence interval, -18.7% to 5.2%; P = .22). Ultrasonography was useful in identifying and characterizing clinically relevant high-grade zone II partial flexor digitorum profundus lacerations in a cadaveric model. © 2017 by the American Institute of Ultrasound in Medicine.

Cost-effectiveness analysis of ultrasonography screening for nonalcoholic fatty liver disease in metabolic syndrome patients

PubMed Central

Phisalprapa, Pochamana; Supakankunti, Siripen; Charatcharoenwitthaya, Phunchai; Apisarnthanarak, Piyaporn; Charoensak, Aphinya; Washirasaksiri, Chaiwat; Srivanichakorn, Weerachai; Chaiyakunapruk, Nathorn

2017-01-01

Abstract Background: Nonalcoholic fatty liver disease (NAFLD) can be diagnosed early by noninvasive ultrasonography; however, the cost-effectiveness of ultrasonography screening with intensive weight reduction program in metabolic syndrome patients is not clear. This study aims to estimate economic and clinical outcomes of ultrasonography in Thailand. Methods: Cost-effectiveness analysis used decision tree and Markov models to estimate lifetime costs and health benefits from societal perspective, based on a cohort of 509 metabolic syndrome patients in Thailand. Data were obtained from published literatures and Thai database. Results were reported as incremental cost-effectiveness ratios (ICERs) in 2014 US dollars (USD) per quality-adjusted life year (QALY) gained with discount rate of 3%. Sensitivity analyses were performed to assess the influence of parameter uncertainty on the results. Results: The ICER of ultrasonography screening of 50-year-old metabolic syndrome patients with intensive weight reduction program was 958 USD/QALY gained when compared with no screening. The probability of being cost-effective was 67% using willingness-to-pay threshold in Thailand (4848 USD/QALY gained). Screening before 45 years was cost saving while screening at 45 to 64 years was cost-effective. Conclusions: For patients with metabolic syndromes, ultrasonography screening for NAFLD with intensive weight reduction program is a cost-effective program in Thailand. Study can be used as part of evidence-informed decision making. Translational Impacts: Findings could contribute to changes of NAFLD diagnosis practice in settings where economic evidence is used as part of decision-making process. Furthermore, study design, model structure, and input parameters could also be used for future research addressing similar questions. PMID:28445256

Hepatic perivascular epithelioid cell tumor (PEComa): dynamic CT, MRI, ultrasonography, and pathologic features--analysis of 7 cases and review of the literature.

PubMed

Tan, Yan; Xiao, En-hua

2012-10-01

To evaluate the dynamic CT, MRI, ultrasonography, and pathologic features of hepatic perivascular epithelioid cell tumor (PEComa), improving the understanding and diagnosis of the tumor. A retrospective analysis of CT, MRI, ultrasonography, and pathologic features of 7 hepatic PEComas diagnosed by pathology during 1st January 2005 to 1st September 2011 in our hospital. The performance of dynamic CT, MRI, and ultrasonography revealed that lesions were regular masses with well-defined borders, the maximum diameters were 2.5-8.5 cm (mean = 4 cm), density was homogeneous, contrast-enhanced CT and MRI showed the lesions were significantly and heterogeneously enhanced on arterial phase, less enhanced on portal venous phase, and slightly hypodense on delayed phase. One patient had multiple hepatic lesions and had delayed enhancement. There were no backgrounds of hepatitis and cirrhosis, enlarged lymph nodes, or distant metastases. Pathology showed the gross appearance of the tumor was smooth. Tumor cells were round or polygonal, with clear boundaries and clear membranes, and had abundant translucent cytoplasm. Nuclei were round, with medium size. Tumor cells were epithelial-like cells and arranged in dense sheets. Immunohistochemistry showed that most of them were positive in HMB45 and MelanA, S-100, SMA, while negative in CgA, Syn, CK, CD117, CD10, and CD34. Dynamic CT, MRI, ultrasonography, and pathology of PEComa had some characteristics of benign tumor's performance. Enhanced scan showed PEComa quickly enhanced on arterial phase and enhanced less on portal venous phase. Knowing these characteristics could help to improve the understanding and diagnosis of hepatic PEComa.

COMPARISON BETWEEN COMPUTED TOMOGRAPHIC ARTHROGRAPHY, RADIOGRAPHY, ULTRASONOGRAPHY, AND ARTHROSCOPY FOR THE DIAGNOSIS OF FEMOROTIBIAL JOINT DISEASE IN WESTERN PERFORMANCE HORSES.

PubMed

Nelson, Brad B; Kawcak, Chris E; Goodrich, Laurie R; Werpy, Natasha M; Valdés-Martínez, Alejandro; McIlwraith, C Wayne

2016-07-01

The femorotibial joints are a common source of lameness in Western performance horses. The objective of this prospective study was to compare the radiography, ultrasonography, computed tomographic arthrography (CTA), and arthroscopy findings in horses with lameness localized to the femorotibial joints. Twenty-five stifles in 24 horses were included and were evaluated with all four of these diagnostic methods. Defects detected in femorotibial joint structures were compared between diagnostic methods using a McNemar's test to evaluate for disagreement. Cranial medial meniscotibial desmopathy was most detected on arthroscopy (in 14/25 cases) and was only detected on ultrasonography in three out of 11 (27.3%) arthroscopically observed cases, but was detected on CTA in nine out of 12 (75%) arthroscopically observed cases. Medial meniscal injury located on the craniolateral border was most detected on arthroscopy (n = 9) and was detected on CTA in five cases, but on ultrasonography in 0 cases. Detection of articular cartilage defects on the medial femoral condyle was most detected with arthroscopy (24/25, 96% cases) and was also detected on CTA in 12/20 (60%) cases with a significant disagreement identified between modalities (P = 0.02). Cranial and caudal cruciate ligament defects were detected on CTA in 6/22 (27.3%) and 7/19 (36.8%) cases, respectively, and with arthroscopy in 3/25 (12%) and 2/25 (8%) cases, respectively. The use of CTA detected more defects in the cruciate ligaments, proximal tibia, and ligament entheses than the other diagnostic methods, but was not reliable for detection of articular cartilage damage on the medial femoral condyle. © 2016 American College of Veterinary Radiology.

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. © 2014 Blackwell Verlag GmbH.

International guidelines for contrast-enhanced ultrasonography: ultrasound imaging in the new millennium

PubMed Central

Lorentzen, Torben

2016-01-01

The intent of this review is to discuss and comment on common clinical scenarios in which contrast-enhanced ultrasonography (CEUS) may play a decisive role and to illustrate important points with typical cases. With the advent of CEUS, the scope of indications for ultrasonography has been dramatically extended, and now includes functional imaging and tissue characterization, which in many cases enable tumor diagnosis without a biopsy. It is virtually impossible to imagine the practice of modern medicine as we know it in high-income countries without the use of imaging, and yet, an estimated two thirds of the global population may receive no such care. Ultrasound imaging with CEUS has the potential to correct this inequity. PMID:26867761

Colour Doppler and microbubble contrast agent ultrasonography do not improve cancer detection rate in transrectal systematic prostate biopsy sampling.

PubMed

Taverna, Gianluigi; Morandi, Giovanni; Seveso, Mauro; Giusti, Guido; Benetti, Alessio; Colombo, Piergiuseppe; Minuti, Francesco; Grizzi, Fabio; Graziotti, Pierpaolo

2011-12-01

What's known on the subject? and What does the study add? Transrectal gray-scale ultrasonography guided prostate biopsy sampling is the method for diagnosing prostate cancer (PC) in patients with an increased prostate specific antigen level and/or abnormal digital rectal examination. Several imaging strategies have been proposed to optimize the diagnostic value of biopsy sampling, although at the first biopsy nearly 10-30% of PC still remains undiagnosed. This study compares the PC detection rate when employing Colour Doppler ultransongraphy with or without the injection of SonoVue™ microbubble contrast agent, versus the transrectal ultrasongraphy-guided systematic biopsy sampling. The limited accuracy, sensitivity, specificity and the additional cost of using the contrast agent do not justify its routine application in PC detection. • To compare prostate cancer (PC) detection rate employing colour Doppler ultrasonography with or without SonoVue™ contrast agent with transrectal ultrasonography-guided systematic biopsy sampling. • A total of 300 patients with negative digital rectal examination and transrectal grey-scale ultrasonography, with PSA values ranging between 2.5 and 9.9 ng/mL, were randomized into three groups: 100 patients (group A) underwent transrectal ultrasonography-guided systematic bioptic sampling; 100 patients (group B) underwent colour Doppler ultrasonography, and 100 patients (group C) underwent colour Doppler ultrasonography before and during the injection of SonoVue™. • Contrast-enhanced targeted biopsies were sampled into hypervascularized areas of peripheral, transitional, apical or anterior prostate zones. • All the patients included in Groups B and C underwent a further 13 systematic prostate biopsies. The cancer detection rate was calculated for each group. • In 88 (29.3%) patients a histological diagnosis of PC was made, whereas 22 (7.4%) patients were diagnosed with high-grade prostatic intraepithelial

Three-dimensional ultrasonography and power Doppler for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding.

PubMed

El-Sharkawy, Mohamed; El-Mazny, Akmal; Ramadan, Wafaa; Hatem, Dina; Abdel-Hafiz, Aly; Hammam, Mohamed; Nada, Adel

2016-03-16

Ultrasonography has been extensively used in women suspected of having a gynecological malignancy. The aim of this study is to evaluate the efficacy of 3D ultrasonography and power Doppler for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding. This cross-sectional study included 78 premenopausal women with abnormal uterine bleeding scheduled for hysteroscopy and endometrial curettage. The endometrial thickness (ET), uterine artery pulsatility index (PI) and resistance index (RI), and endometrial volume (EV) and 3D power Doppler vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were measured and compared with hysteroscopic and histopathologic findings. The ET (P <0.001), EV (P <0.001), and endometrial VI (P <0.001) and VFI (P = 0.043) were significantly increased in patients with atypical endometrial hyperplasia and endometrial carcinoma (n = 10) than those with benign endometrium (n = 68); whereas, the uterine artery PI and RI and endometrial FI were not significantly different between the two groups. The best marker for discrimination between benign and malignant endometrium was the VI with an area under the ROC curve of 0.88 at a cutoff value of 0.81%. 3D ultrasonography and power Doppler, especially endometrial VI, may be useful for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding.

Screening Performance Characteristic of Ultrasonography and Radiography in Detection of Pleural Effusion; a Meta-Analysis.

PubMed

Yousefifard, Mahmoud; Baikpour, Masoud; Ghelichkhani, Parisa; Asady, Hadi; Shahsavari Nia, Kavous; Moghadas Jafari, Ali; Hosseini, Mostafa; Safari, Saeed

2016-01-01

The role of ultrasonography in detection of pleural effusion has long been a subject of interest but controversial results have been reported. Accordingly, this study aims to conduct a systematic review of the available literature on diagnostic value of ultrasonography and radiography in detection of pleural effusion through a meta-analytic approach. An extended search was done in databases of Medline, EMBASE, ISI Web of Knowledge, Scopus, Cochrane Library, and ProQuest. Two reviewers independently extracted the data and assessed the quality of the articles. Meta-analysis was performed using a mixed-effects binary regression model. Finally, subgroup analysis was carried out in order to find the sources of heterogeneity between the included studies. 12 studies were included in this meta-analysis (1554 subjects, 58.6% male). Pooled sensitivity of ultrasonography in detection of pleural effusion was 0.94 (95% CI: 0.88-0.97; I2= 84.23, p<0.001) and its pooled specificity was calculated to be 0.98 (95% CI: 0.92-1.0; I2= 88.65, p<0.001), while sensitivity and specificity of chest radiography were 0.51 (95% CI: 0.33-0.68; I2= 91.76, p<0.001) and 0.91 (95% CI: 0.68-0.98; I2= 92.86, p<0.001), respectively. Sensitivity of ultrasonography was found to be higher when the procedure was carried out by an intensivist or a radiologist using 5-10 MHz transducers. Chest ultrasonography, as a screening tool, has a higher diagnostic accuracy in identification of plural effusion compared to radiography. The sensitivity of this imaging modality was found to be higher when performed by a radiologist or an intensivist and using 5-10MHz probes.

A comparative study of endoscopic ultrasonography versus endoscopic retrograde cholangiopancreatography in children with chronic liver disease.

PubMed

El-Karaksy, Hanaa M; El-Koofy, Nehal M; Okasha, Hussein; Kamal, Naglaa M; Naga, Mazen

2008-09-01

Endoscopic ultrasonography (EUS) is a less invasive modality and may be equal or superior to endoscopic retrograde cholangiopancreatography (ERCP) in visualizing the biliary tree. Its role and feasibility in children need to be accurately defined. This study aimed at evaluation of EUS in assessment of children with chronic liver disease (CLD) in comparison with ERCP. The present study was carried out between September 2004 and February 2006 on 40 children suffering from CLD. Patients were selected from the Pediatric Hepatology Unit, Cairo University Children's Hospital, Egypt. They were included if they had: sonographic (n = 8) or histopathological evidence of biliary pathology (n = 2); autoimmune hepatitis with high gamma glutammyl transpeptidase (GGT) levels and/or not responding to immunosuppressive therapy (n = 15); cryptogenic CLD (n = 13); neonatal cholestasis with relapsing or persistent course (n = 2). They all underwent EUS and ERCP. Three of six cases with intrahepatic biliary radicle dilatation had Caroli's disease by EUS and ERCP; and the other 3 had sclerosing cholangitis. EUS was equal to ERCP in diagnosis of biliary pathology. However, one false positive case was described to have dilatation and tortuosity of the pancreatic duct by EUS as compared to ERCP. EUS could detect early pancreatitis in 5 cases. One case with cryptogenic liver disease proved to have sclerosing cholangitis by both EUS and ERCP. EUS is an important diagnostic tool for biliary pathology and pancreatitis in children with pancreatico-biliary pathology. ERCP should be reserved for therapeutic purposes.

Periportal fibrosis and other liver ultrasonography findings in vinyl chloride workers

PubMed Central

Maroni, M; Mocci, F; Visentin, S; Preti, G; Fanetti, A

2003-01-01

Aims: To investigate the presence of liver lesions and their relation with vinyl chloride monomer (VCM) exposure or other personal risk factors, in workers involved in the production of VCM and polyvinyl chloride (PVC). Methods: A liver ultrasonography examination was conducted in 757 workers, some of whom had long standing service in the production of VCM and PVC. The study involved: assessment of individual past and present VCM exposure of each worker; collection of past personal health history, lifestyle and personal data; routine liver function tests; and liver ultrasonography. Results: No cases of liver malignancies were detected. Angiomas and liver cysts were found with a frequency of occurrence within the expected range of the general population. The main findings consisted of hepatomegaly (34.7%), steatosis (31.8%), and periportal fibrosis (16.0%). A logistic regression analysis indicated that hepatomegaly and steatosis were associated with obesity and lipid metabolism disturbances and not with VCM exposure. Periportal fibrosis, in addition to constitutional or dietary factors, was shown to be associated with VCM exposure, but only when maximum exposure in the subject's history had been at least 200 ppm as a yearly average; no effects were observed at 50 ppm or below. Conclusions: Workers exposed to 200 ppm VCM for at least one year have a fourfold increased risk of developing periportal liver fibrosis. Liver ultrasonography is a suitable and important diagnostic test for the medical surveillance of vinyl chloride workers. PMID:12499459

Ultrasonography assessment of vocal cords mobility in children after cardiac surgery.

PubMed

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

2012-07-01

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

Oxidant/antioxidant status in lambs and sheep with liver and lung cystic echinococcosis diagnosed by ultrasonography and necropsy.

PubMed

Sagkan-Ozturk, A; Durgut, R; Ozturk, O H

2015-03-15

The aim of this study was to evaluate total antioxidant capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI) in sheep and lambs with cyctic eccinocoocosis (CE) diagnosed by ultrasonography and necropsy findings. A total of 9 sheep and 17 lambs with CE were used in this study and the findings were compared to those of 6 healthy control sheep. Ultrasonography were used for the diagnosis of CE in sheep and lambs, and necropsy was performed to check the presence of cysts in liver and lungs. Serum TOS and TAC were measured by a novel colorimetric method. The TOS-to-TAC ratios were also calculated as OSI values. Serum biochemical profiles were determined by conventional measurement methods as well. The mean values for TOS, TAC and OSI were significantly (p<0.001) lower in sheep and lambs with CE when compared with those of the control sheep, and they were also significantly lower in lambs with CE in comparison to the mean values obtained in sheep with CE. The levels of serum albumin, total cholesterol, creatinine, and triglycerides in lambs with CE were found out to decrease significantly (p<0.001) when compared with those of both sheep with EC and the control group. There were no significant differences between the groups in terms of other serum parameters. In addition, when clinically and some biochemical values were evaluated, CE was found to be more severe in lambs than in sheep. It was concluded that although common diagnostic cyst detection is performed by postmortem examination, ultrasonography could successfully be used in conjunction with serum biochemical profile detection and serum TOS, TAC and OSI measurements for diagnosis of cysts in liver and lungs of severely infected living sheep and lambs. Serum albumin, total cholesterol, creatinine, total protein and triglycerides might be used as indicators in sheep and particularly in lambs for the diagnosis of CE. Copyright © 2015 Elsevier B.V. All rights reserved.

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

PubMed Central

2015-01-01

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

Ultrasonography to visualize the upper urinary tract in children with meningomyelocele.

PubMed

Abrahamsson, Kate; Jodal, Ulf; Stokland, Eira; Nordvall, Anders; Sillén, Ulla

2006-10-01

To evaluate the frequency of difficulties when using ultrasonography (US, commonly used to visualize the upper urinary tract) to evaluate renal length and dilatation in children and adolescents with meningomyelocele (MMC), who have excessive obesity or a distorted spine. The records of all children with MMC investigated during 1996-2002 were assessed retrospectively and the last investigation used for analysis. In addition to the US results, the body mass index (BMI) and angulation of the spine were recorded. Of the 160 children investigated, US was not evaluable in 46 (29%), i.e. in 35 (22%) for renal length, in one (1%) for dilatation and in 10 (6%) for both. In 99 patients with a straight spine and mild to moderate angulation, renal length was not measurable in 14 (14%), while dilatation was not evaluable in two (2%). In 61 patients with a severely angled spine, the corresponding values were 31 (51%) and nine (15%), respectively. In eight patients with a BMI of >or= 27 kg/m2 and a straight spine, four of the investigations were not completely evaluable, while six were not in the eight patients with both a BMI of >or= 27 kg/m2 and severe angulation. Both severe spinal angulation and a BMI of >or= 27 kg/m2 significantly reduced the possibility of evaluating the urinary tract by US. However, in an unselected group of children with MMC, dilatation could be evaluated in >90% and renal length in approximately 70%.

A comparison between intrastomal 3D ultrasonography, CT scanning and findings at surgery in patients with stomal complaints.

PubMed

Näsvall, P; Wikner, F; Gunnarsson, U; Rutegård, J; Strigård, K

2014-10-01

Since there are no reliable investigative tools for imaging parastomal hernia, new techniques are needed. The aim of this study was to assess the validity of intrastomal three-dimensional ultrasonography (3D) as an alternative to CT scanning for the assessment of stomal complaints. Twenty patients with stomal complaints, indicating surgery, were examined preoperatively with a CT scan in the supine position and 3D intrastomal ultrasonography in the supine and erect positions. Comparison with findings at surgery, considered to be the true state, was made. Both imaging methods, 3D ultrasonography and CT scanning, showed high sensitivity (ultrasound 15/18, CT scan 15/18) and specificity (ultrasound 2/2, CT scan 1/2) when judged by a dedicated radiologist. Corresponding values for interpretation of CT scans in routine clinical practice was for sensitivity 17/18 and for specificity 1/2. 3D ultrasonography has a high validity and is a promising alternative to CT scanning in the supine position to distinguish a bulge from a parastomal hernia.

External ultrasonography of the neck does not add diagnostic value to integrated positron emission tomography-computed tomography (PET-CT) scanning in the diagnosis of cervical lymph node metastases in patients with esophageal carcinoma.

PubMed

Blom, R L G M; Vliegen, R F A; Schreurs, W M J; Belgers, H J; Stohr, I; Oostenbrug, L E; Sosef, M N

2012-08-01

One of the objectives of preoperative imaging in esophageal cancer patients is the detection of cervical lymph node metastases. Traditionally, external ultrasonography of the neck has been combined with computed tomography (CT) in order to improve the detection of cervical metastases. In general, integrated positron emission tomography-computed tomography (PET-CT) has been shown to be superior to CT or PET regarding staging and therefore may limit the role of external ultrasonography of the neck. The objective of this study was to determine the additional value of external ultrasonography of the neck to PET-CT. This study included all patients referred our center for treatment of esophageal carcinoma. Diagnostic staging was performed to determine treatment plan. Cervical lymph nodes were evaluated by external ultrasonography of the neck and PET-CT. In case of suspect lymph nodes on external ultrasonography or PET-CT, fine needle aspiration (FNA) was performed. Between 2008 and 2010, 170 out of 195 referred patients underwent both external ultrasonography of the neck and PET-CT. Of all patients, 84% were diagnosed with a tumor at or below the distal esophagus. In 140 of 170 patients, the cervical region was not suspect; no FNA was performed. Seven out of 170 patients had suspect nodes on both PET-CT and external ultrasonography. Five out of seven patients had cytologically confirmed malignant lymph nodes, one of seven had benign nodes, in one patient FNA was not performed; exclusion from esophagectomy was based on intra-abdominal metastases. In one out of 170 patients, PET-CT showed suspect nodes combined with a negative external ultrasonography; cytology of these nodes was benign. Twenty-two out of 170 patients had a negative PET-CT with suspect nodes on external ultrasonography. In 18 of 22 patients, cervical lymph nodes were cytologically confirmed benign; in four patients, FNA was not possible or inconclusive. At a median postoperative follow-up of 15 months

Pattern analysis of nerve enlargement using ultrasonography in chronic inflammatory demyelinating polyneuropathy.

PubMed

Jang, Jae Hong; Cho, Charles S; Yang, Kyung-Sook; Seok, Hung Youl; Kim, Byung-Jo

2014-09-01

Focal nerve enlargement is a characteristic finding in chronic inflammatory demyelinating polyneuropathy (CIDP). We performed this study to assess the distribution of nerve enlargement through ultrasonographic examination of peripheral nerves and to correlate the ultrasonographic findings with clinical features. To compare the ultrasonographic features of 10 subjects with CIDP with those of 18 healthy controls, we bilaterally measured the cross-sectional areas (CSA) of the vagus, brachial plexus, musculocutaneous, median, ulnar, radial, sciatic, tibial, common peroneal, and sural nerves. We also analyzed correlations between CSAs and various clinical and electrophysiological features. Mean CSAs were significantly larger in CIDP patients than controls, especially at proximal and non-entrapment sites. CSAs were significantly correlated with muscle strength at initial presentation, but not at the time of ultrasonography. The CSAs of the median and ulnar nerves at the mid-forearm, tibial nerve at 7 cm proximal to the medial malleolus, and sural nerve correlated with the nerve conduction velocity of the corresponding region. Ultrasonography revealed widely distributed nerve enlargement, especially in proximal regions and non-entrapment sites, in patients with CIDP compared with healthy controls. Nerve enlargement correlated well with the electrophysiologic function of the nerve, but not current clinical status. Pattern analysis of nerve enlargement using ultrasonography is a supportive tool in the diagnosis of CIDP. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Comprasion of ovarian stromal blood flow measured by color Doppler ultrasonography in polycystic ovary syndrome patients and healthy women with ultrasonographic evidence of polycystic.

PubMed

Ozdemir, Ozhan; Sari, Mustafa Erkan; Kalkan, Dilek; Koc, Esra Meltem; Ozdemir, Seyda; Atalay, Cemal Resat

2015-04-01

To compare ovarian stromal artery blood flows measured by Doppler ultrasonography of polycystic ovary syndrome (PCOS) patients and healthy women with polycystic ovarian image in ultrasonography. Forty-two patients diagnosed with PCOS according to the criteria of 2003 Rotterdam Concencus Conferance on PCOS and 38 healthy volunteers with polycystic ovarian image in ultrasonography were included in the study. Ovarian volumes and ovarian stromal artery blood flows were measured by 3-dimensional (3-D) ultrasonography and Doppler ultrasonography in all patients. In patients with PCOS, ovarian stromal artery pulsatility index (PI) and resistivity index (RI) were found significantly different from healthy women with polycystic ovarian image in ultrasonography (p < 0.05). 3-D ovarian volumes were found significantly higher in patients with PCOS (p < 0.05), and a negative correlation was also obtained between ovarian volumes and ovarian stromal artery resistivity indices. Ovarian stromal artery Doppler examination could have an importance to explain the pathophysiology of PCOS, but there are few publications in the literature about PCOS and the details of ovarian stromal artery Doppler parameters in patients with polycystic ovarian image only. We conclude that Doppler ultrasonography findings of PCOS patients might be helpful in understanding the clinical follow-up and etiology of the disease.

Practical application of color Doppler ultrasonography in patients with ejaculatory dysfunction.

PubMed

Hara, Ryoei; Nagai, Atsushi; Fujii, Tomohiro; Fukumoto, Kazuhiko; Ohira, Shin; Jo, Yoshimasa; Yokoyama, Teruhiko; Miyaji, Yoshiyuki

2015-06-01

We describe two cases in which dynamic analysis of ejaculation using color Doppler ultrasonography was useful in diagnosis of ejaculatory dysfunction and planning of therapy. The first patient was a 32-year-old man with a diagnosis of retrograde ejaculation. A bladder neck collagen injection was carried out, as the main cause was thought to be the bladder neck remaining open during ejaculation. The patient had antegrade ejaculation 1 week later. The second patient was a 48-year-old man with a diagnosis of anorgasmia accompanied by decreased seminal emission and insufficient function of the rhythmic pelvic striated muscles. The patient was prescribed etilefrine hydrochloride 15 mg/day. The symptom improved 2 weeks after starting this drug. These cases suggest that the use of color Doppler ultrasonography during ejaculation can improve the understanding of ejaculatory dysfunction and therapy for this condition. © 2015 The Japanese Urological Association.

Near-infrared Fluorescence Optical Imaging in Early Rheumatoid Arthritis: A Comparison to Magnetic Resonance Imaging and Ultrasonography.

PubMed

Krohn, Michaela; Ohrndorf, Sarah; Werner, Stephanie G; Schicke, Bernd; Burmester, Gerd-Rüdiger; Hamm, Bernd; Backhaus, Marina; Hermann, Kay-Geert A

2015-07-01

Near-infrared fluorescence optical imaging (FOI) is a novel imaging technology in the detection and evaluation of different arthritides. FOI was validated in comparison to magnetic resonance imaging (MRI), greyscale ultrasonography (GSUS), and power Doppler ultrasonography (PDUS) in patients with early rheumatoid arthritis (RA). Hands of 31 patients with early RA were examined by FOI, MRI, and US. In each modality, synovitis of the wrist, metacarpophalangeal joints (MCP) 2-5, and proximal interphalangeal joints (PIP) 2-5 were scored on a 4-point scale (0-3). Sensitivity and specificity of FOI were analyzed in comparison to MRI and US as reference methods, differentiating between 3 phases of FOI enhancement (P1-3). Intraclass correlation coefficients (ICC) were calculated to evaluate the agreement of FOI with MRI and US. A total of 279 joints (31 wrists, 124 MCP and 124 PIP joints) were evaluated. With MRI as the reference method, overall sensitivity/specificity of FOI was 0.81/0.00, 0.49/0.84, and 0.86/0.38 for wrist, MCP, and PIP joints, respectively. Under application of PDUS as reference, sensitivity was even higher, while specificity turned out to be low, except for MCP joints (0.88/0.15, 0.81/0.76, and 1.00/0.27, respectively). P2 appears to be the most sensitive FOI phase, while P1 showed the highest specificity. The best agreement of FOI was shown for PDUS, especially with regard to MCP and PIP joints (ICC of 0.57 and 0.53, respectively), while correlation with MRI was slightly lower. FOI remains an interesting diagnostic tool for patients with early RA, although this study revealed limitations concerning the detection of synovitis. Further research is needed to evaluate its full diagnostic potential in rheumatic diseases.

Diagnosis and evaluation of gastric cancer by positron emission tomography

PubMed Central

Wu, Chen-Xi; Zhu, Zhao-Hui

2014-01-01

Gastric cancer is the second leading cause of cancer mortality worldwide. The diagnosis of gastric cancer has been significantly improved with the broad availability of gastrointestinal endoscopy. Effective technologies for accurate staging and quantitative evaluation are still in demand to merit reasonable treatment and better prognosis for the patients presented with advanced disease. Preoperative staging using conventional imaging tools, such as computed tomography (CT) and endoscopic ultrasonography, is inadequate. Positron emission tomography (PET), using 18F-fluorodeoxyglucose (FDG) as a tracer and integrating CT for anatomic localization, holds a promise to detect unsuspected metastasis and has been extensively used in a variety of malignancies. However, the value of FDG PET/CT in diagnosis and evaluation of gastric cancer is still controversial. This article reviews the current literature in diagnosis, staging, response evaluation, and relapse monitoring of gastric cancer, and discusses the current understanding, improvement, and future prospects in this area. PMID:24782610

Two-dimensional ultrasonography of the brain: its diagnostic usefullness in herpes simplex encephalitis and cytomegalic inclusion disease.

PubMed

Matsumoto, N; Yano, S; Miyao, M; Kamoshita, S; Itoh, K

1983-01-01

We have used brain ultrasonography in diagnosing and following up two infants, one with herpes simplex encephalitis and the other with cytomegalic inclusion disease. It was found that this technique was very useful to observe the changes of the brain parenchyma such as cystic degeneration and periventricular calcification. Also because it is non-invasive and an easy procedure, ultrasonography can be applied even for infants in critical condition when needed.

[Practical Use of Doppler Ultrasonography of the Cardiovascular System and Clinical Laboratory Tests for the Management of Pulmonary Embolism].

PubMed

Mizukami, Naoko

2015-08-01

Acute or chronic pulmonary embolism (PE) is a serious disease, and the risk of mortality is increased if untreated. In 90% of cases the embolus source is deep vein thrombosis (DVT) of the lower limbs or pelvic cavity. Therefore, it is necessary to recognize these as venous thromboembolism (VTE) which includes both DVT and PE. I suggest that Doppler ultrasonography of cardiovascular and clinical laboratory tests provide very valuable medical support for the management of VTE. Specifically, in the early diagnosis of VTE and the prevention of fatal PE, Doppler ultrasonography (cardiac and vascular) can provide very useful information. On the other hand, blood coagulation and thrombophilia tests are important to determine the risk of VTE and evaluate the effect of anticoagulant therapy on VTE. In this paper, I explain the main points of each examination of VTE by describing representative cases. I also show the results on investigating cases in our hospital involving diseases related to VTE and the onset site of DVT. In addition, I introduce how we convey the results of analysis to the clinical side.

Intra-abdominal fat measurement by ultrasonography: association with anthropometry and metabolic syndrome in adolescents.

PubMed

Novais, Rommel L R; Café, Ana Carolina C; Morais, Aisha A; Bila, Wendell C; Santos, Gilson D da S; Lopes, Carlos Alexandre de O; Belo, Vinícius S; Romano, Márcia Christina C; Lamounier, Joel A

2018-04-27

To associate intra-abdominal fat thickness measured by ultrasonography to the factors related to metabolic syndrome and to determine cutoff points of intra-abdominal fat measurement associated with a greater chance of metabolic syndrome in adolescents. This was a cross-sectional study, with 423 adolescents from public schools. Intra-abdominal fat was measured by ultrasonography. Anthropometric data were collected, and biochemical analyses were performed. Intra-abdominal fat was measured by ultrasonography, showing a statistically significant association with the diagnosis of metabolic syndrome (p=0.037), body mass index (p<0.001), elevated triglyceride levels (p=0.012), decreased plasma HDL levels (p=0.034), and increased systemic blood pressure values (p=0.023). Cutoff values of intra-abdominal fat thickness measurements were calculated by ultrasound to estimate the individuals most likely to develop metabolic syndrome. In the logistic regression models, the cutoff values that showed the highest association with metabolic syndrome in males were 4.50, 5.35, 5.46, 6.24, and 6.50cm for the ages of 14, 15, 16, 17, and 18/19 years, respectively. In the female gender, the cutoff values defined for the same age groups were 4.46, 4.55, 4.45, 4.90, and 6.46cm. In an overall analysis using the ROC curve, without gender and age stratification, the cut-off of 3.67cm showed good sensitivity, but low specificity. Ultrasonography is a useful method to estimate intra-abdominal adipose tissue in adolescents, which is associated with the main factors related to obesity and metabolic syndrome. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Isolated Deep Venous Thrombosis: Implications for 2-Point Compression Ultrasonography of the Lower Extremity.

PubMed

Adhikari, Srikar; Zeger, Wes; Thom, Christopher; Fields, J Matthew

2015-09-01

Two-point compression ultrasonography focuses on the evaluation of common femoral and popliteal veins for complete compressibility. The presence of isolated thrombi in proximal veins other than the common femoral and popliteal veins should prompt modification of 2-point compression technique. The objective of this study is to determine the prevalence and distribution of deep venous thrombi isolated to lower-extremity veins other than the common femoral and popliteal veins in emergency department (ED) patients with clinically suspected deep venous thrombosis. This was a retrospective study of all adult ED patients who received a lower-extremity venous duplex ultrasonographic examination for evaluation of deep venous thrombosis during a 6-year period. The ultrasonographic protocol included B-mode, color-flow, and spectral Doppler scanning of the common femoral, femoral, deep femoral, popliteal, and calf veins. Deep venous thrombosis was detected in 362 of 2,451 patients (14.7%; 95% confidence interval [CI] 13.3% to 16.1%). Thrombus confined to the common femoral vein alone was found in 5 of 362 cases (1.4%; 95% CI 0.2% to 2.6%). Isolated femoral vein thrombus was identified in 20 of 362 patients (5.5%; 95% CI 3.2% to 7.9%). Isolated deep femoral vein thrombus was found in 3 of 362 cases (0.8%; 95% CI -0.1% to 1.8%). Thrombus in the popliteal vein alone was identified in 53 of 362 cases (14.6%; 95% CI 11% to 18.2%). In our study, 6.3% of ED patients with suspected deep venous thrombosis had isolated thrombi in proximal veins other than common femoral and popliteal veins. Our study results support the addition of femoral and deep femoral vein evaluation to standard compression ultrasonography of the common femoral and popliteal vein, assuming that this does not have a deleterious effect on specificity. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

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

2011-01-01

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

Determination of testicular blood flow in camelids using vascular casting and color pulsed-wave Doppler ultrasonography.

PubMed

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

2011-01-01

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

Ultrasonography of Skin Changes in Legs with Chronic Venous Disease.

PubMed

Caggiati, A

2016-10-01

In daily practice, ultrasonography (US) is used only to designate the location and pattern of venous lesions. Skin US is not performed between routine venous investigations. Skin morphology is evaluated by the same probes used for routine Duplex evaluation of superficial veins. US findings from evident skin lesions are comparatively evaluated with those from the surrounding apparently normal skin and from the contralateral leg. Inflammation and dermal edema can be found in the apparently normal skin of C2 legs. Swollen legs show thickening of the subcutaneous layer as a result of diffuse soaking or anechoic cavities, with or without dermal edema. Chronic hypodermitis is characterized by inflammatory edema in initial phases, and by liposclerosis in advanced cases. Recrudescence of inflammation provokes focal rarefactions of the subcutaneous layer, possibly related to ulcer opening. In legs with venous disorders, sonography refines clinical evaluation of the skin and may reveal changes not highlighted by inspection. Some of these changes could require further investigation because they have not yet been explained or described. Skin sonography should improve knowledge of the natural history of skin changes, as well as contribute to a better grading of venous diseases severity In particular, US evidence of cutaneous and subcutaneous changes in C2 legs should be considered to stratify the treatment in C2 legs, by identifying those in which varicose veins are not simply a cosmetic problem. Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Is Routine Intraoperative Contrast-Enhanced Ultrasonography Useful During Whole Liver Transplantation?

PubMed

Golse, Nicolas; Santoni, Simone; Karam, Vincent; Ciacio, Oriana; Pittau, Gabriella; Allard, Marc-Antoine; Cherqui, Daniel; Sa Cunha, Antonio; Adam, René; Castaing, Denis; Vibert, Eric

2018-05-01

Vascular complications following liver transplantation (LT) may result from technical deficiencies. Intraoperative diagnosis remains challenging but can prevent serious delayed complications. Intraoperative Doppler ultrasonography (IOUS) represents the gold standard for imaging, although it requires radiological skills. Contrast-enhanced ultrasonography has been reported during postoperative assessments, but never intraoperatively (CE-IOUS). The aim of this study was to assess the feasibility of routine CE-IOUS, to evaluate its impact on surgical strategy and its usefulness. All 553 whole LTs performed in our tertiary centre between 01/2010 and 12/2014 were reviewed. We compared perioperative outcomes and long-term survival in IOUS (n = 370) versus CE-IOUS (n = 103) groups. Secondarily, the seven cases where the two imaging findings conflicted (CE+ Group) were matched 1:2 and compared with an exclusively IOUS procedure (CE- Group, n = 14) to assess the consequences of a specific CE-guided strategy. CE-IOUS assessments were successful in 100% of cases, without any adverse effects. Vascular complications and patient/graft survival rates were identical in the IOUS and CE-IOUS groups (p = 0.65, 0.95 and 0.86, respectively). CE-IOUS confirmed IOUS findings in 93% of cases (n = 96) and led to the realization of an additional procedure (median arcuate ligament lysis) and six conservative strategies despite poor arterial (n = 5) or venous flow (n = 1) under Doppler analysis. The CE+ and CE- groups presented statistically identical perioperative and long-term outcomes. This study demonstrated the feasibility of CE-IOUS during whole LT. However, we failed to demonstrate any advantages of CE-IOUS over IOUS. Therefore, IOUS currently remains the gold-standard imaging technique for the intraoperative assessment of vascular patency.

3D-Ultrasonography for evaluation of facial muscles in patients with chronic facial palsy or defective healing: a pilot study.

PubMed

Volk, Gerd Fabian; Pohlmann, Martin; Finkensieper, Mira; Chalmers, Heather J; Guntinas-Lichius, Orlando

2014-01-01

While standardized methods are established to examine the pathway from motorcortex to the peripheral nerve in patients with facial palsy, a reliable method to evaluate the facial muscles in patients with long-term palsy for therapy planning is lacking. A 3D ultrasonographic (US) acquisition system driven by a motorized linear mover combined with conventional US probe was used to acquire 3D data sets of several facial muscles on both sides of the face in a healthy subject and seven patients with different types of unilateral degenerative facial nerve lesions. The US results were correlated to the duration of palsy and the electromyography results. Consistent 3D US based volumetry through bilateral comparison was feasible for parts of the frontalis muscle, orbicularis oculi muscle, depressor anguli oris muscle, depressor labii inferioris muscle, and mentalis muscle. With the exception of the frontal muscle, the facial muscles volumes were much smaller on the palsy side (minimum: 3% for the depressor labii inferior muscle) than on the healthy side in patients with severe facial nerve lesion. In contrast, the frontal muscles did not show a side difference. In the two patients with defective healing after spontaneous regeneration a decrease in muscle volume was not seen. Synkinesis and hyperkinesis was even more correlated to muscle hypertrophy on the palsy compared with the healthy side. 3D ultrasonography seems to be a promising tool for regional and quantitative evaluation of facial muscles in patients with facial palsy receiving a facial reconstructive surgery or conservative treatment.

3D-Ultrasonography for evaluation of facial muscles in patients with chronic facial palsy or defective healing: a pilot study

PubMed Central

2014-01-01

Background While standardized methods are established to examine the pathway from motorcortex to the peripheral nerve in patients with facial palsy, a reliable method to evaluate the facial muscles in patients with long-term palsy for therapy planning is lacking. Methods A 3D ultrasonographic (US) acquisition system driven by a motorized linear mover combined with conventional US probe was used to acquire 3D data sets of several facial muscles on both sides of the face in a healthy subject and seven patients with different types of unilateral degenerative facial nerve lesions. Results The US results were correlated to the duration of palsy and the electromyography results. Consistent 3D US based volumetry through bilateral comparison was feasible for parts of the frontalis muscle, orbicularis oculi muscle, depressor anguli oris muscle, depressor labii inferioris muscle, and mentalis muscle. With the exception of the frontal muscle, the facial muscles volumes were much smaller on the palsy side (minimum: 3% for the depressor labii inferior muscle) than on the healthy side in patients with severe facial nerve lesion. In contrast, the frontal muscles did not show a side difference. In the two patients with defective healing after spontaneous regeneration a decrease in muscle volume was not seen. Synkinesis and hyperkinesis was even more correlated to muscle hypertrophy on the palsy compared with the healthy side. Conclusion 3D ultrasonography seems to be a promising tool for regional and quantitative evaluation of facial muscles in patients with facial palsy receiving a facial reconstructive surgery or conservative treatment. PMID:24782657

Ultrasonography in neuralgic amyotrophy: Sensitivity, spectrum of findings, and clinical correlations.

PubMed

ArÁnyi, Zsuzsanna; Csillik, Anita; DéVay, Katalin; Rosero, Maja; Barsi, PéTer; BÖhm, Josef; Schelle, Thomas

2017-12-01

The aim of this study was to assess the value of ultrasonography in neuralgic amyotrophy. Fifty-three patients with 70 affected nerves were examined with high-resolution ultrasound. The most commonly affected nerve was the anterior interosseous (23%). Ultrasonographic abnormalities in the affected nerves, rather than in the brachial plexus, were observed, with an overall sensitivity of 74%. Findings included the swelling of the nerve/fascicle with or without incomplete/complete constriction and rotational phenomena (nerve torsion and fascicular entwinement). A significant difference was found among the categories of ultrasonographic findings with respect to clinical outcome (P = 0.01). In nerves with complete constriction and rotational phenomena, reinnervation was absent or negligible, indicating surgery was warranted. Ultrasonography may be used as a diagnostic aid in neuralgic amyotrophy, which was hitherto a clinical and electrophysiological diagnosis, and may also help in identifying potential surgical candidates. Muscle Nerve 56: 1054-1062, 2017. © 2017 Wiley Periodicals, Inc.

A feasibility study on bedside upper airway ultrasonography compared to waveform capnography for verifying endotracheal tube location after intubation

PubMed Central

2013-01-01

Background In emergency settings, verification of endotracheal tube (ETT) location is important for critically ill patients. Ignorance of oesophageal intubation can be disastrous. Many methods are used for verification of the endotracheal tube location; none are ideal. Quantitative waveform capnography is considered the standard of care for this purpose but is not always available and is expensive. Therefore, this feasibility study is conducted to compare a cheaper alternative, bedside upper airway ultrasonography to waveform capnography, for verification of endotracheal tube location after intubation. Methods This was a prospective, single-centre, observational study, conducted at the HRPB, Ipoh. It included patients who were intubated in the emergency department from 28 March 2012 to 17 August 2012. A waiver of consent had been obtained from the Medical Research Ethics Committee. Bedside upper airway ultrasonography was performed after intubation and compared to waveform capnography. Specificity, sensitivity, positive and negative predictive value and likelihood ratio are calculated. Results A sample of 107 patients were analysed, and 6 (5.6%) had oesophageal intubations. The overall accuracy of bedside upper airway ultrasonography was 98.1% (95% confidence interval (CI) 93.0% to 100.0%). The kappa value (Κ) was 0.85, indicating a very good agreement between the bedside upper airway ultrasonography and waveform capnography. Thus, bedside upper airway ultrasonography is in concordance with waveform capnography. The sensitivity, specificity, positive predictive value and negative predictive value of bedside upper airway ultrasonography were 98.0% (95% CI 93.0% to 99.8%), 100% (95% CI 54.1% to 100.0%), 100% (95% CI 96.3% to 100.0%) and 75.0% (95% CI 34.9% to 96.8%). The likelihood ratio of a positive test is infinite and the likelihood ratio of a negative test is 0.0198 (95% CI 0.005 to 0.0781). The mean confirmation time by ultrasound is 16.4 s. No adverse effects

A mathematical formula to estimate in vivo thyroid volume from two-dimensional ultrasonography.

PubMed

Trimboli, Pierpaolo; Ruggieri, Massimo; Fumarola, Angela; D'Alò, Michele; Straniero, Andrea; Maiuolo, Amelia; Ulisse, Salvatore; D'Armiento, Massimino

2008-08-01

The determination of thyroid volume (TV) is required for the management of thyroid diseases. Since two-dimensional ultrasonography (2D-US) has become the accepted method for the assessment of TV (2D-US-TV), we verified whether it accurately assesses postsurgical measured TV (PS-TV). In 92 patients who underwent total thyroidectomy by conventional cervicotomy, 2D-US-TV obtained by the ellipsoid volume formula was compared to PS-TV, determined by the Archimedes' principle. Mean 2D-US-TV (23.9 +/- 14.8 mL) was significantly lower than mean PS-TV (33.4 +/- 20.1 mL). Underestimation was observed in 77% of cases, and it was related to gland multinodularity and/or nodular involvement of the isthmus, while 2D-US-TV matched the PS-TV in the remaining 21 cases (23%). A mathematical formula, to estimate PS-TV from US-TV, was derived using a linear model (Calculated-TV = [1.24 x 2D-US-TV]+ 3.66). Calculated-TV (mean value 33.4 +/- 18.3 mL) significantly (p < 0.01) increased from 21 (23%) to 31 (34%) of the cases that matched PS-TV. In addition, it significantly (p < 0.01) decreased from 77% to 27% the percentage of cases where PS-TV was underestimated as well as the range of the disagreement from 245% to 92%. This study shows that 2D-US does not provide an accurate estimation of TV and suggests that it can be improved by a mathematical model different from the ellipsoid model. If confirmed in prospective studies, this may contribute to a more appropriate management of thyroid diseases.

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

PubMed Central

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

2009-01-01

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

Evaluation of cerebral blood flow changes in focal cerebral ischemia rats by using transcranial Doppler ultrasonography.

PubMed

Li, Le; Ke, Zheng; Tong, Kai Yu; Ying, Michael

2010-04-01

Ischemic stroke is typically characterized by the disruption of cerebral blood flow. This study aimed to consecutively evaluate the cerebral blood flow changes in a focal ischemia rat model during the occlusion-reperfusion procedure and along the recovery stage after stroke. In 12 Sprague Dawley (SD) rats, a middle cerebral artery occlusion/reperfusion (MCAo/r) surgery was conducted, which combines a permanent occlusion of the right common carotid artery (CCA), external carotid artery (ECA) and a transient occlusion of the right internal carotid artery (ICA) and middle cerebral artery (MCA) with a monofilament introduced from the proximal ICA towards the distal right ICA then removed after 90 min. Blood flow velocity (BFV) from the concerned arteries were measured using ultrasonography (13-4 MHz) at the basal stage before the surgery, after the reperfusion stage and during the post-stroke status. At reperfusion stage and after, BFV increased significantly in the left ICA and in the basilar artery (BA) (starting from post-24 h, p < 0.05 vs. basal). Moreover, BFV were reversed in the distal right ICA and reflow was recorded in the right MCA. Time-average maximum BFV in the right MCA at reperfusion and post-stroke 24-96 h was decreased significantly (p < 0.05 vs. basal). The reversed flow in the right ICA was enabled by the settlement of the collateral supply through the circle of Willis which consisted in higher BFV in the opposite ICA and in the BA still 24 h, although the proximal right ICA remain occluded. Ultrasound measurement of BFV helps to provide information on the redistribution of the blood flow supply after the onset of stroke. Copyright 2010 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Ultrasonography in Detection of Vaginal Foreign Bodies in Girls: A Retrospective Study.

PubMed

Yang, Xiuzhen; Sun, Liying; Ye, Jingjing; Li, Xiaoying; Tao, Ran

2017-12-01

In this study we investigated the sonographic features of vaginal foreign bodies in girls and the diagnostic role of combined transperineal and transabdominal ultrasonography in the detection of vaginal foreign bodies in this population. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A retrospective review of the records of 249 girls seen in the outpatient pediatric and adolescent gynecology clinic of our hospital and referred to our department for sonographic evaluation of suspected vaginal foreign bodies between 2013 and 2016 was performed. All patients were transperineally and transabdominally scanned using an ultrasound machine with 3-MHz and 7.5-MHz transducers. The sonographic features of the detected foreign bodies were recorded and reported. All patients also underwent pelvic radiography. The presence of foreign bodies was confirmed using vaginoscopy. Two hundred forty-nine patients were included in this study, and vaginal foreign bodies were detected in 181 patients. Vaginal foreign bodies often present in girls aged from 2 to 12 years old. The most common vaginal foreign bodies were toilet paper, beads, small parts of toys, cap of water color brush, and crayons. The overall sensitivity, specificity, positive and negative predictive values of transperineal/transabdominal sonography in the diagnosis of vaginal foreign bodies were 81%, 53%, 82%, and 51%, respectively. The sensitivity, specificity, and positive and negative predictive values of transabdominal sonography were 33%, 49%, 63%, and 21%, respectively. The sensitivity, specificity, and positive and negative predictive values of transperineal sonography were 64%, 49%, 77%, and 33%, respectively. Abnormal findings were detected using x-ray in only 43 of the 181 cases (23.7%). The sensitivity, specificity, and positive and negative predictive values of x-ray were 24%, 91%, 88%, and 31%, respectively. The size of the foreign bodies ranged from 2 mm to 35 mm. For foreign

High-definition flow Doppler ultrasonographic technique to assess hepatic vasculature compared with color or power Doppler ultrasonography: preliminary experience.

PubMed

Kim, Se Hyung; Lee, Jeong Min; Kim, Young Jun; Lee, Jae Young; Han, Joon Koo; Choi, Byung Ihn

2008-10-01

The purpose of this study was to introduce a new high-definition flow (HDF) Doppler technique and to compare its performance with those of color Doppler ultrasonography (CDU) and power Doppler ultrasonography (PDU) for assessment of hepatic vasculature in native and transplanted livers. High-definition flow was invented as a high-resolution bidirectional PDU technique. We obtained CDU, PDU, and HDF images of the hepatic artery (HA), portal vein (PV), and hepatic vein from 60 patients. They were divided into 2 groups: a liver transplantation group (group 1, n = 10) and a native liver group (group 2, n = 50). Two radiologists independently reviewed the cine images and graded them using a 4-point scale in terms of the clarity of the vessel margin and degree of depiction of the HA, flow filling, and flash artifacts. The degree of differentiation between the HA and PV was also evaluated. Flow directionality was recorded, and interobserver agreement was finally analyzed. Moderate to almost perfect agreement was achieved between radiologists for all parameters of each ultrasonographic technique. High-definition flow was significantly superior to both CDU and PDU with respect to all analyzed items except the degree of flash artifacts (P < .05). With regard to flash artifacts, CDU was significantly better than either PDU or HDF. High-definition flow provided directional information, as did CDU. The HDF technique provides better resolution for depicting hepatic vessels as well as their margins with less blooming compared with conventional Doppler ultrasonography in both native and transplanted liver. It also provides solid directional flow information. One point of concern, however, is the frequency of flash artifacts compared with that on CDU.

Diagnosis of a sigmoid volvulus in pregnancy: ultrasonography and magnetic resonance imaging findings

PubMed Central

Palmucci, Stefano; Lanza, Maria Letizia; Gulino, Fabrizio; Scilletta, Beniamino; Ettorre, Giovanni Carlo

2014-01-01

Sigmoid volvulus complicating pregnancy is a rare, non-obstetric cause of abdominal pain that requires prompt surgical intervention (decompression) to avoid intestinal ischemia and perforation. We report the case of a 31-week pregnant woman with abdominal pain and subsequent development of constipation. Preoperative diagnosis was achieved using magnetic resonance imaging and ultrasonography: the large bowel distension and a typical whirl sign - near a sigmoid colon transition point - suggested the diagnosis of sigmoid volvulus. The decision to refer the patient for emergency laparotomy was adopted without any ionizing radiation exposure, and the pre-operative diagnosis was confirmed after surgery. Imaging features of sigmoid volvulus and differential diagnosis from other non-obstetric abdominal emergencies in pregnancy are discussed in our report, with special emphasis on the diagnostic capabilities of ultrasonography and magnetic resonance imaging. PMID:24967020

Diagnosis of a sigmoid volvulus in pregnancy: ultrasonography and magnetic resonance imaging findings.

PubMed

Palmucci, Stefano; Lanza, Maria Letizia; Gulino, Fabrizio; Scilletta, Beniamino; Ettorre, Giovanni Carlo

2014-02-01

Sigmoid volvulus complicating pregnancy is a rare, non-obstetric cause of abdominal pain that requires prompt surgical intervention (decompression) to avoid intestinal ischemia and perforation. We report the case of a 31-week pregnant woman with abdominal pain and subsequent development of constipation. Preoperative diagnosis was achieved using magnetic resonance imaging and ultrasonography: the large bowel distension and a typical whirl sign - near a sigmoid colon transition point - suggested the diagnosis of sigmoid volvulus. The decision to refer the patient for emergency laparotomy was adopted without any ionizing radiation exposure, and the pre-operative diagnosis was confirmed after surgery. Imaging features of sigmoid volvulus and differential diagnosis from other non-obstetric abdominal emergencies in pregnancy are discussed in our report, with special emphasis on the diagnostic capabilities of ultrasonography and magnetic resonance imaging.

Association Between Years of Experience and Ankle Joint Disorder in Male Student Basketball Players Based on Ultrasonography.

PubMed

Fukushima, Yaeko

2017-04-01

The goal of the study was to survey ankle joint disorder in male senior high school and college student basketball players based on the results of an ultrasonographic medical check-up of the ankle joint. The subjects were 17 senior high school student and 19 college student basketball players. Ultrasonography, evaluation of ATFL injury, and examination of the talocrural joint region were performed. The subjects were grouped based on the presence or absence of old ATFL injury, and subjects with ATFL injury were classified by the injured region: fibular insertion site, parenchyma, and talar insertion site. The talocrural joint region was evaluated based on the areas of the lateral margin, central region, and medial margin, and sites with an irregular bone contour and osteophyte were counted individually. The questionnaire asked about the patients' history of ankle injuries. A questionnaire survey revealed that 70-79% of all subjects had experienced a sprain at least once and 21-29% had frequently sprained the left or right foot 10 or more times in the past. On ultrasonography, there was no significant difference in ligament injury or injured site between the senior high school and college students, but the number of osteochondral findings in the talocrural joint region was significantly higher in the college students. In addition, the number of injured sites significantly increased in those with 10 or more years of playing experience. These results suggest that disorder of the talocrural joint region progresses with an increase in years of experience in student basketball players who do not take specific preventive measures against this injury.

Simple X-ray versus ultrasonography examination in blunt chest trauma: effective tools of accurate diagnosis and considerations for rib fractures.

PubMed

Hwang, Eun Gu; Lee, Yunjung

2016-12-01

Simple radiography is the best diagnostic tool for rib fractures caused by chest trauma, but it has some limitations. Thus, other tools are also being used. The aims of this study were to investigate the effectiveness of ultrasonography (US) for identifying rib fractures and to identify influencing factors of its effectiveness. Between October 2003 and August 2007, 201 patients with blunt chest trauma were available to undergo chest radiographic and US examinations for diagnosis of rib fractures. The two modalities were compared in terms of effectiveness based on simple radiographic readings and US examination results. We also investigated the factors that influenced the effectiveness of US examination. Rib fractures were detected on radiography in 69 patients (34.3%) but not in 132 patients. Rib fractures were diagnosed by using US examination in 160 patients (84.6%). Of the 132 patients who showed no rib fractures on radiography, 92 showed rib fractures on US. Among the 69 patients of rib fracture detected on radiography, 33 had additional rib fractures detected on US. Of the patients, 76 (37.8%) had identical radiographic and US results, and 125 (62.2%) had fractures detected on US that were previously undetected on radiography or additional fractures detected on US. Age, duration until US examination, and fracture location were not significant influencing factors. However, in the group without detected fractures on radiography, US showed a more significant effectiveness than in the group with detected fractures on radiography ( P =0.003). US examination could detect unnoticed rib fractures on simple radiography. US examination is especially more effective in the group without detected fractures on radiography. More attention should be paid to patients with chest trauma who have no detected fractures on radiography.

[The Value of High Frequency Color Doppler Ultrasonography in the Diagnosis of Solid Skin Tumorsa-a Preliminary Study].

PubMed

Zhong, Lin; Tang, Yuan-Jiao; Yang, Yu-Jia; Qiu, Li

2017-01-01

To explore the value of high frequency color doppler ultrasonography in differentiating benign and malignant skin solid tumors. Clinical and ultrasonic data of cutaneous solid tumors confirmed by pathology in our hospital were collected. The differences in clinical and sonographic features between benign and malignant tumors were statistically analyzed. A total of 512 patients, involving 527 cases of skin solid tumors, were enrolled in this study. The ultrasonic detected 99.43% of the cases, with 99.02% accuracy in locating the lesions. The benign and malignant tumors showed differences in patient age, location, multiple occurance, location and depth, surface skin condition, tumor size, echo, morphology, uniformity, calcification, blood flow status, tumor rear area and peripheral echo, and pathological requests ( P <0.05). High frequency ultrasound has excellent detection rate of skin tumors, which can locate invasion depth of skin accurately. Benign and malignant skin tumors show differences in a number of clinical and ultrasound features.

Sporotrichal Tenosynovitis Diagnosed Helpfully by Musculoskeletal Ultrasonography

PubMed Central

Shimizu, Takashi; Akita, Shosuke; Harada, Yoshinori; Oguro, Eri; Okita, Yasutaka; Shigesaka, Minoru; Matsuoka, Hidetoshi; Nii, Takuro; Teshigawara, Satoru; Kudo-Tanaka, Eriko; Tsuji, Soichiro; Matsushita, Masato; Ohshima, Shiro; Hoshida, Yoshihiko; Hashimoto, Jun; Saeki, Yukihiko

2017-01-01

A 72-year-old man presented with persistent oligoarthritis and positive results for rheumatoid factor and was suspected of having rheumatoid arthritis (RA). However, the musculoskeletal ultrasonography (MSUS) findings were not consistent with those of typical RA. He had undergone surgery for carpal tunnel syndrome, which allowed both histopathological and microbiological examinations to be performed. A synovial tissue culture was positive for Sporothrix schenckii, and he was diagnosed with sporotrichal tenosynovitis. He received anti-fungal therapy, and the sporotrichal tenosynovitis resolved. This case suggests that MSUS is a useful modality, and sporotrichal tenosynovitis, though rare, should be considered in the differential diagnosis of RA. PMID:28502945

Diagnostic utility of carotid artery duplex ultrasonography in the evaluation of syncope: a good test ordered for the wrong reason.

PubMed

Kadian-Dodov, Daniella; Papolos, Alexander; Olin, Jeffrey W

2015-06-01

Syncope refers to a transient loss of consciousness and postural tone secondary to cerebral hypoperfusion. Guidelines recommend against neurovascular testing in cases of syncope without neurologic symptoms; however, many pursue carotid artery duplex ultrasonography (CUS) due to the prognostic implications of identified cerebrovascular disease. Our objective was to determine the diagnostic utility of CUS in the evaluation of syncope and the identification of new or severe atherosclerosis with the potential to change patient management. We reviewed records of 569 patients with CUS ordered for the primary indication of syncope through an accredited vascular laboratory at an academic, urban medical centre. Findings on CUS, patient demographic, clinical and laboratory information, and medications within 6 months of the CUS exam were reviewed. Bivariate relationships between key medical history characteristics and atherosclerosis status (known vs. new disease) were examined. Among 495 patients with complete information, cerebrovascular findings could potentially explain syncope in 2% (10 patients). Optimization of cardiovascular risk factors would benefit patients with known (56.6%) and new atherosclerosis (33.5%) with suboptimal lipid control, (LDL > 70 in 42.2 and 34.9% respectively; LDL > 100 in 15.7 and 20.4%), and those not on high-intensity statin therapy (80 and 87.5%) or antiplatelet medications (13.2 and 50.6%). CUS is a low-yield diagnostic test in the evaluation of syncope, but it is useful in the diagnosis of atherosclerosis and identification of subjects who would benefit from optimal medical therapy. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

The use of the color Doppler ultrasonography in the diagnosis and monitoring of an atypical case of giant-cell arteritis.

PubMed

Martins, N; Polido-Pereira, J; Rodrigues, A M; Soares, F; Batista, P; Pereira da Silva, J A

2016-01-01

Giant Cell Arteritis (GCA) is a large vessels vasculitis that is typically characterised by headache, scalp tenderness, jaw claudication and visual disturbances. Temporal arteries color Doppler ultrasonography (CDUS) is a sensitive and non-invasive image technique used in the diagnosis of this disease. This work highlights the importance of CDUS in the diagnostic workup of GCA and also demonstrates it´s usefullness in the evaluation and documentation of the response to corticosteroids therapy in an atypical case of ACG.

Detection of common carotid artery stenosis using duplex ultrasonography: a validation study with computed tomographic angiography.

PubMed

Slovut, David P; Romero, Javier M; Hannon, Kathleen M; Dick, James; Jaff, Michael R

2010-01-01

stenosis by area. ROC analysis of different PSV thresholds for detecting stenosis >or=50% showed that >182 cm/sec was the most accurate with a sensitivity of 64% and specificity of 88% (P < .0001). Sensitivity, specificity, and accuracy of carotid duplex were higher when the stenosis was located in the mid or distal aspects of the CCA (sensitivity 76%, specificity 89%, area under curve 0.84, P < .001) than in the intrathoracic and proximal segment of the artery (P = NS). ROC analysis of different EDV thresholds for detecting CCA stenosis >or=50% showed that >30 cm/sec was the most accurate with a sensitivity of 54% and a specificity of 74% (P < .0239). Duplex ultrasonography is highly sensitive, specific, and accurate for detecting CCA lesions in the mid and distal CCA. Use of peak systolic velocity may lead to improved detection of CCA disease and initiation of appropriate therapy to reduce the risk of stroke. Copyright 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Visualizing the Vibration of Laryngeal Tissue during Phonation Using Ultrafast Plane Wave Ultrasonography.

PubMed

Jing, Bowen; Tang, Shanshan; Wu, Liang; Wang, Supin; Wan, Mingxi

2016-12-01

Ultrafast plane wave ultrasonography is employed in this study to visualize the vibration of the larynx and quantify the vibration phase as well as the vibration amplitude of the laryngeal tissue. Ultrasonic images were obtained at 5000 to 10,000 frames/s in the coronal plane at the level of the glottis. Although the image quality degraded when the imaging mode was switched from conventional ultrasonography to ultrafast plane wave ultrasonography, certain anatomic structures such as the vocal folds, as well as the sub- and supraglottic structures, including the false vocal folds, can be identified in the ultrafast plane wave ultrasonic image. The periodic vibration of the vocal fold edge could be visualized in the recorded image sequence during phonation. Furthermore, a motion estimation method was used to quantify the displacement of laryngeal tissue from hundreds of frames of ultrasonic data acquired. Vibratory displacement waveforms of the sub- and supraglottic structures were successfully obtained at a high level of ultrasonic signal correlation. Moreover, statistically significant differences in vibration pattern between the sub- and supraglottic structures were found. Variation of vibration amplitude along the subglottic mucosal surface is significantly smaller than that along the supraglottic mucosal surface. Phase delay of vibration along the subglottic mucosal surface is significantly smaller than that along the supraglottic mucosal surface. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

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.…

Ultrasonography and contrast-enhanced CT findings of tularemia in the neck.

PubMed

Doğan, Serap; Ekinci, Afra; Demiraslan, Hayati; Ulu Kılıç, Ayşegül; Mavili, Ertuğrul; Öztürk, Mustafa; İmamoğlu, Hakan; Doğanay, Mehmet

2016-01-01

We aimed to evaluate the ultrasonography (US) and contrast-enhanced computed tomography (CECT) findings of tularemia in the neck. 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. 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. 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.

The role of ultrasonography in the management of lung and pleural diseases.

PubMed

Rumende, C Martin

2012-04-01

Ultrasonographic examination in pulmonology provides a revolutionary advance because it is very helpful in the diagnosis and management of various pleural and peripheral pulmonary defects. Lung ultrasonography allows the clinicians to diagnose some pulmonary abnormalities more rapidly, including the diagnosis of pleural effusion. Ultrasound examination also provides great assistance for the clinicians to perform invasive techniques in the field of pulmonology, which may increase the success rate and reduce the likelihood of complications. In addition to pleural effusion, other lung disorders can be diagnosed by ultrasound such as peripheral lung tumors and other pleural abnormalities caused by pleural fibrosis and tumor metastasis as well as the primary pleural tumor (mesothelioma). Ultrasound-guided invasive procedures include aspiration of minimal effusion, Transthoracal Needle Aspiration, Transthoracal biopsies and chest tube insertion. Lung ultrasound also offers other advantages, i.e. free from radiation hazards, portable, non-invasive and relatively inexpensive. Ultrasonography in the thorax also has its limitations, especially in detecting mediastinal abnormalities.

Dermal Structure in Lymphedema Patients with History of Acute Dermatolymphangioadenitis Evaluated by Histogram Analysis of Ultrasonography Findings: A Case-Control Study.

PubMed

Dai, Misako; Sato, Aya; Maeba, Hiroko; Iuchi, Terumi; Matsumoto, Masaru; Okuwa, Mayumi; Nakatani, Toshio; Sanada, Hiromi; Sugama, Junko

2016-03-01

Acute dermatolymphangioadenitis (ADLA) is a risk factor for increasing of edema and worsening severity. Reducing ADLA frequency is an important objective of lymphedema management because ADLA episodes are strongly associated with poor quality of life. Lymphedema changes dermal and subcutaneous structure, favoring ADLA; ADLA recurrence may be caused by structural change of the dermis. However, the structure of the skin following ADLA episodes has not been studied in depth. The aim of this study was to examine changes in the skin after episodes of ADLA in breast cancer-related lymphedema (BCRL) using histogram analysis of ultrasonography findings. This was a case-control study with matching for the duration of lymphedema. We compared 10 limbs (5 BCRL patients, Cases) with a history of ADLA and 14 limbs (7 BCRL patients, Controls) without. Ultrasonography was performed using a 20-MHz probe, and measurements were made at a site 10 cm proximal to the ulnar styloid process. We compared "skewness" of the images in the dermis from the histogram analysis. This study was approved by the Ethics Committee of Kanazawa University. Skewness was significantly different between the affected and unaffected limbs (p = 0.02). Cases showed a positive value (median 0.74, range -0.18 to 1.26), whereas Controls showed a negative value (median -0.21, range -0.45 to 0.31). Episodes of ADLA changed the distribution of echogenicity on imaging, which indicates a change in the collagen fibers in the dermis. These findings might contribute to improving the management of lymphedema and prevention of recurrent ADLA.

Usability of virtual-reality simulation training in obstetric ultrasonography: a prospective cohort study.

PubMed

Burden, C; Preshaw, J; White, P; Draycott, T J; Grant, S; Fox, R

2013-08-01

To assess the usability of virtual-reality (VR) simulation for obstetric ultrasound trainees. Twenty-six participants were recruited: 18 obstetric ultrasound trainees (with little formal ultrasonography training) and eight certified experts. All performed five sequential VR-simulated crown-rump length (CRL) scans in a single session and three repetitions of biparietal diameter (BPD), occipitofrontal diameter (OFD) and femur length (FL) measurements. Outcome measures included mean percentage deviation from target for all measurements. Time taken to perform each type of scan was recorded. The mean percentage difference for the first scan was significantly greater for the trainee group than for the expert group for BPD (P = 0.035), OFD (P = 0.010) and FL (P = 0.008) and for time taken for the first CRL (P < 0.001) and fetal biometry (including BPD, OFD and FL measurements) scan (P < 0.001), demonstrating that trainees were initially significantly less accurate and less efficient. Over subsequent scans, the trainees became more accurate for all measurements with a significant improvement shown for OFD and FL (P < 0.05). The time taken for trainees to complete CRL and fetal biometry scans decreased significantly (all P < 0.05) with repetition, to near-expert efficiency. All participants were able to use the simulator and produce clinically meaningful biometry results. With repetition, beginners quickly approached near-expert levels of accuracy and speed. These data demonstrate that obstetricians with minimal experience can improve their ultrasonographic skills with short-phase VR-simulation training. The speed of improvement suggests that VR simulation might be useful as a warm-up exercise before clinical training sessions in order to reduce their impact on clinical service. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

Ultrasonographic evaluation of acute pelvic pain in pregnant and postpartum period.

PubMed

Park, Sung Bin; Han, Byoung Hee; Lee, Young Ho

2017-04-22

Acute pelvic pain in pregnant and postpartum patients presents diagnostic and therapeutic challenges. The interpretation of imaging findings in these patients is influenced by the knowledge of the physiological changes that occur during the pregnant and postpartum period, as well as by the clinical history. Ultrasonography remains the primary imaging investigation of the pregnant and postpartum women. This article describes the causes and imaging features of acute pelvic pain in pregnant and postpartum period and suggests characteristics to such diseases, focusing on the ultrasonography features that allow one to arrive at the corrective diagnosis. Knowledge of the clinical settings and imaging features of acute pelvic pain in pregnant and postpartum period can lead to accurate diagnosis and appropriate management of the condition.

Role of Ultrasonography of Regional Nodal Basins in Staging Triple-Negative Breast Cancer and Implications For Local-Regional Treatment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shaitelman, Simona F., E-mail: sfshaitelman@mdanderson.org; Tereffe, Welela; Dogan, Basak E.

2015-09-01

Purpose: We sought to determine the rate at which regional nodal ultrasonography would increase the nodal disease stage in patients with triple-negative breast cancer (TNBC) beyond the clinical stage determined by physical examination and mammography alone, and significantly affect the treatments delivered to these patients. Methods and Materials: We retrospectively reviewed the charts of women with stages I to III TNBC who underwent physical examination, mammography, breast and regional nodal ultrasonography with needle biopsy of abnormal nodes, and definitive local-regional treatment at our institution between 2004 and 2011. The stages of these patients' disease with and without ultrasonography of the regionalmore » nodal basins were compared using the Pearson χ{sup 2} test. Definitive treatments of patients whose nodal disease was upstaged on the basis of ultrasonographic findings were compared to those of patients whose disease stage remained the same. Results: A total of 572 women met the study requirements. In 111 (19.4%) of these patients, regional nodal ultrasonography with needle biopsy resulted in an increase in disease stage from the original stage by physical examination and mammography alone. Significantly higher percentages of patients whose nodal disease was upstaged by ultrasonographic findings compared to that in patients whose disease was not upstaged underwent neoadjuvant systemic therapy (91.9% and 51.2%, respectively; P<.0001), axillary lymph node dissection (99.1% and 34.5%, respectively; P<.0001), and radiation to the regional nodal basins (88.2% and 29.1%, respectively; P<.0001). Conclusions: Regional nodal ultrasonography in TNBC frequently changes the initial clinical stage and plays an important role in treatment planning.« less

Use of colour Doppler and M-mode ultrasonography to confirm the location of an epidural catheter - a retrospective case series.

PubMed

Elsharkawy, Hesham; Sonny, Abraham; Govindarajan, Srinivasa Raghavan; Chan, Vincent

2017-05-01

Epidural anesthesia and analgesia has a reported failure rate ranging from 13% to 32%. We describe a technique using colour Doppler and M-mode ultrasonography to determine the position of the epidural catheter after placement in adults. This retrospective review included 37 adult patients who received postoperative epidural analgesia and underwent technically difficult epidural catheter placement. The demographic characteristics, type of surgery, use of ultrasonography, method of insertion, intervertebral level, and success of epidural localization using colour Doppler were noted for each patient. Pain scores on postoperative day 1 and the presence of a patchy block were also reviewed. Colour Doppler study helped to indicate the catheter's path from the skin to the epidural space during saline injection in 33 patients (89%). Saline flow within the epidural space (catheter tip confirmation) was successfully detected with colour Doppler in 25 patients (67.5%) and with M-mode ultrasonography in 28 patients (75%). Appropriate dermatomal analgesia was noted in 35 patients (94.5%) during local anesthetic infusion. Our preliminary data suggest the feasibility of using colour Doppler and M-mode ultrasonography to confirm proper epidural catheter placement.

Clinical Utility of Magnetic Resonance Imaging (MRI) and Ultrasonography (US) for Diagnosis of Polycystic Ovary Syndrome (PCOS) in Adolescent Girls

PubMed Central

Kenigsberg, Lisa E; Agarwal, Chhavi; Sin, Sanghun; Shifteh, Keivan; Isasi, Carmen R; Crespi, Rebecca; Ivanova, Janeta; Coupey, Susan M; Heptulla, Rubina A; Arens, Raanan

2015-01-01

Objectives Evaluate ovarian morphology using 3-dimensional MRI in adolescent girls with and without PCOS. Compare the utility of MRI versus ultrasonography (US) for diagnosis of PCOS Design Cross-sectional Setting Urban academic tertiary-care children’s hospital Patients Thirty-nine adolescent girls with untreated PCOS and 22 age/BMI-matched controls. Intervention MRI and/or transvaginal/transabdominal US Main Outcome Measure Ovarian volume (OV); follicle number per section (FNPS); correlation between OV on MRI and US; proportion of subjects with features of polycystic ovaries on MRI and US. Results MRI demonstrated larger OV and higher FNPS in subjects with PCOS compared to controls. Within the PCOS group, median OV was 11.9 (7.7) cm3 by MRI, compared with 8.8 (7.8) cm3 by US. Correlation coefficient between OV by MRI and US was 0.701. Due to poor resolution, FNPS could not be determined by US or compared with MRI. ROC curve analysis for MRI demonstrated that increasing volume cut-offs for polycystic ovaries from 10cm3 to 14cm3, increased specificity from 77% to 95%. For FNPS on MRI, specificity increased from 82% to 98% by increasing cut-offs from ≥12 to ≥17. Using Rotterdam cut-offs, 91% of subjects with PCOS met polycystic ovary criteria on MRI, while only 52% met criteria by US. Conclusions US measures smaller OV than MRI, cannot accurately detect follicle number, and is a poor imaging modality for characterizing polycystic ovaries in adolescents with suspected PCOS. For adolescents in whom diagnosis of PCOS remains uncertain after clinical and laboratory evaluation, MRI should be considered as a diagnostic imaging modality. PMID:26354095

Association Between Years of Experience and Ankle Joint Disorder in Male Student Basketball Players Based on Ultrasonography

PubMed Central

Fukushima, Yaeko

2017-01-01

Purpose The goal of the study was to survey ankle joint disorder in male senior high school and college student basketball players based on the results of an ultrasonographic medical check-up of the ankle joint. Materials and Methods The subjects were 17 senior high school student and 19 college student basketball players. Ultrasonography, evaluation of ATFL injury, and examination of the talocrural joint region were performed. The subjects were grouped based on the presence or absence of old ATFL injury, and subjects with ATFL injury were classified by the injured region: fibular insertion site, parenchyma, and talar insertion site. The talocrural joint region was evaluated based on the areas of the lateral margin, central region, and medial margin, and sites with an irregular bone contour and osteophyte were counted individually. The questionnaire asked about the patients’ history of ankle injuries. Results A questionnaire survey revealed that 70–79% of all subjects had experienced a sprain at least once and 21–29% had frequently sprained the left or right foot 10 or more times in the past. On ultrasonography, there was no significant difference in ligament injury or injured site between the senior high school and college students, but the number of osteochondral findings in the talocrural joint region was significantly higher in the college students. In addition, the number of injured sites significantly increased in those with 10 or more years of playing experience. Conclusion These results suggest that disorder of the talocrural joint region progresses with an increase in years of experience in student basketball players who do not take specific preventive measures against this injury. PMID:28603784

Ultrasonography-guided PNL in comparison with laparoscopic ureterolithotomy in the management of large proximal ureteral stone.

PubMed

Karami, Hossein; Mazloomfard, Mohammad Mohsen; Lotfi, Behzad; Alizadeh, Asghar; Javanmard, Babak

2013-01-01

The aim of study was to evaluate the clinical outcomes of PNL in comparison with laparoscopic ureterolithotomy (LUL) in proximal ureteral stones larger than 1 cm. A total of 80 patients who were candidates for treatment of large ureteral stones in our urology center were enrolled in the study between September 2004 and September 2008. By using patient randomization, they were assigned into two forty-patient groups (PNL and LUL). After evaluating the patients with laboratory tests and IVP, PNL was performed under sonography guidance in the prone position or the patients were submitted to classic laparoscopic ureterolithotomy (LUL) transperitoneally. All patients underwent postoperative assessments including KUB and ultrasonography. A hundred-percent success was achieved in both groups. The mean age of the patients were 39.4 (16-63) and 35.2 (18-57) years old in PNL and LUL groups, respectively. The mean stone size in PNL group was 14.2 (10-25) mm and in LUL group was 13.5 (10-28) mm. The duration of the operations were 54.35 (50-82) minutes, and 82.15 (73-180) minutes (P < 0.0001); and the average hospital stay days were 2.6 (2-5) and 3.5 (3-8) days (p = 0.011) in groups PNL and LUL, accordingly. The mean Hb decrease in PNL group was 0.9mg/dL and in LUL group was 0.4mg/dL (p = 0.001). No statistically significant differences in terms of blood transfusion, fever, ICU admission, and prolonged urinary leakage were detected in both groups. According to our study, percutaneous nephrolithotomy under ultrasonography guidance is comparable with the laparoscopic ureterolithotomy for the treatment of proximal ureteral stones larger than 1 cm.

A novel two-dimensional dynamic anal ultrasonography technique to assess anismus comparing with three-dimensional echodefecography.

PubMed

Murad-Regadas, S M; Regadas, F S P; Barreto, R G L; Rodrigues, L V; de Souza, M H L P

2009-10-01

The aim of this prospective study was to test two-dimensional dynamic anorectal ultrasonography (2D-DAUS) in the assessment of anismus and compare it with echodefecography (ECD). Fifty consecutive female patients with outlet delay were submitted to 2D and 3D-DAUS, measuring the relaxing or contracting puborectalis muscle angle during straining. The patients were assigned to one of two groups based on ECD findings. Group I consisted of 29 patients without anismus and group II included 21 patients diagnosed with anismus. Subsequently 2D-DAUS images were checked for anismus and compared with ECD findings. Upon straining, the angle produced by the movement of the puborectalis muscle decreased in 26 out of the 29 (89.6%) patients of group I and increased 19 out of the 21 (90.4%) patients of group II. The mean angle during straining differed significantly between group I and group II. The index of agreement between the two scanning modes was 89.6% (26/29) for group I (Kappa: 0.796; CI: 95%; range: 0.51-1.0) and 90.4% (19/21) for group II (Kappa: 0.796; CI: 95%; range: 0.51-1.0). Two-dimensional dynamic anal ultrasonography can be used as an alternative method to assess patients with anismus, although the 3-D modality is more precise to evaluate the PR angle as the sphincters integrity as the whole muscle length is clearly visualized.

Transrectal ultrasonography-guided biopsy does not reliably identify dominant cancer location in men with low-risk prostate cancer.

PubMed

Washington, Samuel L; Bonham, Michael; Whitson, Jared M; Cowan, Janet E; Carroll, Peter R

2012-07-01

Study Type - Diagnostic (exploratory cohort) Level of Evidence 2b What's known on the subject? and What does the study add? The widespread use of serum PSA testing followed by TRUS-guided biopsy have resulted in profound prostate cancer stage migration with many patients presenting with focal rather than multifocal disease. There is increasing interest in the use of focal rather than whole-gland treatment. However, current biopsy schemes may still miss cancer or, even when cancer is identified, its extent or grade might not be accurately characterized. In order for focal therapy to be effective, the area of highest tumour volume and/or grade needs to localized accurately. The aim of this study was to assess how well biopsy, as currently performed, locates the focus of highest prostate cancer volume and/or grade. To evaluate the ability of transrectal ultrasonography (TRUS)-guided extended core biopsy to identify the dominant tumour accurately in men with early stage prostate cancer. Patients with early stage, low-risk prostate cancer who subsequently underwent radical prostatectomy (RP) and had complete surgical specimens were identified. Re-review was performed by a single uropathologist using ImageJ software to identify tumour location, dominant grade (DG) and dominant volume (DV). Pathology findings were then compared with biopsy results. A total of 51 men with early stage, low-risk prostate cancer, who had undergone RP, had complete specimens for review and a median of 15 biopsy cores taken for diagnosis and grading. Sixteen men had a single diagnostic biopsy, 21 had one repeat biopsy, and 14 had two or more repeat biopsies. Compared with surgical findings, biopsy correctly identified the sextant with the largest tumour volume in 55% (95% CI 0.5-0.6) of specimens and the highest grade in 37% (95 CI 0.3-0.5). No demographic or clinical factors were significantly associated with identification of DG. Interval between last biopsy and RP, total tissue length taken

Parental artistic drawings of the fetus before and after 3-/4-dimensional ultrasonography.

PubMed

Pretorius, Dolores H; Hearon, Heather A; Hollenbach, Kathryn A; Ji, Eun-Kyung; Gattu, Shilpa; Nelson, Novella M; Nelson, Tanya M; Chibuk, Jason; Hull, Andrew D; Newton, Ruth P; Nelson, Thomas R

2007-03-01

The purpose of this study was to assess the impact of 3-/4-dimensional ultrasonography (3D/4DUS) on parental impressions of their fetus using preexamination and postexamination parental drawings. One hundred one parents (32 male and 69 female) were asked to draw pictures of their fetus immediately before and after undergoing 3D/4DUS. A drawing assessment instrument was used to evaluate the fetal anatomy by 4 reviewers. Overall descriptive quality and a comparison of before and after images were assessed. Reviewers judged the drawings as significantly different in 23% to 56% of cases, slightly different in 41% to 64%, and having no significant difference in 2% to 22%; some difference was identified in at least 78%. Reviewers familiar with ultrasonography were able to correctly predict which picture was drawn first in 78%. Differences identified were related to extremity positioning, personalized uterine environment, and artistic nature. No significant difference in the overall total scoring for anatomic differentiation before and after 3D/4DUS was found. A trend in drawing less anatomic structures after 3D/4DUS was discovered. Significantly fewer people drew hair after 3D/4DUS (P<.01) even when they had drawn hair before the 3D/4DUS. Similar significant differences were seen for the lower extremities (P<.01), with less detail being presented after the 3D/4DUS. Differences were seen between drawings made before and after 3D/4DUS by parents. Drawings after 3D/4DUS emphasized structures seen during the 3D/4DUS examination and were more reality based, whereas drawings before 3D/4DUS were more iconographic and based on preconceived anatomic knowledge.

Evaluation of Jaundice in Adults.

PubMed

Fargo, Matthew V; Grogan, Scott P; Saguil, Aaron

2017-02-01

Jaundice in adults can be an indicator of significant underlying disease. It is caused by elevated serum bilirubin levels in the unconjugated or conjugated form. The evaluation of jaundice relies on the history and physical examination. The initial laboratory evaluation should include fractionated bilirubin, a complete blood count, alanine transaminase, aspartate transaminase, alkaline phosphatase, ?-glutamyltransferase, prothrombin time and/or international normalized ratio, albumin, and protein. Imaging with ultrasonography or computed tomography can differentiate between extrahepatic obstructive and intrahepatic parenchymal disorders. Ultrasonography is the least invasive and least expensive imaging method. A more extensive evaluation may include additional cancer screening, biliary imaging, autoimmune antibody assays, and liver biopsy. Unconjugated hyperbilirubinemia occurs with increased bilirubin production caused by red blood cell destruction, such as hemolytic disorders, and disorders of impaired bilirubin conjugation, such as Gilbert syndrome. Conjugated hyperbilirubinemia occurs in disorders of hepatocellular damage, such as viral and alcoholic hepatitis, and cholestatic disorders, such as choledocholithiasis and neoplastic obstruction of the biliary tree.

Non-destructive testing principles and accurate evaluation of the hydraulic measure impact range using the DC method

NASA Astrophysics Data System (ADS)

Qiu, Liming; Shen, Rongxi; Song, Dazhao; Wang, Enyuan; Liu, Zhentang; Niu, Yue; Jia, Haishan; Xia, Shankui; Zheng, Xiangxin

2017-12-01

An accurate and non-destructive evaluation method for the hydraulic measure impact range in coal seams is urgently needed. Aiming at the application demands, a theoretical study and field test are presented using the direct current (DC) method to evaluate the impact range of coal seam hydraulic measures. We firstly analyzed the law of the apparent resistivity response of an abnormal conductive zone in a coal seam, and then investigated the principle of non-destructive testing of the coal seam hydraulic measure impact range using the DC method, and used an accurate evaluation method based on the apparent resistivity cloud chart. Finally, taking hydraulic fracturing and hydraulic flushing as examples, field experiments were carried out in coal mines to evaluate the impact ranges. The results showed that: (1) in the process of hydraulic fracturing, coal conductivity was enhanced by high-pressure water in the coal seam, and after hydraulic fracturing, the boundary of the apparent resistivity decrease area was the boundary impact range. (2) In the process of hydraulic flushing, coal conductivity was reduced by holes and cracks in the coal seam, and after hydraulic flushing, the boundary of the apparent resistivity increase area was the boundary impact range. (3) After the implementation of the hydraulic measures, there may be some blind zones in the coal seam; in hydraulic fracturing blind zones, the apparent resistivity increased or stayed constant, while in hydraulic flushing blind zones, the apparent resistivity decreased or stayed constant. The DC method realized a comprehensive and non-destructive evaluation of the impact range of the hydraulic measures, and greatly reduced the time and cost of evaluation.

Portable duplex ultrasonography: A diagnostic and decision-making tool in reconstructive microsurgery.

PubMed

Gravvanis, Andreas; Karakitsos, Dimitrios; Dimitriou, Vasilios; Zogogiannis, Ioannis; Katsikeris, Nick; Karabinis, Andreas; Tsoutsos, Dimosthenis

2010-07-01

Unidirectional Doppler is a common diagnostic tool by the Reconstructive Microsurgeons; however, it may generate false signals and surely provides less imaging data as compared to duplex ultrasonography. We have reviewed the use of Portable Duplex Ultrasonography (PDU) in 16 patients who underwent complex soft-tissue/bone reconstruction, aiming to determine its role in the design and management of free tissue transfer. According to our data, there were modifications either of the surgical plan and/or of patient's management, based on PDU findings, in 10 out of 16 patients (62.5%). The use of ultrasound directed to subtle modifications in three patients (19%), but to significant changes of the surgical plan in four patients (25%). Also, the use of ultrasound improved significantly the postoperative management in three patients (19%). Thus, significant impact of PDU in patient's treatment was recorded in 44% of cases. Portable ultrasound represents generally available method for preoperative, intraoperative, and postoperative diagnosis and decision-making in free tissue transfer, hence could replace in the near future the unidirectional Doppler in the hands of Microsurgeons. (c) 2010 Wiley-Liss, Inc.

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

Feasibility of using negative ultrasonography results of axillary lymph nodes to predict sentinel lymph node metastasis in breast cancer patients.

PubMed

Chen, Xue; He, Yingjian; Wang, Jiwei; Huo, Ling; Fan, Zhaoqing; Li, Jinfeng; Xie, Yuntao; Wang, Tianfeng; Ouyang, Tao

2018-06-14

Knowledge of the pathology of axillary lymph nodes (ALN) in breast cancer patients is critical for determining their treatment. Ultrasound is the best noninvasive evaluation for the ALN status. However, the correlation between negative ultrasound results and the sentinel lymph nodes (SLN) pathology remains unknown. To test the hypothesis that negative ultrasound results of ALN predict the negative pathology results of SLN in breast cancer patients, we assessed the association between ALN ultrasonography-negative results and the SLN pathology in 3115 patients with breast cancer recruited between October 2010 and April 2016 from a single cancer center, prospective database. Of these patients who met the inclusion criteria, 2317 (74.4%) had no SLN pathological metastasis. In the univariate analysis, other 798 patient with positive SLN tended to be under age 40 and premenopausal, having large tumor sizes (>2 cm), higher histological grade of primary tumor, positive hormone receptors, and negative HER-2 status (P < .05 for all). In the multivariate analysis, menstrual status, tumor size, ER status and histological types of primary tumor remained to be independent predictors for SLN pathological metastasis. The area under curve (AUC) was 0.658 (95% CI = 0.637-0.679), P > .05. In conclusion, only a 74.4% consistency between ALN ultrasonography-negative results and negative pathological SLN results, although menstrual status, tumor size, histologic subtypes of primary tumor and ER status were found to be statistically independent predictors of positive SLN among patients negative for ALN ultrasonography. Therefore, the present study suggests that negative ultrasound results of ALN do not adequately predict the negative pathology results of SLN in breast cancer patients. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

SSAT/AHPBA Joint Symposium on Evaluation and Treatment of Benign Liver Lesions

PubMed Central

Chun, Yun Shin; House, Michael G.; Kaur, Harmeet; Loyer, Evelyne M.; Paradis, Valérie; Vauthey, Jean-Nicolas

2013-01-01

Background Benign liver lesions are common incidental radiologic findings. Methods Experts convened in 2011 at a Society for Surgery of the Alimentary Tract/ Americas Hepato-Pancreato-Biliary Association joint symposium to discuss the evaluation and treatment of benign liver lesions. Results Most benign liver lesions can be accurately diagnosed with high-quality imaging, including ultrasonography, multiphase computed tomography, and magnetic resonance imaging, particularly with hepatocyte-specific contrast agents. Percutaneous biopsy is reserved for lesions that cannot be characterized radiographically, and its accuracy is improved with immunophenotypic markers. Hepatic cysts are the most commonly diagnosed benign liver lesions; these must be distinguished from malignant cystic lesions, which are rare. Among the solid benign liver lesions, hemangiomas and focal nodular hyperplasia seldom require treatment. In contrast, hepatocellular adenomas are associated with a risk for complications. A new classification system for hepatocellular adenomas based on genetic and phenotypic features can help guide patient care. In patients who are symptomatic or at risk for complications, multidisciplinary evaluation and treatment based on clinicopathologic, radiographic, and molecular analysis is needed. Conclusions Most benign liver lesions can be accurately diagnosed radiographically and do not require treatment. Treatment is necessary for patients with symptoms or at risk for complications. PMID:23377783

Grey-scale ultrasonography for monitoring industrial exposure to hepatotoxic agents.

PubMed

Taylor, K J; Williams, D M; Smith, P M; Duck, B W

1975-05-31

Industrial exposure to several potentially hepatotoxic agents, such as vinyl-chloride monomer may occur, and there is a need for non-vasive, diagnostic techniques to detect and monitor progressive pathological processes in liver or spleen. Grey-scale ultrasonography permits display of detailed anatomy and pathology in the liver, portal veins, and spleen. The combination of fine resolution, non-invasiveness, absence of ionising radiation hazard, and portable equipment makes the technique ideal for screening populations at risk.

Comparative Evaluation of Advanced and Conventional Diagnostic Aids for Endodontic Management of Periapical Lesions, An in Vivo Study

PubMed Central

Singh, Smita; Arora, Saurabh; Sandhu, Amneet Kaur; Dhingra, Ravneet

2015-01-01

Aim: To evaluate efficacy of Colour Doppler ultrasonography (CDUSG), direct digital radiography (DDR) and conventional radiography (CR) in diagnosis of periapical lesions and to clinically correlate treatment plan of periapical diseases. Materials and Methods: Thirty patients which were diagnosed with periapical lesions in anterior region by using both conventional and digital radiography were examined using colour doppler ultrasound imaging at the site of lesion. The images of each lesion were analysed by two endodontists and by an expert oral radiologist. A tentative differential diagnosis was agreed upon, based on certain principles discussed in article, then a diagnosis between cyst, granuloma and mixed lesions was made. Periapical lesions diagnosed as mixed lesions by colour doppler ultrasonography (CDUSG) were treated non-surgically whereas other periapical lesions were treated surgically. Tissues obtained during endodontic surgery were processed and examined for histopathological findings, and compared with the diagnosis made by ultrasound images. Statistical analysis was done with Chi-Square test and using one-way-Anova. Results: The periapical lesions which were diagnosed as granuloma by ultrasonographic findings, was confirmed by the results of histopathological examination in all 16 surgically treated cases. The lesions in rest of the 14 cases which showed vascularity and were diagnosed as mixed lesions by ultrasonography, were treated non-surgically and had a favourable prognosis. Conclusion: CR and DDR facilitate diagnosis of the presence of periapical disease, but do not provide and information of its nature. CDUSG imaging facilitates accurate information on the pathological nature of the lesion and hence can lead to predictable treatment planning. PMID:25738075

Automated Breast Ultrasonography (ABUS) in the Screening and Diagnostic Setting: Indications and Practical Use.

PubMed

Rella, Rossella; Belli, Paolo; Giuliani, Michela; Bufi, Enida; Carlino, Giorgio; Rinaldi, Pierluigi; Manfredi, Riccardo

2018-03-16

Automated breast ultrasonography (ABUS) is a new imaging technology for automatic breast scanning through ultrasound. It was first developed to overcome the limitation of operator dependency and lack of standardization and reproducibility of handheld ultrasound. ABUS provides a three-dimensional representation of breast tissue and allows images reformatting in three planes, and the generated coronal plane has been suggested to improve diagnostic accuracy. This technique has been first used in the screening setting to improve breast cancer detection, especially in mammographically dense breasts. In recent years, numerous studies also evaluated its use in the diagnostic setting: they showed its suitability for breast cancer staging, evaluation of tumor response to neoadjuvant chemotherapy, and second-look ultrasound after magnetic resonance imaging. The purpose of this article is to provide a comprehensive review of the current body of literature about the clinical performance of ABUS, summarize available evidence, and identify gaps in knowledge for future research. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Cerebral venous circulatory system evaluation by ultrasonography.

PubMed

Zavoreo, Iris; Basić-Kes, Vanja; Zadro-Matovina, Lucija; Lisak, Marijana; Corić, Lejla; Cvjeticanin, Timon; Ciliga, Dubravka; Bobić, Tatjana Trost

2013-06-01

Venous system can be classified as pulmonary veins, systemic veins and venous sinuses that are present only within the skull. Cerebral venous system is divided into two main parts, the superficial and the deep system. The main assignment of veins is to carry away deoxygenated blood and other maleficient materials from the tissues towards the heart. Veins have thinner walls and larger lumina than arteries. Between 60% and 70% of the total blood volume is found in veins. The major factors that influence venous function are the respiratory cycle, venous tone, the function of the right heart, gravity, and the muscle pump. Venous system, in general, can be presented by selective venography, Doppler sonography, computed tomography (CT) venography and magnetic resonance (MR) venography, and cerebral venous system can be displayed by selective venography, cerebral CT venography, cerebral MR venography, and specialized extracranial and transcranial Doppler sonography. The aim of this paper is to show the possibilities of intracranial and extracranial ultrasound evaluation of the head and neck venous circulation and chronic cerebrospinal venous insufficiency as one of the most common pathologies evaluated as part of neurodegenerative processes in the central nervous system.

Clinical use of ultrasonography associated with color Doppler in the diagnosis and follow-up of acute pyelonephritis.

PubMed

Dell'Atti, Lucio; Borea, Pier Andrea; Ughi, Gianni; Russo, Gian Rosario

2010-12-01

The purpose of this study is to evaluate the current role of the Ultrasound associated with the color-Doppler in the diagnosis of acute pyelonephritis (APN) and to compare ultrasound images with CT images in order to reduce the amount radiation absorbe without significant loss of diagnostic efficacy, since this disease in most cases affects young adults. We studied 38 patients (aged 17-65 years) who presented from September 2007 to March 2010 to the emergency department with suspected diagnosis of APN. All patients underwent first to an ultrasound study, then to abdominal CT. Renal, perirenal and extrarenal tomographic findings usually associated with acute pyelonephritis were analyzed, in an attempt to identify what are the differences with respect to the images obtained with an ultrasound study. All patients then performed ultrasonography and/or abdominal CT evaluation one month later, 25 patients repeated both examinations, while the other 13 repeated only ultrasound. In 38 subjects with suspected APN, CT assessed the presence in 79% and in 21% the absence of the disease. Ultrasonography in 68% of cases diagnosed APN, by an increase in kidney size related to the presence of hypoechoic areas associated to edema, blurred margins and reduction of the color-Doppler vascularity. Ultrasound associated with the use of color-Doppler revealed a sensibility of 76% and specificity of 75%. Color and power-Doppler have better diagnostic accuracy than basic gray scale ultrasound, in the diagnosis of focal pyelonephritis. Therefore the combined use of ultrasound and color-Doppler can obtain useful information about the diagnosis and follow-up of the disease, with an improvement in terms of cost, without significantly altering the diagnostic efficacy and reducing the amount of radiation absorbed.

Ultrasonography of uterine leiomyomas.

PubMed

Woźniak, Andrzej; Woźniak, Sławomir

2017-12-01

Uterine leiomyomas or uterine fibroids are the most common gynaecological tumours and occur in about 20-50% of women around the world. Ultrasonography (USG) is the first-line imaging examination in suspected fibroids and shows high sensitivity and specificity in diagnosing this condition. Ultrasound scans can be performed transvaginally (transvaginal scan - TVS) or transabdominally (transabdominal scan - TAS); both scans have advantages and limitations, but, in general, transvaginal sonography is superior to transabdominal sonography in most cases of pelvic pathology. Whether a leiomyoma is symptomatic or not depends primarily on its size and location. During ultrasound examination, leiomyomas usually appear as well-defined, solid, concentric, hypoechoic masses that cause a variable amount of acoustic shadowing. During the examination of leiomyomas differential diagnosis is important. Some of the most common misdiagnosed pathologies are adenomyosis, solid tumours of adnexa, and endometrial polyps. Misdiagnosis of a leiomyosarcoma has the most negative consequences, presenting symptoms are very similar to benign leiomyoma, and there is no pelvic imaging technique that can reliably differentiate between those pathologies. Magnetic resonance and computer tomography might be helpful in the diagnostics of uterine leiomyoma; however, ultrasound examination is the basic imaging test confirming the existence of leiomyomas, allowing the differentiation of myomas with adenomyosis, endometrial polyps, ovarian tumours, and pregnant uterus.

Ultrasonography of uterine leiomyomas

PubMed Central

Woźniak, Andrzej

2017-01-01

Uterine leiomyomas or uterine fibroids are the most common gynaecological tumours and occur in about 20-50% of women around the world. Ultrasonography (USG) is the first-line imaging examination in suspected fibroids and shows high sensitivity and specificity in diagnosing this condition. Ultrasound scans can be performed transvaginally (transvaginal scan – TVS) or transabdominally (transabdominal scan – TAS); both scans have advantages and limitations, but, in general, transvaginal sonography is superior to transabdominal sonography in most cases of pelvic pathology. Whether a leiomyoma is symptomatic or not depends primarily on its size and location. During ultrasound examination, leiomyomas usually appear as well-defined, solid, concentric, hypoechoic masses that cause a variable amount of acoustic shadowing. During the examination of leiomyomas differential diagnosis is important. Some of the most common misdiagnosed pathologies are adenomyosis, solid tumours of adnexa, and endometrial polyps. Misdiagnosis of a leiomyosarcoma has the most negative consequences, presenting symptoms are very similar to benign leiomyoma, and there is no pelvic imaging technique that can reliably differentiate between those pathologies. Magnetic resonance and computer tomography might be helpful in the diagnostics of uterine leiomyoma; however, ultrasound examination is the basic imaging test confirming the existence of leiomyomas, allowing the differentiation of myomas with adenomyosis, endometrial polyps, ovarian tumours, and pregnant uterus. PMID:29483851

Ultrasonographic evaluation of the renal dimensions in captive tigers.

PubMed

Huaijantug, Somkiat; Manatpreprem, Komsan; Manatpreprem, Sukhumarn; Yatmark, Paranee

2017-01-10

Ultrasonographic measurements of kidney size are useful in the practical diagnosis of kidney diseases in animals. In tigers, there is a lack of information regarding the ultrasonography methods used to measure the kidney size of the tiger. Thirty-three healthy captive tigers (Panthera tigris) were placed in lateral recumbency for ultrasonography. The measurements obtained from the ultrasonography were computed, and the results showed that there was a statistically significant difference between genders in terms of body weight and renal length. The length of the right kidney was significantly different from that of the left kidney (10.23 ± 0.76 cm in males versus 9.94 ± 0.80 cm in females; P<0.05). Interestingly, this study demonstrated that kidney length was statistically significantly associated with the body weight, and it also had a positive linear relationship with the body weight. Therefore, ultrasonographic renal dimensions could prove to be beneficial and modality for use in the evaluation of kidneys in unconscious tigers. However, kidney size evaluation must be performed using not only ultrasound but other clinical forms of technology and parameters.

Impact of target organ damage assessment in the evaluation of global risk in patients with essential hypertension.

PubMed

Viazzi, Francesca; Leoncini, Giovanna; Parodi, Denise; Ratto, Elena; Vettoretti, Simone; Vaccaro, Valentina; Parodi, Angelica; Falqui, Valeria; Tomolillo, Cinzia; Deferrari, Giacomo; Pontremoli, Roberto

2005-03-01

Accurate assessment of cardiovascular risk is a key step toward optimizing the treatment of hypertensive patients. We analyzed the impact and cost-effectiveness of routine, thorough assessment of target organ damage (TOD) in evaluating risk profile in hypertension. A total of 380 never-treated patients with essential hypertension underwent routine work-up plus evaluation of albuminuria and ultrasonography of cardiac and vascular structures. The impact of these tests on risk stratification, as indicated by European Society of Hypertension-European Society of Cardiology guidelines, was assessed in light of their cost and sensitivity. The combined use of all of these tests greatly improved the detection of TOD, therefore leading to the identification of a higher percentage of patients who were at high/very high risk, as compared with those who were detected by routine clinical work-up (73% instead of 42%; P < 0.0001). Different signs of TOD only partly cluster within the same subgroup of patients; thus, all three tests should be performed to maximize the sensitivity of the evaluation process. The diagnostic algorithm yielding the lowest cost per detected case of TOD is the search for microalbuminuria, followed by echocardiography and then carotid ultrasonography. Adopting lower cut-off values to define microalbuminuria allows us to optimize further the cost-effectiveness of diagnostic algorithms. In conclusion, because of its low cost and widespread availability, measuring albuminuria is an attractive and cost-effective screening test that is especially suitable as the first step in the large-scale diagnostic work-up of hypertensive patients.

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

USDA-ARS?s Scientific Manuscript database

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...

Transdural doppler ultrasonography monitors cerebral blood flow changes in relation to motor tasks.

PubMed

Hatanaka, Nobuhiko; Tokuno, Hironobu; Nambu, Atsushi; Takada, Masahiko

2009-04-01

Monitoring changes in cerebral blood flow in association with neuronal activity has widely been used to evaluate various brain functions. However, current techniques do not directly measure blood flow changes in specified blood vessels. The present study identified arterioles within the cerebral cortex by echoencephalography and color Doppler imaging, and then measured blood flow velocity (BFV) changes in pulsed-wave Doppler mode. We applied this "transdural Doppler ultrasonography (TDD)" to examine BFV changes in the cortical motor-related areas of monkeys during the performance of unimanual (right or left) and bimanual key-press tasks. BFV in the primary motor cortex (MI) was increased in response to contralateral movement. In each of the unimanual and bimanual tasks, bimodal BFV increases related to both the instruction signal and the movement were observed in the supplementary motor area (SMA). Such BFV changes in the SMA were prominent during the early stage of task training and gradually decreased with improvements in task performance, leaving those in the MI unchanged. Moreover, BFV changes in the SMA depended on task difficulty. The present results indicate that TDD is useful for evaluating regional brain functions.

Feasibility of Using Ultrasonography to Establish Relationships Among Sacral Base Position, Sacral Sulcus Depth, Body Mass Index, and Sex.

PubMed

Lockwood, Michael D; Kondrashova, Tatyana; Johnson, Jane C

2015-11-01

Identifying relationships among anatomical structures is key in diagnosing somatic dysfunction. Ultrasonography can be used to visualize anatomical structures, identify sacroiliac landmarks, and validate anatomical findings and measurements in relation to somatic dysfunction. As part of the osteopathic manipulative medicine course at A.T. Still University-Kirksville College of Osteopathic Medicine, first-year students are trained to use ultrasonography to establish relationships among musculoskeletal structures. To determine the ability of first-year osteopathic medical students to establish sacral base position (SBP) and sacral sulcus depth (SSD) using ultrasonography and to identify the relationship of SBP and SSD to body mass index (BMI) and sex. Students used ultrasonography to obtain the distance between the skin and the sacral base (the SBP) and the distance between the skin and the tip of the posterior superior iliac spine bilaterally. Next, students calculated the SSD (the distance between the tip of the posterior superior iliac spine and the SBP). Data were analyzed with respect to side of the body, BMI, sex, and age. The BMI data were subdivided into normal (18-25 mg/kg) and overweight (25-30 mg/kg) groups. Ultrasound images of 211 students were included in the study. The SBP was not significantly different between the left and right sides (36.5 mm vs 36.5 mm; P=.95) but was significantly different between normal and overweight BMI categories (33.0 mm vs 40.0 mm; P<.001) and between men and women (34.1 mm vs 39.0 mm; P<.001). The SSD was not significantly different between left and right sides (18.9 mm vs 19.8 mm; P=.08), normal and overweight BMI categories (18.9 mm vs 19.7 mm, P=.21), or men and women (19.7 mm vs 19.0 mm; P=.24). No significant relationship was identified between age and SBP (P=.46) or SSD (P=.39); however, the age range was narrow (21-33 years). The study yielded repeatable and reproducible results when establishing SBP and SSD using

Use of ultrasonography to diagnose large colon volvulus in horses.

PubMed

Abutarbush, Sameeh M

2006-02-01

To describe the use of ultrasonography to diagnose large colon volvulus (LCV) in horses. Descriptive report. 4 horses with clinical signs of abdominal pain. Each horse was administered analgesic agents for pain control and placed in stocks. Ultrasonographic evaluations were performed with a 3.5-MHz sector scanning transducer that was placed parallel to the long axis of the horse (longitudinal imaging) over an area of the left ventral aspect of the abdomen. The boundaries of the evaluated region included the ventral midline, 2 vertical lines at the level of the left 10th and 17th intercostal spaces, and a horizontal line between the 2 vertical lines at the level of the costal arch of the left 10th intercostal area. In all horses, nonsacculated large colon was identified ultrasonographically in the left ventral portion of the abdomen; this finding was considered indicative of LCV. In 3 horses, the LCV involved intestinal rotation of 180 degrees, whereas in 1 horse, the LCV involved intestinal rotation of 540 degrees. As confirmed by surgical or postmortem findings, the degree and location of the volvulus were correctly estimated from ultrasonographic images. In horses, this method of diagnosis of LCV appears to be of value regardless of the location at which the rotation of the large colon occurs. Ultrasonographic findings may aid in the earlier diagnosis of LCV in horses, especially at an early stage of the disease when other clinical signs are equivocal.

A prospective evaluation of preoperative localization by technetium-99m sestamibi scintigraphy and ultrasonography in primary hyperparathyroidism.

PubMed

Lo, Chung-Yau; Lang, Brian H; Chan, W F; Kung, Annie W C; Lam, Karen S L

2007-02-01

Ultrasonography (USG) and technetium-99m sestamibi (MIBI) scintigraphy are commonly used imaging modalities in the era of minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism (pHPT). However, their relative importance and actual contribution to MIP have not been prospectively assessed. A total of 100 consecutive pHPT patients planning for MIP were recruited. Both USG and MIBI findings were correlated with intraoperative findings and postoperative outcome. Clinicopathologic factors were examined for potential association with a correct localizing result. Thirty men and 70 women (age range 13 to 93 years [median 55.5]) were included in the study. The final pathology included 98 patients with solitary adenoma and 2 patients with multiglandular disease. The sensitivities, accuracies, and positive predicted values for USG and MIBI alone were 57% vs 89%, 56% vs 85%, and 97% vs 94%, respectively. Correctly localized adenomas were significantly heavier than incorrectly localized ones. MIBI is preferred over USG in pHPT patients planning for MIP. Weight of adenoma appeared to be the only clinicopathologic factor determining localization accuracy.

Quadriceps Function and Knee Joint Ultrasonography after ACL Reconstruction.

PubMed

Pamukoff, Derek N; Montgomery, Melissa M; Moffit, Tyler J; Vakula, Michael N

2018-02-01

Individuals with anterior cruciate ligament reconstruction (ACLR) are at greater risk for knee osteoarthritis, partially because of chronic quadriceps dysfunction. Articular cartilage is commonly assessed using magnetic resonance imaging and radiography, but these methods are expensive and lack portability. Ultrasound imaging may provide a cost-effective and portable alternative for imaging the femoral cartilage. The purpose of this study was to compare ultrasonography of the femoral cartilage between the injured and uninjured limbs of individuals with unilateral ACLR, and to examine the association between quadriceps function and ultrasonographic measures of femoral cartilage. Bilateral femoral cartilage thickness and quadriceps function were assessed in 44 individuals with unilateral ACLR. Quadriceps function was assessed using peak isometric strength, and early (RTD100) and late (RTD200) rate of torque development. Cartilage thickness at the medial femoral condyle (P < 0.001) and femoral cartilage cross-sectional area (P = 0.007) were smaller in the injured compared with the uninjured limb. After accounting for time since ACLR, quadriceps peak isometric strength was associated with cartilage thickness at the medial femoral condyle (r = 0.35, P = 0.02) and femoral cartilage cross-sectional area (r = 0.28, P = 0.04). RTD100 and RTD200 were not associated with femoral cartilage thickness or cross-sectional area. Individuals with ACLR have thinner cartilage in their injured limb compared with uninjured limb, and cartilage thickness is associated with quadriceps function. These results indicate that ultrasonography may be useful for monitoring cartilage health and osteoarthritis progression after ACLR.

Hot biopsy forceps vs. endoscopic ultrasonography in determining the depth of gastric epithelial neoplasia: a simple novel method to decide whether or not to perform endoscopic submucosal dissection.

PubMed

Huikai, Li; Enqiang, Linghu

2013-01-01

It is of vital importance to determine the depth of lesions to be treated by endoscopic submucosal dissection. This study aimed to compare the accuracy of using hot biopsy forceps method with endoscopic ultrasonography for determination of the depth of gastric epithelial neoplasia. Hot biopsy forceps method and/or endoscopic ultrasonography were used to determine the depth of lesions in 27 patients. With hot biopsy forceps method, we assumed a lesion completely lifted up by a hot biopsy forceps to be confined to the mucosal layer, and one partly lifted up to be located beyond the mucosal layer. The accuracy of hot biopsy forceps method and endoscopic ultrasonography in determining the depth of lesions were compared. Of the 27 patients, 25 underwent endoscopic submucosal dissection and 2 underwent surgery. The total accuracy of hot biopsy forceps method in determining the depth of lesions was 92.6% and that of endoscopic ultrasonography was 81.8%. Overestimation of hot biopsy forceps method and endoscopic ultrasonography were 3.7% vs. 13.6%, respectively. The sensitivity and the specificity of hot biopsy forceps method were 95.5% and 80.0% and those of EUS were 83.3% and 75.0%. Hot biopsy forceps method has a trend towards higher accuracy and lower overestimation than endoscopic ultrasonography.

Gear Shifting of Quadriceps during Isometric Knee Extension Disclosed Using Ultrasonography.

PubMed

Zhang, Shu; Huang, Weijian; Zeng, Yu; Shi, Wenxiu; Diao, Xianfen; Wei, Xiguang; Ling, Shan

2018-01-01

Ultrasonography has been widely employed to estimate the morphological changes of muscle during contraction. To further investigate the motion pattern of quadriceps during isometric knee extensions, we studied the relative motion pattern between femur and quadriceps under ultrasonography. An interesting observation is that although the force of isometric knee extension can be controlled to change almost linearly, femur in the simultaneously captured ultrasound video sequences has several different piecewise moving patterns. This phenomenon is like quadriceps having several forward gear ratios like a car starting from rest towards maximal voluntary contraction (MVC) and then returning to rest. Therefore, to verify this assumption, we captured several ultrasound video sequences of isometric knee extension and collected the torque/force signal simultaneously. Then we extract the shapes of femur from these ultrasound video sequences using video processing techniques and study the motion pattern both qualitatively and quantitatively. The phenomenon can be seen easier via a comparison between the torque signal and relative spatial distance between femur and quadriceps. Furthermore, we use cluster analysis techniques to study the process and the clustering results also provided preliminary support to the conclusion that, during both ramp increasing and decreasing phases, quadriceps contraction may have several forward gear ratios relative to femur.

Ultrasonography of the lungs and pleura in healthy camels (Camelus dromedarius).

PubMed

Tharwat, Mohamed

2013-09-01

This study describes ultrasonography of the lungs and pleura in healthy camels (Camelus dromedarius). The different layers of the thoracic wall appeared as narrow bands of variable echogenicity. Reverberation artefacts appeared as lines of variable echogenicity that ran parallel to the pulmonary surface medial to the pleura. Because of its air content, the pulmonary parenchyma was not visualised in all camels. On the right side, the pulmonary surface was seen in the 5th through the 10th intercostal space (ICS). In addition, it was imaged in the 11th ICS in 20 camels and in the 4th ICS in three camels. The dimension of the ventral lung border was largest at the 4th ICS and smallest at the 11th ICS. The echogenic line on the surface of the lung, consisting of the costal and the parietal pleurae, was 1 to 4 mm thick. The left pulmonary surface and pleura were imaged with approximately the same frequencies as the right side. At this side, only the pulmonary surface and pleura were imaged in 15 camels in the 11th ICS. In conclusion, ultrasonography of the lungs and pleura provides information that can be used as a reference when examining camels suspected to have respiratory diseases.

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

PubMed

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

2016-01-01

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. 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. 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%). 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.

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. © 2015 Blackwell Verlag GmbH.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moschouris, Hippocrates, E-mail: hipmosch@gmail.co; Malagari, Katerina; Kornezos, Ioannis

2010-12-15

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

Point-of-Care Ultrasonography in Emergency and Critical Care Medicine.

PubMed

Chen, Leon; Malek, Tony

To stabilize critically ill patients, emergency and critical care medicine providers often require rapid diagnosis and intervention. The demand for a safe, timely diagnostic device, alongside technological innovation, led to the advent of point-of-care ultrasonography (POCUS). POCUS allows the provider to gain invaluable clinical information with a high level of accuracy, leading to better clinical decision-making and improvements in patient safety. We have outlined the history of POCUS adaptation in emergency and critical care medicine and various clinical applications of POCUS described in literature.

Anatomy, histology, and ultrasonography of the normal adrenal gland in brown lemur: Eulemur fulvus.

PubMed

Raharison, Fidiniaina; Bourges Abella, Nathalie; Sautet, Jean; Deviers, Alexandra; Mogicato, Giovanni

2017-04-01

The medical care currently to brown lemurs (Eulemur fulvus) is limited by a lack of knowledge of their anatomy. The aim of this study was to describe the anatomy and histology and obtain ultrasonographic measurements of normal adrenal glands in these animals. The adrenal glands of four lemurs cadavers were used for the anatomical and histological studies, and those of 15 anesthetized lemurs were examined by ultrasonography. Anatomically, the adrenal glands of brown lemurs are comparable to those of other species. The histological findings showed that the cortex is organized into three distinct layers, whereas most domestic mammals have an additional zone. The surface area of the adrenal glands increased with body weight, and the area of the right adrenal was slightly larger than the left. We suggest using ultrasonography to aid the etiological diagnosis of behavioral abnormalities that might be due to dysfunctions of the adrenal gland. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Diagnosis of post-partum ovarian vein thrombophlebitis by color Doppler ultrasonography: about 10 cases.

PubMed

Giraud, J R; Poulain, P; Renaud-Giono, A; Darnault, J P; Proudhon, J F; Grall, J Y; Mocquet, P Y

1997-09-01

Post-partum ovarian vein thrombosis is often overlooked or mistaken for other complications such as endometritis. Color Doppler ultrasonography is a very good diagnostic method when properly indicated and correctly interpreted according to clinical data. This study reports ten cases that were retrospectively studied, during which color Doppler ultrasonography was used. The clinical signs and the results are reviewed. The lesions were clearly visualized in eight of the ten cases; one of the two failures resulted from a methodological fault (uninterpretable result); the other one was due to the lack of experience of the operator and nonrecognition of the clinical signs. Thrombosis appears as a hypoechogenic and tubular image. This type of examination is particularly indicated in the presence of certain clinical signs that were observed in our cases: fever and iliac pain are the main precursor signs, often associated with abdominal meteorism and slow digestive transit; provoked cul-de-sac pain during vaginal probing was the only constant sign, sometimes associated with painful swelling.

Impact on Clinical Management of After-Hours Emergent or Urgent Breast Ultrasonography in Patients with Clinically Suspected Breast Abscesses

PubMed Central

Moseley, Tanya W.; Stanley, Ashley; Wei, Wei; Parikh, Jay R.

2018-01-01

Newly diagnosed breast abscesses are generally treated as a medical emergency that may necessitate immediate interventional treatment. At our institution, there is no in-house after-hours coverage for breast ultrasonography. We could find no peer-reviewed studies on the cost-effectiveness or clinical management impact of on-call ultrasound technologist coverage for imaging of breast abscesses. The purposes of this study were to determine the incidence of breast abscess in patients with clinical findings highly suggestive of abscess, identify clinical factors associated with breast abscess in such patients, and determine the impact of after-hours emergent or urgent breast ultrasonography on the clinical management of breast abscesses in both outpatients and inpatients. We retrospectively reviewed 100 after-hours breast ultrasound studies performed at our tertiary care center from 2011 to 2015 for evaluation of a suspected breast abscess. Only 26% of our patients with clinically suspected abscess ultimately had a confirmed abscess. Factors associated with breast abscess were a palpable abnormality and a history of breast surgery within the eight weeks before presentation. After-hours diagnosis of an abscess was associated with after-hours clinical intervention. Of the 74 patients in whom after-hours ultrasound imaging showed no evidence of abscess, only three patients underwent after-hours drainage. Our findings support overnight and weekend breast ultrasound coverage in large tertiary care centers. PMID:29473859

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.

Ultrasonography and renography to visualize upper urinary tract in children with meningomyelocele - a prospective study.

PubMed

Abrahamsson, Kate; Stokland, Eira; Sixt, Rune; Jodal, Ulf

2012-04-01

Ultrasonography (US) is commonly used to visualize the upper urinary tract in children and adolescents with meningomyelocele (MMC). The aim of this investigation was to prospectively evaluate US in those with spinal angulation or obesity and compare it to the corresponding results obtained by mercaptoacetyltriglycine renography. Twenty-five children and adolescents with MMC and pronounced angulation of the spine or obesity, were prospectively investigated with both US and renography during the period 2006 to 2008. In 13 (52%) patients the kidneys could not be fully evaluated; in 4 (16%) neither renal size nor pelvic dilation, in 12 (48%) renal length and in 5 (20%) dilation was not accessible. In 23 individuals where dilatation could be evaluated uni- or bilaterally, US was compared to OEE% (%outflow excretion efficiency) at renography. In 1 of these individuals there was normal OEE% while slight dilatation on US was noticed. In 2/15 individuals, split function at renography did not correlate with renal length on US. Severe spinal angulation and obesity in individuals with MMC reduced the possibility to evaluate the urinary tract by US. However, it seems that renography could be a reliable alternative to evaluate renal condition in those patients where US is insufficient. Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

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…

Comparison of radiography and ultrasonography for the diagnosis of osteochondritis dissecans in the equine femoropatellar joint.

PubMed

Bourzac, C; Alexander, K; Rossier, Y; Laverty, S

2009-09-01

Osteochondritis dissecans (OCD) lesions of the femoropatellar (FP) joint are diagnosed routinely by radiography, but lesions located in the trochlear groove or without accompanying subchondral bone changes can be difficult to visualise. Ultrasonography allows evaluation of articular cartilage and subchondral bone in the FPjoint. To document the radiographic and ultrasonographic appearance of OCD lesions in the equine FP joint, grade ultrasonographic lesions and compare their accuracy in the diagnosis of these lesions. The medical records of all horses diagnosed with FP OCD between 1995 and 2006 were assessed. Inclusion criteria included availability of both radiographic and ultrasonographic images. Lesion characteristics were evaluated in each trochlear ridge and trochlear groove. For assessment of the accuracy (sensitivity and specificity) of both imaging techniques in the diagnosis of OCD, only cases with an arthroscopic or necropsy examination were studied. Twenty-one horses were included. OCD lesions were diagnosed by radiography (30/32 joints) and ultrasound (32/32 joints). The lateral trochlear ridge (LTR, 91%) and the medial trochlear ridge (MTR, 17%) were involved on radiography. The localisation on ultrasound examination was similar (97% LTR, 25% MTR). All but one lesion seen on radiography were also detected with ultrasound; 2 LTR and 3 MTR lesions, not seen on radiography were diagnosed by ultrasound and confirmed at arthroscopy or necropsy. The specificity was 100% regardless of the site and imaging procedure except for the distal third of the MTR (94% for ultrasound). The sensitivity varied, depending on lesion site. Ultrasonography is a valuable diagnostic tool to diagnose OCD lesions in the FP joint and more sensitive than radiography for lesions affecting the MTR of the distal femur. Ultrasound should be considered as a useful adjunct to radiography for diagnosing equine FP OCD, especially in cases of high clinical suspicion but equivocal

Transmission ultrasonography. [time delay spectrometry for soft tissue transmission imaging

NASA Technical Reports Server (NTRS)

Heyser, R. C.; Le Croissette, D. H.

1973-01-01

Review of the results of the application of an advanced signal-processing technique, called time delay spectrometry, in obtaining soft tissue transmission images by transmission ultrasonography, both in vivo and in vitro. The presented results include amplitude ultrasound pictures and phase ultrasound pictures obtained by this technique. While amplitude ultrasonographs of tissue are closely analogous to X-ray pictures in that differential absorption is imaged, phase ultrasonographs represent an entirely new source of information based on differential time of propagation. Thus, a new source of information is made available for detailed analysis.

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

PubMed Central

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

2016-01-01

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. PMID:27733929

Accuracy of Point-of-care Ultrasonography for Diagnosing Acute Appendicitis: A Systematic Review and Meta-analysis.

PubMed

Matthew Fields, J; Davis, Joshua; Alsup, Carl; Bates, Amanda; Au, Arthur; Adhikari, Srikar; Farrell, Isaac

2017-09-01

The use of ultrasonography (US) to diagnose appendicitis is well established. More recently, point-of-care ultrasonography (POCUS) has also been studied for the diagnosis of appendicitis, which may also prove a valuable diagnostic tool. The purpose of this study was through systematic review and meta-analysis to identify the test characteristics of POCUS, specifically US performed by a nonradiologist physician, in accurately diagnosing acute appendicitis in patients of any age. We conducted a thorough and systematic literature search of English language articles published on point-of-care, physician-performed transabdominal US used for the diagnosis of acute appendicitis from 1980 to May, 2015 using OVID MEDLINE In-Process & Other Non-indexed Citations and Scopus. Studies were selected and subsequently independently abstracted by two trained reviewers. A random-effects pooled analysis was used to construct a hierarchical summary receiver operator characteristic curve, and a meta-regression was performed. Quality of studies was assessed using the QUADAS-2 tool. Our search yielded 5,792 unique studies and we included 21 of these in our final review. Prevalence of disease in this study was 29.8%, (range = 6.4%-75.4%). The sensitivity and specificity for POCUS in diagnosing appendicitis were 91% (95% confidence interval [CI] = 83%-96%) and 97% (95% CI = 91%-99%), respectively. The positive and negative predictive values were 91 and 94%, respectively. Studies performed by emergency physicians had slightly lower test characteristics (sensitivity = 80%, specificity = 92%). There was significant heterogeneity between studies (I 2 = 99%, 95% CI = 99%-100%) and the quality of the reported studies was moderate, mostly due to unclear reporting of blinding of physicians and timing of scanning and patient enrollment. Several of the studies were performed by a single operator, and the education and training of the operators were variably reported. Point-of-care US has relatively

Affects of Anxiety and Depression on Health-Related Quality of Life among Patients with Benign Breast Lumps Diagnosed via Ultrasonography in China.

PubMed

Lou, Zhe; Li, Yinyan; Yang, Yilong; Wang, Lie; Yang, Jun

2015-08-28

There is a high incidence of benign breast lumps among women, and these lumps may lead to physical and psychological problems. This study aims to evaluate anxiety and depressive symptoms among patients with benign breast lumps diagnosed via ultrasonography and investigate their impacts on health-related quality of life (HRQOL). A cross-sectional survey was conducted in Shenyang, China, from January to November 2013. Data were collected with self-administered questionnaires, including the Zung Self-Rating Anxiety Scale (SAS), the Center for Epidemiologic Studies Depression Scale (CES-D), and the 36-item Short-Form Health Survey (SF-36), together with demographic characteristics, from patients of the Department of Breast Surgery of the First Affiliated Hospital of China Medical University. Hierarchical multiple regression analysis (HMR) was performed to explore the effects of anxiety and depression on HRQOL. The overall prevalences of anxiety (SAS score ≥ 40) and depression (CES-D scores ≥ 16) were 40.2% and 62.0%, respectively, and 37.5% of the participants had both of these psychological symptoms. The means and standard deviations of PCS and MCS were 75.42 (15.22) and 68.70 (17.71), respectively. Anxiety and depressive symptoms were significantly negatively associated with the HRQOL of patients with benign breast lumps diagnosed via ultrasonography. Women with benign breast lumps diagnosed via ultrasonography in China experienced relatively high levels of anxiety and depressive symptoms. Anxiety and depressive symptoms had significant negative impacts on both the mental and physical quality of life (QOL) of women with benign breast lumps. Beyond the necessary clinical treatment procedures, psychological guidance and detailed explanations of the disease should be offered to alleviate the anxiety and depressive symptoms and enhance the HRQOL of patients with benign breast lumps.

Reliable and valid assessment of point-of-care ultrasonography.

PubMed

Todsen, Tobias; Tolsgaard, Martin Grønnebæk; Olsen, Beth Härstedt; Henriksen, Birthe Merete; Hillingsø, Jens Georg; Konge, Lars; Jensen, Morten Lind; Ringsted, Charlotte

2015-02-01

To explore the reliability and validity of the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale for point-of-care ultrasonography (POC US) performance. POC US is increasingly used by clinicians and is an essential part of the management of acute surgical conditions. However, the quality of performance is highly operator-dependent. Therefore, reliable and valid assessment of trainees' ultrasonography competence is needed to ensure patient safety. Twenty-four physicians, representing novices, intermediates, and experts in POC US, scanned 4 different surgical patient cases in a controlled set-up. All ultrasound examinations were video-recorded and assessed by 2 blinded radiologists using OSAUS. Reliability was examined using generalizability theory. Construct validity was examined by comparing performance scores between the groups and by correlating physicians' OSAUS scores with diagnostic accuracy. The generalizability coefficient was high (0.81) and a D-study demonstrated that 1 assessor and 5 cases would result in similar reliability. The construct validity of the OSAUS scale was supported by a significant difference in the mean scores between the novice group (17.0; SD 8.4) and the intermediate group (30.0; SD 10.1), P = 0.007, as well as between the intermediate group and the expert group (72.9; SD 4.4), P = 0.04, and by a high correlation between OSAUS scores and diagnostic accuracy (Spearman ρ correlation coefficient = 0.76; P < 0.001). This study demonstrates high reliability as well as evidence of construct validity of the OSAUS scale for assessment of POC US competence. Hence, the OSAUS scale may be suitable for both in-training as well as end-of-training assessment.

Use of musculoskeletal ultrasonography in the diagnosis of pes anserine tendinitis: a case report.

PubMed

Valley, V T; Shermer, C D

2001-01-01

A 45-year-old woman presented to the Emergency Department with a chief complaint of acute, nontraumatic medial knee pain. Musculoskeletal ultrasonography was performed, and the diagnosis of pes anserine tendinitis was elucidated. A discussion of this clinical entity, the characteristic ultrasonographic findings, and therapy follow in this case report.

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. Copyright © 2015 Elsevier Inc. All rights reserved.

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. Copyright © 2013 Elsevier Inc. All rights reserved.

Reference values for the genitalia of male dromedary before and after puberty using caliper and ultrasonography in subtropics.

PubMed

Derar, Derar Refaat; Hussein, Hasan Ali; Ali, Ahmad

2012-01-15

The aim of the present study was to characterize the dynamic changes of the testes and the pelvic genitalia in vivo in male dromedary. Eighty-one clinically healthy male dromedaries aged 1.5 to 12 years were assigned for the present study. Testicular length, breadth, and depth as well as epididymal head and tail were measured using caliper and ultrasonography. The pelvic genitalia, including bulbourethral gland, prostate, and pelvic urethra were examined using ultrasonography. The results revealed that the three dimensions of the testes and epididymal tail and head showed significant increase with age (P < 0.01). Concerning the epididymal measurements, differences between the pre- and peri-pubertal groups were not significant. Left testes tended to be larger than the right (not statistically significant) although only the breadth of the left testes in the prepubertal group was significantly larger (P < 0.05). The volume of both testes correlated positively with the age (r(2) = 0.91 for left and 1.00 for the right, P < 0.01). There were no significant correlations between the values measured using caliper and those by ultrasonography between groups, but the correlation was highly significant (P < 0.01) for the total number of the examined animals. There were significant and steady increases of the size of bulbourethral gland in all examined groups (P < 0.01). Pars disseminata of the prostate gland and pelvic urethra were significantly higher in sexually mature compared with prepubertal groups (P < 0.01). It was concluded that ultrasonography is a useful tool in studying the developmental changes of the testes and accessory glands of the male dromedary. The obtained data could provide a reference values for predicting camel puberty and future fertility. Copyright © 2012 Elsevier Inc. All rights reserved.

Fluorescence optical imaging and musculoskeletal ultrasonography in juvenile idiopathic polyarticular disease before and during antirheumatic treatment - a multicenter non-interventional diagnostic evaluation.

PubMed

Klein, Ariane; Just, Georg Werner; Werner, Stephanie Gabriele; Oommen, Prasad T; Minden, Kirsten; Becker, Ingrid; Langer, Hans-Eckhard; Klee, Dirk; Horneff, Gerd

2017-06-30

Valid detection of inflamed joints is essential for correct classification, therapeutic decisions, prognosis and assessment of treatment efficacy in juvenile idiopathic arthritis (JIA). Fluorescence optical imaging (FOI) enables visualization of inflammation in arthritis of finger and hand joints and might be used for monitoring. A 24-week observational study in polyarticular JIA patients newly starting treatment with methotrexate or an approved biologic was performed in three centers. Patients were evaluated clinically, by gray-scale ultrasonography (GSUS), power-Doppler ultrasonography (PDUS) and FOI at baseline, week 12 and week 24. Of 37 patients enrolled, 24 patients started methotrexate and 13 patients a biologic for the first time (etanercept n = 11, adalimumab and tocilizumab n = 1 each). Mean JADAS 10 decreased significantly from 17.7 at baseline to 12.2 and 7.2 at week 12 and 24 respectively. PedACR 30/50/70/100 response rates at week 24 were 85%/73%/50%/27%. The total number of clinically active joints in hand and fingers at baseline/week 12/week 24 was 262 (23.6%)/162 (16.4%)/162 (9.0%). By GSUS, at baseline/week 12/week 24, 192 (19.4%)/135 (16.1%)/83 (11.5%) joints showed effusions and 186 (18.8%)/107 (12.7%)/69 (9.6%) showed synovial thickening, and by PDUS 68 (6.9%)/15 (1.8%)/36 (5%) joints showed hyperperfusion. Any sign of arthritis was detected by US in a total of 243 joints (24.5%) at baseline, 161 joints (19.2%) at week 12 and 123 joints (17%) at week 24. By FOI at baseline/week 12/week 24, 430 (38.7%)/280 (29.2%)/215 (27.6%) showed a signal enhancement in at least one phase. Summarizing all three points of time, the highest numbers of signals were detected by FOI with 32% of joints, especially in phase 2, while by US 20.7% and by clinical examination 17.5% of joints were active. A high number of joints (21.1%) had FOI signals but were inactive by clinical examination. A total 20.1% of joints with signals in FOI did not show effusion

Neurilemmoma of the glans penis: ultrasonography and magnetic resonance imaging findings.

PubMed

Jung, Dae Chul; Hwang, Sung Il; Jung, Sung Il; Kim, Sun Ho; Kim, Seung Hyup

2006-01-01

Neurilemmoma of the glans penis is rare, and no imaging findings have been reported. A case of neurilemmoma of the glans penis is presented. Ultrasonography (US) and magnetic resonance imaging revealed a well-defined small mass in the glans penis. The mass appeared hypoechoic on gray-scale US and hypervascular on color Doppler US. Magnetic resonance imaging revealed high signal intensity of the mass on a T2-weighted image and strong enhancement on a contrast-enhanced T1-weighted image.

B-scan ultrasonography for the detection of space-occupying ocular masses.

PubMed

Miller, W W; Cartee, R E

1985-07-01

A noninvasive technique, B-scan ultrasonography, was used to obtain detailed cross-sectional images of ocular and orbital structure and form. When a low-frequency probe (5 MHz) was used, tissue penetration was excellent; however, axial resolution was limited. The technique was used in a study of 2 cats and 1 dog. The use of low-frequency B-scan ultrasound should aid in the diagnostic examinations of space-occupying masses in the posterior portion of the ocular bulb and the orbit.

Accuracy of Ultrasonography and Computed Tomography in the Evaluation of Patients Undergoing Sialendoscopy for Sialolithiasis.

PubMed

Thomas, W Walsh; Douglas, Jennifer E; Rassekh, Christopher H

2017-05-01

Objective To determine the accuracy of the 2 most utilized imaging modalities in obstructive sialadenitis secondary to sialolithiasis-computed tomography (CT) and ultrasonography (US)-using sialendoscopic findings as a comparison standard. To review the impact of CT and US on the management of sialolithiasis managed with sialendoscopy alone and through combined approaches. Study Design Retrospective cohort study. Setting Quaternary academic referral center. Subjects and Methods All cases of patients undergoing sialendoscopy by a single surgeon for suspected parotid and submandibular gland pathology between the October 2013 and April 2016 were reviewed. Results Sixty-eight patients were in this cohort, of whom 44 underwent US, CT, and sialendoscopy; 20 underwent CT and sialendoscopy only; and 4 underwent US and sialendoscopy only. The sensitivity and specificity were 65% and 80% for US and 98% and 88% for CT, respectively. These 68 patients had 84 total stones addressed, with 79 being removed and 5 remaining in situ. The methods of stone removal were sialendoscopy alone (34 stones), open transoral approaches (36 stones), and an external approach: transcervical for submandibular and transfacial for parotid (11 stones). Conclusion US had a lower sensitivity (65%) than what has been reported in the literature (70%-94%), and the majority of missed stones were anterior Wharton's duct stones. These sialoliths were likely missed due to an incomplete examination. US and CT were complementary in this study, and the findings suggest that both modalities can be utilized to optimize the outcome of sialendoscopy and combined approaches.

Association of vitamin D insufficiency/deficiency with thyroid artery Doppler ultrasonography in patients with Hashimoto thyroiditis.

PubMed

Nalbant, Ahmet; Aydin, Ayhan; Karacan, Alper; Onmez, Attila; Tamer, Ali; Cinemre, Hakan

2017-01-01

During the course of the autoimmune thyroid diseases, ultrasonography change parallel to histopathology. Vitamin D is associated with autoimmune diseases and thus can affect thyroid blood flow. Our aim was to investigate the relationship between vitamin D insufficiency/deficiency and thyroid hemodynamic indices in patients with Hashimoto thyroiditis. A total of 93 patients who presented to Sakarya University Endocrinology outpatient clinic from April to September 2016 and diagnosed with Hashimoto thyroiditis were included in this study. Clinical and serologic data, thyroid antibodies and 25(OH)D3 were evaluated. Mean peak systolic velocity(mPSV), mean end-diastolic velocity (EDV), mean resistive index (RI) flows of superior and inferior thyroid arteries were measured with B-mode Doppler ultrasonography. Vitamin D insufficiency/deficiency was detected in 59 (63.4%). TPO Ab and TgAb levels were found higher in patients with vitamin D insufficiency/deficiency. In the normal vitamin D group, superior thyroid artery mPSV (32.21±6.73cm/s) and EDV(13.27±2.80 cm/s) were higher than in the low vitamin D group [mPSV (28.32±8.99cm/s) and EDV(10.67±3.68 cm/s)] (P=0.034, P=0.001, respectively). Inferior thyroid artery EDV value was higher in the normal compared to the low vitamin D group (0.032). RI measured in all arteries were higher in the vitamin D insufficient/deficient group compared to the Vitamin D normal group (p=0.001). Vitamin-D insufficiency/deficiency has led to reduced parenchymal blood supply and increased micro-vascular resistance in Hashimoto thyroiditis patients.

Imaging of intrahepatic progression of hepatocellular carcinoma post transarterial chemoembolization. A long-term, prospective evaluation of contrast-enhanced ultrasonography (CEUS).

PubMed

Moschouris, Hippocrates; Kalokairinou-Motogna, Mariana; Vrakas, Spyros; Papadatou, Aggeliki; Karagiannis, Eyaggelos; Kiltenis, Michail; Kladis-Kalentzis, Konstantinos; Marmaridou, Kyriaki; Papadogeorgopoulos, Nikolaos; Malagari, Katerina

2017-04-22

To assess the diagnostic efficacy of contrast-enhanced ultrasonography (CEUS) in the context of intrahepatic progression (IHP) of hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE). Sixty HCC patients were prospectively included in the study. They were treated with transarterial chemoembolization (TACE)with doxorubicin-eluting microspheres (231 sessions). Imaging follow-up was performed 1 month after each session and at 3-6 month intervals after the last session of TACE and included CEUS and contrast-enhanced magnetic resonance (MR) imaging (reference modality). The diagnosis of IHP was based on mRECIST criteria and the respective findings of MR and CEUS were recorded, categorized and correlated. A total of 441 CEUS studies were compared with the corresponding MR studies. During a follow-up period of 5-82 months (mean: 22 months), MR diagnosed 51 cases of IHP in 34/60 (56.6%) patients. CEUS correctly diagnosed 12/14 (85.7%) cases of IHP of target tumors, 2/5 (40%) cases of IHP of non-target tumors, 13/18 (72.2%) cases of distal and 6/9 (66.6%) cases of proximal new lesions, and 5/5 (100%) cases of major vessel involvement. On a per-lesion basis, CEUS was significantly inferior to MR in the detection of new lesions (p=0.002). No false positive CEUS diagnoses of IHP were observed. 54% of the diagnostic failures of CEUS were considered clinically significant.  In the long term evaluation of HCC post TACE, CEUS appears to have limitations in the detection of IHP, which are more prominent in the case of new lesions and of progressive non-target tumors.

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

Breast ultrasonography: state of the art.

PubMed

Hooley, Regina J; Scoutt, Leslie M; Philpotts, Liane E

2013-09-01

Ultrasonography (US) is an indispensable tool in breast imaging and is complementary to both mammography and magnetic resonance (MR) imaging of the breast. Advances in US technology allow confident characterization of not only benign cysts but also benign and malignant solid masses. Knowledge and understanding of current and emerging US technology, along with the application of meticulous scanning technique, is imperative for image optimization and diagnosis. The ability to synthesize breast US findings with multiple imaging modalities and clinical information is also necessary to ensure the best patient care. US is routinely used to guide breast biopsies and is also emerging as a supplemental screening tool in women with dense breasts and a negative mammogram. This review provides a summary of current state-of-the-art US technology, including elastography, and applications of US in clinical practice as an adjuvant technique to mammography, MR imaging, and the clinical breast examination. The use of breast US for screening, preoperative staging for breast cancer, and breast intervention will also be discussed.

Silicone-based composite materials simulate breast tissue to be used as ultrasonography training phantoms.

PubMed

Ustbas, Burcin; Kilic, Deniz; Bozkurt, Ayhan; Aribal, Mustafa Erkin; Akbulut, Ozge

2018-08-01

A silicone-based composite breast phantom is fabricated to be used as an education model in ultrasonography training. A matrix of silicone formulations is tracked to mimic the ultrasonography and tactile response of human breast tissue. The performance of two different additives: (i) silicone oil and (ii) vinyl-terminated poly (dimethylsiloxane) (PDMS) are monitored by a home-made acoustic setup. Through the use of 75 wt% vinyl-terminated PDMS in two-component silicone elastomer mixture, a sound velocity of 1.29 ± 0.09 × 10 3  m/s and an attenuation coefficient of 12.99 ± 0.08 dB/cm-values those match closely to the human breast tissue-are measured with 5 MHz probe. This model can also be used for needle biopsy as well as for self-exam trainings. Herein, we highlight the fabrication of a realistic, durable, accessible, and cost-effective training platform that contains skin layer, inner breast tissue, and tumor masses. Copyright © 2018 Elsevier B.V. All rights reserved.

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

PubMed

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

2014-10-01

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

Power Doppler Ultrasonography and Shear Wave Elastography as Complementary Imaging Methods for Suspected Local Breast Cancer Recurrence.

PubMed

Jales, Rodrigo Menezes; Dória, Maira Teixeira; Serra, Kátia Piton; Miranda, Mila Meneguelli; Menossi, Carlos Alberto; Schumacher, Klaus; Sarian, Luis Otávio

2018-06-01

To prospectively investigate the diagnostic accuracy and clinical consequences of power Doppler morphologic criteria and shear wave elastography (SWE) as complementary imaging methods for evaluation of suspected local breast cancer recurrence in the ipsilateral breast or chest wall. Thirty-two breast masses with a suspicion of local breast cancer recurrence on B-mode ultrasonography underwent complementary power Doppler and SWE evaluations. Power Doppler morphologic criteria were classified as avascular, hypovascular, or hypervascular. Shear wave elastography was classified according to a 5-point scale (SWE score) and SWE maximum elasticity. Diagnostic accuracy was assessed by the sensitivity, specificity, and area under the curve. A decision curve analysis assessed clinical consequences of each method. The reference standard for diagnosis was defined as core needle or excisional biopsy. Histopathologic examinations revealed 9 (28.2%) benign and 23 (71.8%) malignant cases. Power Doppler ultrasonography (US) had sensitivity of 34.8% (95% confidence interval [CI], 6.6%-62.9%) and specificity of 45.4% (95% CI, 19.3%-71.5%). The SWE score (≥3) had sensitivity of 87.0% (95% CI, 66.4%-97.2%) and specificity of 44.4% (95% CI, 13.7%-78.8%). The SWE maximum elasticity (velocity > 6.5cm/s) had sensitivity of 87% (95% CI, 66.4%-97.2%) and specificity of 77.8% (95% CI, 40.0% to 97.2%). The areas under the curves for the SWE score and SWE maximum elasticity were 0.71 (95% CI, 0.53-0.87) and 0.82 (95% CI, 0.64-0.93), respectively (P = .32). Power Doppler US is unsuitable for discrimination between local breast cancer recurrence and fibrosis. Although the SWE score and SWE maximum elasticity can make this discrimination, the use of these methods to determine biopsy may lead to poorer clinical outcomes than the current practice of performing biopsies of all suspicious masses. © 2017 by the American Institute of Ultrasound in Medicine.

An accurate evaluation of the performance of asynchronous DS-CDMA systems with zero-correlation-zone coding in Rayleigh fading

NASA Astrophysics Data System (ADS)

Walker, Ernest; Chen, Xinjia; Cooper, Reginald L.

2010-04-01

An arbitrarily accurate approach is used to determine the bit-error rate (BER) performance for generalized asynchronous DS-CDMA systems, in Gaussian noise with Raleigh fading. In this paper, and the sequel, new theoretical work has been contributed which substantially enhances existing performance analysis formulations. Major contributions include: substantial computational complexity reduction, including a priori BER accuracy bounding; an analytical approach that facilitates performance evaluation for systems with arbitrary spectral spreading distributions, with non-uniform transmission delay distributions. Using prior results, augmented by these enhancements, a generalized DS-CDMA system model is constructed and used to evaluated the BER performance, in a variety of scenarios. In this paper, the generalized system modeling was used to evaluate the performance of both Walsh- Hadamard (WH) and Walsh-Hadamard-seeded zero-correlation-zone (WH-ZCZ) coding. The selection of these codes was informed by the observation that WH codes contain N spectral spreading values (0 to N - 1), one for each code sequence; while WH-ZCZ codes contain only two spectral spreading values (N/2 - 1,N/2); where N is the sequence length in chips. Since these codes span the spectral spreading range for DS-CDMA coding, by invoking an induction argument, the generalization of the system model is sufficiently supported. The results in this paper, and the sequel, support the claim that an arbitrary accurate performance analysis for DS-CDMA systems can be evaluated over the full range of binary coding, with minimal computational complexity.

Use of transesophageal Doppler ultrasonography in ventilated pediatric patients: derivation of cardiac output.

PubMed

Tibby, S M; Hatherill, M; Murdoch, I A

2000-06-01

To ascertain if cardiac output (CO) could be derived from blood flow velocity measured in the descending aorta of ventilated children by transesophageal Doppler ultrasonography (TED) without the need for direct aortic cross sectional area measurement, and to evaluate the ability of TED to follow changes in CO when compared with femoral artery thermodilution. Prospective, comparison study. A 16-bed pediatric intensive care unit of a university hospital. A total of 100 ventilated infants and children aged 4 days to 18 yrs (median age, 27 months). Diagnoses included postcardiac surgery (n = 58), sepsis/multiple organ failure (n = 32), respiratory disease (n = 5), and other (n = 5). A total of 55 patients were receiving inotropes or vasodilators. When patients were hemodynamically stable, a TED probe was placed into the distal esophagus to obtain optimal signal, and minute distance (MD) was recorded. Five consecutive MD measurements were made concurrently with five femoral artery thermodilution measurements, and the concurrent measurements were averaged. CO was then manipulated by fluid administration or inotrope adjustment, and the readings were repeated. Femoral artery thermodilution CO ranged from 0.32 to 9.19 L/min, (median, 2.46 L/min), and encompassed a wide range of high and low flow states. Theoretical consideration revealed the optimal TED estimate for CO to be (MD x patient height2 x 10(-7)). Linear regression analysis yielded a power function model such that: estimated CO = 1.158 x (MD x height2 x 10(-7))(0.785), r2 = 0.879, standard error of the estimate = 0.266. Inclusion of a correction factor for potential changes in aortic cross-sectional area with hypo- and hypertension did not appreciably improve the predictive value of the model. MD was able to follow percentage changes in CO, giving a mean bias of 0.87% (95% confidence interval -0.85% to 2.59%), and limits of agreement of +/- 16.82%. The median coefficient of variation for MD was 3.3%. TED provides

Modified carotid sinus massage using an ultrasonography for maximizing vagal tone: a crossover simulation study.

PubMed

Ha, Seung Min; Cho, Young Suk; Cho, Gyu Chong; Jo, Choong Hyun; Ryu, Ji Young

2015-07-01

The aim of this study was to ascertain if a modified carotid sinus massage (CSM) using ultrasonography is superior to the conventional CSM for vagal tone generation. This was a prospective, crossover, clinical trial including 30 subjects with sinus rhythm. Participants were paired, and they performed 2 types of CSM to each other. To perform the conventional technique, pressure was exerted at the point where the maximal impulse of the carotid pulse was palpated. In the modified technique, participants localized the point of maximal diameter just above the bifurcation of the common carotid artery using ultrasonography and applied pressure to that point. Mean differences between premaneuver and postmaneuver R-R intervals and heart rates were compared. The distance from the midline of the neck (x distance) to the angle of the mandible (y distance) was measured, and the mean distance between the 2 techniques was compared. The baseline mean premaneuver R-R interval and heart rate did not differ significantly between the 2 techniques. The postmaneuver R-R interval and heart rate as well as the mean R-R interval and heart rate differences were significantly greater in the modified CSM. The mean location determined using the modified CSM was located 0.8 cm lateral and 0.8 cm superior to the mean location of the conventional CSM. The modified CSM using ultrasonography might be more useful than the conventional CSM in reverting episodes of paroxysmal supraventricular tachycardia and may be a suitable alternative for treating the same in the emergency department. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Reliability of assessment of upper trapezius morphology, its mechanical properties and blood flow in female patients with myofascial pain syndrome using ultrasonography.

PubMed

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

2017-01-01

In the present study, the intra-rater reliability of upper trapezius morphology, its mechanical properties and intramuscular blood circulation in females with myofascial pain syndrome were assessed using ultrasonography. A total of 37 patients (31.05 ± 10 years old) participated in this study. Ultrasonography producer was set up in three stages: a) Gray-scale: to measure muscle thickness, size and area of trigger points; b) Ultrasound elastography: to measure muscle stiffness; and c) Doppler imaging: to assess blood flow indices. According to data analysis, all variables, except End Diastolic Velocity (EDV), had excellent reliability (>0.806). Intra-class Correlation Coefficient (ICC) for EDV was 0.738, which was considered a poor to good reliability. The results of this study introduced a reliable method for developing details of upper trapezius features using muscular ultrasonography in female patients. These variables could be used for objective examination and provide guidelines for treatment plans in clinical settings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Usefulness of Ultrasonography and Cortical Transit Time to Differentiate Nonobstructive From Obstructive Dilatation in the Management of Prenatally Detected Pelvic Ureteric Junction Like Obstruction.

PubMed

Sharma, Gyanendra; Sharma, Anshu

2017-12-01

To differentiate a nonobstructive dilatation from an obstructive dilatation in prenatally detected presumed pelvi-ureteric junction obstruction so that intervention can be planned before irreversible damage can occur to the renal unit. From January 2012 to December 2016, all patients with prenatally detected or asymptomatic incidentally detected presumed pelvi-ureteric junction obstruction were evaluated by ultrasonography and renogram. The anteroposterior diameter of the renal pelvis was measured in supine and prone position. Presence of calyceal dilatation in prone position was noted. They were categorized into obstructed, nonobstructed, and equivocal groups based on sonography findings. The differential renal function and the cortical transit time (CTT) was calculated and compared with the sonography groups. Of the 98 patients, 72 were in the obstructed, 18 were in the nonobstructed, and 8 were in the equivocal category. All except 1 in the nonobstructed category had a function of >40% with CTT of <3 minutes. Seventy patients in the obstructed category had a CTT of >3 minutes, whereas 61 had function <40% on initial evaluation. Eleven patients in the obstructed category with an initial function of >40% had CTT of >3 minutes. All of them showed increasing hydronephrosis and deterioration of function during follow-up, necessitating pyeloplasty. All patients in the equivocal group had function >40% and CTT <3 minutes. Ultrasonography along with CTT can help to differentiate nonobstructive from obstructive dilatation. Copyright © 2017 Elsevier Inc. All rights reserved.

[Comparative evaluation of ultrasonography, computerized tomography, angiography and lipiodol CT in defining extent of hepatocarcinoma. A multicenter study].

PubMed

Dalla Palma, L; Pozzi Mucelli, R; Sponza, M; Bartolozzi, C; De Santis, M; Gandini, G; Mannella, P; Matricardi, L; Rossi, C; Simonetti, G

1995-03-01

The authors report the results of a multicentric trial on hepatocellular carcinoma (HCC) patients, whose lesions were confirmed with biopsy or by high (> 400 ng/ml) alpha-fetoprotein levels. The series consisted of 149 patients examined in 8 different centers and submitted to ultrasonography (US), Computed Tomography (CT) before and after contrast agent administration, angiography and Lipiodol CT. According to lesion size and number, the patients were divided with each imaging modality into three groups: a) group 1: unifocal HCC < 5 cm diameter; b) group 2: multifocal HCC with 2-3 nodules and/or tumor mass < 80 ml; c) multifocal HCC with more than 3 nodules (with total tumor mass not exceeding 40% of liver volume) or with total tumor mass > 80 ml. In 77 patients all the examinations were available for comparison. US and CT diagnosed more patients as belonging to group 1 than angiography and Lipiodol CT, while more patients were classified as groups 2 and 3 with angiography and Lipiodol CT, meaning that US and CT may understage some HCC cases (about 15%) because they show a lower number of nodules. This observation was confirmed by the direct comparison between US and Lipiodol CT (in 114 patients), CT and Lipiodol CT (in 103 patients) and angiography and Lipiodol CT (in 116 patients). US and Lipiodol CT were in disagreement in 18 cases, CT and Lipiodol CT in 16 cases and angiography and Lipiodol CT in 13 cases. In most of these cases, Lipiodol CT showed more lesions than the other techniques. The size of the undetected lesions was small, ranging few mm to 2 cm in nearly all cases. To conclude, the results of this multicentric trial show that Lipiodol CT is a fundamental tool to evaluate HCC extent. In contrast, conventional CT appeared not to add any significant piece of information and can therefore be excluded from the diagnostic protocol of HCC.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Matsui, T; Ohki, M; Nakamura, T

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

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

PubMed Central

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

2015-01-01

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

Ultrasonography in the preoperative difficult airway assessment.

PubMed

Fulkerson, Justin S; Moore, Heather M; Anderson, Tristan S; Lowe, Robert F

2017-06-01

To evaluate the utility of ultrasound for detection of the difficult intubation in a preoperative setting. PubMed, Ovid, CINAHL Plus Full Text, and Google Scholar searches using ["difficult airway" OR "difficult intubation" OR "difficult laryngoscopy" OR "difficult ventilation"] AND [ultrasonography OR sonography OR ultrasound] without date limitations. Abstracts without publications, case reports, letters, textbooks, unrelated topics, or foreign language articles were excluded. Ancestry references were included from the reviewed articles. Two reviewers independently performed the query. Each study was reviewed using the STARD checklist to assess blinding, incomplete data reporting, subject attrition, and selection of appropriate statistical tests. Ten studies were included. All used convenience sampling of adult subjects requiring direct laryngoscopy in elective surgical settings. One study is retrospective and nine are prospective observational. Populations included non-obese, obese, pregnant, and thyroidectomy patients in the United States, Turkey, Israel, Canada, Portugal, and China. Airway locations scanned are variable using different protocols and patient positioning. The outcome variable is uniformly the Cormack-Lehane Grade. 114 of the 681 total subjects had difficult laryngoscopies. Significance for sonographic prediction of difficult laryngoscopy occurred at three locations: hyomental distance [52.6 ± 5.8 mm (p < 0.01)], anterior tissue at the hyoid bone [16.9 mm (95 % CI 11.9-21.9) and 15.9 ± 2.7 mm (p < 0.0001)], and the thyrohyoid membrane [34.7 mm (95 % CI 28.8-40.7) and 23.9 ± 3.4 mm (p < 0.0001) and 28.25 ± 4.43 mm (p < 0.001)]. The vocal cords and sternal notch levels have conflicting significance. Limitations include the heterogeneous populations and lack of standard scanning protocols.

Can endoscopic ultrasonography differentiate nonneoplastic from neoplastic gallbladder polyps?

PubMed

Akatsu, Tomotaka; Aiura, Koichi; Shimazu, Motohide; Ueda, Masakazu; Wakabayashi, Go; Tanabe, Minoru; Kawachi, Shigeyuki; Kitajima, Masaki

2006-02-01

The present study aimed to clarify the endoscopic ultrasonography (EUS) features of nonneoplastic (cholesterol polyps and adenomyomatosis) and neoplastic (adenoma and adenocarcinoma) gallbladder polyps and to evaluate the effectiveness and limitation of EUS in the differential diagnosis of these lesions. We retrospectively compared EUS images with histologic findings in 29 surgical cases with gallbladder polyps with a diameter of 10 to 20 mm. Those cases were indicated for surgery based on the findings of a sessile appearance, a solitary lesion, low echogenicity, and/or a lobulated surface. Six of 10 cholesterol polyps were atypically seen as partially or completely hypoechoic due to predominant proliferation of glandular epithelia. Nine of 10 cholesterol polyps demonstrated an aggregation of hyperechoic spots, which represented multiple granules of cholesterosis. All adenomyomatoses (n = 10) showed multiple microcysts, which corresponded to proliferated Rokitansky-Aschoff sinuses. However, three of nine neoplastic lesions (three adenomas and six adenocarcinomas) showed one of these signs due to concomitant cholesterosis (n = 2) or proliferated Rokitansky-Aschoff sinuses (n = 1). In conclusion, 69% (20/29) of gallbladder polyps larger than 10 mm that were preoperatively suspected of malignancy were nonneoplastic. An aggregation of hyperechoic spots and multiple microcysts are considered to be important predictive factors for cholesterol polyps and adenomyomatosis, respectively. However, we should caution that these findings can also occur in neoplastic polyps when they contain a concomitant nonneoplastic component (cholesterosis or proliferated Rokitansky-Aschoff sinuses).

Tactile sensor is useful for estimating liver hardness and liver fibrosis compared with ultrasonography and computed tomography.

PubMed

Suzuki, Satoshi; Watanabe, Yohei; Yazawa, Takashi; Ishigame, Teruhide; Sassa, Motoki; Monma, Tomoyuki; Takawa, Tadashi; Kumamoto, Kensuke; Nakamura, Izumi; Ohoki, Shinji; Hatakeyama, Yuichi; Sakuma, Hiroshi; Ono, Toshiyuki; Omata, Sadao; Takenoshita, Seiichi

2014-01-01

We examined whether conventional ultrasonography (US) and computed tomography (CT) were useful to evaluate liver hardness and hepatic fibrosis by comparing the results with those obtained by a tactile sensor using rats with liver fibrosis. We used 44 Wistar rats in which liver fibrosis was induced by intraperitoneal administration of thioacetamide. The CT and US values of each liver were measured before laparotomy. After laparotomy, a tactile sensor was used to measure liver hardness. We prepared Azan stained sections of each excised liver specimen and calculated the degree of liver fibrosis (HFI: hepatic fibrosis index) by computed color image analysis. The stiffness values and HFI showed a positive correlation (r=0.690, p<0.001), as did the tactile values and HFI (r=0.709, p<0.001).In addition, the stiffness and tactile values correlated positively with each other (r=0.814, p<0.001). There was no correlation between the CT values and HFI, as well as no correlation between the US values and HFI. We confirmed that it was difficult to evaluate liver hardness and HFI by CT or US examination, and considered that, at present, a tactile sensor is useful method for evaluating HFI.

Imaging in juvenile idiopathic arthritis with a focus on ultrasonography.

PubMed

Laurell, Louise; Court-Payen, Michel; Boesen, Mikael; Fasth, Anders

2013-01-01

Early therapeutic intervention and use of new highly efficacious treatments have improved the outcome in many patients with juvenile idiopathic arthritis (JIA), but have also led to the need for more precise methods to evaluate disease activity. In adult rheumatology, numerous studies have established the importance of magnetic resonance imaging (MRI) and ultrasonography (US), and MRI is considered the reference standard. Nevertheless, due to differences in disease characteristics and the unique features of the growing skeleton, the findings obtained in adults are not directly applicable to children and adolescents. For paediatric patients, US offers specific advantages over MRI, because it is non-invasive, does not require sedation or general anesthesia (which facilitates repeated examinations for follow-up), is quickly accessible bedside, and is easy to combine with clinical assessment (interactivity). Agitation of the patient is rarely a problem, and hence young children can be seated on a parent's lap or play while being examined, and multiple locations can be assessed during a single session. Furthermore, modern high-frequency US transducers used by experienced US examiners can provide unsurpassed resolution of the superficial musculoskeletal structures in children. US is also the best available technique for imaging guidance of steroid injections. Unfortunately, there are still no validated MRI or US scoring systems for evaluating inflammatory and joint damage abnormalities in JIA, and few US studies have been conducted. Sonographic assessment of disease activity has, however, been proven to be more informative than clinical examination and is also readily available at points of care. This review summarises the literature on imaging in JIA, focusing on US and the important role this technique will play in JIA in the future.

Rapid and Accurate Evaluation of the Quality of Commercial Organic Fertilizers Using Near Infrared Spectroscopy

PubMed Central

Wang, Chang; Huang, Chichao; Qian, Jian; Xiao, Jian; Li, Huan; Wen, Yongli; He, Xinhua; Ran, Wei; Shen, Qirong; Yu, Guanghui

2014-01-01

The composting industry has been growing rapidly in China because of a boom in the animal industry. Therefore, a rapid and accurate assessment of the quality of commercial organic fertilizers is of the utmost importance. In this study, a novel technique that combines near infrared (NIR) spectroscopy with partial least squares (PLS) analysis is developed for rapidly and accurately assessing commercial organic fertilizers quality. A total of 104 commercial organic fertilizers were collected from full-scale compost factories in Jiangsu Province, east China. In general, the NIR-PLS technique showed accurate predictions of the total organic matter, water soluble organic nitrogen, pH, and germination index; less accurate results of the moisture, total nitrogen, and electrical conductivity; and the least accurate results for water soluble organic carbon. Our results suggested the combined NIR-PLS technique could be applied as a valuable tool to rapidly and accurately assess the quality of commercial organic fertilizers. PMID:24586313

Rapid and accurate evaluation of the quality of commercial organic fertilizers using near infrared spectroscopy.

PubMed

Wang, Chang; Huang, Chichao; Qian, Jian; Xiao, Jian; Li, Huan; Wen, Yongli; He, Xinhua; Ran, Wei; Shen, Qirong; Yu, Guanghui

2014-01-01

The composting industry has been growing rapidly in China because of a boom in the animal industry. Therefore, a rapid and accurate assessment of the quality of commercial organic fertilizers is of the utmost importance. In this study, a novel technique that combines near infrared (NIR) spectroscopy with partial least squares (PLS) analysis is developed for rapidly and accurately assessing commercial organic fertilizers quality. A total of 104 commercial organic fertilizers were collected from full-scale compost factories in Jiangsu Province, east China. In general, the NIR-PLS technique showed accurate predictions of the total organic matter, water soluble organic nitrogen, pH, and germination index; less accurate results of the moisture, total nitrogen, and electrical conductivity; and the least accurate results for water soluble organic carbon. Our results suggested the combined NIR-PLS technique could be applied as a valuable tool to rapidly and accurately assess the quality of commercial organic fertilizers.

Chest Ultrasonography in Modern Day Extreme Settings: From Military Setting and Natural Disasters to Space Flights and Extreme Sports

PubMed Central

Mucci, Viviana

2018-01-01

Chest ultrasonography (CU) is a noninvasive imaging technique able to provide an immediate diagnosis of the underlying aetiology of acute respiratory failure and traumatic chest injuries. Given the great technologies, it is now possible to perform accurate CU in remote and adverse environments including the combat field, extreme sport settings, and environmental disasters, as well as during space missions. Today, the usage of CU in the extreme emergency setting is more likely to occur, as this technique proved to be a fast diagnostic tool to assist resuscitation manoeuvres and interventional procedures in many cases. A scientific literature review is presented here. This was based on a systematic search of published literature, on the following online databases: PubMed and Scopus. The following words were used: “chest sonography,” “ thoracic ultrasound,” and “lung sonography,” in different combinations with “extreme sport,” “extreme environment,” “wilderness,” “catastrophe,” and “extreme conditions.” This manuscript reports the most relevant usages of CU in the extreme setting as well as technological improvements and current limitations. CU application in the extreme setting is further encouraged here. PMID:29736195

B-mode and power Doppler ultrasonography of the equine suspensory ligament branches: A descriptive study on 13 horses.

PubMed

Rabba, Silvia; Grulke, Sigrid; Verwilghen, Denis; Evrard, Laurence; Busoni, Valeria

2018-03-01

Ultrasonography is routinely used to achieve the diagnosis of equine suspensory ligament desmopathy. In human medicine, power Doppler ultrasonography has also been found to be useful for the diagnosis of tendon/ligament injuries. The aim of this prospective, pilot study was to assess the presence or absence of power Doppler signal in suspensory ligament branches and compare B-mode findings with power Doppler findings in suspensory ligament branches of lame and non-lame limbs. Thirteen horses were used (eight lame horses, with lameness related to pain in the suspensory ligament branches, and five non-lame horses). Ten lame limbs and 24 sound limbs were assessed by B-mode and power Doppler ultrasonography. The severity of power Doppler signal was scored by two independent readers. The B-mode ultrasonographic examination revealed abnormalities in branches of lame limbs and in branches of sound limbs. Suspensory ligament branches that were considered normal in B-mode showed no power Doppler signal. However, power Doppler signal was detected in suspensory ligament branches that were abnormal in B-mode, both in lame and sound limbs. Power Doppler scores were subjectively higher in suspensory ligament branches of lame limbs and in branches with more severe B-mode changes. Findings supported the use of power Doppler as an adjunctive diagnostic test for lame horses with suspected suspensory desmopathy. © 2018 American College of Veterinary Radiology.

Carpal tunnel syndrome assessment with ultrasonography: value of inlet-to-outlet median nerve area ratio in patients versus healthy volunteers.

PubMed

Fu, Tengfei; Cao, Manlin; Liu, Fang; Zhu, Jiaan; Ye, Dongmei; Feng, Xianxuan; Xu, Yiming; Wang, Gang; Bai, Yuehong

2015-01-01

To evaluate the diagnostic value of the Inlet-to-outlet median nerve area ratio (IOR) in patients with clinically and electrophysiologically confirmed carpal tunnel syndrome (CTS). Forty-six wrists in 46 consecutive patients with clinical and electrodiagnostic evidence of CTS and forty-four wrists in 44 healthy volunteers were examined with ultrasonography. The cross-sectional area (CSA) of the median nerve was measured at the carpal tunnel inlet (the level of scaphoid-pisiform) and outlet (the level of the hook of the hamate), and the IOR was calculated for each wrist. Ultrasonography and electrodiagnostic tests were performed under blinded conditions. Electrodiagnostic testing combined with clinical symptoms were considered to be the gold standard test. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value between the inlet CSA and IOR. The study population included 16 men and 30 women (mean age, 45.3 years; range, 18-83 years). The control population included 18 men and 26 women (mean age, 50.4 years; range, 18-79 years). The mean inlet CSA was 8.7 mm2 in healthy controls and 14.6mm2 in CTS group (P<0.001). The mean IOR in healthy volunteers (1.0) was smaller than that in patients (1.6, P<0.001). Receiver operating characteristic analysis revealed a diagnostic advantage to using the IOR rather than the inlet CSA (P<0.01). An IOR cutoff value of ≥ 1.3 would yield 93% specificity and 91% sensitivity in the diagnosis of CTS. The IOR of median nerve area promises to be an effective means in the diagnosis of CTS. A large-scale, randomized controlled trial is required to determine how and when this parameter will be used.

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

Coexistence of Nerve Enlargement and Neuratrophy Detected by Ultrasonography in Leprosy Patients.

PubMed

Chen, Xiaohua; Zhang, Liangfu; Huang, Meiying; Zhai, Xiuli; Wen, Yan; Pan, Chunzhi

2018-05-17

The purpose of this study was to evaluate peripheral neural impairment in leprosy patients by ultrasonography (US). The cross-sectional areas (CSAs) of the median (M), ulnar (U) and common fibular (CF) nerves were compared in 71 leprosy patients and 29 healthy controls, and the data were analyzed between the leprosy, multibacillary (MB)/paucibacillary (PB), reaction (R)/no reaction (NR), disability (D)/no disability (ND), and longer/shorter duration groups after treatment. We found that for the nerves located in upper limbs, the CSAs were significantly increased in the leprosy patients vs the controls; the PB group vs the MB group; the R group vs the NR group; the ND group vs the D group; and the longer duration group vs the shorter duration group at some positions of the M nerve and U nerve. In contrast, for the nerves located in lower limbs, the CSAs were significantly reduced in the leprosy patients vs the controls and in the longer duration group vs the shorter duration group at some positions of the CF nerve. This result indicated that nerve enlargement and neuratrophy coexist in leprosy patients.

Evaluation of New Reference Genes in Papaya for Accurate Transcript Normalization under Different Experimental Conditions

PubMed Central

Chen, Weixin; Chen, Jianye; Lu, Wangjin; Chen, Lei; Fu, Danwen

2012-01-01

Real-time reverse transcription PCR (RT-qPCR) is a preferred method for rapid and accurate quantification of gene expression studies. Appropriate application of RT-qPCR requires accurate normalization though the use of reference genes. As no single reference gene is universally suitable for all experiments, thus reference gene(s) validation under different experimental conditions is crucial for RT-qPCR analysis. To date, only a few studies on reference genes have been done in other plants but none in papaya. In the present work, we selected 21 candidate reference genes, and evaluated their expression stability in 246 papaya fruit samples using three algorithms, geNorm, NormFinder and RefFinder. The samples consisted of 13 sets collected under different experimental conditions, including various tissues, different storage temperatures, different cultivars, developmental stages, postharvest ripening, modified atmosphere packaging, 1-methylcyclopropene (1-MCP) treatment, hot water treatment, biotic stress and hormone treatment. Our results demonstrated that expression stability varied greatly between reference genes and that different suitable reference gene(s) or combination of reference genes for normalization should be validated according to the experimental conditions. In general, the internal reference genes EIF (Eukaryotic initiation factor 4A), TBP1 (TATA binding protein 1) and TBP2 (TATA binding protein 2) genes had a good performance under most experimental conditions, whereas the most widely present used reference genes, ACTIN (Actin 2), 18S rRNA (18S ribosomal RNA) and GAPDH (Glyceraldehyde-3-phosphate dehydrogenase) were not suitable in many experimental conditions. In addition, two commonly used programs, geNorm and Normfinder, were proved sufficient for the validation. This work provides the first systematic analysis for the selection of superior reference genes for accurate transcript normalization in papaya under different experimental conditions. PMID

Temporal resolution required for accurate evaluation of the interplay effect in spot scanning proton therapy

NASA Astrophysics Data System (ADS)

Seo, Jeongmin; Han, Min Cheol; Yeom, Yeon Soo; Lee, Hyun Su; Kim, Chan Hyeong; Jeong, Jong Hwi; Kim, SeongHoon

2017-04-01

In proton therapy, the spot scanning method is known to suffer from the interplay effect induced from the independent movements of the proton beam and the organs in the patient during the treatment. To study the interplay effect, several investigators have performed four-dimensional (4D) dose calculations with some limited temporal resolutions (4 or 10 phases per respiratory cycle) by using the 4D computed tomography (CT) images of the patient; however, the validity of the limited temporal resolutions has not been confirmed. The aim of the present study is to determine whether the previous temporal resolutions (4 or 10 phases per respiratory cycle) are really high enough for adequate study of the interplay effect in spot scanning proton therapy. For this study, a series of 4D dose calculations were performed with a virtual water phantom moving in the vertical direction during dose delivery. The dose distributions were calculated for different temporal resolutions (4, 10, 25, 50, and 100 phases per respiratory cycle), and the calculated dose distributions were compared with the reference dose distribution, which was calculated using an almost continuously-moving water phantom ( i.e., 1000 phases per respiratory cycle). The results of the present study show that the temporal resolutions of 4 and 10 phases per respiratory cycle are not high enough for an accurate evaluation of the interplay effect for spot scanning proton therapy. The temporal resolution should be at least 14 and 17 phases per respiratory cycle for 10-mm and 20-mm movement amplitudes, respectively, even for rigid movement ( i.e., without deformation) of the homogeneous water phantom considered in the present study. We believe that even higher temporal resolutions are needed for an accurate evaluation of the interplay effect in the human body, in which the organs are inhomogeneous and deform during movement.

Accuracy of determining preoperative cancer extent measured by automated breast ultrasonography.

PubMed

Tozaki, Mitsuhiro; Fukuma, Eisuke

2010-12-01

The aim of this study was to determine the accuracy of measuring preoperative cancer extent using automated breast ultrasonography (US). This retrospective study consisted of 40 patients with histopathologically confirmed breast cancer. All of the patients underwent automated breast US (ABVS; Siemens Medical Solutions, Mountain View, CA, USA) on the day before the surgery. The sizes of the lesions on US were measured on coronal multiplanar reconstruction images using the ABVS workstation. Histopathological measurement of tumor size included not only the invasive foci but also any in situ component and was used as the gold standard. The discrepancy of the tumor extent between automated breast US and the histological examination was calculated. Automated breast US enabled visualization of the breast carcinomas in all patients. The mean size of the lesions on US was 12 mm (range 4-62 mm). The histopathological diagnosis was ductal carcinoma in situ (DCIS) in seven patients and invasive ductal carcinoma in 33 patients (18 without an intraductal component, 15 with an intraductal component). Lesions ranged in diameter from 4 to 65 mm (mean 16 mm). The accuracy of determination of the tumor extent with a deviation in length of <2 cm was 98% (39/40). Automated breast US is thought to be useful for evaluating tumor extent preoperatively.

Contrast-enhanced endoscopic ultrasonography: advance and current status

PubMed Central

2014-01-01

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

The core content of clinical ultrasonography fellowship training.

PubMed

Lewiss, Resa E; Tayal, Vivek S; Hoffmann, Beatrice; Kendall, John; Liteplo, Andrew S; Moak, James H; Panebianco, Nova; Noble, Vicki E

2014-04-01

The purpose of developing a core content for subspecialty training in clinical ultrasonography (US) is to standardize the education and qualifications required to provide oversight of US training, clinical use, and administration to improve patient care. This core content would be mastered by a fellow as a separate and unique postgraduate training, beyond that obtained during an emergency medicine (EM) residency or during medical school. The core content defines the training parameters, resources, and knowledge of clinical US necessary to direct clinical US divisions within medical specialties. Additionally, it is intended to inform fellowship directors and candidates for certification of the full range of content that might appear in future examinations. This article describes the development of the core content and presents the core content in its entirety. © 2014 by the Society for Academic Emergency Medicine.

Fundamentals of diagnostic ultrasonography.

PubMed

Noce, J P

1990-01-01

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

Evaluation of hepatic function with (99m)Tc-galactosylated serum albumin scintigraphy in patients with malaria: comparison with (99m)Tc-colloid scintigraphy and liver ultrasonography.

PubMed

Lee, Sang-Woo; Lee, Jaetae; Lee, Deog-Young; Chun, Kyung-Ah; Ahn, Byeong-Cheol; Kang, Young-Mo; Lee, Kyubo

2007-02-01

Malarial parasites injected by the mosquito rapidly target hepatocytes, and hepatomegaly is commonly observed during the progress of the disease in malaria patients. To evaluate the degree of hepatic damage and functional status of hepatocytes in malaria patients, we performed liver scintigraphy using (99m)Tc-galactosylated serum albumin (GSA) prospectively and the findings were compared with those of (99m)Tc-colloid scintigraphy, ultrasonography and clinical results in the same subject. Eight malaria patients (all male, mean age 22 years) confirmed to be infected with Plasmodium vivax underwent (99m)Tc-GSA liver scintigraphy, followed by liver ultrasonography and (99m)Tc-colloid scintigraphy using phytate within 3 days. For hepatocyte scintigraphy, anterior images of cardiac blood-pool and liver were continuously acquired for 30 min after injection of 185 MBq (99m)Tc-GSA (3 mg). In addition to visual interpretation of the images, quantitative measurement of hepatic function was performed with several functional parameters, such as hepatic uptake index (LHL15), blood clearance index (HH15) and modified receptor index (LHL/HH) calculated from the radioactivity of the liver and heart. (99m)Tc-colloid images were assessed and graded visually. Severity of hepatic dysfunction or reticuloendothelial system activation was classified as normal, mild, moderate and severe on GSA or colloid images. Hepatomegaly was observed in five and splenomegaly in seven of the eight patients. Serum levels of transaminase and alkaline phosphatase were mildly elevated in two. Visual assessment of GSA scintigraphy revealed normal findings in all subjects, except for mild increases in size. The mean values of LHL15, HH15 and LHL/HH were 0.928+/-0.014, 0.537+/-0.031 and 1.732+/-0.106, respectively. They were graded as normal in five, and near-normal to mild dysfunction in three subjects. In contrast, (99m)Tc-colloid scintigraphy revealed abnormal findings in all of the subjects, and graded as

Accurate modeling and evaluation of microstructures in complex materials

NASA Astrophysics Data System (ADS)

Tahmasebi, Pejman

2018-02-01

Accurate characterization of heterogeneous materials is of great importance for different fields of science and engineering. Such a goal can be achieved through imaging. Acquiring three- or two-dimensional images under different conditions is not, however, always plausible. On the other hand, accurate characterization of complex and multiphase materials requires various digital images (I) under different conditions. An ensemble method is presented that can take one single (or a set of) I(s) and stochastically produce several similar models of the given disordered material. The method is based on a successive calculating of a conditional probability by which the initial stochastic models are produced. Then, a graph formulation is utilized for removing unrealistic structures. A distance transform function for the Is with highly connected microstructure and long-range features is considered which results in a new I that is more informative. Reproduction of the I is also considered through a histogram matching approach in an iterative framework. Such an iterative algorithm avoids reproduction of unrealistic structures. Furthermore, a multiscale approach, based on pyramid representation of the large Is, is presented that can produce materials with millions of pixels in a matter of seconds. Finally, the nonstationary systems—those for which the distribution of data varies spatially—are studied using two different methods. The method is tested on several complex and large examples of microstructures. The produced results are all in excellent agreement with the utilized Is and the similarities are quantified using various correlation functions.

Point-of-Care Ultrasonography to Assess Portal Vein Pulsatility and the Effect of Inhaled Milrinone and Epoprostenol in Severe Right Ventricular Failure: A Report of 2 Cases.

PubMed

Tremblay, Jan-Alexis; Beaubien-Souligny, William; Elmi-Sarabi, Mahsa; Desjardins, Georges; Denault, André Y

2017-10-15

This article describes 2 patients with severe acute right ventricular failure causing circulatory shock. Portal vein pulsatility assessed by bedside ultrasonography suggested clinically relevant venous congestion. Management included cardiac preload reduction and combined inhalation of milrinone and epoprostenol to reduce right ventricular afterload. Portal vein ultrasonography may be useful in assessing right ventricular function in the acutely ill patient.

An accurate method of extracting fat droplets in liver images for quantitative evaluation

NASA Astrophysics Data System (ADS)

Ishikawa, Masahiro; Kobayashi, Naoki; Komagata, Hideki; Shinoda, Kazuma; Yamaguchi, Masahiro; Abe, Tokiya; Hashiguchi, Akinori; Sakamoto, Michiie

2015-03-01

The steatosis in liver pathological tissue images is a promising indicator of nonalcoholic fatty liver disease (NAFLD) and the possible risk of hepatocellular carcinoma (HCC). The resulting values are also important for ensuring the automatic and accurate classification of HCC images, because the existence of many fat droplets is likely to create errors in quantifying the morphological features used in the process. In this study we propose a method that can automatically detect, and exclude regions with many fat droplets by using the feature values of colors, shapes and the arrangement of cell nuclei. We implement the method and confirm that it can accurately detect fat droplets and quantify the fat droplet ratio of actual images. This investigation also clarifies the effective characteristics that contribute to accurate detection.

Imaging of female infertility: a pictorial guide to the hysterosalpingography, ultrasonography, and magnetic resonance imaging findings of the congenital and acquired causes of female infertility.

PubMed

Kaproth-Joslin, Katherine; Dogra, Vikram

2013-11-01

Hysterosalpingography is the gold standard in assessing the patency of the fallopian tubes, which is among the most common causes of female factor infertility, making this technique the most frequent first-choice imaging modality in the assessment of female infertility. Ultrasonography and magnetic resonance imaging are typically used for evaluation of indeterminate or complicated cases of female infertility and presurgical planning. Imaging also plays a role in the detection of the secondary causes of ovarian factor infertility, including endometriosis and polycystic ovarian syndrome. Copyright © 2013 Elsevier Inc. All rights reserved.

[Ultrasonography-guided therapeutic procedures in the neck region].

PubMed

Brzac, Hrvojka Tomić

2009-12-01

Minimally invasive therapeutic procedures in medicine have become very popular because of the reduced risk compared to classic surgical treatment, speed of recovery, little or no side effects, and frequently lower cost. One of these methods is ultrasonography-guided percutaneous injection of 95% ethanol (PEIT, percutaneous ethanol injection therapy), which is especially suitable for the neck region. Other methods like laser photocoagulation (ILP) or radiofrequency ablation (RFA) are more aggressive and expensive. The procedure of sterile 95% ethanol injecting is performed on an outpatient basis, without preparation. A specific amount of alcohol is injected into the lesion using a thin spinal needle, under ultrasonography guidance. The amount of alcohol depends on the size of the lesion. Complications are rare and the procedure can be repeated several times. PEIT is used in the treatment of parathyroid glands, especially secondary hyperparathyroidism, thyroid nodules (toxic adenoma, goiters and cysts), other cysts on the neck, and cervical metastases of thyroid cancer. Direct ethanol injection into the tissue causes cellular dehydration and protein denaturation, followed by the development of necrosis, fibrosis, and thrombosis of the small blood vessels. In this way, reduction or disappearance of the nodes can be achieved, along with functional normalization (for parathyroid glands and toxic adenoma), with longer or shorter disease remission or complete recovery. Today, PEIT is mostly used in dialyzed patients with secondary hyperparathyroidism. The treatment gives best results in combination with vitamin D analogs, if 1-2 parathyroid glands are enlarged, and for residual parathyroid gland after parathyroidectomy. A success rate of 50%-70% has been reported, depending on the number of enlarged parathyroid glands. Therapeutic effect is manifested in the size reduction or complete fibrozation of the gland, reduction or disappearance of vascularization, and a decrease

Evaluation of transplant renal artery blood flow by Doppler sound-spectrum analysis.

PubMed

Reinitz, E R; Goldman, M H; Sais, J; Rittgers, S E; Lee, H M; Mendez-Picon, G; Muakkassa, W F; Barnes, R W

1983-04-01

Doppler ultrasonography sound-spectrum analysis (SSA) was used to evaluate blood flow in the transplanted kidney and its renal artery. Seven patients with posttransplant hypertension and a bruit over the transplanted kidney were screened for renal artery stenosis (RAS). In five patients, RAS was diagnosed by SSA, and in two it was not. These findings were confirmed by subsequent angiography in all patients. Three patients studied after surgical correction of their RAS had improvement in their SSA patterns. Fourteen hypertensive patients with a cause other than RAS were evaluated by SSA. None of them had SSA findings suggestive of RAS. Doppler ultrasonography with SSA is an effective, noninvasive technique of monitoring transplant renal blood flow, especially in the screening of hypertensive transplant recipients for transplant RAS.

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…

A practical guideline for examining a uterine niche using ultrasonography in non-pregnant women: a modified Delphi method amongst European experts.

PubMed

Jordans, I P M; de Leeuw, R; Stegwee, S I; Amso, N N; Barri-Soldevila, P N; van den Bosch, T; Bourne, T; Brolmann, H A M; Donnez, O; Dueholm, M; Hehenkamp, W J K; Jastrow, N; Jurkovic, D; Mashiach, R; Naji, O; Streuli, I; Timmerman, D; Vd Voet, L F; Huirne, J A F

2018-03-14

To generate a uniform, internationally recognized guideline for detailed uterine niche evaluation by ultrasonography in non-pregnant women using a modified Delphi method amongst international experts. Fifteen international gynecological experts were recruited by their membership of the European niche taskforce group. All experts were physicians with extensive experience in niche evaluation in clinical practice and/or authors of niche studies. Relevant items for niche measurement were determined based on the results of a literature search and recommendations of a focus group. Two online questionnaires were sent to the expert panel and one group meeting was organized. Consensus was predefined as a consensus rate of at least 70%. In total 15 experts participated in this study. Consensus was reached for a total of 42 items on niche evaluation, including definitions, relevance, method of measurement and tips for visualization of the niche. All experts agreed on the proposed guideline for niche evaluation in non-pregnant women as presented in this paper. Consensus between niche experts was achieved on all items regarding ultrasonographic niche measurement. This article is protected by copyright. All rights reserved.

Clinical value of combining transvaginal contrast-enhanced ultrasonography with serum human epididymisprotein-4 and the resistance index for early-stage epithelial ovarian cancer

PubMed Central

Meng, Wu; Ying, Wang; Qichao, Zheng; Ping, Li; Jie, Tang

2017-01-01

Objectives: To increase accuracy of the detection and differential diagnosis of the early epithelial ovarian cancer (EOC) with transvaginal contrast-enhanced ultrasonography (TVCEUS) combining serum human epididymisprotein 4 (HE4), and resistance index (RI). Methods: This retrospectively case-control study of 230 patients with ovarian tumors were reviewed at the Department of Gynecology and Obstetrics, Zhongnan Hospital, Wuhan University, Wuhan, China between June 2008 and September 2015. Before the operation of 110 cases with EOC (Group A) and 120 cases of patients with benign ovarian tumor (Group B), we observe and calculate both Groups’ tumor vascular contrast-enhanced ultrasonography morphology scores (U), time-intensity curve (TIC) of contrast-enhanced ultrasonography, HE4, and RI. Results were compared with the histopathological analysis results. Results: The ultrasonography morphology scores, peak intensity (PI) enhancement rate (ER) with the parameters of the TIC and HE4 are higher in Group A compared with patients in Group B and the RI was lower than Group B. The detection rates for all indexes in the benign and malignant groups and their comparisons to the histopathological results were determined. The detection rate differences for HE4 (p=0.001), RI (p=0.001), U (p=0.001), PI (p=0.001), and ER (p=0.001) were all statistically significant (p<0.05). Conclusion: The high clinical value through combined TVCEUS, HE4, and RI detection can increase the sensitivity of the diagnosis and differential diagnosis of the early EOC. PMID:28578437

Hamstring Elongation Quantified Using Ultrasonography During the Straight Leg Raise Test in Individuals With Low Back Pain.

PubMed

Kellis, Eleftherios; Ellinoudis, Athanasios; Kofotolis, Nikolaos

2015-06-01

Although the straight leg raise (SLR) test frequently is used to assess hamstring extensibility in individuals with low back pain (LBP), evidence relating LBP, SLR, and hamstring extensibility remains unclear. The SLR measures the angle between the lifted leg and the horizontal, however, and, as such, it is not a direct measure of the elongation capacity of the hamstrings. To examine the differences in hamstring elongation (quantified via ultrasonography) and SLR score between individuals with LBP and asymptomatic controls and to determine the relationship between hamstring elongation, SLR, and functional disability scores. Cross-sectional study. University laboratory. Forty men and women with chronic LBP (mean ± SD, age 43.51 ± 3.71 years and 40 control subjects (age 45.11 ± 4.01 years) participated in this study. Passive SLR, elongation assessed via ultrasonography, and functional disability. SLR score, elongation of tendinous tissue within the semitendinosus muscle, and Oswestry Disability Index. Two-way analysis of variance tests indicated a significantly lower SLR score and a greater Oswestry score in LBP group compared with control subjects (P < .05). In contrast, there were no significant group differences in hamstring elongation (P > .05). Gender did not have an effect on all dependent measures (P > .05). Hamstring elongation showed a low correlation with SLR score and a minimal correlation with Oswestry score. These results indicate that the SLR score is not determined by hamstring elongation (quantified via ultrasonography). Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Ultrasonography parameters and histopathology findings in transplanted kidney.

PubMed

Rigler, A A; Vizjak, A; Ferluga, D; Kandus, A; Buturović-Ponikvar, J

2013-05-01

Until now studies have shown conflicting results about morphologic and hemodynamic parameters in predicting histopathology results in renal graft malfunction. We sought to analyze whether parenchymal thickness relative to graft length and resistive index (RI) measured by ultrasonography can predict histopathology findings on renal biopsy. We retrospectively analyzed 72 deceased donor renal allograft biopsies and respective allograft ultrasounds, performed on 68 patients (57% men) with mean age of 50 years (range, 21-73), with kidney graft dysfunction in 2010 and 2011. Parenchymal thickness relative to graft length and RI were compared with different histopathology diagnoses: Acute rejection, chronic rejection, chronic kidney changes, acute tubular necrosis (ATN), and other diagnoses. The mean value of the RI and of the parenchymal thickness/graft length ratio (parenchyma size index [PSI]) was 0.81 ± 0.10 (SD) and 1.48 ± 0.27 (SD), respectively. Enlarged PSI was significantly higher in ATN (mean 1.72 ± 0.26) compared with no ATN (mean 1.39 ± 0.23; P < .001), and lower when chronic changes were present (mean 1.40 ± 0.25 for chronic changes vs mean 1.62 ± 0.28 for no chronic changes; P = .004). In the group without ATN, PSI was enlarged in acute graft rejection compared with no graft rejection (mean 1.50 ± 0.24 vs 1.24 ± 0.13, respectively; P < .001), whereas in the whole group, including ATN, PSI showed no differentiating power for acute rejection (P = .526). RI was significantly higher in ATN than without it (mean 0.91 ± 0.10 vs 0.79 ± 0.08, respectively; P < .001), whereas the RI was not increased (but was actually lower) in acute graft rejection compared with no graft rejection, neither in the whole group (mean 0.81 ± 0.09 vs 0.82 ± 0.12, respectively; P = .611). Enlarged parenchymal thickness/graft length ratio on ultrasonography was observed in ATN and acute allograft rejection. The RI was increased in ATN, but not in acute allograft rejection

The accuracy of the SONOBREAST statistical model in comparison to BI-RADS for the prediction of malignancy in solid breast nodules detected at ultrasonography.

PubMed

Paulinelli, Regis R; Oliveira, Luis-Fernando P; Freitas-Junior, Ruffo; Soares, Leonardo R

2016-01-01

The objective of the present study was to compare the accuracy of SONOBREAST for the prediction of malignancy in solid breast nodules detected at ultrasonography with that of the BI-RADS system and to assess the agreement between these two methods. This prospective study included 274 women and evaluated 500 breast nodules detected at ultrasonography. The probability of malignancy was calculated based on the SONOBREAST model, available at www.sonobreast.com.br, and on the BI-RADS system, with results being compared with the anatomopathology report. The lesions were considered suspect in 171 cases (34.20%), according to both SONOBREAST and BI-RADS. Agreement between the methods was perfect, as shown by a Kappa coefficient of 1 (p<0.001). SONOBREAST and BI-RADS proved identical insofar as sensitivity (95.40%), specificity (78.69%), positive predictive value (48.54%), negative predictive value (98.78%) and accuracy (81.60%) are concerned. With respect to the categorical variables (BI-RADS categories 3, 4 and 5), the area under the receiver operating characteristic (ROC) curve was 94.41 for SONOBREAST (range 92.20-96.62) and 89.99 for BI-RADS (range 86.60-93.37). The accuracy of the SONOBREAST model is identical to that found with BI-RADS when the same parameters are used with respect to the cut-off point at which malignancy is suspected. Regarding the continuous probability of malignancy with BI-RADS categories 3, 4 and 5, SONOBREAST permits a more precise and individualized evaluation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Ultrasonography and clinical outcome comparison of extracorporeal shock wave therapy and corticosteroid injections for chronic plantar fasciitis: A randomized controlled trial.

PubMed

Lai, Ta-Wei; Ma, Hsiao-Li; Lee, Meng-Shiunn; Chen, Po-Ming; Ku, Ming-Chou

2018-03-01

Extracorporeal shockwave therapy (ESWT) and corticosteroid injection (CSI) are treatment options for plantar fasciitis. Their clinical outcome comparison remains a debate. Also, the thickness changes of the plantar fascia on objective evaluation under the medium energy ESWT and CSI therapy are elusive. A total of 97 patients with chronic plantar fasciitis were enrolled in the randomized prospective trial. Forty-seven patients received extracorporeal shock wave therapy (ESWT), and fifty patients received corticosteroid injection (CSI). The thickness of the plantar fascia was evaluated respectively before ESWT and CSI, and at the 4 th and 12 th week after ESWT and CSI by ultrasonography. Pain level and clinical outcomes were recorded using visual analogue scale (VAS) and 100-points scoring systems. Correlation analysis was performed between the thickness change and clinical outcome. Under ultrasonography, we observed more increase of plantar fascia thickness of ESWT group than CSI group at 4 th week (p=0.048). VAS of plantar fasciitis patients receiving ESWT was lower than those who received corticosteroid injection (0.001 and p⟨0.001, at 4 th and 12 th week). On the assessment of 100-points scoring systems, the pain level of patients with ESWT was lower than those with CSI at the 12 th week (p⟨0.001). On the other hand, the increase of plantar fascia thickness at 4 th week was positively correlated with the decrease of VAS score at 12 th week follow-up (R=0.302, P=0.039). At 4 th week after treatment, the thickness of plantar fascia increased. Then it decreased gradually, but not to the baseline at 12 th week. On the pain level outcome at 12 th week, extracorporeal shockwave therapy (ESWT) was more efficient than corticosteroid injection (CSI) on chronic plantar fasciitis. The more change of plantar fascia after ESWT, the more efficient on clinical outcome.

SU-D-17A-07: Development and Evaluation of a Prototype Ultrasonography Respiratory Monitoring System for 4DCT Reconstruction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yan, P; Cheng, S; Chao, C

Purpose: Respiratory motion artifacts are commonly seen in the abdominal and thoracic CT images. A Real-time Position Management (RPM) system is integrated with CT simulator using abdominal surface as a surrogate for tracking the patient respiratory motion. The respiratory-correlated four-dimensional computed tomography (4DCT) is then reconstructed by GE advantage software. However, there are still artifacts due to inaccurate respiratory motion detecting and sorting methods. We developed an Ultrasonography Respiration Monitoring (URM) system which can directly monitor diaphragm motion to detect respiratory cycles. We also developed a new 4DCT sorting and motion estimation method to reduce the respiratory motion artifacts. Themore » new 4DCT system was compared with RPM and the GE 4DCT system. Methods: Imaging from a GE CT scanner was simultaneously correlated with both the RPM and URM to detect respiratory motion. A radiation detector, Blackcat GM-10, recorded the X-ray on/off and synchronized with URM. The diaphragm images were acquired with Ultrasonix RP system. The respiratory wave was derived from diaphragm images and synchronized with CT scanner. A more precise peaks and valleys detection tool was developed and compared with RPM. The motion is estimated for the slices which are not in the predefined respiratory phases by using block matching and optical flow method. The CT slices were then sorted into different phases and reconstructed, compared with the images reconstructed from GE Advantage software using respiratory wave produced from RPM system. Results: The 4DCT images were reconstructed for eight patients. The discontinuity at the diaphragm level due to an inaccurate identification of phases by the RPM was significantly improved by URM system. Conclusion: Our URM 4DCT system was evaluated and compared with RPM and GE 4DCT system. The new system is user friendly and able to reduce motion artifacts. It also has the potential to monitor organ motion

Contrast-enhanced ultrasonography for the detection of joint vascularity in arthritis--subjective grading versus computer-aided objective quantification.

PubMed

Klauser, A S; Franz, M; Bellmann Weiler, R; Gruber, J; Hartig, F; Mur, E; Wick, M C; Jaschke, W

2011-12-01

To compare joint inflammation assessment using subjective grading of power Doppler ultrasonography (PDUS) and contrast-enhanced ultrasonography (CEUS) versus computer-aided objective CEUS quantification. 37 joints of 28 patients with arthritis of different etiologies underwent B-mode ultrasonography, PDUS, and CEUS using a second-generation contrast agent. Synovial thickness, extent of vascularized pannus and intensity of vascularization were included in a 4-point PDUS and CEUS grading system. Subjective CEUS and PDUS scores were compared to computer-aided objective CEUS quantification using Qontrast® software for the calculation of the signal intensity (SI) and the ratio of SI for contrast enhancement. The interobserver agreement for subjective scoring was good to excellent (κ = 0.8 - 1.0; P < 0.0001). Computer-aided objective CEUS quantification correlated statistically significantly with subjective CEUS (P < 0.001) and PDUS grading (P < 0.05). The Qontrast® SI ratio correlated with subjective CEUS (P < 0.02) and PDUS grading (P < 0.03). Clinical activity did not correlate with vascularity or synovial thickening (P = N. S.) and no correlation between synovial thickening and vascularity extent could be found, neither using PDUS nor CEUS (P = N. S.). Both subjective CEUS grading and objective CEUS quantification are valuable for assessing joint vascularity in arthritis and computer-aided CEUS quantification may be a suitable objective tool for therapy follow-up in arthritis. © Georg Thieme Verlag KG Stuttgart · New York.

Accurate CT-MR image registration for deep brain stimulation: a multi-observer evaluation study

NASA Astrophysics Data System (ADS)

Rühaak, Jan; Derksen, Alexander; Heldmann, Stefan; Hallmann, Marc; Meine, Hans

2015-03-01

Since the first clinical interventions in the late 1980s, Deep Brain Stimulation (DBS) of the subthalamic nucleus has evolved into a very effective treatment option for patients with severe Parkinson's disease. DBS entails the implantation of an electrode that performs high frequency stimulations to a target area deep inside the brain. A very accurate placement of the electrode is a prerequisite for positive therapy outcome. The assessment of the intervention result is of central importance in DBS treatment and involves the registration of pre- and postinterventional scans. In this paper, we present an image processing pipeline for highly accurate registration of postoperative CT to preoperative MR. Our method consists of two steps: a fully automatic pre-alignment using a detection of the skull tip in the CT based on fuzzy connectedness, and an intensity-based rigid registration. The registration uses the Normalized Gradient Fields distance measure in a multilevel Gauss-Newton optimization framework and focuses on a region around the subthalamic nucleus in the MR. The accuracy of our method was extensively evaluated on 20 DBS datasets from clinical routine and compared with manual expert registrations. For each dataset, three independent registrations were available, thus allowing to relate algorithmic with expert performance. Our method achieved an average registration error of 0.95mm in the target region around the subthalamic nucleus as compared to an inter-observer variability of 1.12 mm. Together with the short registration time of about five seconds on average, our method forms a very attractive package that can be considered ready for clinical use.

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

Clinical Utility of High-Frequency Musculoskeletal Ultrasonography in Foot and Ankle Pathology: How Ultrasound Imaging Influences Diagnosis and Management.

PubMed

Delzell, Patricia B; Tritle, Benjamin A; Bullen, Jennifer A; Chiunda, Stella; Forney, Michael C

The use of high-frequency (high-resolution) musculoskeletal ultrasonography is increasing and has shown promising utility in many areas of medicine. The utility of musculoskeletal ultrasonography for foot and ankle complaints has not been widely investigated, however. Although some conditions of the foot and ankle are easily diagnosed by physical examination, others can have nonspecific examination findings, making optimal treatment decisions difficult. We hypothesized that high-resolution musculoskeletal ultrasound scanning of the foot and ankle can affect the diagnosis and/or treatment for patients presenting with foot or ankle complaints. Retrospectively, the cases of 98 patients who had undergone musculoskeletal ultrasound scanning of the foot or ankle were reviewed. The pre-ultrasound clinical diagnosis and treatment were compared with the post-ultrasound diagnosis and treatment. In 64% of the patients, the diagnosis or treatment changed after the ultrasound examination. In 43% of patients, both the diagnosis and the treatment changed after ultrasound scanning. For those patients for whom the diagnosis and treatment were unchanged after the ultrasound examination, the ultrasound findings were concordant with the pre-ultrasound clinical diagnosis for 100% of the patients. These results suggest that in a large proportion of patients, high-resolution musculoskeletal ultrasonography of the foot or ankle can facilitate appropriate diagnosis and management. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

High-frequency ultrasonography (HFUS) as a useful tool in differentiating between plaque morphea and extragenital lichen sclerosus lesions

PubMed Central

Reszke, Radomir; Szepietowski, Jacek C.

2017-01-01

Introduction Morphea and lichen sclerosus (LS) are chronic inflammatory diseases that may pose a diagnostic challenge for a physician. High-frequency ultrasonography (HFUS) is a versatile diagnostic method utilized in dermatologic practice, allowing monitoring the course of the disease, treatment response and differentiation between certain skin disorders. Aim To prove the usefulness of HFUS in differentiating between plaque morphea and extragenital LS lesions. Material and methods We examined 16 patients with plaque morphea and 4 patients with extragenital LS using 20 MHz taberna pro medicum TM (Germany) device. Results Investigations revealed hyperechogenic entrance echo in both morphea and LS lesions, whereas a distinct polycyclic surface of the entrance echo was detected exclusively in LS. Conclusions High-frequency ultrasonography is a current diagnostic modality that may prove useful in differentiating between morphea and LS lesions. PMID:29507565

Recovery of muscle function after deep neuromuscular block by means of diaphragm ultrasonography and adductor of pollicis acceleromyography with comparison of neostigmine vs. sugammadex as reversal drugs: study protocol for a randomized controlled trial.

PubMed

Cappellini, Iacopo; Picciafuochi, Fabio; Ostento, Daniele; Danti, Ginevra; De Gaudio, Angelo Raffaele; Adembri, Chiara

2018-02-21

The extensive use of neuromuscular blocking agents (NMBAs) during surgical procedures still leads to potential residual paralyzing effects in the postoperative period. Indeed, neuromuscular monitoring in an intra-operative setting is strongly advocated. Acetylcholinesterase inhibitors can reverse muscle block, but their short half-life may lead to residual curarization in the ward, especially when intermediate or long-acting NMBAs have been administered. Sugammadex is the first selective reversal drug for steroidal NMBAs; it has been shown to give full and rapid recovery of muscle strength, thus minimizing the occurrence of residual curarization. Acceleromyography of the adductor pollicis is the gold standard for detecting residual curarization, but it cannot be carried out on conscious patients. Ultrasonography of diaphragm thickness may reveal residual effects of NMBAs in conscious patients. This prospective, double-blind, single-center randomized controlled study will enroll patients (of American Society of Anesthesiologists physical status I-II, aged 18-80 years) who will be scheduled to undergo deep neuromuscular block with rocuronium for ear, nose, or throat surgery. The study's primary objective will be to compare the effects of neostigmine and sugammadex on postoperative residual curarization using two different tools: diaphragm ultrasonography and acceleromyography of the adductor pollicis. Patients will be extubated when the train-of-four ratio is > 0.9. Diaphragm ultrasonography will be used to evaluate the thickening fraction, which is the difference between the end expiratory thickness and the end inspiratory thickness, normalized to the end expiratory thickness. Ultrasonography will be performed before the initiation of general anesthesia, before extubation, and 10 and 30 min after discharging patients from the operating room. The secondary objective will be to compare the incidence of postoperative complications due to residual neuromuscular

Reduction in hospital admissions with the addition of prophylactic intramuscular ceftriaxone before transrectal ultrasonography-guided prostate biopsies.

PubMed

Luong, Benjamin; Danforth, Teresa; Visnjevac, Ognjen; Suraf, Margaret; Duff, Michael; Chevli, K Kent

2015-03-01

To evaluate the hospitalization rates in 2 pre-prostate biopsy antibiotic protocols. Two prebiopsy protocols were compared. CiproAlone required ciprofloxacin 500 mg twice daily starting 1 day before biopsy and continuing for 3 days after biopsy (4 days total). Diabetic patients were prescribed ciprofloxacin for 4 days after biopsy. CiproCeft required 1 dose of oral ciprofloxacin 500 mg 1 hour before the biopsy and ceftriaxone 1 g intramuscular at the time of the biopsy. Hospitalization rates between the CiproAlone vs CiproCeft protocols were examined. A total of 4134 biopsies were identified-2093 in the CiproAlone cohort and 2041 in the CiproCeft cohort. The post-prostate biopsy infection hospitalization rate was 0.6% (14 patients) in the CiproAlone group vs 0.0% (0 patients) in the CiproCeft group (P <.0001). Of the patients hospitalized, 12 fit systemic inflammatory response syndrome (SIRS) criteria. Eight of 14 hospitalized patients fit the sepsis (SIRS and source of infection) criteria. Positive cultures (urine and/or blood) resulted from 71% (n = 10) of hospitalized patients. Antibiotic resistance was analyzed. Diabetes mellitus was associated with hospitalization after prostate biopsy (P = .01) in our population, but there was no difference between the 2 groups in the rates of diabetes mellitus (P = .46). Patient age, prostate-specific antigen level, number of biopsy cores obtained, race, and previous antibiotics exposure were not found to be independent predictors of post-transrectal ultrasonography biopsy hospitalization for infection using a multivariate regression analysis. A prophylactic prebiopsy protocol including 2 classes of antibiotics, single-dose ciprofloxacin, and single-dose intramuscular ceftriaxone reduced post-transrectal ultrasonography biopsy rates of hospitalizations compared to oral ciprofloxacin alone. Copyright © 2015 Elsevier Inc. All rights reserved.

Incidence of upper tract abnormalities in patients with neurovesical dysfunction secondary to multiple sclerosis: analysis of risk factors at initial urologic evaluation.

PubMed

Lemack, Gary E; Hawker, Kathleen; Frohman, Elliot

2005-05-01

To determine the incidence of upper tract abnormalities on renal ultrasonography in patients with multiple sclerosis (MS) referred for urologic evaluation, as well as to identify any risk factors present on the basis of the historical information and urodynamic findings. Data were derived from all patients with MS referred to the neurourology clinic during a 4-year period. The database was specifically queried for patients found to have upper tract abnormalities on screening renal ultrasonography. Demographic parameters, as well as laboratory values (creatinine) and urodynamic results, were evaluated for risk factors associated with abnormal upper tract findings. Of the 113 patients referred and evaluated, 66 completed both urodynamic testing and renal ultrasonography. Eleven (16.7%) had abnormal ultrasound findings, with focal caliectasis the most common finding. No demographic parameter (age, sex, time since MS diagnosis, MS pattern) was associated with a greater likelihood of abnormal renal ultrasonography on univariate analysis. Neither serum creatinine nor any urodynamic finding (including the presence of dyssynergia or the threshold and amplitude of detrusor overactivity) was associated with abnormal renal ultrasound findings. No patients in our series had any indication of obstructive uropathy more severe than mild hydronephrosis. Of the 16.7% of patients with any abnormal findings, most were noted to have minor caliectasis, likely to be of little clinical significance. Although no factors identifying patients at risk of renal abnormalities at presentation were found, ongoing evaluation of patients with baseline findings will serve to identify those at risk of progression.

Endoscopic ultrasonography predicts early esophageal variceal bleeding in liver cirrhosis: A case report.

PubMed

Men, Changjun; Zhang, Guoliang

2017-04-01

Bleeding esophageal and gastric varices constitute a serious complication in liver cirrhosis. Previous studies have shown that endoscopic ultrasonography (EUS) can be used to predict early esophageal variceal bleeding in liver cirrhosis. We report a case of a 46-year-old man with hepatitis B liver cirrhosis (CTP score, 5; Child-Pugh class, A) who was admitted to our hospital due to a decreased appetite lasting 1 week. He was initially diagnosed with decompensated hepatitis B cirrhosis; an abdominal computed tomography (CT) scan indicated a diagnosis of liver cirrhosis and portal hypertension (PHT). Common endoscopic examination showed no evidence of gastroesophageal varices; EUS revealed distinct varices of the esophageal and gastric veins. Six months after discharge, the patient was rehospitalized because of upper gastrointestinal bleeding. Endoscopic ligation was implemented as well as esophageal varices loop ligature (EVL). Six months later, EUS showed obvious collateral and perforator veins. We should strongly recommend that patients with liver cirrhosis undergo EUS in addition to a routine endoscopic examination. EUS can play an important role in evaluating the risk for bleeding in PHT and can be used to assess the efficacy of EVL.

High resolution ultrasonography of the tibial nerve in diabetic peripheral neuropathy.

PubMed

Singh, Kunwarpal; Gupta, Kamlesh; Kaur, Sukhdeep

2017-12-01

High-resolution ultrasonography of the tibial nerve is a fast and non invasive tool for diagnosis of diabetic peripheral neuropathy. Our study was aimed at finding out the correlation of the cross sectional area and maximum thickness of nerve fascicles of the tibial nerve with the presence and severity of diabetic peripheral neuropathy. 75 patients with type 2 diabetes mellitus clinically diagnosed with diabetic peripheral neuropathy were analysed, and the severity of neuropathy was determined using the Toronto Clinical Neuropathy Score. 58 diabetic patients with no clinical suspicion of diabetic peripheral neuropathy and 75 healthy non-diabetic subjects were taken as controls. The cross sectional area and maximum thickness of nerve fascicles of the tibial nerves were calculated 3 cm cranial to the medial malleolus in both lower limbs. The mean cross sectional area (22.63 +/- 2.66 mm 2 ) and maximum thickness of nerve fascicles (0.70 mm) of the tibial nerves in patients with diabetic peripheral neuropathy compared with both control groups was significantly larger, and statistically significant correlation was found with the Toronto Clinical Neuropathy Score ( p < 0.001). The diabetic patients with no signs of peripheral neuropathy had a larger mean cross sectional area (14.40 +/- 1.72 mm 2 ) and maximum thickness of nerve fascicles of the tibial nerve (0.40 mm) than healthy non-diabetic subjects (12.42 +/- 1.01 mm 2 and 0.30 mm respectively). The cross sectional area and maximum thickness of nerve fascicles of the tibial nerve is larger in diabetic patients with or without peripheral neuropathy than in healthy control subjects, and ultrasonography can be used as a good screening tool in these patients.

The role of ultrasonography in examination of the stability of Tile-B2 pelvic fractures: 7 case reports and a literature review.

PubMed

Zhang, Bin-Fei; Zhang, Hong; Wang, Peng-Fei; Wang, Hu; Lei, Jin-Lai; Fu, Ya-Hui; Cong, Yu-Xuan; Huang, Hai; Huo, Xiao-Ming; Zhuang, Yan; Zhang, Kun

2017-09-01

Determining whether a Tile-B2 pelvic fracture is stable is very challenging. We sought to identify the role of ultrasonography in determining the stability of Tile-B2 pelvic fractures. We collected the clinical data of patients with Tile-B2 pelvic fractures who presented at Xi'an Hong-Hui Hospital between June 1, 2016, and August 5, 2016. The treatment strategy of each patient was determined by a team of senior surgeons in the department. A single sinologist observed the movement of the fracture sites in patients during rest, under compression, and during separation to determine fracture stability. According to the pelvic fracture stability assessment, an appropriate treatment strategy was redetermined. Overall, 7 patients, including 5 women and 2 men, with Tile-B2 pelvic fractures were included in this case series. During the initial examination, senior surgeons recommended that 2 patients should undergo internal fixation and 4 patients, conservative treatment; treatment was undecided for 1 patient. After ultrasonography examination, 4 patients underwent surgery via the Stoppa (n = 2) or ilioinguinal approach (n = 1) or cannulated screw fixation (n = 1). The rest of the patients (n = 3) received conventional treatment. Follow-up ranged from 6 to 10 months. Most of the patients showed excellent functions based on their last Majeed grading scores. There were no complications during the follow-up. Using ultrasonography examination, the preoperative treatment plan in 1 patient was changed, and the uncertain preoperative plan in 1 patient was identified. Preoperative assessment of stability using ultrasonography may assist surgeons in making appropriate treatment choices for patients with Tile-B2 pelvic fractures.

Lung ultrasonography of pulmonary complications in preterm infants with respiratory distress syndrome.

PubMed

Lovrenski, Jovan

2012-03-01

To evaluate the diagnostic possibilities of lung ultrasonography (LUS) in detecting pulmonary complications in preterm infants with respiratory distress syndrome (RDS). A prospective study included 120 preterm infants with clinical and radiographic signs of RDS. LUS was performed using both a transthoracic and a transabdominal approach within the first 24 h of life, and, after that, follow-up LUS examinations were performed. In 47 detected pulmonary complications of RDS (hemorrhage, pneumothorax, pneumonia, atelectasis, bronchopulmonary dysplasia), comparisons between LUS and chest X-ray (CXR) were made. Also, 90 subpleural consolidations registered during LUS examinations were analysed. Statistical analysis included MANOVA and discriminant analysis, t-test, confidence interval, and positive predictive value. In 45 of 47 instances the same diagnosis of complication was detected with LUS as with CXR, indicating a high reliability of the method in premature infants with RDS. The only two false negative findings concerned partial pneumothorax. The positive predictive value of LUS was 100%. A statistically significant difference of LUS findings between the anterior and posterior lung areas was observed in both right and left hemithoraces. LUS enables the detection of pulmonary complications in preterm infants with RDS and has the potential to reduce the number of CXRs. The specific guidelines for its use should be provided in a more extensive study.

Effect of ISDN bandwidth on image quality for telemedicine transmission of obstetric ultrasonography.

PubMed

Malone, F D; Athanassiou, A; Nores, J; D'Alton, M E

1998-01-01

To evaluate objectively the effect of different bandwidths on the ability to interpret obstetric ultrasound scans transmitted live over a commercial telephone network. An integrated services digital network (ISDN) was established from three satellite offices to our central prenatal diagnostic center. In the first half of the study, the network was based on four ISDN channels transmitting at a bandwidth of 256 kbits per second (kbps), while in the second half of the study, this was increased to six ISDN channels transmitting at 384 kbps. A physician trained in obstetric ultrasonography provided an interpretation of fetal anatomy using a live, real-time telemedicine link. A scoring system consisting of 33 anatomic items was used to evaluate image quality objectively. The number of transmissions complicated by motion artifact was also recorded. One hundred patients had a fetal anatomy survey performed using the 256 kbps system, and these interpretations were compared with those from another group of 100 patients who were examined using the 384 kbps system. Although the visibility of the 33 anatomic items was similar using the two systems, significantly more examinations at 256 kbps were complicated by motion artifact (12% vs. 3%; P = 0.02). Remote sonographic viewing of fetal anatomy was adequate using both 256 and 384 kbps systems, although motion artifact was significantly more likely to occur using the slower system. This problem may affect the ability of the lower-bandwidth system to allow optimal detection when fetal anomalies are present.

Advantages of contrast-enhanced ultrasonography over computed tomography for the detection of persistent type II endoleak after embolization: A case report.

PubMed

Cury, Maysa Heineck; Cury, Marcus Vinícius Martins; Godoy, Marcos Roberto; Matielo, Marcelo Fernando

2016-10-01

The aim of this case report is to describe the use of contrast-enhanced ultrasonography in the detection of a type II endoleak after prior embolization with Onyx. A 74-year-old male patient with hypertension previously underwent endovascular repair of a 7.1-cm infrarenal aortic aneurysm. CT angiography surveillance revealed a type II endoleak associated with aneurysm sac expansion. Selective transarterial embolization of the endoleak was performed, but it was not possible to detect the persistent endoleak using CT angiography because of image artifacts caused by Onyx. Contrast-enhanced ultrasonography enabled us to detect the persistent endoleak in this patient. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:522-526, 2016. © 2016 Wiley Periodicals, Inc.

Selected Adnexal Cystic Masses in Postmenopausal Women Can be Safely Managed by Laparoscopy

PubMed Central

Lee, Jeong-Won; Kim, Chul Jung; Lee, Ji Eun; Lee, Sun-Joo; Kim, Byoung-Gie; Lee, Je-Ho; Bae, Duk-Soo

2005-01-01

The aim of this study was to assess the efficacy and safety of laparoscopic treatment for adnexal cystic masses that were predicted to be benign in postmenopausal women. Postmenopausal women found to have an adnexal cystic mass were retrospectively evaluated with transvaginal ultrasonography, and serum CA-125 levels. The selection criteria were adnexal cystic masses greater than 3 cm but less than 10 cm, the masses were in the benign range (4-8) of Sassone's scoring system for transvaginal ultrasonography, and the patients had serum CA-125 levels less than 65 IU/mL. Two hundred nineteen women fulfilled the criteria and underwent operative laparoscopy. Almost all the masses (99.5%) were accurately predicted to be benign except for one borderline ovarian tumor. Two hundreds thirteen (97.3%) women were successfully managed by operative laparoscopy and six (2.7%) required laparotomy. For the patients managed by laparoscopy, the mean operative time was 51.3 min; the mean hospital stay was 2.5 days. There was no significant morbidity and surgery-related mortality. The combination of the Sassone's scoring system for transvaginal ultrasonography and serum CA-125 level can accurately predict benign cystic masses, and operative laparoscopy is technically feasible and safe for the management of adnexal mass in postmenopausal women. PMID:15953871

Evaluation of the Normal Tonsils in Pediatric Patients With Ultrasonography.

PubMed

Hosokawa, Takahiro; Yamada, Yoshitake; Tanami, Yutaka; Hattori, Shinya; Sato, Yumiko; Hosokawa, Mayumi; Oguma, Eiji

2017-05-01

To evaluate how well the tonsils can be viewed, in addition to echogenicity, using ultrasound, and to compare these results between children younger and older than the age of 3. We evaluated the tonsils of 99 patients (72.0 ± 59.1 months) by ultrasound. Ultrasound scans of both the left and right side, in both the transverse and longitudinal planes, were obtained. Images were scored with one of four grades according to how well the tonsil border could be distinguished, 0 being the worst and 3 being the best. Grades 2 or 3 (>50% of the tonsil border was detectable) in both tonsils, in either the transverse or longitudinal image, were considered "evaluable." Echogenicity was designated as imperceptible, low echoic, or striated in appearance. Statistical analysis was performed using the Mann-Whitney U test. Bilateral tonsils were evaluable in 96.0% (96/99) of cases. The mean grades were 2.44 ± 0.65/2.03 ± 0.68 in the right transverse/longitudinal images, and 2.40 ± 0.59/2.12 ± 0.73 in the left transverse/longitudinal images. The grades in children older than the age of 3 were significantly higher than those in younger patients (all P < .05). Echogenicity classification on the right and left side revealed a striated appearance in 97.0% (96/99) and 90.0% (89/99) of cases, respectively. The tonsils of almost all pediatric patients could be evaluated by ultrasound, particularly for patients older than 3 years. Additionally, a striated pattern of the tonsils was observed in most cases. © 2017 by the American Institute of Ultrasound in Medicine.

Estimation of sensitivity and specificity of pregnancy diagnosis using transrectal ultrasonography and ELISA for pregnancy-associated glycoprotein in dairy cows using a Bayesian latent class model.

PubMed

Shephard, R W; Morton, J M

2018-01-01

To determine the sensitivity (Se) and specificity (Sp) of pregnancy diagnosis using transrectal ultrasonography and an ELISA for pregnancy-associated glycoprotein (PAG) in milk, in lactating dairy cows in seasonally calving herds approximately 85-100 days after the start of the herd's breeding period. Paired results were used from pregnancy diagnosis using transrectal ultrasonography and ELISA for PAG in milk carried out approximately 85 and 100 days after the start of the breeding period, respectively, from 879 cows from four herds in Victoria, Australia. A Bayesian latent class model was used to estimate the proportion of cows pregnant, the Se and Sp of each test, and covariances between test results in pregnant and non-pregnant cows. Prior probability estimates were defined using beta distributions for the expected proportion of cows pregnant, Se and Sp for each test, and covariances between tests. Markov Chain Monte Carlo iterations identified posterior distributions for each of the unknown variables. Posterior distributions for each parameter were described using medians and 95% probability (i.e. credible) intervals (PrI). The posterior median estimates for Se and Sp for each test were used to estimate positive predictive and negative predictive values across a range of pregnancy proportions. The estimate for proportion pregnant was 0.524 (95% PrI = 0.485-0.562). For pregnancy diagnosis using transrectal ultrasonography, Se and Sp were 0.939 (95% PrI = 0.890-0.974) and 0.943 (95% PrI = 0.885-0.984), respectively; for ELISA, Se and Sp were 0.963 (95% PrI = 0.919-0.990) and 0.870 (95% PrI = 0.806-0.931), respectively. The estimated covariance between test results was 0.033 (95% PrI = 0.008-0.046) and 0.035 (95% PrI = 0.018-0.078) for pregnant and non-pregnant cows, respectively. Pregnancy diagnosis results using transrectal ultrasonography had a higher positive predictive value but lower negative predictive value than results from the

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

PubMed Central

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

2015-01-01

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

Ultrasonographic evaluation of abdominal distension in 52 camels (Camelus dromedarius).

PubMed

Tharwat, Mohamed; Al-Sobayil, Fahd; Ali, Ahmed; Buczinski, Sébastien

2012-08-01

The purpose of this study was to assess the diagnostic value of ultrasonography in the evaluation of abdominal distension in 52 camels (Camelus dromedarius). The conditions included trypanosomiasis (n=35), intestinal obstruction (n=12) and ruptured urinary bladder (n=5). Fifteen clinically normal camels were included as controls. Transabdominal and transrectal ultrasonography was carried out on all camels. In animals with trypanosomiasis, ultrasonographic findings included accumulation of massive amounts of hypoechoic abdominal fluids where liver, intestine, kidney, spleen and urinary bladder were imaged floating. Except in two cases of bile duct calcification and one of hepatic abscessation, no detectable abnormal sonographic lesions were detected while imaging the hepatic and renal parenchyma, and the heart and its valves and major blood vessels. In camels with intestinal obstruction, ultrasonographic findings included distended intestinal loops with markedly reduced or absent motility. In one camel, the intestinal lumen contained localised hyperechoic material that was consistent with a foreign body. Hypoechoic fluid with or without fibrin was seen between intestinal loops. In camels with ruptured urinary bladder, ultrasonographic findings included collapsed and perforated bladder, echogenic blood clots within the urinary bladder and peritoneal cavity, increased thickness of the bladder wall, floating intestines in hypoechogenic fluid and echogenic calculi within the urethra. Ultrasonography was considered a useful tool for the evaluation of dromedary camels with abdominal distension. Copyright © 2011 Elsevier Ltd. All rights reserved.

Botulinum toxin type A injection into the gastrocnemius muscle for spastic equinus in adults with stroke: a randomized controlled trial comparing manual needle placement, electrical stimulation and ultrasonography-guided injection techniques.

PubMed

Picelli, Alessandro; Tamburin, Stefano; Bonetti, Paola; Fontana, Carla; Barausse, Martina; Dambruoso, Francesca; Gajofatto, Francesca; Santilli, Valter; Smania, Nicola

2012-11-01

The aim of this study was to compare the clinical outcomes of manual needle placement, electrical stimulation, and ultrasonography-guided techniques for botulinum toxin injection into the gastrocnemius of adults with spastic equinus after stroke. After randomization into three groups, each patient received the same dose of botulinum toxin type A into the lateral and medial head of the gastrocnemius muscle (OnabotulinumtoxinA, 100U per head) of the affected leg. The manual needle placement group (n = 15) underwent injections using anatomic landmarks and palpation; the electrical stimulation group (n = 15) received injections with electrical stimulation guidance; and the ultrasonography group (n = 17) was injected under sonographic guidance. The modified Ashworth scale, the Tardieu scale, and the ankle passive range of motion were measured at baseline and 1 mo after injection. Nonparametric statistical analysis was used. One month after injection, the modified Ashworth scale improved better in the ultrasonography group than in the manual needle placement group (P = 0.008). The ankle passive range of motion improved better in the ultrasonography group than in the electrical stimulation (P = 0.004) and manual needle placement (P < 0.001) groups. No difference was found between groups for the Tardieu scale. Ultrasonography-guided injection technique could improve the clinical outcome of botulinum toxin injections into the gastrocnemius of adults with spastic equinus.

Three-dimensional ultrasonography of the breast; An adequate replacement for MRI in neoadjuvant chemotherapy tumour response evaluation? - RESPONDER trial.

PubMed

van Egdom, L S E; Lagendijk, M; Heijkoop, E H M; Koning, A H J; van Deurzen, C H M; Jager, A; van Lankeren, W; Koppert, L B

2018-07-01

Accurate measurement of tumour response during and after neoadjuvant chemotherapy (NAC) is important and may influence treatment decisions in invasive breast cancer patients. Breast MRI forms the gold standard but is more burdensome, time consuming and costly. In this study response measurement was done with 3-D ultrasound by Automated Breast Volume Scanner (ABVS) and compared to breast MRI. Moreover, patient satisfaction with both techniques was compared. A single-institution, prospective observational pilot study evaluating tumour response by ABVS in addition to breast MRI (standard care) was performed in 25 invasive breast cancer patients receiving NAC. Tumour response was evaluated comparing longest tumour diameters as well as tumour volumes at predefined time points using Bland-Altman analysis. Volume measurements for breast MRI were obtained using a fully immersive virtual reality system (a Barco I-Space) and V-Scope software. Same software was used to obtain ABVS volume measurements using an in-house developed desktop VR system. Inter- and intra-observer agreement was evaluated by Intraclass Correlation Coefficient (ICC). Twenty-five patients were eligible for baseline measurement, 20 for a mid-NAC response evaluation, and five for a post-NAC response evaluation. MRI and ABVS showed absolute concordance in 73% of patients for the mid-NAC evaluation, with a 'good' correlation for the difference in longest diameter measurement (ICC 0.73, p < 0.01) as compared to baseline assessment. Concerning difference in volume measurement in the mid-NAC response evaluation showed a 'fair' correlation (ICC 0.52, p < 0.01) and in the post-NAC response evaluation an 'excellent' correlation (ICC 0.98, p < 0.01). 'Excellent' inter- and intra-observer agreement was found (ICC 0.88, p < 0.01) with comparable limits of agreement (LOA) for observer 1 and 2 in both diameter and volume measurement. Patient satisfaction was higher for ABVS compared to breast MRI, 93

Accuracy of ultrasonography in the detection of severe hepatic lipidosis in cats.

PubMed

Yeager, A E; Mohammed, H

1992-04-01

The accuracy of ultrasonography in detection of feline hepatic lipidosis was studied retrospectively. The following ultrasonographic criteria were associated positively with severe hepatic lipidosis: the liver hyperechoic, compared with falciform fat; the liver isoechoic or hyperechoic, compared with omental fat; poor visualization of intrahepatic vessel borders; and increased attenuation of sound by the liver. In a group of 36 cats with clinically apparent hepatobiliary disease and in which liver biopsy was done, liver hyperechoic, compared with falciform fat, was the best criterion for diagnosis of severe hepatic lipidosis with 91% sensitivity, 100% specificity, and 100% positive predictive value.

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

USDA-ARS?s Scientific Manuscript database

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...

Non-destructive evaluation of the cladding thickness in LEU fuel plates by accurate ultrasonic scanning technique

DOE Office of Scientific and Technical Information (OSTI.GOV)

Borring, J.; Gundtoft, H.E.; Borum, K.K.

1997-08-01

In an effort to improve their ultrasonic scanning technique for accurate determination of the cladding thickness in LEU fuel plates, new equipment and modifications to the existing hardware and software have been tested and evaluated. The authors are now able to measure an aluminium thickness down to 0.25 mm instead of the previous 0.35 mm. Furthermore, they have shown how the measuring sensitivity can be improved from 0.03 mm to 0.01 mm. It has now become possible to check their standard fuel plates for DR3 against the minimum cladding thickness requirements non-destructively. Such measurements open the possibility for the acceptancemore » of a thinner nominal cladding than normally used today.« less

Pure ultrasonography-guided radiation-free percutaneous nephrolithotomy: report of 357 cases.

PubMed

Hosseini, Mohammad Mehdi; Yousefi, Alireza; Rastegari, Mohsen

2015-01-01

To assess the safety and effectiveness of pure ultrasound-guided percutaneous nephrolithotomy. Three hundred fifty-seven patients were treated; 139 women and 218 men, with a mean age of 33.7 years (range 21-69 years) and a mean stone size of 33.5 mm in maximum diameter (range 20-52 mm). Stone locations were renal pelvis (174), lower calyx (68) or both (115) with mild to moderate hydronephrosis seen on excretory urography. A ureteral stent was inserted by cystoscope, and saline was injected for better localization of the pelvicaliceal system (PCS), if needed. Puncture of the PCS was done by an 18-gauge nephrostomy needle through the lower pole calyx, and all the steps, including dilatation, were done under the guidance of ultrasonography. The day after the operation, 318 (89.07%) patients were stone-free in the kidneys, ureters, and bladder x-rays. Nineteen patients (5.3%) had multiple fragments that measured equal or less than 5 mm and passed them spontaneously in 2-4 weeks (total stone-free rate 94.4%). Access failure occurred in ten obese patients (2.8%) and fluoroscopy was required. Residual fragments with sizes of 10-12 mm were seen in seven patients, all of who underwent shock wave lithotripsy. In one patient, a fragment measuring 7-8 mm migrated into the distal part of the ureter. It was fragmented with ureteroscopy and pneumatic lithoclast 2 days after the operation. In two patients who had large (>15 mm) residual stone redo percutaneous nephrolithotomy was performed 48 h after the first procedure. Percutaneous nephrolithotomy guided by ultrasonography seems to be as effective as fluoroscopy in selected cases and poses no risk of surgeon and patient exposure to radiation; however, more experience is required.

Ultrasonography of the cervical muscles: a critical review of the literature.

PubMed

Javanshir, Khodabakhsh; Amiri, Mohsen; Mohseni-Bandpei, Mohammad Ali; Rezasoltani, Asghar; Fernández-de-las-Peñas, César

2010-10-01

This article presents a review of the literature concerning size measurement of cervical muscles using real-time ultrasound imaging (RUSI) in patients with neck pain and in healthy populations. A literature search from 1996 to December 2009 making use of Science Direct and PubMed databases was conducted. Medical Subject Headings and other terms were as follows: ultrasonography, cervical, muscle, neck, size, pain, validity, reliability, neck pain, and healthy subjects. We included studies using RUSI for assessing cervical paraspinal muscles both in healthy subjects and in patients with neck pain. We assessed muscles investigated and the reliability and validity of the method used. The literature search yielded 16 studies. Twelve (75%) studies assessed the posterior muscles, whereas in the remaining 4 (25%), the anterior muscles were studied. Three studies quantified the size of the muscles during contraction; 3 assessed the relationship between cross-sectional area, linear dimensions, and anthropometric variables; 1 evaluated the training-induced changes in muscle size; 1 assessed the differences in muscle shape and cross-sectional area of cervical multifidus between patients with chronic neck pain and controls; 8 studies looked at the reliability of using RUSI in patients with neck pain or healthy subjects; and 3 studies evaluated the validity of RUSI compared with magnetic resonance imaging. This literature review has shown that there are not sufficient studies for assessing neck muscles with RUSI. It seems that using constant landmarks, knowledge of anatomy and function of target muscle, and a proper definition of muscle borders can help to take a clear image. Standardized position of the subject, correct placement of the transducer, and using multiple RUSI for statistical analyses may improve results. Copyright © 2010 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Ultrasound evaluation of valsartan therapy for renal cortical perfusion.

PubMed

Kishimoto, Noriko; Mori, Yasukiyo; Nishiue, Takashi; Nose, Atsuko; Kijima, Yasuaki; Tokoro, Toshiko; Yamahara, Hideki; Okigaki, Mitsuhiko; Kosaki, Atsushi; Iwasaka, Toshiji

2004-05-01

An increase in renal blood flow with a concomitant decrease in filtration fraction at the onset of angiotensin II receptor blocker treatment has been shown to predict a long-term renoprotective effect. However, no studies are available regarding angiotensin receptor blocker-induced changes in renal cortical perfusion observed in the clinical setting. We have recently developed a convenient method of evaluating human renal cortical blood flow with contrast-enhanced harmonic ultrasonography. The goal of this study was to use this method to examine the effect of valsartan, an angiotensin II receptor blocker, on renal cortical perfusion. We performed intermittent second harmonic imaging with venous infusion of a microbubble contrast agent in 7 healthy volunteers. Contrast-enhanced harmonic ultrasonography performed after oral administration of valsartan (80mg) showed a significant increase in microbubble velocity, which correlated well with the increase in total renal blood flow determined by p-aminohippurate clearance (r=0.950, p < 0.001). Although fractional vascular volume was not significantly increased, alterations in renal cortical blood flow calculated by the product of microbubble velocity and fractional volume were also correlated with the change in total renal blood flow (r=0.756, p < 0.05). These results indicate that valsartan increases the renal cortical blood flow in normal kidneys, mainly by increasing blood flow velocity. Contrast-enhanced harmonic ultrasonography is a promising technique for evaluating the precise effect on renal cortical perfusion and optimal dose of valsartan in diseased kidneys.

Non-contact photoacoustic tomography and ultrasonography for tissue imaging

PubMed Central

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

2011-01-01

The detection of ultrasound in photoacoustic tomography (PAT) and ultrasonography (US) usually relies on ultrasonic transducers in contact with the biological tissue. This is a major drawback for important potential applications such as surgery and small animal imaging. Here we report the use of remote optical detection, as used in industrial laser-ultrasonics, to detect ultrasound in biological tissues. This strategy enables non-contact implementation of PAT and US without exceeding laser exposure safety limits. The method uses suitably shaped laser pulses and a confocal Fabry-Perot interferometer in differential configuration to reach quantum-limited sensitivity. Endogenous and exogenous inclusions exhibiting optical and acoustic contrasts were detected ex vivo in chicken breast and calf brain specimens. Inclusions down to 0.5 mm in size were detected at depths well exceeding 1 cm. The method could significantly expand the scope of applications of PAT and US in biomedical imaging. PMID:22254164

Ultrasonography to investigate the effect of supplementing whole milk with complex carbohydrates and specific amino acids on curd retention in the abomasum of dairy calves.

PubMed

Singh, K; Leath, S R; Henderson, H V; Molenaar, A J; Watson, T J; Pacheco, D; McMahon, C D

2016-09-01

To determine whether the retention time of curd in the abomasum of calves was influenced by supplementing milk with a plant-derived carbohydrate and amino acid supplement, evaluated non-invasively using ultrasonography. Female dairy calves aged between 2-6 days of age were sourced from a commercial farm in March 2013. All calves were fed whole milk until weaning (4 L per day); 21 calves were supplemented with a probiotic until 18 days of age, and thereafter with a plant-derived complex carbohydrate and amino acid supplement until weaning, and 22 calves were just fed whole milk. Treatment groups were balanced for age, weight and breed. At 9-14, 24-29 and 52-57 days of age, the abomasum of each calf was examined using ultrasonography immediately before and after feeding, 1 and 2 hours after feeding, and then at 30 minute intervals until curd was no longer visible in the abomasum. Abomasal volume and curd size were recorded to assess retention time of curd in the abomasum. At 9-14 days of age, mean retention time of curd in the abomasum was similar (4.6 hours) in both groups. At 24-29 days of age, when the supplemented calves had been receiving the supplement for approximately 10 days, mean curd retention time was longer by 1.4 (SE 0.28) hours in supplemented compared with unsupplemented calves (p<0.001). At 52-57 days of age, mean retention time was longer by 0.7 (SE 0.34) hours compared to unsupplemented calves (p=0.05). Using ultrasonography, changes in abomasal content could be followed non-invasively over time and it was demonstrated that the plant-derived complex carbohydrate supplement increased the curd retention time in the abomasum. We speculate that the increased retention time enables an increased availability of nutrients following a more complete digestion of milk, thereby improving animal performance.

Multimodality imaging of the orbit

PubMed Central

Hande, Pradipta C; Talwar, Inder

2012-01-01

The role of imaging is well established in the evaluation of orbital diseases. Ultrasonography, Computed tomography and Magnetic resonance imaging are complementary modalities, which allow direct visualization of regional anatomy, accurate localization and help to characterize lesions to make a reliable radiological diagnosis. The purpose of this pictorial essay is to highlight the imaging features of commonly encountered pathologies which involve the orbit. PMID:23599570

Preserved hyperaemic response in supraclavicular ultrasonography demonstrates function on demand of the LIMA to LAD string sign graft after CABG.

PubMed

Hartman, J M; Kelder, H C; Ackerstaff, R G A; Swieten, H A; Vermeulen, F E E; Bogers, A J J C

2007-02-01

To correlate supraclavicular ultrasonography with angiographically patent and string sign left internal mammary artery (LIMA) to left anterior descending artery (LAD) grafts. Sixteen patients with a single LIMA anastomosis to the LAD were prospectively entered in a follow-up study. The supraclavicular ultrasonography of the LIMA origin was studied preoperatively and at 5.3+/-3.6 months and 1.7+/-0.4 year postoperatively. At the late postoperative ultrasonography electrocardiographically controlled hyperemic response was also studied for 6 min. Control angiography was performed at 1.5+/-0.8 year. Differences within groups were tested with a paired t-test and between groups with an unpaired t-test. Control angiography showed in 13 patients (group I) a patent LIMA graft and in 3 patients (group II) a string sign LIMA graft. Preoperative blood velocities were not significantly different between groups. Postoperatively, both groups revealed higher diastolic and lower systolic blood velocities compared to preoperative values. The blood velocities at rest did not change in group I and all velocities decreased in group II in time postoperatively. The blood velocities in maximal hyperemic response increased significantly within the groups and were not significantly different between the groups. No ischemia could be detected electrocardiographically during hyperemic response and no patient presented angina. Both groups showed a shift towards coronary type diastolic blood velocities at rest and at hyperaemic response. Significant hyperemic response was also present in string sign LIMA grafts and demonstrates response capacity to increased myocardial oxygen demand.

A Comparative Study on Quantitative Assessment of Blood Flow and Vascularization in Polycystic Ovary Syndrome Patients and Normal Women Using Three-Dimensional Power Doppler Ultrasonography.

PubMed

Garg, Nitasha; Khaira, Harkiran Kaur; Kaur, Manjot; Sinha, Smita

2018-04-01

To compare the quantitative assessment of blood flow and vascularization of ovaries in polycystic ovary syndrome patients and normal women using three-dimensional power Doppler ultrasonography. This cross-sectional quantitative study was conducted on women of reproductive age group (15-45 years) attending Gynaecology OPD AIMSR, Bathinda, Punjab. Thirty women were enrolled in polycystic ovarian syndrome (PCOS) group and 30 healthy women in control group. Women were categorized as polycystic ovary syndrome according to Rotterdam's criteria. The women with PCOS underwent transvaginal USG Doppler on day 6 of the cycle using 3D power Doppler USG equipment (GE Voluson E8), and vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were measured. The mean values of VI, FI and VFI measured by power Doppler ultrasonography were significantly increased ( P value = 0.000) in women with PCOS when compared with healthy women. This study suggests that blood flow and vascularization measured by 3D power Doppler ultrasonography in ovaries of polycystic ovary syndrome patients were significantly more than the ovaries of normal women.

Relation Between Subacromial Bursitis on Ultrasonography and Efficacy of Subacromial Corticosteroid Injection in Rotator Cuff Disease: A Prospective Comparison Study.

PubMed

Lee, Doo-Hyung; Hong, Ji Yeon; Lee, Michael Young; Kwack, Kyu-Sung; Yoon, Seung-Hyun

2017-05-01

To evaluate the correlations between subacromial bursitis (bursal thickening and effusion) on ultrasonography and its response to subacromial corticosteroid injection in patients with rotator cuff disease. Prospective, longitudinal comparison study. University-affiliated tertiary care hospital. Patients with rotator cuff disease (N=69) were classified into 3 groups based on ultrasonographic findings; (1) normative bursa group (group 1, n=23): bursa and effusion thickness <1mm; (2) bursa thickening group (group 2, n=22): bursa thickness >2mm and effusion thickness <1mm; and (3) bursa effusion group (group 3, n=24): bursa thickness <1mm and effusion thickness >2mm. A single subacromial injection with 20mg of triamcinolone acetonide. Visual analog scale (VAS) of shoulder pain, Shoulder Disability Questionnaire (SDQ), angles of active shoulder range of motion (flexion, abduction, external rotation, and internal rotation), and bursa and effusion thickness at pre- and posttreatment at week 8. There were no significant differences between the 3 groups in demographic characteristics pretreatment. Groups 2 and 3 showed a significant difference compared with group 1 in changes on the VAS and abduction; group 3 showed a significant difference compared with group 1 in changes of the SDQ, internal rotation, and external rotation; and all groups showed significant differences when compared with each other (groups 1 and 3, 2 and 3, and 1 and 2) in changes of thickness. A patient with ultrasonographic observation of subacromial bursitis, instead of normative bursa, can expect better outcome with subacromial corticosteroid injection. Therefore, we recommend a careful selection of patients using ultrasonography prior to injection. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Four-dimensional ultrasonography of the fetal heart using color Doppler spatiotemporal image correlation.

PubMed

Gonçalves, Luís F; Romero, Roberto; Espinoza, Jimmy; Lee, Wesley; Treadwell, Marjorie; Chintala, Kavitha; Brandl, Helmut; Chaiworapongsa, Tinnakorn

2004-04-01

To describe clinical and research applications of 4-dimensional imaging of the fetal heart using color Doppler spatiotemporal image correlation. Forty-four volume data sets were acquired by color Doppler spatiotemporal image correlation. Seven subjects were examined: 4 fetuses without abnormalities, 1 fetus with ventriculomegaly and a hypoplastic cerebellum but normal cardiac anatomy, and 2 fetuses with cardiac anomalies detected by fetal echocardiography (1 case of a ventricular septal defect associated with trisomy 21 and 1 case of a double-inlet right ventricle with a 46,XX karyotype). The median gestational age at the time of examination was 21 3/7 weeks (range, 19 5/7-34 0/7 weeks). Volume data sets were reviewed offline by multiplanar display and volume-rendering methods. Representative images and online video clips illustrating the diagnostic potential of this technology are presented. Color Doppler spatiotemporal image correlation allowed multiplanar visualization of ventricular septal defects, multiplanar display and volume rendering of tricuspid regurgitation, volume rendering of the outflow tracts by color and power Doppler ultrasonography (both in a normal case and in a case of a double-inlet right ventricle with a double-outlet right ventricle), and visualization of venous streams at the level of the foramen ovale. Color Doppler spatiotemporal image correlation has the potential to simplify visualization of the outflow tracts and improve the evaluation of the location and extent of ventricular septal defects. Other applications include 3-dimensional evaluation of regurgitation jets and venous streams at the level of the foramen ovale.

Modified devascularization surgery for isolated gastric varices assessed by endoscopic ultrasonography.

PubMed

Hsieh, J-S; Wang, W-M; Perng, D-S; Huang, C-J; Wang, J-Y; Huang, T-J

2004-04-01

This study aimed to assess the role of endoscopic ultrasonography (EUS) in the surgical management of isolated gastric varices (IGV), and to report the authors' experience in the treatment of IGV with modified devascularization surgery. In this study, 26 cirrhotic patients with IGV were treated with devascularization surgery for variceal hemorrhage. Preoperatively, percutaneous transhepatic portography (PTP) and EUS were used to determine the mode of therapy for IGV. Fundectomy was performed for 14 patients with fundic IGV, whereas 12 patients with cardiac IGV underwent proximal gastrectomy. A significantly higher proportion of patients with cardiac varices showed grade 3 IGV on preoperative EUS than those who had fundic varices (p < 0.05). No major complications were observed during or after the operation, and only one patient died of prolonged shock and massive transfusion. Postoperatively, gastric varices had been eradicated completely in 25 of 26 patients, as determined by EUS study. During a mean follow-up period of 50 months, two patients had recurrent varices without bleeding, as demonstrated by EUS. The overall 5-year survival rate for the fundic IGV group was 67.9%, whereas that for the cardiac IGV group was 64.3% (p > 0.05). This study showed that devascularization surgery is highly effective for the prevention of recurrent bleeding from IGV and provides an alternative treatment method. Preoperatively, EUS is very helpful in detailed devascularization of patients with specific IGV, and may be used also for postoperative follow-up evaluation.

[Contribution of vascular ultrasonography in patients with ischemic strokes in Brazzaville (Congo)].

PubMed

Ikama, S M; Nsitou, B M; Ossou-Nguiet, P M; Otiobanda, G F; Matali, E

2014-05-01

To determine the prevalence of the carotid lesions during ischemic strokes. This was a descriptive cross-sectional study, conducted in Brazzaville from January 2011 to June 2012 in a consecutive series of 73 patients, victims of a transient ischemic attack or ischemic stroke, documented by a brain computed tomography. All patients underwent vascular ultrasonography of the supra-aortic trunks, carried out within the framework of etiological assessment. The examination searched for plaques, parietal infiltration (measurement of intima-media thickness), and carotid stenosis or occlusion. There were 49 men (67%) and 24 women (33%), mean age 58.7 ± 11.8 years. Eleven patients (15%) had a transient ischemic attack and 62 (85%) an ischemic stroke. The identified independent vascular risk factors were known and treated hypertension (n=66, 90.4%), dyslipidemia (n=16, 22%), diabetes mellitus (n=9, 12.3%), and smoking (n=5, 6.8%), with on average 2.5 factors per individual. Vascular ultrasonography of the supra-aortic trunks, normal in 44 patients (60.3%) was pathological in the other 29 (39.7%). The main anomalies were atheromatous plaque (n=10, 13.7%), parietal infiltration (n=19, 26%). On average intima-media thickness was 0.86 ± 0.11 mm on the left and 0.83 ± 0.11 mm on the right. Two cases of moderate stenosis were noted on the right and left internal carotids, respectively. This preliminary study confirms the existence of carotid atherosclerosis anomalies during ischemic strokes. These lesions, though non-significant, must nevertheless be taken into consideration when searching for the cause of stroke in high-risk vascular patients. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Ultrasonography and clinical outcome comparison of extracorporeal shock wave therapy and corticosteroid injections for chronic plantar fasciitis: A randomized controlled trial

PubMed Central

Lai, Ta-Wei; Ma, Hsiao-Li; Lee, Meng-Shiunn; Chen, Po-Ming; Ku, Ming-Chou

2018-01-01

Objectives: Extracorporeal shockwave therapy (ESWT) and corticosteroid injection (CSI) are treatment options for plantar fasciitis. Their clinical outcome comparison remains a debate. Also, the thickness changes of the plantar fascia on objective evaluation under the medium energy ESWT and CSI therapy are elusive. Methods: A total of 97 patients with chronic plantar fasciitis were enrolled in the randomized prospective trial. Forty-seven patients received extracorporeal shock wave therapy (ESWT), and fifty patients received corticosteroid injection (CSI). The thickness of the plantar fascia was evaluated respectively before ESWT and CSI, and at the 4th and 12th week after ESWT and CSI by ultrasonography. Pain level and clinical outcomes were recorded using visual analogue scale (VAS) and 100-points scoring systems. Correlation analysis was performed between the thickness change and clinical outcome. Results: Under ultrasonography, we observed more increase of plantar fascia thickness of ESWT group than CSI group at 4th week (p=0.048). VAS of plantar fasciitis patients receiving ESWT was lower than those who received corticosteroid injection (0.001 and p<0.001, at 4th and 12th week). On the assessment of 100-points scoring systems, the pain level of patients with ESWT was lower than those with CSI at the 12th week (p<0.001). On the other hand, the increase of plantar fascia thickness at 4th week was positively correlated with the decrease of VAS score at 12th week follow-up (R=0.302, P=0.039). Conclusions: At 4th week after treatment, the thickness of plantar fascia increased. Then it decreased gradually, but not to the baseline at 12th week. On the pain level outcome at 12th week, extracorporeal shockwave therapy (ESWT) was more efficient than corticosteroid injection (CSI) on chronic plantar fasciitis. The more change of plantar fascia after ESWT, the more efficient on clinical outcome. PMID:29504578

[Doppler ultrasonography of the renal artery: Guidelines and predictive factors for the presence of a tight stenosis. Retrospective analysis of 450 consecutive examinations].

PubMed

Dejerome, C; Grange, C; De Laforcade, L; Bonin, O; Laville, M; Lermusiaux, P; Long, A

2018-05-01

Duplex ultrasonography screening for renal artery stenosis has been the object of guidelines published by four societies designed to optimize the cost-effectiveness of the examination. To determine how well guideline indications for ultrasonography matched with requests and results in our university hospital; to determine whether compliance with guidelines was predictive of renal artery stenosis; to identify guidelines predictive of presence of stenosis; and to determine whether other predictive factors can be recognized. Requests and results of 450 Duplex ultrasonography examinations of the renal arteries performed from January 1st 2014 to December 31st 2015 were compared with published guidelines. At least one guideline indication was identified for 212 of the 450 examinations performed (47.1%). Among these examinations, renal artery stenosis≥70% was identified in 18 patients (8.0%). No case of stenosis was identified during examinations performed outside guideline indications. Factors predictive of stenosis were: compliance with guidelines (OR=21.86 [2.88; 165.8]). Predictive guidelines were: resistant hypertension in spite of appropriate treatment (OR=3.85, [1.44; 10.33], P=0.011), accelerated hypertension (OR=7.30, [1.40; 37.99], P=0.049), sudden unexplained pulmonary edema (OR=7.30, [1.40; 37.99], P=0.049), unexplained renal insufficiency (OR=3.58, [1.37; 9.37], P=0.011), unexplained renal hypotrophy (OR=16.69, [4.38; 63.69], P<0.001), renal asymmetry (OR=4.32, [1.45; 12.85], P<0.016). No other factor was predictive of renal stenosis. These examinations had therapeutic consequences in only 50% of patients. This study confirms the relevance of published guidelines. The diagnostic-effectiveness of Duplex ultrasonography examinations to search for renal artery stenosis depends upon compliance with these guidelines. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Real-time detection of gastric insufflation related to facemask pressure-controlled ventilation using ultrasonography of the antrum and epigastric auscultation in nonparalyzed patients: a prospective, randomized, double-blind study.

PubMed

Bouvet, Lionel; Albert, Marie-Laure; Augris, Caroline; Boselli, Emmanuel; Ecochard, René; Rabilloud, Muriel; Chassard, Dominique; Allaouchiche, Bernard

2014-02-01

The authors sought to determine the level of inspiratory pressure minimizing the risk of gastric insufflation while providing adequate pulmonary ventilation. The primary endpoint was the increase in incidence of gastric insufflation detected by ultrasonography of the antrum while inspiratory pressure for facemask pressure-controlled ventilation increased from 10 to 25 cm H2O. In this prospective, randomized, double-blind study, patients were allocated to one of the four groups (P10, P15, P20, and P25) defined by the inspiratory pressure applied during controlled-pressure ventilation: 10, 15, 20, and 25 cm H2O. Anesthesia was induced using propofol and remifentanil; no neuromuscular-blocking agent was administered. Once loss of eyelash reflex occurred, facemask ventilation was started for a 2-min period while gastric insufflation was detected by auscultation and by real-time ultrasonography of the antrum. The cross-sectional antral area was measured using ultrasonography before and after facemask ventilation. Respiratory parameters were recorded. Sixty-seven patients were analyzed. The authors registered statistically significant increases in incidences of gastric insufflation with inspiratory pressure, from 0% (group P10) to 41% (group P25) according to auscultation, and from 19 to 59% according to ultrasonography. In groups P20 and P25, detection of gastric insufflation by ultrasonography was associated with a statistically significant increase in the antral area. Lung ventilation was insufficient for group P10. Inspiratory pressure of 15 cm H2O allowed for reduced occurrence of gastric insufflation with proper lung ventilation during induction of anesthesia with remifentanil and propofol in nonparalyzed and nonobese patients. (Anesthesiology 2014; 120:326-34).

Validation of color Doppler ultrasonography for evaluating the uterine blood flow and perfusion during late normal pregnancy and uterine torsion in buffaloes.

PubMed

Hussein, Hassan A

2013-04-15

The aim of this study was to verify the efficacy of color Doppler ultrasonography for diagnosis of degree and duration of uterine torsion in buffaloes. In Assiut province/Upper Egypt, 65 buffaloes (37 with uterine torsion, 28 with normal late pregnancy) were examined clinically and using Doppler ultrasonography. The Doppler indices including resistance index (RI), pulsatility index (PI), time-averaged maximum velocity (TAMV), and blood flow volume (BFV) in the arteries ipsilateral to the uterine torsion (IPUT) and in arteries contralateral to the uterine torsion (COUT) were recorded. Methods of correction were documented along with dam and calf survival. Torsion was recorded postcervically with vaginal involvement in 35/37 (94.6%) of the cases. The degrees of uterine torsion were light and high in 9/37 (24.3%) and 28/37 (75.7%) of the cases, respectively (P = 0.001). Right uterine torsion was present in 36/37 (97.3%) of the cases (P = 0.0001). Pulsatility index, RI, TAMV, and BFV in IPUT and COUT did not differ significantly (P > 0.05) in normal late pregnancy. The PI and RI in IPUT were significantly higher (P < 0.01) than in COUT, and the TAMV and BFV in IPUT were less (P < 0.001) than that in COUT in uterine torsion. The PI and RI of torsion cases in IPUT were higher (P < 0.001) than that in normal pregnancy. Time-averaged maximum velocity and BFV in torsion cases were lower (P < 0.01) than that of normal pregnancy in IPUT. There was approximately 50% of RI and PI higher than in light degree uterine torsion in IPUT (P < 0.001). Consequently, TAMV and BFV were greatly lower (P < 0.0001) than that in light degree in IPUT. Pulsatility index and RI were positively correlated (r = 0.856; P < 0.001) with the duration and degree of the uterine torsion, and TAMV and BFV were negatively correlated (r = -0.763; P < 0.001). In all cases of uterine torsion the uterine flow velocity waveform showed high systolic flow and absence of early diastolic flow and poor uterine and

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gurel, Kamil; Karabay, Oguz; Gurel, Safiye

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 ofmore » 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.« less

Encapsulated Papillary Carcinoma in A Man with Gynecomastia: Ultrasonography, Mammography and Magnetic Resonance Imaging Features with Pathologic Correlation.

PubMed

Yılmaz, Ravza; Cömert, Rana Günöz; Aliyev, Samil; Toktaş, Yücel; Önder, Semen; Emirikçi, Selman; Özmen, Vahit

2018-04-01

Male breast cancer is an uncommon disease that constitutes 1% of all breast cancers and encapsulated papillary carcinoma (EPC) is a rare subtype of malignant male diseases. Gynecomastia is the most common disease of the male breast. We report a 63-year-old male patient with EPC accompanied by gynecomastia that was diagnosed and treated at our breast center. Mammography showed an oval-shaped dense mass with circumscribed margins on the ground of nodular gynecomastia. On ultrasonographic exam, we saw a well-circumscribed complex mass with a solid component which was vascular on Doppler ultrasonography. Magnetic resonance imaging revealed a complex cystic mass containing solid components. Dynamic images showed enhancement of the cystic mass wall and mural components. Tumor stage was evaluated as T2N0. The lesion's histologic examination and immunohistochemical analysis by showing no myoepithelial layer revealed an encapsulated papillary carcinoma. To our knowledge, this is the first case report which describes MR imaging findings of male breast encapsulated papillary cancer.

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

PubMed Central

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

2011-01-01

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

Painless thyroiditis associated to thyroid carcinoma: role of initial ultrasonography evaluation.

PubMed

Valentini, Raisa Bressan; Macedo, Bruno Mussoi de; Izquierdo, Rogério Friedrich; Meyer, Erika Laurini Souza

2016-04-01

Even though it is a rare event, most associations of thyroid carcinoma with subacute thyroiditis described in the literature are related to its granulomatous form (Quervain's thyroiditis). We present a patient with subacute lymphocytic thyroiditis (painless thyroiditis) and papillary thyroid cancer that was first suspected in an initial ultrasound evaluation. A 30-year old female patient who was referred to the emergency room due to hyperthyroidism symptoms was diagnosed with painless thyroiditis established by physical examination and laboratory findings. With the presence of a palpable painless thyroid nodule an ultrasound was prescribed and the images revealed a suspicious thyroid nodule, microcalcification focus in the heterogeneous thyroid parenquima and cervical lymphadenopathy. Fine needle aspiration biopsy was taken from this nodule; cytology was assessed for compatibility with papillary thyroid carcinoma. Postsurgical pathology evaluation showed a multicentric papillary carcinoma and lymphocytic infiltration. Subacute thyroiditis, regardless of type, may produce transitory ultrasound changes that obscure the coexistence of papillary carcinoma. Due to this, initial thyroid ultrasound evaluation should be delayed until clinical recovery. We recommended a thyroid ultrasound exam for initial evaluation of painless thyroiditis, particularly in patients with palpable thyroid nodule. Further cytological examination is recommended in cases presenting with suspect thyroid nodule and/or non-nodular hypoechoic (> 1 cm) or heterogeneous areas with microcalcification focus.

Fixed-Wing Micro Aerial Vehicle for Accurate Corridor Mapping

NASA Astrophysics Data System (ADS)

Rehak, M.; Skaloud, J.

2015-08-01

In this study we present a Micro Aerial Vehicle (MAV) equipped with precise position and attitude sensors that together with a pre-calibrated camera enables accurate corridor mapping. The design of the platform is based on widely available model components to which we integrate an open-source autopilot, customized mass-market camera and navigation sensors. We adapt the concepts of system calibration from larger mapping platforms to MAV and evaluate them practically for their achievable accuracy. We present case studies for accurate mapping without ground control points: first for a block configuration, later for a narrow corridor. We evaluate the mapping accuracy with respect to checkpoints and digital terrain model. We show that while it is possible to achieve pixel (3-5 cm) mapping accuracy in both cases, precise aerial position control is sufficient for block configuration, the precise position and attitude control is required for corridor mapping.

Primary Neuroendocrine Breast Carcinoma in a 13-Year-Old Girl: Ultrasonography and Pathology Findings

PubMed Central

Folligan, Koué; Sabi, Akomola; Sonhaye, Lantam; Boumé, Azanledji; Bassowa, Akila; Adani-Ifé, Solange; Napo-Koura, Gado

2017-01-01

Neuroendocrine carcinoma (NEC) of the breast is a rare disease and has been scarcely reported by African authors. The authors report a case of breast NEC in a 13-year-old African girl initially diagnosed as an atypical adenofibroma by ultrasonography. Ultrasound-guided biopsy and conventional histological examination indicated two potential diagnoses: primary malignant non-Hodgkin's lymphoma and undifferentiated carcinoma. According to immunohistochemistry performed on paraffin blocks in France, infiltrating ductal carcinoma with a strong neuroendocrine component was confirmed by CD56, CD57, and chromogranin A markers. PMID:29082059

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

PubMed

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

2015-11-21

Fetal growth restriction is a major determinant of adverse perinatal outcome. Screening procedures for fetal growth restriction need to identify small babies and then differentiate between those that are healthy and those that are pathologically small. We sought to determine the diagnostic effectiveness of universal ultrasonic fetal biometry in the third trimester as a screening test for small-for-gestational-age (SGA) infants, and whether the risk of morbidity associated with being small differed in the presence or absence of ultrasonic markers of fetal growth restriction. The Pregnancy Outcome Prediction (POP) study was a prospective cohort study of nulliparous women with a viable singleton pregnancy at the time of the dating ultrasound scan. Women participating had clinically indicated ultrasonography in the third trimester as per routine clinical care and these results were reported as usual (selective ultrasonography). Additionally, all participants had research ultrasonography, including fetal biometry at 28 and 36 weeks' gestational age. These results were not made available to participants or treating clinicians (universal ultrasonography). We regarded SGA as a birthweight of less than the 10th percentile for gestational age and screen positive for SGA an ultrasonographic estimated fetal weight of less than the 10th percentile for gestational age. Markers of fetal growth restriction included biometric ratios, utero-placental Doppler, and fetal growth velocity. We assessed outcomes for consenting participants who attended research scans and had a livebirth at the Rosie Hospital (Cambridge, UK) after the 28 weeks' research scan. Between Jan 14, 2008, and July 31, 2012, 4512 women provided written informed consent of whom 3977 (88%) were eligible for analysis. Sensitivity for detection of SGA infants was 20% (95% CI 15-24; 69 of 352 fetuses) for selective ultrasonography and 57% (51-62; 199 of 352 fetuses) for universal ultrasonography (relative sensitivity 2�

Lung Ultrasonography: A Viable Alternative to Chest Radiography in Children with Suspected Pneumonia?

PubMed

Ambroggio, Lilliam; Sucharew, Heidi; Rattan, Mantosh S; O'Hara, Sara M; Babcock, Diane S; Clohessy, Caitlin; Steinhoff, Mark C; Macaluso, Maurizio; Shah, Samir S; Coley, Brian D

2016-09-01

To determine the interrater reliability (IRR) of lung ultrasonography (LUS) and chest radiography (CXR) and evaluate the accuracy of LUS compared with CXR for detecting pediatric pneumonia compared with chest computed tomography (CT) scan. This was a prospective cohort study of children aged 3 months to 18 years with a CXR and LUS performed between May 1, 2012, and January 31, 2014 with or without a clinical diagnosis of pneumonia. Four pediatric radiologists blinded to clinical information reported findings for the CXR and LUS images. IRR was estimated for 50 LUS and CXR images. The main outcome was the finding from CT ordered clinically or the probability of the CT finding for patients clinically requiring CT. Two radiologists reviewed CT scans to determine an overall finding. Latent class analysis was used to evaluate the sensitivity and specificity for findings (eg, consolidation) for LUS and CXR compared with CT. Of the 132 patients in the cohort, 36 (27%) had CT performed for a clinical reason. Pneumonia was clinically documented in 47 patients (36%). The IRR for lung consolidation was 0.55 (95% CI, 0.40-0.70) for LUS and 0.36 (95% CI, 0.21-0.51) for CXR. The sensitivity for detecting consolidation, interstitial disease, and pleural effusion was statistically similar for LUS and CXR compared with CT; however, specificity was higher for CXR. The negative predictive value was similar for CXR and LUS. LUS has a sufficiently high IRR for detection of consolidation. Compared with CT, LUS and CXR have similar sensitivity, but CXR is more specific for findings indicating pneumonia. Copyright © 2016 Elsevier Inc. All rights reserved.

Fast and accurate computation of projected two-point functions

NASA Astrophysics Data System (ADS)

Grasshorn Gebhardt, Henry S.; Jeong, Donghui

2018-01-01

We present the two-point function from the fast and accurate spherical Bessel transformation (2-FAST) algorithm1Our code is available at https://github.com/hsgg/twoFAST. for a fast and accurate computation of integrals involving one or two spherical Bessel functions. These types of integrals occur when projecting the galaxy power spectrum P (k ) onto the configuration space, ξℓν(r ), or spherical harmonic space, Cℓ(χ ,χ'). First, we employ the FFTLog transformation of the power spectrum to divide the calculation into P (k )-dependent coefficients and P (k )-independent integrations of basis functions multiplied by spherical Bessel functions. We find analytical expressions for the latter integrals in terms of special functions, for which recursion provides a fast and accurate evaluation. The algorithm, therefore, circumvents direct integration of highly oscillating spherical Bessel functions.

Competency-based assessment in surgeon-performed head and neck ultrasonography: A validity study.

PubMed

Todsen, Tobias; Melchiors, Jacob; Charabi, Birgitte; Henriksen, Birthe; Ringsted, Charlotte; Konge, Lars; von Buchwald, Christian

2018-06-01

Head and neck ultrasonography (HNUS) increasingly is used as a point-of-care diagnostic tool by otolaryngologists. However, ultrasonography (US) is a very operator-dependent image modality. Hence, this study aimed to explore the diagnostic accuracy of surgeon-performed HNUS and to establish validity evidence for an objective structured assessment of ultrasound skills (OSAUS) used for competency-based assessment. A prospective experimental study. Six otolaryngologists and 11 US novices were included in a standardized test setup for which they had to perform focused HNUS of eight patients suspected for different head and neck lesions. Their diagnostic accuracy was calculated based on the US reports, and two blinded raters assessed the video-recorded US performance using the OSAUS scale. The otolaryngologists obtained a high diagnostic accuracy on 88% (range 63%-100%) compared to the US novices on 38% (range 0-63%); P < 0.001. The OSAUS score demonstrated good inter-case reliability (0.85) and inter-rater reliability (0.76), and significant discrimination between otolaryngologist and US novices; P < 0.001. A strong correlation between the OSAUS score and the diagnostic accuracy was found (Spearman's ρ, 0.85; P < P 0.001), and a pass/fail score was established at 2.8. Strong validity evidence supported the use of the OSAUS scale to assess HNUS competence with good reliability, significant discrimination between US competence levels, and a strong correlation of assessment score to diagnostic accuracy. An OSAUS pass/fail score was established and could be used for competence-based assessment in surgeon-performed HNUS. NA. Laryngoscope, 128:1346-1352, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Multimodal imaging evaluation in staging of rectal cancer

PubMed Central

Heo, Suk Hee; Kim, Jin Woong; Shin, Sang Soo; Jeong, Yong Yeon; Kang, Heoung-Keun

2014-01-01

Rectal cancer is a common cancer and a major cause of mortality in Western countries. Accurate staging is essential for determining the optimal treatment strategies and planning appropriate surgical procedures to control rectal cancer. Endorectal ultrasonography (EUS) is suitable for assessing the extent of tumor invasion, particularly in early-stage or superficial rectal cancer cases. In advanced cases with distant metastases, computed tomography (CT) is the primary approach used to evaluate the disease. Magnetic resonance imaging (MRI) is often used to assess preoperative staging and the circumferential resection margin involvement, which assists in evaluating a patient’s risk of recurrence and their optimal therapeutic strategy. Positron emission tomography (PET)-CT may be useful in detecting occult synchronous tumors or metastases at the time of initial presentation. Restaging after neoadjuvant chemoradiotherapy (CRT) remains a challenge with all modalities because it is difficult to reliably differentiate between the tumor mass and other radiation-induced changes in the images. EUS does not appear to have a useful role in post-therapeutic response assessments. Although CT is most commonly used to evaluate treatment responses, its utility for identifying and following-up metastatic lesions is limited. Preoperative high-resolution MRI in combination with diffusion-weighted imaging, and/or PET-CT could provide valuable prognostic information for rectal cancer patients with locally advanced disease receiving preoperative CRT. Based on these results, we conclude that a combination of multimodal imaging methods should be used to precisely assess the restaging of rectal cancer following CRT. PMID:24764662

Prevalence of and risk factors for gallbladder polyps detected by ultrasonography among healthy Chinese: analysis of 34 669 cases.

PubMed

Lin, Wey-Ran; Lin, Deng-Yn; Tai, Dar-In; Hsieh, Sen-Yung; Lin, Chun-Yen; Sheen, I-Shyan; Chiu, Cheng-Tang

2008-06-01

Gallbladder (GB) polyps are tumor or tumor-like projections arising from GB mucosa. Although most polyps are benign, some early GB carcinomas present as polypoid lesions. The diagnosis of GB polyps is relatively easy by ultrasonography. Although numerous studies have investigated GB polyps, few studies have addressed the prevalence of and factors associated with GB polyps for specific ethnic populations. This study analyzes the prevalence and factors associated with GB polyps in a Chinese population who can afford a paid general checkup. The prevalence of and risk factors for GB polyps diagnosed by ultrasonography were retrospectively investigated in 34 669 Chinese patients who underwent a general checkup at Chang Gung Memorial Hospital (Taipei, Taiwan) between 2000 and 2003. Demographic, hemogram, serum biochemistry, hepatitis B surface antigen, hepatitis C antibody, and ultrasonography study data was available for all the patients. The correlations between the prevalence of GB polyps and age, sex, body height, body weight, body mass index, hemogram, serum biochemistry, and viral markers were examined for all the patients. Excluding the patients who underwent cholecystectomy, the overall prevalence of GB polyps was 9.5% and highest for middle-aged males. The analyzed risk factors with increased odds ratios (OR) for the development of GB polyps were male sex (OR 0.646, P < 0.0005) and hepatitis B virus surface antigen positivity (OR 1.113, P < 0.0005). Other demographic characteristics and biochemical parameters, including body height, body weight, body mass index, lipid profile, chronic hepatitis C virus infection, and liver function did not correlate with the presence of GB polyps. The prevalence of GB polyps among the Chinese in this study is higher than that reported for other populations. Chinese males and other patients with chronic hepatitis B viral infections have a high risk for developing GB polyps.

Comparative Diagnostic Performance of Ultrasonography and 99mTc-Sestamibi Scintigraphy for Parathyroid Adenoma in Primary Hyperparathyroidism; Systematic Review and Meta- Analysis

PubMed

Nafisi Moghadam, Reza; Amlelshahbaz, Amir Pasha; Namiranian, Nasim; Sobhan-Ardekani, Mohammad; Emami-Meybodi, Mahmood; Dehghan, Ali; Rahmanian, Masoud; Razavi-Ratki, Seid Kazem

2017-12-28

Objective: Ultrasonography (US) and parathyroid scintigraphy (PS) with 99mTc-MIBI are common methods for preoperative localization of parathyroid adenomas but there discrepancies exist with regard to diagnostic accuracy. The aim of the study was to compare PS and US for localization of parathyroid adenoma with a systematic review and meta-analysis of the literature. Methods: Pub Med, Scopus (EMbase), Web of Science and the reference lists of all included studies were searched up to 1st January 2016. The search strategy was according PICO characteristics. Heterogeneity between the studies was accounted by P < 0.1. Point estimates were pooled estimate of sensitivity, specificity and positive predictive value of SPECT and ultrasonography with 99% confidence intervals (CIs) by pooling available data. Data analysis was performed using Meta-DiSc software (version 1.4). Results: Among 188 studies and after deletion of duplicated studies (75), a total of 113 titles and abstracts were studied. From these, 12 studies were selected. The meta-analysis determined a pooled sensitivity for scintigraphy of 83% [99% confidence interval (CI) 96.358 -97.412] and for ultra-sonography of 80% [99% confidence interval (CI) 76-83]. Similar results for specificity were also obtained for both approache. Conclusion: According this meta- analysis, there were no significant differences between the two methods in terms of sensitivity and specificity. There were overlaps in 99% confidence intervals. Also features of the two methods are similar. Creative Commons Attribution License

Perivascular epithelioid cell tumor (PEComa) of the liver diagnosed by contrast-enhanced ultrasonography.

PubMed

Akitake, Reiko; Kimura, Hiroyuki; Sekoguchi, Satoru; Nakamura, Hideki; Seno, Hiroshi; Chiba, Tsutomu; Fujimoto, Sotaro

2009-01-01

Perivascular epithelioid cell (PEC) is a unique cell which expresses both myogenic and melanocytic markers, and forms PEComa. A 36-year-old woman presented with a 35 mm-diameter liver tumor. MRI showed poor fat component in the tumor. Contrast-enhanced ultrasonography using the newly developed enhancing reagent, Sonazoid, clearly demonstrated early-phase enhancement of the tumor and rapid drainage of the reagent to veins, suggesting a PEComa. Lateral segmentectomy of the liver was performed. Histologically, epithelioid tumor cells around the vessels were immunostained with both HMB-45 and alpha-smooth muscle actin, confirming the diagnosis of PEComa. No recurrence has been found for 18 months following the operation.

Early diagnosis of Budd-Chiari syndrome by computed tomography and ultrasonography: report of five cases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baert, A.L.; Fevery, J.; Marchal, G.

1983-03-01

In 5 patients with Budd-Chiari syndrome, computed tomography after intravenous bolus injection of iodinated contrast agents demonstrated images not previously seen in other diseases. The images are compatible with stagnation of contrast material at the periphery of the liver. In 3 of the 5 cases, grey-scale ultrasonography failed to document the normal hepatic veins draining into the inferior caval vein, but showed an intrahepatic network of comma-shaped venous structures. It is proposed that these two noninvasive approaches can help in establishing an early diagnosis.

Comparison of gray-scale contrast-enhanced ultrasonography with contrast-enhanced computed tomography in different grading of blunt hepatic and splenic trauma: an animal experiment.

PubMed

Tang, Jie; Li, Wenxiu; Lv, Faqin; Zhang, Huiqin; Zhang, Lihai; Wang, Yuexiang; Li, Junlai; Yang, Li

2009-04-01

To compare the diagnostic value of contrast-enhanced ultrasonography (CEUS) with contrast-enhanced computed tomography (CECT) for the detection of different grading of solid organ injuries in blunt abdominal trauma in animals. A self-made miniature tools were used as models to simulate a blunt hepatic or splenic trauma in 16 and 14 anesthetized dogs, respectively. Baseline ultrasound, CEUS and CECT were used to detect traumatic injuries of livers and spleens. The degree of injuries was determined by CEUS according to the American Association for the Surgery of Trauma (AAST) scale and the results compared with injury scale based on CECT evaluation. CEUS showed 22 hepatic injury sites in 16 animals and 17 splenic injury sites in other 14 animals. According to AAST scale, 2 grade I, 4 grade II, 3 grade III, 5 grade IV and 2 grade V hepatic lesions were present in 16 animals; 2 grade I, 4 grade II, 6 grade III and 2 grade IV splenic lesions in 14 animals. On CECT scan, 21 hepatic and 17 splenic injuries were demonstrated. According to Becker CT scaling for hepatic injury, 1 grade I, 2 grade II, 4 grade III, 5 grade IV and 2 grade V hepatic injuries were present. On the basis of Buntain spleen scaling, 2 grade I, 5 grade II, 5 grade III, 2 grade IV splenic injuries were showed. After Spearman rank correlation analysis, the agreement of CEUS with CECT on the degree of hepatic and splenic injury is 93.3% and 92.9%, respectively. CT is currently considered as the reference method for grading blunt abdominal trauma, according to experiment results, CEUS grading showed high levels of concordance with CECT. CEUS can accurately determine the degree of injury and will play an important role in clinical application.

Core needle biopsy of soft tissue tumors, CEUS vs US guided: a pilot study.

PubMed

Coran, Alessandro; Di Maggio, Antonio; Rastrelli, Marco; Alberioli, Enrico; Attar, Shady; Ortolan, Paolo; Bortolanza, Carlo; Tosi, Annalisa; Montesco, Maria Cristina; Bezzon, Elisabetta; Rossi, Carlo Riccardo; Stramare, Roberto

2015-12-01

The purpose of this study was to evaluate the usefulness of contrast-enhanced ultrasonography (CEUS) in the bioptic sampling of soft tissue tumors (STT) compared with unenhanced ultrasonography alone. This is a prospective longitudinal study of 40 patients subjected to ultrasonography (US)-guided core needle biopsy (CNB) to characterize a suspected STT. Three series of bioptic samplings were carried out on each patient, respectively using unenhanced US alone and CEUS in both the areas of the tumor enhanced or not by the contrast medium. All bioptic samples underwent a histological evaluation and the results were analyzed by comparing the histology of the biopsy with the definitive diagnosis in 15 surgically excised samples. 27 (67.5 %) of the 40 patients completed the entire study procedure; in 19 cases (70.3 %) the three bioptic samplings gave unanimous results, also when compared to the surgical specimen; in seven cases (25.9 %) use of CEUS allowed to obtain additional or more accurate information about the mass in question, compared to simple US guidance without contrast; in one patient (3.7 %) sampling obtained using unenhanced ultrasonography guidance and in the areas enhanced by the contrast agent had precisely the same results of the surgical specimen. CEUS, due to its ability to evaluate microvascular areas, has proven to be a promising method in guiding bioptic sampling of soft tissue tumor, directing the needle to the most significant areas of the tumor. Given the small number of patients evaluated in our study, to achieve statistically significant results, it would be appropriate to obtain a larger sample size, since the very first results seem to be encouraging and to justify the increase of the population.

Magnetic Resonance Imaging Verification of a Case of Sacrococcygeal Teratoma.

PubMed

Dedushi, Kreshnike; Kabashi, Serbeze; Mucaj, Sefedin; Ramadani, Naser; Hoxhaj, Astrit; Shatri, Jeton; Hasbahta, Gazmend

2016-08-01

Although rare, sacrococcygeal teratoma is the most common congenital neoplasm, occurring in 1 in 40,000 infants. Approximately 75% of affected infants are female. The aim of the present study was to correlate ultrasonography and magnetic resonance imaging (MRI) findings in patients with fetal sacrococcygeal teratoma. Three pregnant women in 27th week of gestation underwent fetal MRI after ultrasonography examination, with findings suggestive for fetal sacrococcygeal teratoma. Tumor size, location, extent and content were evaluated both by MRI and ultrasonography. Findings regarding tumor location, size and content were similar for both methods. There was a large well-circumscribed mixed, cystic/solid oval mass, originating from right sacro-gluteal region and projecting into the amniotic cavity, 132 × 110 × 76 mm in size. The mass had a heterogeneous appearance. The T1 high signal suggested fat component of the tumor, while T1 and T2 hypointense components suggested calcified/bony components. There was also T1 hypointense component consistent with cystic and fluid component. The imaging findings were characteristic for sacrococcygeal teratoma. There was not obvious lumbar or thoracic spinal involvement. There was no gross intrapelvic or abdominal extension, and even sacrum and coccyx appeared deformed. The amount of amniotic fluid was increased. MRI was superior to ultrasonography in the evaluation of the exact tumor extent, accurately demonstrating pelvic involvement in all of the three cases. Fetal MRI has shown to be a valuable adjunct to obstetric sonography in the evaluation of fetal sacrococcygeal teratoma, because of its higher accuracy in the determination of tumors extent and content, playing a significant role in the therapeutic planning and increasing the chances of cure for these fetuses.

Magnetic Resonance Imaging Verification of a Case of Sacrococcygeal Teratoma

PubMed Central

Dedushi, Kreshnike; Kabashi, Serbeze; Mucaj, Sefedin; Ramadani, Naser; Hoxhaj, Astrit; Shatri, Jeton; Hasbahta, Gazmend

2016-01-01

Although rare, sacrococcygeal teratoma is the most common congenital neoplasm, occurring in 1 in 40,000 infants. Approximately 75% of affected infants are female. The aim of the present study was to correlate ultrasonography and magnetic resonance imaging (MRI) findings in patients with fetal sacrococcygeal teratoma. Three pregnant women in 27th week of gestation underwent fetal MRI after ultrasonography examination, with findings suggestive for fetal sacrococcygeal teratoma. Tumor size, location, extent and content were evaluated both by MRI and ultrasonography. Findings regarding tumor location, size and content were similar for both methods. There was a large well-circumscribed mixed, cystic/solid oval mass, originating from right sacro-gluteal region and projecting into the amniotic cavity, 132 × 110 × 76 mm in size. The mass had a heterogeneous appearance. The T1 high signal suggested fat component of the tumor, while T1 and T2 hypointense components suggested calcified/bony components. There was also T1 hypointense component consistent with cystic and fluid component. The imaging findings were characteristic for sacrococcygeal teratoma. There was not obvious lumbar or thoracic spinal involvement. There was no gross intrapelvic or abdominal extension, and even sacrum and coccyx appeared deformed. The amount of amniotic fluid was increased. MRI was superior to ultrasonography in the evaluation of the exact tumor extent, accurately demonstrating pelvic involvement in all of the three cases. Fetal MRI has shown to be a valuable adjunct to obstetric sonography in the evaluation of fetal sacrococcygeal teratoma, because of its higher accuracy in the determination of tumors extent and content, playing a significant role in the therapeutic planning and increasing the chances of cure for these fetuses. PMID:28983369

Prenatal and accurate perinatal diagnosis of type 2 H or ductular duplicate gallbladder.

PubMed

Maggi, Umberto; Farris, Giorgio; Carnevali, Alessandra; Borzani, Irene; Clerici, Paola; Agosti, Massimo; Rossi, Giorgio; Leva, Ernesto

2018-02-07

Double gallbladder is a rare biliary anomaly. Perinatal diagnosis of the disorder has been reported in only 6 cases, and in 5 of them the diagnosis was based on ultrasound imaging only. However, the ultrasound technique alone does not provide a sufficiently precise description of cystic ducts and biliary anatomy, an information that is crucial for a correct classification and for a possible future surgery. At 21 weeks of gestational age of an uneventful pregnancy in a 38 year old primipara mother, a routine ultrasound screening detected a biliary anomaly in the fetus suggestive of a double gallbladder. A neonatal abdominal ultrasonography performed on postnatal day 2 confirmed the diagnosis. On day 12 the newborn underwent a Magnetic Resonance Cholangiopancreatography (MRCP) that clearly characterized the anatomy of the anomaly: both gallbladders had their own cystic duct and both had a separate insertion in the main biliary duct. We report a case of early prenatal suspected duplicate gallbladder that was confirmed by a neonatal precise diagnosis of a Type 2, H or ductular duplicate gallbladder, using for the first time 3D images of Magnetic resonance cholangiopancreatography in a newborn. An accurate anatomical diagnosis is mandatory in patients undergoing a possible future cholecystectomy, to avoid surgical complications or reoperations. Therefore, in case of a perinatal suspicion of a double gallbladder, neonates should undergo a Magnetic resonance cholangiopancreatography. A review of the Literature about this variant is included.

Washout Ratio in the Hepatic Vein Measured by Contrast-Enhanced Ultrasonography to Distinguish Between Inflammatory and Noninflammatory Hepatic Disorders in Dogs.

PubMed

Morishita, K; Hiramoto, A; Michishita, A; Takagi, S; Osuga, T; Lim, S Y; Nakamura, K; Sasaki, N; Ohta, H; Takiguchi, M

2017-05-01

Perflubutane microbubbles, a second-generation ultrasound contrast agent, are phagocytized by Kupffer cells. This characteristic may be useful to differentiate diffuse hepatic diseases in dogs. To determine whether the washout ratio in the hepatic vein (HV) measured by contrast-enhanced ultrasonography (CEUS) can distinguish between inflammatory and noninflammatory hepatic disorders in dogs. Forty-one client-owned dogs with hepatic disorders including 14 with hepatitis, 7 with primary hypoplasia of the portal vein (PHPV), 9 with congenital portosystemic shunt (cPSS), and 11 with other hepatopathy were enrolled. Six dogs without hepatic disease also were evaluated as healthy controls. Dogs with hepatic disorders were prospectively included. Contrast-enhanced ultrasonography of the HV was performed for 2 minutes. Washout ratio was defined as the attenuation rate from peak intensity to the intensity at the end of the CEUS study. Washout ratio in the hepatitis group (median, 18.0%; range, 2.0-37.0%) was significantly lower than that of the PHPV (median, 52.2%; range, 11.5-86.3%), cPSS (median, 60.0%; range, 28.6-77.4%), other hepatopathy (median, 70.5%; range, 26.6-88.4%), and normal (median, 78.0%; range, 60.7-91.7%) groups. The area under the receiver operating characteristic curve for hepatitis was 0.960, with a 95% confidence interval (CI) of 0.853-0.990. Washout ratio ≤37.1% resulted in a sensitivity of 100% (95% CI, 78.5-100%) and specificity of 85.2% (95% CI, 67.5-94.1%) for the prediction of hepatitis. Washout ratio can distinguish hepatitis from the other noninflammatory disorders with high accuracy. This result might reflect impaired Kupffer cell phagocytosis in dogs with hepatitis. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Residual gastric volume evaluation with ultrasonography after ingestion of carbohydrate- or carbohydrate plus glutamine-enriched beverages: a randomized, crossover clinical trial with healthy volunteers.

PubMed

Gomes, Paulo Cesar; Caporossi, Cervantes; Aguilar-Nascimento, Jose Eduardo; Silva, Ageo Mario Candido da; Araujo, Viviane Maeve Tavares de

2017-01-01

- Abbreviation of preoperative fasting to 2 hours with maltodextrin (CHO)-enriched beverage is a safe procedure and may enhance postoperative recovery. Addition of glutamine (GLN) to CHO beverages may include potential benefits to the metabolism. However, by adding a nitrogenous source to CHO beverages, gastric emptying may be delayed and increase the risk of bronchoaspiration during anesthesia. - In this study of safety, we aimed at investigating the residual gastric volume (RGV) 2 hours after the intake of either CHO beverage alone or CHO beverage combined with GLN. - We performed a randomized, crossover clinical trial. We assessed RGV by means of abdominal ultrasonography (US) in 20 healthy volunteers (10 males and 10 females) after an overnight fast of 8 hours. Then, they were randomized to receive 600 mL (400 mL immediately after US followed by another 200 mL 2 hours afterwards) of either CHO (12.5% maltodextrin) or CHO-GLN (12.5% maltodextrin plus 15 g GLN). Two sequential US evaluations were done at 120 and 180 minutes after ingestion of the second dose. The interval of time between ingestion of the two types of beverages was 2 weeks. - The mean (SD) RGV observed after 8 hours fasting (13.56±13.25 mL) did not statistically differ (P>0.05) from the RGV observed after ingesting CHO beverage at both 120 (16.32±11.78 mL) and 180 minutes (14.60±10.39 mL). The RGV obtained at 120 (15.63±18.83 mL) and 180 (13.65±10.27 mL) minutes after CHO-GLN beverage also was not significantly different from the fasting condition. - The RGV at 120 and 180 minutes after ingestion of CHO beverage combined with GLN is similar to that observed after an overnight fast.

Early Psoriatic Arthritis Versus Early Seronegative Rheumatoid Arthritis: Role of Dermoscopy Combined with Ultrasonography for Differential Diagnosis.

PubMed

Zabotti, Alen; Errichetti, Enzo; Zuliani, Francesca; Quartuccio, Luca; Sacco, Stefania; Stinco, Giuseppe; De Vita, Salvatore

2018-05-01

Exclusion of psoriatic skin/nail lesions is important in differentiating early seronegative rheumatoid arthritis (ERA) from early polyarticular psoriatic arthritis (EPsA) and such manifestations may go unnoticed in atypical or minimally expressed cases. The aim of this study is to assess the usefulness of integrated rheumatological-dermatological evaluation in highlighting dermatological lesions missed on rheumatological examination and to investigate the role of ultrasonography (US) and dermoscopy in improving the recognition of subclinical psoriatic findings. Patients with a new diagnosis of seropositive or seronegative ERA and EPsA with prevalent hands involvement were recruited. All were reassessed for the presence of psoriatic lesions during an integrated rheumatological-dermatological clinical evaluation and underwent hands US and proximal nailfold dermoscopy. Seventy-three consecutive subjects were included in the study: 25 with seropositive ERA, 23 with seronegative ERA, and 25 with EPsA. One-fourth of the subjects initially diagnosed as seronegative ERA presented cutaneous or nail psoriasis on integrated rheumatological-dermatological evaluation, thereby being reclassified as EPsA. The presence of at least 1 extrasynovial feature on hand US and dotted vessels on proximal nailfold dermoscopy was significantly associated with EPsA, with a sensitivity of 68.0% and 96.0% and a specificity of 88.1% and 83.3% for US and dermoscopy, respectively. When used together, specificity for PsA diagnosis raised to 90.5%. Integrated rheumatological-dermatological clinical evaluation may be helpful in identifying patients with EPsA misclassified as seronegative ERA. Additionally, US and dermoscopy may be used as supportive tools in identifying subclinical psoriatic features, which may come in handy in distinguishing EPsA from ERA.

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

Rapid glucosinolate detection and identification using accurate mass MS-MS

USDA-ARS?s Scientific Manuscript database

Currently, there is a demand for accurate evaluation of brassica plat species for their glucosinolate content. An optimized method has been developed for detecting and identifying glucosinolates in plant extracts using MS-MS fragmentation with ion trap collision induced dissociation (CID) and higher...

Influence of simethicone and fasting on the quality of abdominal ultrasonography in New Zealand White rabbits.

PubMed

da Silva, Kassy Gomes; de Andrade, Carla; Sotomaior, Cristina Santos

2017-07-17

Presence of significant quantities of gas in the intestines may hinder a proper conduction of abdominal ultrasonography. In humans, preparatory techniques are used to solve this, but measures to avoid ultrasonographic complications due to intestinal gas in rabbits have not been reported. The objective of this study was to evaluate the influence of fasting and simethicone administered orally on the quality of ultrasonographic images of the gallbladder, kidneys, and jejunum in adult New Zealand White (NZW) rabbits. A total of 28 adult NZW rabbits were included in a crossover design study, involving four groups: F: fasting for 4-6 h before the examination; FS: fasting and application of simethicone (20 mg/kg, orally) 20 to 30 min before the examination; S: application of simethicone 20-30 min before the examination without fasting; and C: controls without fasting and no application of simethicone. Evaluation of the ultrasonographic images was done in terms of percentage of visualization of each organ and image quality using a 3-point scoring system (unacceptable, acceptable, or excellent). The kidneys and the gallbladder were visualized at an equal frequency in all groups, while the jejunum was visualized more frequently in the FS group. The image quality scores for gallbladder, right kidney, and left kidney was similar for all groups, but for the jejunum, a higher number of images with acceptable scores was found within the FS group.

The learning curve for access creation in solo ultrasonography-guided percutaneous nephrolithotomy and the associated skills.

PubMed

Yu, Weimin; Rao, Ting; Li, Xing; Ruan, Yuan; Yuan, Run; Li, Chenglong; Li, Haoyong; Cheng, Fan

2017-03-01

The aim of the current trial was to evaluate the learning curve of access creation through solo ultrasonography (US)-guided percutaneous nephrolithotomy (PCNL), and clarify the technical details of the procedure. We evaluated the first 240 solo US-guided PCNLs performed by one surgeon at our institution. The data including the puncture procedure, access characteristics, access-related complications and stone-free rates were assessed in four sequential groups. The puncture duration and number of times decreased from a mean of 4.4 min and 2.1 times for the first 60 patients to 1.3 min and 1.2 times for the last 60 patients. There was a significant decrease from 3.7 min and 1.8 times for the 61th-120th patients to 1.5 min and 1.3 times for the 121th-180th patients. All of the access-related severe bleeding appeared in the first 120 patients, while perforations only occurred in the first 60 patients. The stone-free rates were 68.3, 83.3, 90.0, and 93.3% for the four sequential groups. The increase in experience lead to an improvement in the puncture duration and times, which accompany with better stone-free rates and lower complications. We propose that 60 operations are sufficient to gain competency, and a cutoff point of 120 operations will allow the surgeon to achieve excellence in the solo US-guided PCNL.

Assessment of pulsed electromagnetic field therapy with Serum YKL-40 and ultrasonography in patients with knee osteoarthritis.

PubMed

Dündar, Ümit; Aşık, Gülşah; Ulaşlı, Alper Murat; Sınıcı, Şükrü; Yaman, Fatima; Solak, Özlem; Toktaş, Hasan; Eroğlu, Selma

2016-03-01

The use of biomarkers of osteoarthritis (OA) have potential for early diagnosis, evaluation of disease severity and monitoring treatment. Serum and synovial fluid YKL-40 levels are increased in severe knee OA. Pulsed electromagnetic field (PEMF) therapy is a novel treatment method for OA. However, studies evaluating the PEMF therapy in treatment of knee OA revealed conflicting results. This study was conducted to objectively assess the effect of PEMF therapy in patients with knee OA, by using ultrasonographic measurements and a novel biomarker, YKL-40. Forty patients were randomized into two treatment groups. Both groups received conventional physical therapy, while Group 1 received additional PEMF therapy. The patients were asked to rate their pain on a visual analogue scale (VAS) and complete a Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Serum YKL-40 levels were measured, and knee effusion and cartilage degeneration level were evaluated with ultrasonography before and after treatment. Pre-treatment YKL-40 level was correlated with WOMAC pain subscale (P = 0.032, r = 0.339). VAS and WOMAC scores significantly improved in both treatment groups (P < 0.05). The effusion in the right knee significantly decreased in Group 1. The change in YKL-40 level was not correlated with the change in VAS, WOMAC scores and knee effusion. This study revealed that adjuvant PEMF therapy has no additional effect on pain in patients with knee OA. Serum YKL-40 level seems to be unuseful for monitoring the treatment in knee OA. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

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

PubMed

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

2015-06-01

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

Endosonography for suspected obstructive jaundice with no definite pathology on ultrasonography.

PubMed

Chen, Chien-Hua; Yang, Chi-Chieh; Yeh, Yung-Hsiang; Yang, Tsang; Chung, Tieh-Chi

2015-09-01

Ultrasonography (US) cannot demonstrate all the etiologies of biliary tract dilatation in patients with jaundice. Thus, we evaluated the etiologic yield of endosonography (EUS) for suspected obstructive jaundice when no definite pathology was found on US. Additionally, we sought to identify the predictors of the most common etiologies. We performed a retrospective review of 123 consecutive patients who had undergone EUS for suspected obstructive jaundice when no definite pathology was identified on US. The most common diagnoses included no pathological obstruction (n = 43), pancreatobiliary malignancy (n = 41), and choledocholithiasis (n = 28). Pancreatobiliary malignancy was associated with common bile duct (CBD) dilatation, and fever and elevated alanine aminotransferase were predictors of choledocholithiasis (p < 0.05). The accuracy of EUS was 95.9% (118/123) for overall cause of suspected obstructive jaundice, 100% (40/40) for no pathological finding, 100% (23/23) for ampullary cancer, 100% (13/13) for pancreatic cancer, 75% (3/4) for CBD cancer, and 92.9% (26/28) for choledocholithiasis, respectively. Besides the two patients with focal chronic pancreatitis misdiagnosed as with pancreatic cancer, EUS missed the lesions in one CBD cancer patient and two patients with choledocholithiasis. The overall accuracy of EUS in ascertaining pancreatobiliary malignancy and choledocholithiasis was comparable (97.6%, 40/41 vs. 92.9%, 26/28; p > 0.05). Marked CBD dilatation (≥12 mm) should remind us of the high risk of malignancy, and the presence of CBD dilatation and fever is suggestive of choledocholithiasis. Negative EUS findings cannot assure any pathological obstruction in patients with clinically suspected obstructive jaundice. Copyright © 2013. Published by Elsevier B.V.

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.

Endobronchial ultrasonography using a guide sheath technique for diagnosis of peripheral pulmonary lesions

PubMed Central

Zhang, Lei; Wu, Hongxu; Wang, Guiqi

2017-01-01

Endobronchial ultrasonography using a guide sheath (EBUS-GS) is a novel method used for collecting peripheral pulmonary lesion (PPL) samples. EBUS-GS is performed by introducing a guide sheath-covered miniprobe into the target bronchus and then withdrawing the miniprobe after lesion detection, leaving the guide sheath in situ as a working channel for obtaining lesion samples. EBUS-GS can improve PPL diagnosis rates and be used for obtaining specimens for molecular analysis. In this review, we discuss the clinical applications of EBUS-GS, the factors that affect its diagnostic sensitivity, and potential complications. We also compare EBUS-GS with other available diagnostic techniques and discuss the strengths and limitations of this method. PMID:29063872

Validity and reliability of the abdominal test and evaluation systems tool (ABTEST) to accurately measure abdominal force.

PubMed

Glenn, Jordan M; Galey, Madeline; Edwards, Abigail; Rickert, Bradley; Washington, Tyrone A

2015-07-01

Ability to generate force from the core musculature is a critical factor for sports and general activities with insufficiencies predisposing individuals to injury. This study evaluated isometric force production as a valid and reliable method of assessing abdominal force using the abdominal test and evaluation systems tool (ABTEST). Secondary analysis estimated 1-repetition maximum on commercially available abdominal machine compared to maximum force and average power on ABTEST system. This study utilized test-retest reliability and comparative analysis for validity. Reliability was measured using test-retest design on ABTEST. Validity was measured via comparison to estimated 1-repetition maximum on a commercially available abdominal device. Participants applied isometric, abdominal force against a transducer and muscular activation was evaluated measuring normalized electromyographic activity at the rectus-abdominus, rectus-femoris, and erector-spinae. Test, re-test force production on ABTEST was significantly correlated (r=0.84; p<0.001). Mean electromyographic activity for the rectus-abdominus (72.93% and 75.66%), rectus-femoris (6.59% and 6.51%), and erector-spinae (6.82% and 5.48%) were observed for trial-1 and trial-2, respectively. Significant correlations for the estimated 1-repetition maximum were found for average power (r=0.70, p=0.002) and maximum force (r=0.72, p<0.001). Data indicate the ABTEST can accurately measure rectus-abdominus force isolated from hip-flexor involvement. Negligible activation of erector-spinae substantiates little subjective effort among participants in the lower back. Results suggest ABTEST is a valid and reliable method of evaluating abdominal force. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Musculoskeletal ultrasonography delineates ankle symptoms in rheumatoid arthritis.

PubMed

Toyota, Yukihiro; Tamura, Maasa; Kirino, Yohei; Sugiyama, Yumiko; Tsuchida, Naomi; Kunishita, Yosuke; Kishimoto, Daiga; Kamiyama, Reikou; Miura, Yasushi; Minegishi, Kaoru; Yoshimi, Ryusuke; Ueda, Atsuhisa; Nakajima, Hideaki

2017-05-01

To clarify the use of musculoskeletal ultrasonography (US) of ankle joints in rheumatoid arthritis (RA). Consecutive RA patients with or without ankle symptoms participated in the study. The US, clinical examination (CE), and patients' visual analog scale for pain (pVAS) for ankles were assessed. Prevalence of tibiotalar joint synovitis and tenosynovitis were assessed by grayscale (GS) and power Doppler (PD) US using a semi-quantitative grading (0-3). The positive US and CE findings were defined as GS score ≥2 and/or PD score ≥1, and joint swelling and/or tenderness, respectively. Multivariate analysis with the generalized linear mixed model was performed by assigning ankle pVAS as a dependent variable. Among a total of 120 ankles from 60 RA patients, positive ankle US findings were found in 21 (35.0%) patients. The concordance rate of CE and US was moderate (kappa 0.57). Of the 88 CE negative ankles, US detected positive findings in 9 (10.2%) joints. Multivariate analysis revealed that ankle US, clinical disease activity index, and foot Health Assessment Questionnaire, but not CE, was independently associated with ankle pVAS. US examination is useful to illustrate RA ankle involvement, especially for patients who complain ankle pain but lack CE findings.

Evaluation of Canine Sperm and Management of Semen Disorders.

PubMed

Kolster, Kara A

2018-04-17

Semen evaluation of the male dog is a critical step in any canine infertility work-up. Assessment of total sperm count, sperm viability, and sperm morphology are the mainstay of breeding soundness evaluation. Adjunct tests, such as ultrasonography and serum hormone levels, can aid in diagnosis. Pharmacologic treatments, dietary supplements, and management practices may help improve breeding success in subfertile dogs. This article discusses a clinically practical approach to assessing sperm abnormalities and fertility in male dogs. Copyright © 2018 Elsevier Inc. All rights reserved.

Effect of ultrasonography surveillance in patients with liver cancer: a population-based longitudinal study

PubMed Central

Chiang, Jui-Kun; Chih-Wen, Lin; Kao, Yee-Hsin

2017-01-01

Objective Liver cancer is a growing global public health problem. Ultrasonography is an imaging tool widely used for the early diagnosis of liver cancer. However, the effect of ultrasonography surveillance (US) on the survival of patients with liver cancer is unknown. Therefore, this study examined the association between survival and US frequency during the 2 years preceding patients’ liver cancer diagnosis. Methods This population-based longitudinal study was conducted in Taiwan, a region with high liver cancer incidence, by using the National Health Insurance Research Database. We compared survival between patients who received US three times or more (≥3 group) and less than three times (<3 group) during the 2 years preceding their liver cancer diagnosis, and identified the predictors for the ≥3 group. Results This study enrolled 4621 patients with liver cancer who had died between 1997 and 2010. The median survival rate was higher in the ≥3 group (1.42 years) than in the <3 group (0.51 years). Five-year survival probability was also significantly higher in the ≥3 group (14.4%) than in the <3 group (7.7%). The multivariate logistic regression results showed that the three most common positive predictors for receiving three or more US sessions were indications of viral hepatitis, gallbladder diseases and kidney–urinary–bladder diseases; the most common negative predictors for receiving three or more US sessions were male sex and indications of abdominal pain. Conclusion Patients with liver cancer who received US three times or more during the 2 years preceding their liver cancer diagnosis exhibited a higher 5-year survival probability. PMID:28645973

Targeted vs systematic robot-assisted transperineal magnetic resonance imaging-transrectal ultrasonography fusion prostate biopsy.

PubMed

Mischinger, Johannes; Kaufmann, Sascha; Russo, Giorgio I; Harland, Niklas; Rausch, Steffen; Amend, Bastian; Scharpf, Marcus; Loewe, Lorenz; Todenhoefer, Tilman; Notohamiprodjo, Mike; Nikolaou, Konstantin; Stenzl, Arnulf; Bedke, Jens; Kruck, Stephan

2018-05-01

To evaluate the performance of transperineal robot-assisted (RA) targeted (TB) and systematic (SB) prostate biopsy in primary and repeat biopsy settings. Patients underwent RA biopsy between 2014 and 2016. Before RA-TB, multiparametric magnetic resonance imaging (mpMRI) was performed. Prostate lesions were scored (Prostate Imaging, Reporting and Data System, version 2) and used for RA-TB planning. In addition, RA-SB was performed. Available, whole-gland pathology was analysed. In all, 130 patients were biopsy naive and 72 had had a previous negative transrectal ultrasonography-guided biopsy. In total, 202 patients had suspicious mpMRI lesions. Clinically significant prostate cancer was found in 85% of all prostate cancer cases (n = 123). Total and clinically significant prostate cancer detection rates for RA-TB vs RA-SB were not significantly different at 77% vs 84% and 80% vs 82%, respectively. RA-TB demonstrated a better sampling performance compared to RA-SB (26.4% vs 13.9%; P < 0.001). Transperineal RA-TB and -SB showed similar clinically significant prostate cancer detection rates in primary and repeat biopsy settings. However, RA-TB offered a 50% reduction in biopsy cores. Omitting RA-SB is associated with a significant risk of missing clinically significant prostate cancer. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.