Sample records for ultrasound examination measurements

  1. An Examination of Ultrasound Measured Tissue Perfusion on Breast Cancer

    DTIC Science & Technology

    1998-12-01

    is similar to those of the study by Ivey et al. [9] in which high intensity fields were used to produce cavitation bubbles for ultrasound contrast...ft * * AD AWARD NUMBER DAMD17-94-J-4144 TITLE: ^ Examination of Ultrasound Measured Tissue Perfusion on Breast Cancer...Examination of Ultrasound Measured Tissue Perfusion on Breast Cancer 3. REPORT TYPE AND DATES COVERED Final (1 Jun 94 - 30 Nov 98) 5. FUNDING

  2. Measurement of tissue viscoelasticity with ultrasound

    NASA Astrophysics Data System (ADS)

    Greenleaf, J. F.; Alizad, A.

    2017-02-01

    Tissue properties such as elasticity and viscosity have been shown to be related to such tissue conditions as contraction, edema, fibrosis, and fat content among others. Magnetic Resonance Elastography has shown outstanding ability to measure the elasticity and in some cases the viscosity of tissues, especially in the liver, providing the ability to stage fibrotic liver disease similarly to biopsy. We discuss ultrasound methods of measuring elasticity and viscosity in tissues. Many of these methods are becoming widely available in the extant ultrasound machines distributed throughout the world. Some of the methods to be discussed are in the developmental stage. The advantages of the ultrasound methods are that the imaging instruments are widely available and that many of the viscoelastic measurements can be made during a short addition to the normal ultrasound examination time. In addition, the measurements can be made by ultrasound repetitively and quickly allowing evaluation of dynamic physiologic function in circumstances such as muscle contraction or artery relaxation. Measurement of viscoelastic tissue mechanical properties will become a consistent part of clinical ultrasound examinations in our opinion.

  3. Comparison of a pocket-size ultrasound device with a premium ultrasound machine: diagnostic value and time required in bedside ultrasound examination.

    PubMed

    Stock, Konrad Friedrich; Klein, Bettina; Steubl, Dominik; Lersch, Christian; Heemann, Uwe; Wagenpfeil, Stefan; Eyer, Florian; Clevert, Dir-Andre

    2015-10-01

    Time savings and clinical accuracy of a new miniature ultrasound device was investigated utilizing comparison with conventional high-end ultrasound instruments. Our objective was to determine appropriate usage and limitations of this diagnostic tool in internal medicine. We investigated 28 patients from the internal-medicine department. Patients were examined with the Acuson P10 portable device and a Sonoline Antares instrument in a cross-over design. All investigations were carried out at the bedside; the results were entered on a standardized report form. The time for the ultrasound examination (transfer time, setting up and disassembly, switching on and off, and complete investigation time) was recorded separately. Mean time for overall examination per patient with the portable ultrasound device was shorter (25.0 ± 4.5 min) than with the high-end machine (29.4 ± 4.4 min; p < 0.001). When measuring the size of liver, spleen, and kidneys, the values obtained differed significantly between portable device and the high-end instrument. In our study, we identified 113 pathological ultrasound findings with the high-end ultrasound machine, while 82 pathological findings (73%) were concordantly detected with the portable ultrasound device. The main diagnostic strengths of the portable device were in the detection of ascites (sensitivity 80%), diagnosis of fatty liver, and identification of severe parenchymal liver damage. The clinical utility of portable ultrasound machines is limited. There will be clinical roles for distinct clinical questions such as detection of ascites or pleural effusion when used by experienced examiners. However, sensitivity in detecting multiple pathologies is not comparable to high-end ultrasound machines.

  4. Spinal curvature measurement by tracked ultrasound snapshots.

    PubMed

    Ungi, Tamas; King, Franklin; Kempston, Michael; Keri, Zsuzsanna; Lasso, Andras; Mousavi, Parvin; Rudan, John; Borschneck, Daniel P; Fichtinger, Gabor

    2014-02-01

    Monitoring spinal curvature in adolescent kyphoscoliosis requires regular radiographic examinations; however, the applied ionizing radiation increases the risk of cancer. Ultrasound imaging is favored over radiography because it does not emit ionizing radiation. Therefore, we tested an ultrasound system for spinal curvature measurement, with the help of spatial tracking of the ultrasound transducer. Tracked ultrasound was used to localize vertebral transverse processes as landmarks along the spine to measure curvature angles. The method was tested in two scoliotic spine models by localizing the same landmarks using both ultrasound and radiographic imaging and comparing the angles obtained. A close correlation was found between tracked ultrasound and radiographic curvature measurements. Differences between results of the two methods were 1.27 ± 0.84° (average ± SD) in an adult model and 0.96 ± 0.87° in a pediatric model. Our results suggest that tracked ultrasound may become a more tolerable and more accessible alternative to radiographic spine monitoring in adolescent kyphoscoliosis. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  5. Cardiac Limited Ultrasound Examination Techniques to Augment the Bedside Cardiac Physical Examination.

    PubMed

    Kimura, Bruce J; Shaw, David J; Amundson, Stan A; Phan, James N; Blanchard, Daniel G; DeMaria, Anthony N

    2015-09-01

    The current practice of physical diagnosis is dependent on physician skills and biases, inductive reasoning, and time efficiency. Although the clinical utility of echocardiography is well known, few data exist on how to integrate 2-dimensional screening "quick-look" ultrasound applications into a novel, modernized cardiac physical examination. We discuss the evidence basis behind ultrasound "signs" pertinent to the cardiovascular system and elemental in synthesis of bedside diagnoses and propose the application of a brief cardiac limited ultrasound examination based on these signs. An ultrasound-augmented cardiac physical examination can be taught in traditional medical education and has the potential to improve bedside diagnosis and patient care. © 2015 by the American Institute of Ultrasound in Medicine.

  6. Disparity between Clinical and Ultrasound Examinations in Neonatal Hip Screening.

    PubMed

    Kyung, Bong Soo; Lee, Soon Hyuck; Jeong, Woong Kyo; Park, Si Young

    2016-06-01

    For early detection of developmental dysplasia of the hip (DDH), neonatal hip screening using clinical examination and/or ultrasound has been recommended. Although there have been many studies on the reliability of both screening techniques, there is still controversy in the screening strategies; clinical vs. selective or universal ultrasound screening. To determine the screening strategy, we assessed the agreement among the methods; clinical examination by an experienced pediatric orthopedic surgeon, sonographic morphology, and sonographic stability. From January 2004 to June 2009, a single experienced pediatric orthopedic surgeon performed clinical hip screenings for 2,686 infants in the neonatal unit and 43 infants who were referred due to impressions of hip dysplasia before 3 months of age. Among them, 156 clinically unstable or high-risk babies selectively received bilateral hip ultrasound examinations performed by the same surgeon using the modified Graf method. The results were analyzed statistically to detect any correlations between the clinical and sonographic findings. Although a single experienced orthopedic surgeon conducted all examinations, we detected only a limited relationship between the results of clinical and ultrasound examinations. Ninety-three percent of the clinically subluxatable hips were normal or immature based on static ultrasound examination, and 74% of dislocating hips and 67% of limited abduction hips presented with the morphology below Graf IIa. A total of 80% of clinically subluxatable, 42% of dislocating and 67% of limited abduction hips appeared stable or exhibited minor instability on dynamic ultrasound examination. About 7% of clinically normal hips were abnormal upon ultrasound examination; 5% showed major instability and 3% showed dysplasia above Graf IIc. Clinical stability had small coefficients between ultrasound examinations; 0.39 for sonographic stability and 0.37 for sonographic morphology. Between sonographic

  7. Using Ultrasound to Enhance Medical Students' Femoral Vascular Physical Examination Skills.

    PubMed

    Ahn, Justin S; French, Andrew J; Thiessen, Molly E W; Browne, Vaughn; Deutchman, Mark; Guiton, Gretchen; Madigosky, Wendy; Kendall, John L

    2015-10-01

    To determine whether the addition of ultrasound to traditional physical examination instruction improves junior medical students' abilities to locate the femoral pulse. Initially, 150 second-year medical students were taught the femoral pulse examination using traditional bedside teaching on standardized patients and online didactic videos. Students were then randomized into 2 groups: group 1 received ultrasound training first and then completed the standardized examination; and group 2 performed the standardized examination first and then received ultrasound training. On the standardized patients, the femoral artery was marked with invisible ink before the sessions using ultrasound. Compared to these markers, students were then evaluated on the accuracy of femoral artery pulse palpation and the estimated location of the femoral vein. All students completed a self-assessment survey after the ultrasound sessions. Ultrasound training improved the students' ability to palpate the femoral pulse (P= .02). However, ultrasound did not facilitate correct estimation of the femoral vein's anatomic location (P = .09). Confidence levels in localizing the femoral artery and vein were equal between groups at baseline, and both increased after the ultrasound sessions. The addition of ultrasound teaching to traditional physical examination instruction enhanced medical student competency and confidence with the femoral vascular examination. However, understanding of anatomy may require emphasis on precourse didactic material, but further study is required. © 2015 by the American Institute of Ultrasound in Medicine.

  8. Standardized Six-Step Approach to the Performance of the Focused Basic Obstetric Ultrasound Examination.

    PubMed

    Abuhamad, Alfred; Zhao, Yili; Abuhamad, Sharon; Sinkovskaya, Elena; Rao, Rashmi; Kanaan, Camille; Platt, Lawrence

    2016-01-01

    This study aims to validate the feasibility and accuracy of a new standardized six-step approach to the performance of the focused basic obstetric ultrasound examination, and compare the new approach to the regular approach performed in the scheduled obstetric ultrasound examination. A new standardized six-step approach to the performance of the focused basic obstetric ultrasound examination, to evaluate fetal presentation, fetal cardiac activity, presence of multiple pregnancy, placental localization, amniotic fluid volume evaluation, and biometric measurements, was prospectively performed on 100 pregnant women between 18(+0) and 27(+6) weeks of gestation and another 100 pregnant women between 28(+0) and 36(+6) weeks of gestation. The agreement of findings for each of the six steps of the standardized six-step approach was evaluated against the regular approach. In all ultrasound examinations performed, substantial to perfect agreement (Kappa value between 0.64 and 1.00) was observed between the new standardized six-step approach and the regular approach. The new standardized six-step approach to the focused basic obstetric ultrasound examination can be performed successfully and accurately between 18(+0) and 36(+6) weeks of gestation. This standardized approach can be of significant benefit to limited resource settings and in point of care obstetric ultrasound applications. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. Standards of the Polish Ultrasound Society - update. Ultrasound examination of the kidneys, ureters and urinary bladder.

    PubMed

    Tyloch, Janusz F; Woźniak, Magdalena Maria; Wieczorek, Andrzej Paweł

    2013-09-01

    The paper presents the principles of performing proper ultrasound examinations of the urinary tract. The following are discussed: preparation of patients, type of optimal apparatus, technique of examination and conditions which its description should fulfill. Urinary track examination in adults and in children constitutes an integral part of each abdominal examination. Such examinations should be performed with fasting patients or several hours after the last meal, with filled urinary bladder. Ultrasound examinations in children and infants are performed using transducers with the frequency of 5.0-9.0 MHz and in adults - with the frequency of 2.0-6.0 MHz. Doppler options are desirable since they improve diagnostic capacity of sonography in terms of differentiation between renal focal lesions. Renal examinations are performed with the patients in the supine position. The right kidney is examined in the right hypochondriac region using the liver as the ultrasound "window." The left kidney is examined in the left hypochondriac region, preferably in the posterior axillary line. Ultrasound examinations of the upper segment of the ureters are performed after renal examination when the pelvicalyceal system is dilated. A condition necessary for a proper examination of the perivesical portion of the ureter is full urinary bladder. The scans of the urinary bladder are performed in transverse, longitudinal and oblique planes when the bladder is filled. The description should include patient's personal details, details of the referring unit, of the unit in which the examination is performed, examining physician's details, type of ultrasound apparatus and transducers as well as the description proper.

  10. Mistakes in ultrasound examination of salivary glands

    PubMed Central

    Jakubowski, Wiesław

    2016-01-01

    Ultrasonography is the first imaging method applied in the case of diseases of the salivary glands. The article discusses basic mistakes that can be made during an ultrasound examination of these structures. The reasons for these mistakes may be examiner-dependent or may be beyond their control. The latter may include, inter alia, difficult conditions during examination (technical or patient-related), similarity of ultrasound images in different diseases, the lack of clinical and laboratory data as well as the lack of results of other examinations, their insufficient number or incorrectness. Doctor-related mistakes include: the lack of knowledge of normal anatomy, characteristics of ultrasound images in various salivary gland diseases and statistical incidence of diseases, but also attaching excessive importance to such statistical data. The complex anatomical structures of the floor of the oral cavity may be mistaken for benign or malignant tumors. Fragments of correct anatomical structures (bones, arterial wall fibrosis, air bubbles in the mouth) can be wrongly interpreted as deposits in the salivary gland or in its excretory duct. Correct lymph nodes in the parotid glands may be treated as pathologic structures. Lesions not being a simple cyst, e.g. lymphoma, benign or malignant tumors of the salivary glands or metastatic lymph nodes, can be mistaken for one. The image of disseminated focal changes, both anechoic and solid, is not pathognomonic for specific diseases in the salivary glands. However, in part, it occurs typically and requires an extended differential diagnosis. Small focal changes and infiltrative lesions pose a diagnostic problem because their etiology cannot be safely suggested on the basis of an ultrasound examination itself. The safest approach is to refer patients with abnormal focal changes for an ultrasoundguided fine-needle aspiration biopsy. PMID:27446603

  11. Effects of ultrasound implementation on physical examination learning and teaching during the first year of medical education.

    PubMed

    Dinh, Vi Am; Frederick, Jon; Bartos, Rebekah; Shankel, Tamara M; Werner, Leonard

    2015-01-01

    Increasing emphasis has been placed on point-of-care ultrasound in medical school. The overall effects of ultrasound curriculum implementation on the traditional physical examination skills of medical students are still unknown. We studied the effects on the Objective Standardized Clinical Examination (OSCE) scores of year 1 medical students before and after ultrasound curriculum implementation. An ultrasound curriculum was incorporated into the physical diagnosis course for year 1 medical students in the 2012-2013 academic year. We performed a prospective observational study comparing traditional OSCE scores of year 1 medical students exposed to the ultrasound curriculum (post-ultrasound) versus historic year 1 medical student controls (pre-ultrasound) with no ultrasound exposure. Questionnaire data were also obtained from year 1 medical students and physical diagnosis faculty to assess attitudes toward ultrasound implementation. The final overall OSCE scores were graded with a 5-point Likert-type scale from unsatisfactory to outstanding. There was a significant increase in outstanding scores in the post-ultrasound compared to the pre-ultrasound group (27.0% versus 10.9%; P< .001). The post-ultrasound group had significantly (P< .05) increased first-time pass rates on blood pressure measurements, the abdominal examination, and professionalism. Student and physical diagnosis faculty questionnaire data showed an overall positive response, with most agreeing or strongly agreeing that ultrasound should be included in the future year 1 medical student curriculum. Ultrasound implementation into a physical diagnosis curriculum for year 1 medical students is feasible and may improve their overall traditional physical examination skills. © 2015 by the American Institute of Ultrasound in Medicine.

  12. Clinical workflow for spinal curvature measurement with portable ultrasound

    NASA Astrophysics Data System (ADS)

    Tabanfar, Reza; Yan, Christina; Kempston, Michael; Borschneck, Daniel; Ungi, Tamas; Fichtinger, Gabor

    2016-03-01

    PURPOSE: Spinal curvature monitoring is essential in making treatment decisions in scoliosis. Monitoring entails radiographic examinations, however repeated ionizing radiation exposure has been shown to increase cancer risk. Ultrasound does not emit ionizing radiation and is safer for spinal curvature monitoring. We investigated a clinical sonography protocol and challenges associated with position-tracked ultrasound in spinal curvature measurement in scoliosis. METHODS: Transverse processes were landmarked along each vertebra using tracked ultrasound snapshots. The transverse process angle was used to determine the orientation of each vertebra. We tested our methodology on five patients in a local pediatric scoliosis clinic, comparing ultrasound to radiographic curvature measurements. RESULTS: Despite strong correlation between radiographic and ultrasound curvature angles in phantom studies, we encountered new challenges in the clinical setting. Our main challenge was differentiating transverse processes from ribs and other structures during landmarking. We observed up to 13° angle variability for a single vertebra and a 9.85° +/- 10.81° difference between ultrasound and radiographic Cobb angles for thoracic curvatures. Additionally, we were unable to visualize anatomical landmarks in the lumbar region where soft tissue depth was 25-35mm. In volunteers with large Cobb angles (greater than 40° thoracic and 60° lumbar), we observed spinal protrusions resulting in incomplete probe-skin contact and partial ultrasound images not suitable for landmarking. CONCLUSION: Spinal curvature measurement using tracked ultrasound is viable on phantom spine models. In the clinic, new challenges were encountered which must be resolved before a universal sonography protocol can be developed.

  13. Ocular examination for trauma; clinical ultrasound aboard the International Space Station.

    PubMed

    Chiao, Leroy; Sharipov, Salizhan; Sargsyan, Ashot E; Melton, Shannon; Hamilton, Douglas R; McFarlin, Kellie; Dulchavsky, Scott A

    2005-05-01

    Ultrasound imaging is a successful modality in a broad variety of diagnostic applications including trauma. Ultrasound has been shown to be accurate when performed by non-radiologist physicians; recent reports have suggested that non-physicians can perform limited ultrasound examinations. A multipurpose ultrasound system is installed on the International Space Station (ISS) as a component of the Human Research Facility (HRF). This report documents the first ocular ultrasound examination conducted in space, which demonstrated the capability to assess physiologic alterations or pathology including trauma during long-duration space flight. An ISS crewmember with minimal sonography training was remotely guided by an imaging expert from Mission Control Center (MCC) through a comprehensive ultrasound examination of the eye. A multipurpose ultrasound imager was used in conjunction with a space-to-ground video downlink and two-way audio. Reference cards with topological reference points, hardware controls, and target images were used to facilitate the examination. Multiple views of the eye structures were obtained through a closed eyelid. Pupillary response to light was demonstrated by modifying the light exposure of the contralateral eye. A crewmember on the ISS was able to complete a comprehensive ocular examination using B- and M-mode ultrasonography with remote guidance from an expert in the MCC. Multiple anteroposterior, oblique, and coronal views of the eye clearly demonstrated the anatomic structures of both segments of the globe. The iris and pupil were readily visualized with probe manipulation. Pupillary diameter was assessed in real time in B- and M-mode displays. The anatomic detail and fidelity of ultrasound video were excellent and could be used to answer a variety of clinical and space physiologic questions. A comprehensive, high-quality ultrasound examination of the eye was performed with a multipurpose imager aboard the ISS by a non-expert operator using

  14. Ocular examination for trauma; clinical ultrasound aboard the International Space Station

    NASA Technical Reports Server (NTRS)

    Chiao, Leroy; Sharipov, Salizhan; Sargsyan, Ashot E.; Melton, Shannon; Hamilton, Douglas R.; McFarlin, Kellie; Dulchavsky, Scott A.

    2005-01-01

    BACKGROUND: Ultrasound imaging is a successful modality in a broad variety of diagnostic applications including trauma. Ultrasound has been shown to be accurate when performed by non-radiologist physicians; recent reports have suggested that non-physicians can perform limited ultrasound examinations. A multipurpose ultrasound system is installed on the International Space Station (ISS) as a component of the Human Research Facility (HRF). This report documents the first ocular ultrasound examination conducted in space, which demonstrated the capability to assess physiologic alterations or pathology including trauma during long-duration space flight. METHODS: An ISS crewmember with minimal sonography training was remotely guided by an imaging expert from Mission Control Center (MCC) through a comprehensive ultrasound examination of the eye. A multipurpose ultrasound imager was used in conjunction with a space-to-ground video downlink and two-way audio. Reference cards with topological reference points, hardware controls, and target images were used to facilitate the examination. Multiple views of the eye structures were obtained through a closed eyelid. Pupillary response to light was demonstrated by modifying the light exposure of the contralateral eye. RESULTS: A crewmember on the ISS was able to complete a comprehensive ocular examination using B- and M-mode ultrasonography with remote guidance from an expert in the MCC. Multiple anteroposterior, oblique, and coronal views of the eye clearly demonstrated the anatomic structures of both segments of the globe. The iris and pupil were readily visualized with probe manipulation. Pupillary diameter was assessed in real time in B- and M-mode displays. The anatomic detail and fidelity of ultrasound video were excellent and could be used to answer a variety of clinical and space physiologic questions. CONCLUSIONS: A comprehensive, high-quality ultrasound examination of the eye was performed with a multipurpose imager

  15. Functional anatomy and ultrasound examination of the canine penis.

    PubMed

    Goericke-Pesch, Sandra; Hölscher, Catharina; Failing, Klaus; Wehrend, Axel

    2013-07-01

    The aim of this study was to identify the functional-anatomical structures of the canine penis during and after erection to demonstrate the respective changes to provide a basis for further examinations of pathological conditions like priapism. Additionally, a gray-scale analysis was performed to quantify results from the ultrasound examination. In total, 80 dogs were examined. In group (Gr.) A, 44 intact or castrated dogs were examined, and in Gr. B, 36 dogs were examined during erection and after complete detumescence of the penis. The following parameters were assessed: (1) using physical measurements: length of the Pars longa glandis [Plg] and length of the Bulbus glandis [Bg]; and (2) using ultrasound: total penile diameter, width of the erectile tissue of the Plg, diameter of the Corpus spongiosum [Cs] including the penile bone and urethra, vertical diameter, circumference of the penis, cross-sectional area, and area of the Cs including the urethra. The mentioned parameters could be assessed in all dogs of Gr. A and Gr. B with the only exception being the urethra that could be visualized using ultrasound in some dogs only and predominantly in the erected penis (Gr. B). Concomitantly, the erectile tissue of the Plg and the Cs was more heterogenous and hypo- to anechoic during erection compared with dogs in Gr. A and Gr. B after detumescence. Comparing the results in Gr. B, the length of the Plg and the Bg were decreased approximately 40.6% and 38.0%, the total width of the penis 40.5%, the total width of the erectile tissue of the Plg 48.0%, and the width of the Cs 15.6% during detumescence compared with erection. Comparing the decrease in size at the different locations (apex penis, middle of Plg, middle of Bg) for vertical diameter, total circumference, and cross-section area, it was largest at the Bg. B-mode ultrasound is a suitable tool to investigate not only the morpho-functional structures of the resting canine penis, but also of the erected and

  16. Estimation of prenatal aorta intima-media thickness from ultrasound examination

    NASA Astrophysics Data System (ADS)

    Veronese, E.; Tarroni, G.; Visentin, S.; Cosmi, E.; Linguraru, M. G.; Grisan, E.

    2014-10-01

    Prenatal events such as intrauterine growth restriction and increased cardiovascular risk in later life have been shown to be associated with an increased intima-media thickness (aIMT) of the abdominal aorta in the fetus. In order to assess and manage atherosclerosis and cardiovascular disease risk in adults and children, in recent years the measurement of abdominal and carotid artery thickness has gained a growing appeal. Nevertheless, no computer aided method has been proposed for the analysis of prenatal vessels from ultrasound data, yet. To date, these measurements are being performed manually on ultrasound fetal images by skilled practitioners. The aim of the presented study is to introduce an automatic algorithm that identifies abdominal aorta and estimates its diameter and aIMT from routine third trimester ultrasonographic fetal data. The algorithm locates the aorta, then segments it and, by modeling the arterial wall longitudinal sections by means of a gaussian mixture, derives a set of measures of the aorta diameter (aDiam) and of the intima-media thickness (aIMT). After estimating the cardiac cycle, the mean diameter and the aIMT at the end-diastole phase are computed. Considering the aIMT value for each subject, the correlation between automatic and manual end-diastolic aIMT measurements is 0.91 in a range of values 0.44-1.10 mm, corresponding to both normal and pathological conditions. The automatic system yields a mean relative error of 19%, that is similar to the intra-observer variability (14%) and much lower that the inter-observer variability (42%). The correlation between manual and automatic measurements and the small error confirm the ability of the proposed system to reliably estimate aIMT values in prenatal ultrasound sequences, reducing measurement variability and suggesting that it can be used for an automatic assessment of aIMT. Preliminary results have been presented in E Veronese, E Cosmi, S Visentin, E Grisan: 'Semiautomatic estimation

  17. An orthopedist's guide to shoulder ultrasound: a systematic review of examination protocols.

    PubMed

    Amoo-Achampong, Kelms; Nwachukwu, Benedict U; McCormick, Frank

    2016-11-01

    The utilization of musculoskeletal ultrasound has expanded within the setting of the orthopedic clinic as a cost-effective, point-of-care diagnostic tool for shoulder pathology. In experienced hands, ultrasound exhibits capabilities equivalent to that of magnetic resonance imaging in the diagnosis of many shoulder diseases including full-thickness and partial-thickness rotator cuff tears. Although similarly effective in identifying additional shoulder disease processes, major obstacles to its widespread use include user dependence and intrinsic limitation to extra-articular diagnosis. The purpose of this review is to present a step-by-step guide of how to perform a comprehensive shoulder examination and to discuss the appropriate use, economic benefit and implementation of ultrasound within the clinic. A systematic search (June 2016) of PubMed, Scopus, and EMBASE databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for literature presenting shoulder ultrasound examination protocols. Included studies were peer-reviewed articles or academic society endorsed protocols presenting comprehensive sonographic examinations of the adult shoulder. Papers with limited or single structure examination descriptions, non-English language, and publication dates before 1980 were excluded. Final papers meeting criteria were secondarily screened for publication after 2005 to reflect the current state of ultrasound imaging. The search yielded 1,725 unique articles with 17 studies meeting final selection criteria. Information from identified studies was summarized to formulate a 4-part shoulder examination protocol, including steps most pertinent to orthopedic in-office diagnoses. In agreement with previous studies, the inexperienced orthopedic surgeon can be quickly trained to expert level proficiency in shoulder ultrasound diagnosis. Using an established protocol, a comprehensive, yet effective shoulder

  18. Measurement of fetal head descent using the 'angle of progression' on transperineal ultrasound imaging is reliable regardless of fetal head station or ultrasound expertise.

    PubMed

    Dückelmann, A M; Bamberg, C; Michaelis, S A M; Lange, J; Nonnenmacher, A; Dudenhausen, J W; Kalache, K D

    2010-02-01

    To assess whether ultrasound experience or fetal head station affects the reliability of measurement of fetal head descent using the angle of progression on intrapartum ultrasound images obtained by a single experienced operator, and to determine reliability of measurements when images were acquired by different operators with variable ultrasound experience. One experienced obstetrician performed 44 transperineal ultrasound examinations of women at term and in prolonged second stage of labor with the fetus in the occipitoanterior position. Three midwives without ultrasound experience, three obstetricians with < 5 years' experience and three obstetricians with > 10 years' experience measured fetal head descent based on the angle of progression in the images obtained. The angle of progression was measured by two obstetricians in independent ultrasound examinations of 24 laboring women at term with the fetus in the cephalic position to allow assessment of the reliability of image acquisition. Intraclass correlation coefficients (ICCs) with 95% confidence interval (CI) were used to evaluate interobserver reliability and Bland-Altman analysis was used to assess interobserver agreement. In total, 444 measurements were performed and compared. Interobserver reliability with respect to offline image analysis was substantial (overall ICC, 0.72; 95% CI, 0.63-0.81). ICCs were 0.82 (95% CI, 0.70-0.89), 0.81 (95% CI, 0.71-0.88) and 0.61 (95% CI, 0.43-074) for observers with > 10 years', < 5 years' and no ultrasound experience, respectively. There were no significant differences between ICCs among observer groups according to ultrasound experience. Fetal head station did not affect reliability. Bland-Altman analysis indicated reasonable agreement between measurements obtained by two different operators with > 10 years' and < 5 years' ultrasound experience (bias, -1.09 degrees ; 95% limits of agreement, -8.76 to 6.58). The reliability of measurement of the angle of progression

  19. [Feasibility and accuracy of ultrasound-guided methodology in the examination of lumbar spine facet joints].

    PubMed

    Wen, Chuan-Bing; Li, Yong-Zhong; Tang, Qin-Qin; Sun, Lin; Xiao, Hong; Yang, Bang-Xiang; Song, Li; Liu, Hui

    2013-03-01

    To investigate the feasibility, accuracy of B ultrasound in the examination of joint space of lumbar spine facet joints compared with CT scan. Ten healthy adult volunteers were enrolled. The joint space of lumbar facet joints was measured by ultrasound. To identify the spinal levels, the posterior parasagittal sonograms were obtained at levels L1 to S1. The lumbar facet joints were delineated with the help of transverse sonograms at each level. Meanwhile, the lumbar facet joints were evaluated by spiral CT on the same plane, reformatted to 1-mm axial slices. A total of 88 lumbar facet joints from L1 to S1 were clearly visualized in the 10 volunteers. Both ultrasound and CT measurements showed the same average depth and lateral distance of lumbar facet joint space (P > 0.05). The lumbar facet joint space can be accurately demonstrated by ultrasound.

  20. Validity of gestational age estimates by last menstrual period and neonatal examination compared to ultrasound in Vietnam.

    PubMed

    Deputy, Nicholas P; Nguyen, Phuong H; Pham, Hoa; Nguyen, Son; Neufeld, Lynnette; Martorell, Reynaldo; Ramakrishnan, Usha

    2017-01-11

    Accurate estimation of gestational age is important for both clinical and public health purposes. Estimates of gestational age using fetal ultrasound measurements are considered most accurate but are frequently unavailable in low- and middle-income countries. The objective of this study was to assess the validity of last menstrual period and Farr neonatal examination estimates of gestational age, compared to ultrasound estimates, in a large cohort of women in Vietnam. Data for this analysis come from a randomized, placebo-controlled micronutrient supplementation trial in Vietnam. We analyzed 912 women with ultrasound and prospectively-collected last menstrual period estimates of gestational age and 685 women with ultrasound and Farr estimates of gestational age. We used the Wilcoxon signed rank sum test to assess differences in gestational age estimated by last menstrual period or Farr examination compared to ultrasound and computed the intraclass correlation coefficient (ICC) and concordance correlation coefficient (CCC) to quantify agreement between methods. We computed the Kappa coefficient (κ) to quantify agreement in preterm, term and post-term classification. The median gestational age estimated by ultrasound was 273.9 days. Gestational age was slightly overestimated by last menstrual period (median 276.0 days, P < 0.001) and more greatly overestimated by Farr examination (median 286.7 days, P < 0.001). Gestational age estimates by last menstrual period and ultrasound were moderately correlated (ICC = 0.78) and concordant (CCC = 0.63), whereas gestational age estimates by Farr examination and ultrasound were weakly correlated (ICC = 0.26) and concordant (CCC = 0.05). Last menstrual period and ultrasound estimates of gestational age were within ± 14 days for 88.4% of women; Farr and ultrasound estimates were within ± 14 days for 55.8% of women. Last menstrual period and ultrasound estimates of gestational age had higher

  1. [The Hungarian adaptation and potential use of the Maternal-Fetal Attachment Scale questionnaire measuring mother-to-fetus attachment during ultrasound communication examinations].

    PubMed

    Andrek, Andrea; Hadházi, Éva; Kekecs, Zoltán

    2016-05-15

    Research measuring the effectiveness of communication during ultrasound examinations draw attention to its use in strengthening the bond between mother and fetus. Hungarian adaptation of the Maternal-Fetal Attachment Scale, which is the most commonly used tool for measuring intrauterine attachment. 114 pregnant women in the second or third trimester filled out the Hungarian version of the Maternal-Fetal Attachment Scale and an application form. The questionnaire showed excellent internal consistency, with a Cronbach's alpha of 0.87 for the total score. Married women scored significantly higher and scores increased as pregnancy progressed. Uncertainty surrounding the fetus's gender influenced attachment in the negative direction. There was no significant relationship between attachment total scores and a number of psycho-social factors. In the family-centered prenatal care the Maternal-Fetal Attachment Scale is a suitable tool to analyze ultrasound screening situations that strengthen the bond between mother and fetus.

  2. Nerve ultrasound reliability of upper limbs: Effects of examiner training.

    PubMed

    Garcia-Santibanez, Rocio; Dietz, Alexander R; Bucelli, Robert C; Zaidman, Craig M

    2018-02-01

    Duration of training to reliably measure nerve cross-sectional area with ultrasound is unknown. A retrospective review was performed of ultrasound data, acquired and recorded by 2 examiners-an expert and either a trainee with 2 months (novice) or a trainee with 12 months (experienced) of experience. Data on median, ulnar, and radial nerves were reviewed for 42 patients. Interrater reliability was good and varied most with nerve site but little with experience. Coefficient of variation (CoV) range was 9.33%-22.5%. Intraclass correlation coefficient (ICC) was good to excellent (0.65-95) except ulnar nerve-wrist/forearm and radial nerve-humerus (ICC = 0.39-0.59). Interrater differences did not vary with nerve size or body mass index. Expert-novice and expert-experienced interrater differences and CoV were similar. The ulnar nerve-wrist expert-novice interrater difference decreased with time (r s  = -0.68, P = 0.001). A trainee with at least 2 months of experience can reliably measure upper limb nerves. Reliability varies by nerve and location and slightly improves with time. Muscle Nerve 57: 189-192, 2018. © 2017 Wiley Periodicals, Inc.

  3. Measurement considerations on examiner-dependent factors in the ultrasound assessment of developmental dysplasia of the hip.

    PubMed

    Kolb, Alexander; Benca, Emir; Willegger, Madeleine; Puchner, Stephan E; Windhager, Reinhard; Chiari, Catharina

    2017-06-01

    The standardized sonographic hip screening according to Graf has increased reliability and comparability of measurements in the screening of developmental dysplasia of the hip (DDH). However, examiner dependent factors have been discussed to influence sonographic measurements. The objectives of this study were to examine the tolerance of the transducer positioning and to analyse the impact of transducer inclinations on Graf's hip grading system. Twenty-four hips in consecutive newborns were screened sonographically in combination with an optoelectronic motion capture system to trace transducer positions in space. Subsequently five defined inclinations of the transducer relative to Graf's neutral transducer position were analysed, giving a total of 144 sonographic images. We found a permissible transducer inclination in the axial plane of 8.8° to anterior and 8.1° to posterior. In the frontal plane we found a permissible inclination of 15.4° to caudal and 7.2° to cranial. The impact on the α-angle was significant for posterior-cranial (p < 0.001), cranial (p = 0.009), and caudal (p < 0.001) inclined transducer positions. The effect on the results according to Graf's grading system was significant for the caudal inclination of the transducer position (p < 0.001). Our findings show that the standardized plane defined by Graf's criteria allows notable inclinations of the transducer positions. Transducer inclinations show an impact on measurement results, which are clinically relevant. Those effects cannot be ruled out using Graf's ultrasound criteria alone. The examiner should pay attention to avoid transducer inclinations in the frontal plane and a combination of posterior and cranial inclination.

  4. Utility of intravascular ultrasound examination during carotid stenting.

    PubMed

    Joan, M Mellado; Moya, B Gómez; Agustí, F Pañella; Vidal, R García; Arjona, Y Abril; Alija, M P Fariñas; Paredero, V Martín

    2009-01-01

    Intravascular ultrasound (IVUS) examination may provide useful information during endovascular procedures. However, its actual clinical utility for carotid stenting remains unclear. We evaluated the usefulness of IVUS as a complementary tool during endovascular procedures in the carotid arteries and its impact on the modification of the therapeutic strategy. Between April 2006 and April 2007, 18 symptomatic patients (nine with transient ischemic attack, nine with stroke) underwent angioplasty and stenting of >70% stenosis of the internal carotid artery (ICA). Target lesions were identified with preoperative duplex scanning and further confirmed at angiography. Intraoperative IVUS examination was performed in all patients. Multilevel measurement of the artery as well as virtual histology images, before and after stenting, were obtained. The technique was 100% successful. There were no complications at the femoral puncture site and no neurological or other events. Compared with angiography, IVUS findings showed an average arterial diameter that was greater than 1.64+/-0.22mm. Based on virtual histology information, endovascular treatment was excluded in two patients and carotid endarterectomy was performed. Type or size of the stent was modified after IVUS examination in eight cases. IVUS examination provides complementary information to that obtained using conventional diagnostic procedures. It may be useful for characterizing the composition and measurement of the target lesion, choosing the type and size of the stent, and evaluating the results after the procedure.

  5. Development of a Duplex Ultrasound Simulator and Preliminary Validation of Velocity Measurements in Carotid Artery Models.

    PubMed

    Zierler, R Eugene; Leotta, Daniel F; Sansom, Kurt; Aliseda, Alberto; Anderson, Mark D; Sheehan, Florence H

    2016-07-01

    Duplex ultrasound scanning with B-mode imaging and both color Doppler and Doppler spectral waveforms is relied upon for diagnosis of vascular pathology and selection of patients for further evaluation and treatment. In most duplex ultrasound applications, classification of disease severity is based primarily on alterations in blood flow velocities, particularly the peak systolic velocity (PSV) obtained from Doppler spectral waveforms. We developed a duplex ultrasound simulator for training and assessment of scanning skills. Duplex ultrasound cases were prepared from 2-dimensional (2D) images of normal and stenotic carotid arteries by reconstructing the common carotid, internal carotid, and external carotid arteries in 3 dimensions and computationally simulating blood flow velocity fields within the lumen. The simulator displays a 2D B-mode image corresponding to transducer position on a mannequin, overlaid by color coding of velocity data. A spectral waveform is generated according to examiner-defined settings (depth and size of the Doppler sample volume, beam steering, Doppler beam angle, and pulse repetition frequency or scale). The accuracy of the simulator was assessed by comparing the PSV measured from the spectral waveforms with the true PSV which was derived from the computational flow model based on the size and location of the sample volume within the artery. Three expert examiners made a total of 36 carotid artery PSV measurements based on the simulated cases. The PSV measured by the examiners deviated from true PSV by 8% ± 5% (N = 36). The deviation in PSV did not differ significantly between artery segments, normal and stenotic arteries, or examiners. To our knowledge, this is the first simulation of duplex ultrasound that can create and display real-time color Doppler images and Doppler spectral waveforms. The results demonstrate that an examiner can measure PSV from the spectral waveforms using the settings on the simulator with a mean absolute error

  6. Point-of-care cardiac ultrasound techniques in the physical examination: better at the bedside.

    PubMed

    Kimura, Bruce J

    2017-07-01

    The development of hand-carried, battery-powered ultrasound devices has created a new practice in ultrasound diagnostic imaging, called 'point-of-care' ultrasound (POCUS). Capitalising on device portability, POCUS is marked by brief and limited ultrasound imaging performed by the physician at the bedside to increase diagnostic accuracy and expediency. The natural evolution of POCUS techniques in general medicine, particularly with pocket-sized devices, may be in the development of a basic ultrasound examination similar to the use of the binaural stethoscope. This paper will specifically review how POCUS improves the limited sensitivity of the current practice of traditional cardiac physical examination by both cardiologists and non-cardiologists. Signs of left ventricular systolic dysfunction, left atrial enlargement, lung congestion and elevated central venous pressures are often missed by physical techniques but can be easily detected by POCUS and have prognostic and treatment implications. Creating a general set of repetitive imaging skills for these entities for application on all patients during routine examination will standardise and reduce heterogeneity in cardiac bedside ultrasound applications, simplify teaching curricula, enhance learning and recollection, and unify competency thresholds and practice. The addition of POCUS to standard physical examination techniques in cardiovascular medicine will result in an ultrasound-augmented cardiac physical examination that reaffirms the value of bedside diagnosis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Examining Neosho madtom reproductive biology using ultrasound and artificial photothermal cycles

    USGS Publications Warehouse

    Bryan, J.L.; Wildhaber, M.L.; Noltie, Douglas B.

    2005-01-01

    We examined whether extended laboratory simulation of natural photothermal conditions could stimulate reproduction in the Neosho madtom Noturus placidus, a federally threatened species. For 3 years, a captive population of Neosho madtoms was maintained under simulated natural conditions and monitored routinely with ultrasound for reproductive condition. Female Neosho madtoms cycled in and out of spawning condition, producing and absorbing oocytes annually. Internal measurements made by means of ultrasound indicated the summer mean oocyte size remained consistent over the years, although estimated fecundity increased with increasing fish length. In the summer of 2001, after 3 years in the simulated natural environment, 13 out of 41 fish participated in 10 spawnings. Simulation of the natural photothermal environment, coupled with within-day temperature fluctuations during the spring rise, seemed important for the spawning of captive Neosho madtoms. The use of ultrasound to assess the reproductive status in Neosho madtoms was effective and resulted in negligible stress or injury to the fish. These procedures may facilitate future culture of this species and other madtoms Noturus spp., especially when species are rare, threatened, or endangered. ?? Copyright by the American Fisheries Society 2005.

  8. The ultrasound-assisted physical examination in the periodic health evaluation of the elderly.

    PubMed

    Siepel, T; Clifford, D S; James, P A; Cowan, T M

    2000-07-01

    Except for specific procedures such as blood pressure measurement, the conventional physical examination (PE) does not have sufficient sensitivity to be useful as part of the periodic health evaluation. Ultrasound has demonstrated greater sensitivity and specificity in numerous studies but has been too expensive to be widely employed in health screening. The purpose of our study was to determine whether an examination in which conventional and ultrasound techniques are blended and applied by a primary care physician might be feasible and useful in the periodic health evaluations of senior citizens. Seventy-two patients presenting to a community-based family physician for periodic health evaluations received an ultrasound-assisted physical examination (USA-PE) from a second family physician. The results were reported to the primary physician, and the outcomes were tracked for periods of up to 2 years. Twenty-two of the 72 patients (31%) had abnormalities found by the USA-PE that were not apparent during the conventional PE. Five of these patients (7%) had serious conditions that received prompt treatment with apparent benefit. Findings included endometrial carcinoma, abdominal aortic aneurysm, carotid stenosis, hydronephrosis, and urinary retention. The USA-PE found more abnormalities in this group of patients than conventional PE. Whether it can improve outcomes for senior citizens undergoing periodic health evaluations in a cost-effective manner is yet to be determined.

  9. Measurement of corneal tangent modulus using ultrasound indentation.

    PubMed

    Wang, Li-Ke; Huang, Yan-Ping; Tian, Lei; Kee, Chea-Su; Zheng, Yong-Ping

    2016-09-01

    Biomechanical properties are potential information for the diagnosis of corneal pathologies. An ultrasound indentation probe consisting of a load cell and a miniature ultrasound transducer as indenter was developed to detect the force-indentation relationship of the cornea. The key idea was to utilize the ultrasound transducer to compress the cornea and to ultrasonically measure the corneal deformation with the eyeball overall displacement compensated. Twelve corneal silicone phantoms were fabricated with different stiffness for the validation of measurement with reference to an extension test. In addition, fifteen fresh porcine eyes were measured by the developed system in vitro. The tangent moduli of the corneal phantoms calculated using the ultrasound indentation data agreed well with the results from the tensile test of the corresponding phantom strips (R(2)=0.96). The mean tangent moduli of the porcine corneas measured by the proposed method were 0.089±0.026MPa at intraocular pressure (IOP) of 15mmHg and 0.220±0.053MPa at IOP of 30mmHg, respectively. The coefficient of variation (CV) and intraclass correlation coefficient (ICC) of tangent modulus were 14.4% and 0.765 at 15mmHg, and 8.6% and 0.870 at 30mmHg, respectively. The preliminary study showed that ultrasound indentation could be applied to the measurement of corneal tangent modulus with good repeatability and improved measurement accuracy compared to conventional surface displacement-based measurement method. The ultrasound indentation can be a potential tool for the corneal biomechanical properties measurement in vivo. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. System and method for improving ultrasound image acquisition and replication for repeatable measurements of vascular structures

    NASA Technical Reports Server (NTRS)

    Selzer, Robert H. (Inventor); Hodis, Howard N. (Inventor)

    2006-01-01

    High resolution B-mode ultrasound images of the common carotid artery are obtained with an ultrasound transducer using a standardized methodology. Subjects are supine with the head counter-rotated 45 degrees using a head pillow. The jugular vein and carotid artery are located and positioned in a vertical stacked orientation. The transducer is rotated 90 degrees around the centerline of the transverse image of the stacked structure to obtain a longitudinal image while maintaining the vessels in a stacked position. A computerized methodology assists operators to accurately replicate images obtained over several spaced-apart examinations. The methodology utilizes a split-screen display in which the arterial ultrasound image from an earlier examination is displayed on one side of the screen while a real-time live ultrasound image from a current examination is displayed next to the earlier image on the opposite side of the screen. By viewing both images, whether simultaneously or alternately, while manually adjusting the ultrasound transducer, an operator is able to bring into view the real-time image that best matches a selected image from the earlier ultrasound examination. Utilizing this methodology, measurement of vascular dimensions such as carotid arterial IMT and diameter, the coefficient of variation is substantially reduced to values approximating from about 1.0% to about 1.25%. All images contain anatomical landmarks for reproducing probe angulation, including visualization of the carotid bulb, stacking of the jugular vein above the carotid artery, and initial instrumentation settings, used at a baseline measurement are maintained during all follow-up examinations.

  11. Does Ultrasound-Enhanced Instruction of Musculoskeletal Anatomy Improve Physical Examination Skills of First-Year Medical Students?

    PubMed

    Walrod, Bryant J; Schroeder, Allison; Conroy, Mark J; Boucher, Laura C; Bockbrader, Marcia; Way, David P; McCamey, Kendra L; Hartz, Clinton A; Jonesco, Michael A; Bahner, David P

    2018-01-01

    Ultrasound imaging is commonly used to teach basic anatomy to medical students. The purpose of this study was to determine whether learning musculoskeletal anatomy with ultrasound improved performance on medical students' musculoskeletal physical examination skills. Twenty-seven first-year medical students were randomly assigned to 1 of 2 instructional groups: either shoulder or knee. Both groups received a lecture followed by hands-on ultrasound scanning on live human models of the assigned joint. After instruction, students were assessed on their ability to accurately palpate 4 anatomic landmarks: the acromioclavicular joint, the proximal long-head biceps tendon, and the medial and lateral joint lines of the knee. Performance scores were based on both accuracy and time. A total physical examination performance score was derived for each joint. Scores for instructional groups were compared by a 2-way analysis of variance with 1 repeated measure. Significant findings were further analyzed with post hoc tests. All students performed significantly better on the knee examination, irrespective of instructional group (F = 14.9; df = 1.25; P = .001). Moreover, the shoulder instruction group performed significantly better than the knee group on the overall assessment (t = -3.0; df = 25; P < .01). Post hoc analyses revealed that differences in group performance were due to the shoulder group's higher scores on palpation of the biceps tendon (t = -2.8; df = 25; P = .01), a soft tissue landmark. Both groups performed similarly on palpation of all other anatomic structures. The use of ultrasound appears to provide an educational advantage when learning musculoskeletal physical examination of soft tissue landmarks. © 2017 by the American Institute of Ultrasound in Medicine.

  12. Focused ultrasound thermal therapy system with ultrasound image guidance and temperature measurement feedback.

    PubMed

    Lin, Kao-Han; Young, Sun-Yi; Hsu, Ming-Chuan; Chan, Hsu; Chen, Yung-Yaw; Lin, Win-Li

    2008-01-01

    In this study, we developed a focused ultrasound (FUS) thermal therapy system with ultrasound image guidance and thermocouple temperature measurement feedback. Hydraulic position devices and computer-controlled servo motors were used to move the FUS transducer to the desired location with the measurement of actual movement by linear scale. The entire system integrated automatic position devices, FUS transducer, power amplifier, ultrasound image system, and thermocouple temperature measurement into a graphical user interface. For the treatment procedure, a thermocouple was implanted into a targeted treatment region in a tissue-mimicking phantom under ultrasound image guidance, and then the acoustic interference pattern formed by image ultrasound beam and low-power FUS beam was employed as image guidance to move the FUS transducer to have its focal zone coincident with the thermocouple tip. The thermocouple temperature rise was used to determine the sonication duration for a suitable thermal lesion as a high power was turned on and ultrasound image was used to capture the thermal lesion formation. For a multiple lesion formation, the FUS transducer was moved under the acoustic interference guidance to a new location and then it sonicated with the same power level and duration. This system was evaluated and the results showed that it could perform two-dimensional motion control to do a two-dimensional thermal therapy with a small localization error 0.5 mm. Through the user interface, the FUS transducer could be moved to heat the target region with the guidance of ultrasound image and acoustic interference pattern. The preliminary phantom experimental results demonstrated that the system could achieve the desired treatment plan satisfactorily.

  13. Challenges and regulatory considerations in the acoustic measurement of high-frequency (>20 MHz) ultrasound.

    PubMed

    Nagle, Samuel M; Sundar, Guru; Schafer, Mark E; Harris, Gerald R; Vaezy, Shahram; Gessert, James M; Howard, Samuel M; Moore, Mary K; Eaton, Richard M

    2013-11-01

    This article examines the challenges associated with making acoustic output measurements at high ultrasound frequencies (>20 MHz) in the context of regulatory considerations contained in the US Food and Drug Administration industry guidance document for diagnostic ultrasound devices. Error sources in the acoustic measurement, including hydrophone calibration and spatial averaging, nonlinear distortion, and mechanical alignment, are evaluated, and the limitations of currently available acoustic measurement instruments are discussed. An uncertainty analysis of acoustic intensity and power measurements is presented, and an example uncertainty calculation is done on a hypothetical 30-MHz high-frequency ultrasound system. This analysis concludes that the estimated measurement uncertainty of the acoustic intensity is +73%/-86%, and the uncertainty in the mechanical index is +37%/-43%. These values exceed the respective levels in the Food and Drug Administration guidance document of 30% and 15%, respectively, which are more representative of the measurement uncertainty associated with characterizing lower-frequency ultrasound systems. Recommendations made for minimizing the measurement uncertainty include implementing a mechanical positioning system that has sufficient repeatability and precision, reconstructing the time-pressure waveform via deconvolution using the hydrophone frequency response, and correcting for hydrophone spatial averaging.

  14. Multimedia systems in ultrasound image boundary detection and measurements

    NASA Astrophysics Data System (ADS)

    Pathak, Sayan D.; Chalana, Vikram; Kim, Yongmin

    1997-05-01

    Ultrasound as a medical imaging modality offers the clinician a real-time of the anatomy of the internal organs/tissues, their movement, and flow noninvasively. One of the applications of ultrasound is to monitor fetal growth by measuring biparietal diameter (BPD) and head circumference (HC). We have been working on automatic detection of fetal head boundaries in ultrasound images. These detected boundaries are used to measure BPD and HC. The boundary detection algorithm is based on active contour models and takes 32 seconds on an external high-end workstation, SUN SparcStation 20/71. Our goal has been to make this tool available within an ultrasound machine and at the same time significantly improve its performance utilizing multimedia technology. With the advent of high- performance programmable digital signal processors (DSP), the software solution within an ultrasound machine instead of the traditional hardwired approach or requiring an external computer is now possible. We have integrated our boundary detection algorithm into a programmable ultrasound image processor (PUIP) that fits into a commercial ultrasound machine. The PUIP provides both the high computing power and flexibility needed to support computationally-intensive image processing algorithms within an ultrasound machine. According to our data analysis, BPD/HC measurements made on PUIP lie within the interobserver variability. Hence, the errors in the automated BPD/HC measurements using the algorithm are on the same order as the average interobserver differences. On PUIP, it takes 360 ms to measure the values of BPD/HC on one head image. When processing multiple head images in sequence, it takes 185 ms per image, thus enabling 5.4 BPD/HC measurements per second. Reduction in the overall execution time from 32 seconds to a fraction of a second and making this multimedia system available within an ultrasound machine will help this image processing algorithm and other computer-intensive imaging

  15. The comparison of measurement between ultrasound and computed tomography for abnormal degenerative facet joints: A STROBE-compliant article.

    PubMed

    Shi, Wen; Tian, Dan; Liu, Da; Yin, Jing; Huang, Ying

    2017-08-01

    Besides the study on examining facet joints of lumbar spine by ultrasound in normal population, there has not been any related report about examining normal facet joints of lumbar spine by ultrasound so far. This study was aimed to explore the feasibility of ultrasound assessment of lumber spine facet joints by comparing ultrasound measure values of normal and degenerative lumber spine facet joints, and by comparing measure values of ultrasound and computed tomography (CT) of degenerative lumber spine facet joints.This study included 15 patients who had chronic low back pain because of degenerative change in lumbar vertebrae, and 19 volunteers who did not have low back pain or pain in the lower limb. The ultrasound measure values (height [H] and width [W]) of normal and degenerative lumber spine facet joints were compared. And the differentiation between measure values (H and W) of ultrasound and CT of degenerative lumber spine facet joints was also analyzed.The ultrasound clearly showed abnormal facet joints lesion, which was characterized by hyperostosis on the edge of joints, bone destruction under joints, and thinner or thicker articular cartilage. There were significant differences between the ultrasound measure values of the normal (H: 1.26 ± 0.03 cm, W: 0.18 ± 0.01 cm) and abnormal facet joints (H: 1.43 ± 0.05 cm, W: 0.15 ± 0.02 cm) (all P < .05). However, there were no significant differences between the measure values of the ultrasound (H: 1.43 ± 0.17 cm, W: 0.15 ± 0.03 cm) and CT (H: 1.42 ± 0.16, W: 0.14 ± 0.03) of the degenerative lumber spine facet joints (all P > .05).Ultrasound can clearly show the structure of facet joints of lumbar spine. It is precise and feasible to assess facet joints of lumbar spine by ultrasound. This study has important significance for the diagnosis of lumbar facet joint degeneration.

  16. Technical aspects of contrast-enhanced ultrasound (CEUS) examinations: tips and tricks.

    PubMed

    Greis, C

    2014-01-01

    Ultrasound contrast agents have substantially extended the clinical value of ultrasound, allowing the assessment of blood flow and distribution in real-time down to microcapillary level. Selective imaging of contrast agent signals requires a contrast-specific imaging mode on the ultrasound scanner, allowing real-time separation of tissue and contrast agent signals. The creation of a contrast image requires a specific interaction between the insonated ultrasound wave and the contrast agent microbubbles, leading to persistent oscillation of the bubbles. Several technical and procedural parameters have a significant influence on the quality of CEUS images and should be controlled carefully to obtain good image quality and a reliable diagnosis. Achieving the proper balance between the respective parameters is a matter of technical knowledge and experience. Appropriate training and education should be mandatory for every investigator performing CEUS examinations.

  17. An automated in vitro model for the evaluation of ultrasound modalities measuring myocardial deformation

    PubMed Central

    2010-01-01

    Background Echocardiography is the method of choice when one wishes to examine myocardial function. Qualitative assessment of the 2D grey scale images obtained is subjective, and objective methods are required. Speckle Tracking Ultrasound is an emerging technology, offering an objective mean of quantifying left ventricular wall motion. However, before a new ultrasound technology can be adopted in the clinic, accuracy and reproducibility needs to be investigated. Aim It was hypothesized that the collection of ultrasound sample data from an in vitro model could be automated. The aim was to optimize an in vitro model to allow for efficient collection of sample data. Material & Methods A tissue-mimicking phantom was made from water, gelatin powder, psyllium fibers and a preservative. Sonomicrometry crystals were molded into the phantom. The solid phantom was mounted in a stable stand and cyclically compressed. Peak strain was then measured by Speckle Tracking Ultrasound and sonomicrometry. Results We succeeded in automating the acquisition and analysis of sample data. Sample data was collected at a rate of 200 measurement pairs in 30 minutes. We found good agreement between Speckle Tracking Ultrasound and sonomicrometry in the in vitro model. Best agreement was 0.83 ± 0.70%. Worst agreement was -1.13 ± 6.46%. Conclusions It has been shown possible to automate a model that can be used for evaluating the in vitro accuracy and precision of ultrasound modalities measuring deformation. Sonomicrometry and Speckle Tracking Ultrasound had acceptable agreement. PMID:20822532

  18. Prospective Controlled Study of Buttock Fat Transfer Using Ultrasound and Photographic Measurements

    PubMed Central

    2016-01-01

    Background: Buttock fat transfer is now the preferred method for gluteal augmentation. However, its efficacy has not been well-documented using measurements. Methods: Twenty-five consecutive patients underwent buttock fat transfer performed by the author. Twenty-one patients returned for measurements ≥3 months after surgery (inclusion rate, 84%). A separate group of 25 patients undergoing cosmetic surgery without buttock fat transfer served as controls. All patients underwent superwet liposuction using total intravenous anesthesia and no prone positioning. A closed filtration system was used to collect the fat. Subcutaneous fat thickness was assessed using ultrasound imaging. Measurements were made on standardized photographs. The data were controlled for change in body mass index. Clinical data were also evaluated. Results: The mean fat volume injected per buttock was 287 mL (range, 70–550 mL). Ultrasound measurements detected a significant increase in the subcutaneous fat thickness (P ≤ 0.001), with mean increments of 0.66 cm for the right buttock and 0.86 cm for the left buttock and no significant change for control patients. The mean calculated fat retention, based on the measured surface area injected, was 66%. Photographic measurements of buttock projection revealed a significant increase in treated patients (P < 0.01) and no significant change in control patients. There were no clinical complications at either recipient or donor sites and no evidence of oily cysts on ultrasound examinations. Conclusions: Photographic and ultrasound measurements, and clinical findings, confirm that buttock fat transfer effectively and safely increases buttock projection. PMID:27579222

  19. Acoustic pressure measurement of pulsed ultrasound using acousto-optic diffraction

    NASA Astrophysics Data System (ADS)

    Jia, Lecheng; Chen, Shili; Xue, Bin; Wu, Hanzhong; Zhang, Kai; Yang, Xiaoxia; Zeng, Zhoumo

    2018-01-01

    Compared with continuous ultrasound wave, pulsed ultrasound has been widely used in ultrasound imaging. The aim of this work is to show the applicability of acousto-optic diffraction on pulsed ultrasound transducer. In this paper, acoustic pressure of two ultrasound transducers is measured based on Raman-Nath diffraction. The frequencies of transducers are 5MHz and 10MHz. The pulse-echo method and simulation data are used to evaluate the results. The results show that the proposed method is capable to measure the absolute sound pressure. We get a sectional view of acoustic pressure using a displacement platform as an auxiliary. Compared with the traditional sound pressure measurement methods, the proposed method is non-invasive with high sensitivity and spatial resolution.

  20. Ovary and vaginal epithelium dynamics during the estrous cycle in Dasyprocta prymnolopha Wagler, 1831: ultrasound and cytological examinations

    PubMed Central

    Carreiro, Artur N.; Diniz, João A. R. A.; Souza, Joyce G.; Araújo, Débora V. F.; Dias, Rômulo F. F.; Azerêdo, Liliane M. S.; Rocha, Ediane F.; La Salles, Ana Y. F.; Peña-Alfaro, Carlos E.; Carvalho, Maria A. M.; Illera, Maria J.

    2018-01-01

    The objective of the present study was to monitor and characterize morphological alterations in ovaries of agouti (Dasyprocta prymnolopha), reared in captivity, by using abdominal ultrasonography. All animals underwent daily vaginal cytological examination to identify the current cycle phase. For each phase of the estrous cycle, ultrasound examinations were carried out to identify and describe the morphology of both ovaries. Topographic parameters in an ultrasound window were established to locate the ovaries. The agouti estrous cycle lasted an average of 29.94 ± 6.77 days. During vaginal cytology examinations, all cell types were identified, and each phase of the estrous cycle was established by cell counts. No significant alterations were observed in the assessed ovarian morphometry measurements. In 75% of the animals examined, ovarian follicle presence was observed in the proestrus phase. PMID:29284211

  1. Summative Objective Structured Clinical Examination Assessment at the End of Anesthesia Residency for Perioperative Ultrasound.

    PubMed

    Mitchell, John D; Amir, Rabia; Montealegre-Gallegos, Mario; Mahmood, Feroze; Shnider, Marc; Mashari, Azad; Yeh, Lu; Bose, Ruma; Wong, Vanessa; Hess, Philip; Amador, Yannis; Jeganathan, Jelliffe; Jones, Stephanie B; Matyal, Robina

    2018-06-01

    While standardized examinations and data from simulators and phantom models can assess knowledge and manual skills for ultrasound, an Objective Structured Clinical Examination (OSCE) could assess workflow understanding. We recruited 8 experts to develop an OSCE to assess workflow understanding in perioperative ultrasound. The experts used a binary grading system to score 19 graduating anesthesia residents at 6 stations. Overall average performance was 86.2%, and 3 stations had an acceptable internal reliability (Kuder-Richardson formula 20 coefficient >0.5). After refinement, this OSCE can be combined with standardized examinations and data from simulators and phantom models to assess proficiency in ultrasound.

  2. [Efficacy and problems of bladder volume measurement using portable three dimensional ultrasound scanning device--in particular, on measuring bladder volume lower than 100ml].

    PubMed

    Oh-Oka, Hitoshi; Nose, Ryuichiro

    2005-09-01

    Using a portable three dimensional ultrasound scanning device (The Bladder Scan BVI6100, Diagnostic Ultrasound Corporation), we examined measured values of bladder volume, especially focusing on volume lower than 100 ml. A total of 100 patients (male: 66, female: 34) were enrolled in the study. We made a comparison study between the measured value (the average of three measurements of bladder urine volume after a trial in male and female modes) using BVI6100, and the actual measured value of the sample obtained by urethral catheterization in each patient. We examined the factors which could increase the error rate. We also introduced the effective techniques to reduce measurement errors. The actual measured values in all patients correlated well with the average value of three measurements after a trial in a male mode of the BVI6100. The correlation coefficient was 0.887, the error rate was--4.6 +/- 24.5%, and the average coefficient of variation was 15.2. It was observed that the measurement result using the BVI6100 is influenced by patient side factors (extracted edges between bladder wall and urine, thickened bladder wall, irregular bladder wall, flattened rate of bladder, mistaking prostate for bladder in male, mistaking bladder for uterus in a female mode, etc.) or examiner side factors (angle between BVI and abdominal wall, compatibility between abdominal wall and ultrasound probe, controlling deflection while using probe, etc). When appropriate patients are chosen and proper measurement is performed, BVI6100 provides significantly higher accuracy in determining bladder volume, compared with existing abdominal ultrasound methods. BVI6100 is a convenient and extremely effective device also for the measurement of bladder urine over 100 ml.

  3. Evaluation of a Novel Wireless Transmission System for Trauma Ultrasound Examinations From Moving Ambulances.

    PubMed

    Morchel, Herman; Ogedegbe, Chinwe; Chaplin, William; Cheney, Brianna; Zakharchenko, Svetlana; Misch, David; Schwartz, Matthew; Feldman, Joseph; Kaul, Sanjeev

    2018-03-01

    To determine if physicians trained in ultrasound interpretation perceive a difference in image quality and usefulness between Extended Focused Assessment with Sonography ultrasound examinations performed at bedside in a hospital vs. by emergency medical technicians minimally trained in medical ultrasound on a moving ambulance and transmitted to the hospital via a novel wireless system. In particular, we sought to demonstrate that useful images could be obtained from patients in less than optimal imaging conditions; that is, while they were in transport. Emergency medical technicians performed the examinations during transport of blunt trauma patients. Upon patient arrival at the hospital, a bedside Extended Focused Assessment with Sonography examination was performed by a physician. Both examinations were recorded and later reviewed by physicians trained in ultrasound interpretation. Data were collected on 20 blunt trauma patients over a period of 13 mo. Twenty ultrasound-trained physicians blindly compared transmitted vs. bedside images using 11 Questionnaire for User Interaction Satisfaction scales. Four paired samples t-tests were conducted to assess mean differences between ratings for ambulatory and base images. Although there is a slight tendency for the average rating across all subjects and raters to be slightly higher in the base than in the ambulatory condition, none of these differences are statistically significant. These results suggest that the quality of the ambulatory images was viewed as essentially as good as the quality of the base images.

  4. Comparison of portable and conventional ultrasound imaging in spinal curvature measurement

    NASA Astrophysics Data System (ADS)

    Yan, Christina; Tabanfar, Reza; Kempston, Michael; Borschneck, Daniel; Ungi, Tamas; Fichtinger, Gabor

    2016-03-01

    PURPOSE: In scoliosis monitoring, tracked ultrasound has been explored as a safer imaging alternative to traditional radiography. The use of ultrasound in spinal curvature measurement requires identification of vertebral landmarks, but bones have reduced visibility in ultrasound imaging and high quality ultrasound machines are often expensive and not portable. In this work, we investigate the image quality and measurement accuracy of a low cost and portable ultrasound machine in comparison to a standard ultrasound machine in scoliosis monitoring. METHODS: Two different kinds of ultrasound machines were tested on three human subjects, using the same position tracker and software. Spinal curves were measured in the same reference coordinate system using both ultrasound machines. Lines were defined by connecting two symmetric landmarks identified on the left and right transverse process of the same vertebrae, and spinal curvature was defined as the transverse process angle between two such lines, projected on the coronal plane. RESULTS: Three healthy volunteers were scanned by both ultrasound configurations. Three experienced observers localized transverse processes as skeletal landmarks and obtained transverse process angles in images obtained from both ultrasounds. The mean difference per transverse process angle measured was 3.00 +/-2.1°. 94% of transverse processes visualized in the Sonix Touch were also visible in the Telemed. Inter-observer error in the Telemed was 4.5° and 4.3° in the Sonix Touch. CONCLUSION: Price, convenience and accessibility suggest the Telemed to be a viable alternative in scoliosis monitoring, however further improvements in measurement protocol and image noise reduction must be completed before implementing the Telemed in the clinical setting.

  5. Study on text mining algorithm for ultrasound examination of chronic liver diseases based on spectral clustering

    NASA Astrophysics Data System (ADS)

    Chang, Bingguo; Chen, Xiaofei

    2018-05-01

    Ultrasonography is an important examination for the diagnosis of chronic liver disease. The doctor gives the liver indicators and suggests the patient's condition according to the description of ultrasound report. With the rapid increase in the amount of data of ultrasound report, the workload of professional physician to manually distinguish ultrasound results significantly increases. In this paper, we use the spectral clustering method to cluster analysis of the description of the ultrasound report, and automatically generate the ultrasonic diagnostic diagnosis by machine learning. 110 groups ultrasound examination report of chronic liver disease were selected as test samples in this experiment, and the results were validated by spectral clustering and compared with k-means clustering algorithm. The results show that the accuracy of spectral clustering is 92.73%, which is higher than that of k-means clustering algorithm, which provides a powerful ultrasound-assisted diagnosis for patients with chronic liver disease.

  6. Validity of measurement of shear modulus by ultrasound shear wave elastography in human pennate muscle.

    PubMed

    Miyamoto, Naokazu; Hirata, Kosuke; Kanehisa, Hiroaki; Yoshitake, Yasuhide

    2015-01-01

    Ultrasound shear wave elastography is becoming a valuable tool for measuring mechanical properties of individual muscles. Since ultrasound shear wave elastography measures shear modulus along the principal axis of the probe (i.e., along the transverse axis of the imaging plane), the measured shear modulus most accurately represents the mechanical property of the muscle along the fascicle direction when the probe's principal axis is parallel to the fascicle direction in the plane of the ultrasound image. However, it is unclear how the measured shear modulus is affected by the probe angle relative to the fascicle direction in the same plane. The purpose of the present study was therefore to examine whether the angle between the principal axis of the probe and the fascicle direction in the same plane affects the measured shear modulus. Shear modulus in seven specially-designed tissue-mimicking phantoms, and in eleven human in-vivo biceps brachii and medial gastrocnemius were determined by using ultrasound shear wave elastography. The probe was positioned parallel or 20° obliquely to the fascicle across the B-mode images. The reproducibility of shear modulus measurements was high for both parallel and oblique conditions. Although there was a significant effect of the probe angle relative to the fascicle on the shear modulus in human experiment, the magnitude was negligibly small. These findings indicate that the ultrasound shear wave elastography is a valid tool for evaluating the mechanical property of pennate muscles along the fascicle direction.

  7. Diaphragm breathing movement measurement using ultrasound and radiographic imaging: a concurrent validity.

    PubMed

    Noh, Dong K; Lee, Jae J; You, Joshua H

    2014-01-01

    Recent ultrasound imaging evidence asserts that the diaphragm is an important multifunctional muscle to control breathing as well as stabilize the core and posture in humans. However, the validity and accuracy of ultrasound for the measurement of dynamic diaphragm movements during breathing and functional core activities have not been determined. The specific aim of this study was to validate the accuracy of ultrasound imaging measurements of diaphragm movements by concurrently comparing these measurements to the gold standard of radiographic imaging measurements. A total of 14 asymptomatic adults (9 males, 5 females; mean age =28.4 ± 3.0 years) were recruited to participate in the study. Ultrasound and radiographic images were used concurrently to determine diaphragm movement (inspiration, expiration, and excursion) during tidal breathing. Pearson correlation analysis showed strong correlations, ranging from r=0.78 to r=0.83, between ultrasound and radiographic imaging measurements of the diaphragm during inhalation, exhalation, and excursion. These findings suggest that ultrasound imaging measurement is useful to accurately evaluate diaphragm movements during tidal breathing. Clinically, ultrasound imaging measurements can be used to diagnose and treat diaphragm movement impairments in individuals with neuromuscular disorders including spinal cord injuries, stroke, and multiple sclerosis.

  8. Intelligent scanning: automated standard plane selection and biometric measurement of early gestational sac in routine ultrasound examination.

    PubMed

    Zhang, Ling; Chen, Siping; Chin, Chien Ting; Wang, Tianfu; Li, Shengli

    2012-08-01

    To assist radiologists and decrease interobserver variability when using 2D ultrasonography (US) to locate the standardized plane of early gestational sac (SPGS) and to perform gestational sac (GS) biometric measurements. In this paper, the authors report the design of the first automatic solution, called "intelligent scanning" (IS), for selecting SPGS and performing biometric measurements using real-time 2D US. First, the GS is efficiently and precisely located in each ultrasound frame by exploiting a coarse to fine detection scheme based on the training of two cascade AdaBoost classifiers. Next, the SPGS are automatically selected by eliminating false positives. This is accomplished using local context information based on the relative position of anatomies in the image sequence. Finally, a database-guided multiscale normalized cuts algorithm is proposed to generate the initial contour of the GS, based on which the GS is automatically segmented for measurement by a modified snake model. This system was validated on 31 ultrasound videos involving 31 pregnant volunteers. The differences between system performance and radiologist performance with respect to SPGS selection and length and depth (diameter) measurements are 7.5% ± 5.0%, 5.5% ± 5.2%, and 6.5% ± 4.6%, respectively. Additional validations prove that the IS precision is in the range of interobserver variability. Our system can display the SPGS along with biometric measurements in approximately three seconds after the video ends, when using a 1.9 GHz dual-core computer. IS of the GS from 2D real-time US is a practical, reproducible, and reliable approach.

  9. Comparative evaluation of ultrasound scanner accuracy in distance measurement

    NASA Astrophysics Data System (ADS)

    Branca, F. P.; Sciuto, S. A.; Scorza, A.

    2012-10-01

    The aim of the present study is to develop and compare two different automatic methods for accuracy evaluation in ultrasound phantom measurements on B-mode images: both of them give as a result the relative error e between measured distances, performed by 14 brand new ultrasound medical scanners, and nominal distances, among nylon wires embedded in a reference test object. The first method is based on a least squares estimation, while the second one applies the mean value of the same distance evaluated at different locations in ultrasound image (same distance method). Results for both of them are proposed and explained.

  10. Remote just-in-time telementored trauma ultrasound: a double-factorial randomized controlled trial examining fluid detection and remote knobology control through an ultrasound graphic user interface display.

    PubMed

    Kirkpatrick, Andrew W; McKee, Ian; McKee, Jessica L; Ma, Irene; McBeth, Paul B; Roberts, Derek J; Wurster, Charles L; Parfitt, Robbie; Ball, Chad G; Oberg, Scott; Sevcik, William; Hamilton, Douglas R

    2016-05-01

    Remote-telementored ultrasound involves novice examiners being remotely guided by experts using informatic-technologies. However, requiring a novice to perform ultrasound is a cognitively demanding task exacerbated by unfamiliarity with ultrasound-machine controls. We incorporated a randomized evaluation of using remote control of the ultrasound functionality (knobology) within a study in which the images generated by distant naive examiners were viewed on an ultrasound graphic user interface (GUI) display viewed on laptop computers by mentors in different cities. Fire-fighters in Edmonton (101) were remotely mentored from Calgary (n = 65), Nanaimo (n = 19), and Memphis (n = 17) to examine an ultrasound phantom randomized to contain free fluid or not. Remote mentors (2 surgeons, 1 internist, and 1 ED physician) were randomly assigned to use GUI knobology control during mentoring (GUIK+/GUIK-). Remote-telementored ultrasound was feasible in all cases. Overall accuracy for fluid detection was 97% (confidence interval = 91 to 99%) with 3 false negatives (FNs). Positive/negative likelihood ratios were infinity/0.0625. One FN occurred with the GUIK+ and 2 without (GUIK-). There were no statistical test performance differences in either group (GUIK+ and GUIK-). Ultrasound-naive 1st responders can be remotely mentored with high accuracy, although providing basic remote control of the knobology did not affect outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Measuring Femoral Torsion In Vivo Using Freehand 3-D Ultrasound Imaging.

    PubMed

    Passmore, Elyse; Pandy, Marcus G; Graham, H Kerr; Sangeux, Morgan

    2016-02-01

    Despite variation in bone geometry, muscle and joint function is often investigated using generic musculoskeletal models. Patient-specific bone geometry can be obtained from computerised tomography, which involves ionising radiation, or magnetic resonance imaging (MRI), which is costly and time consuming. Freehand 3-D ultrasound provides an alternative to obtain bony geometry. The purpose of this study was to determine the accuracy and repeatability of 3-D ultrasound in measuring femoral torsion. Measurements of femoral torsion were performed on 10 healthy adults using MRI and 3-D ultrasound. Measurements of femoral torsion from 3-D ultrasound were, on average, smaller than those from MRI (mean difference = 1.8°; 95% confidence interval: -3.9°, 7.5°). MRI and 3-D ultrasound had Bland and Altman repeatability coefficients of 3.1° and 3.7°, respectively. Accurate measurements of femoral torsion were obtained with 3-D ultrasound offering the potential to acquire patient-specific bone geometry for musculoskeletal modelling. Three-dimensional ultrasound is non-invasive and relatively inexpensive and can be integrated into gait analysis. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  12. Effect of mild pressure applied by the ultrasound transducer on fetal cephalic measurements at 20-24 weeks' gestation.

    PubMed

    Kliper, Yael; Ben-Ami, Moshe; Perlitz, Yuri

    2014-01-01

    The aim of this study was to assess the effect of mild pressure applied on the abdominal wall by the ultrasound transducer on fetal cephalic indices. We examined by ultrasound 60 fetuses of healthy women, at 20-24 weeks of pregnancy, during routine prenatal evaluation. For every fetus biparietal diameter and head circumference were measured, with and without applying mild pressure by the ultrasound transducer. The weight and gestational age (GA) were calculated. The pressure applied by the transducer had a significant effect on the cephalic indices and on the weight and GA evaluations (p < 0.001). Fetal positioning significantly affected the impact that applied pressure had on head circumference and on the weight evaluation derived from it (p < 0.05). Applied pressure by an abdominal ultrasound probe affects cephalic indices and the derived weight and GA estimations. This may lead to incorrect diagnoses or hide pathological findings. The effect of applied pressure depends on fetal positioning. The examiner must be aware of this effect when evaluating the results of the measurements.

  13. [Ultrasound examination for lower extremity deep vein thrombosis].

    PubMed

    Toyota, Kosaku

    2014-09-01

    Surgery is known to be a major risk factor of vein thrombosis. Progression from lower extremity deep vein thrombosis (DVT) to pulmonary embolism can lead to catastrophic outcome, although the incidence ratio is low. The ability to rule in or rule out DVT is becoming essential for anesthesiologists. Non-invasive technique of ultrasonography is a sensitive and specific tool for the assessment of lower extremity DVT. This article introduces the basics and practical methods of ultrasound examination for lower extremity DVT.

  14. Prevalence of uterine myoma detected by ultrasound examination in the atomic bomb survivors

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

    Kawamura, Sachiko; Kodama, Kazunori; Fujiwara, Saeko

    1997-06-01

    Benign tumors of several organs have been demonstrated to occur as late effects of atomic bomb exposure, and a recent addition to the list of affected organs in the uterus. The increased incidence of uterine myoma noted in Radiation Effects Research Foundation (REFR) Adult Health Study Report 7, however, was based on self-reported information, optional gynecological examination and patient-requested ultrasound examination. Thus the possibility of dose-related bias in case detection was a serious concern. Therefore, the relationship between the prevalence of uterine myoma and dose to the uterus was examined after excluding as much bias as possible by asking allmore » women who had undergone biennial examinations from December 1991 through December 1993 to undergo ultrasound examinations. Among 2506 female participants in Hiroshima, the uterus was visualized by ultrasound examination in 1190, and 238 were found to have uterine nodules. Multiple logistic analysis using Dosimetry System 1986 uterine doses revealed a significant dose response for the prevalence of uterine nodules. The odds ratio at 1 Gy was 1.61 (95% confidence interval: 1.12-2.31). It is unlikely that the observed relationship after adjusting for bladder filling, volume of the uterus, age and menopause status was the result of dose-related bias. These results support previous findings at RERF and provide further evidence that radiation exposure is one of the factors associated with uterine myoma. 28 refs., 3 figs., 4 tabs.« less

  15. Measuring the volume of uterine fibroids using 2- and 3-dimensional ultrasound and comparison with histopathology.

    PubMed

    Zivković, Nikica; Zivković, Kreiimir; Despot, Albert; Paić, Josip; Zelić, Ana

    2012-12-01

    The aim of this study was clinical testing of the reliability and usability of three-dimensional (3D) and two-dimensional (2D) ultrasound (US) technology. The ultimate aim and purpose of this study was to establish ultrasound methods, standards and protocols for determining the volume of any gynecologic organ or tumor. The study included 31 women in reproductive age and postmenopause. All patients were examined with a RIC 5-9 3D-endovaginal probe (4.3-7.5 MHz) on a Voluson 730 Pro ultrasound device. The volume of myomas was measured by using the existing 2D and 3D ultrasound methods on the above mentioned device. All patients underwent myomectomy or hysterectomy due to clinically and ultrasonographically diagnosed uterine myomas indicating operative intervention. After the operation, the pathologist determined the volume of removed myomas by measuring them in a gauge bowl containing water, i.e. using Archimedes' principle (lift), serving as the control group with histopathologic diagnosis. A total of 155 myoma volumes were processed on 2D display, 31 myoma volumes were preoperatively measured on 3D display and 31 myoma volumes were measured by the pathologist. The values of US measurements for each US method were expressed as mean value of all measurements of myoma volumes. Statistical processing of the results and Student's t-test for independent samples revealed that the 2nd examined US method (measuring of myoma by using an ellipse and the longer tumor diameter) and 4th examined US method (measuring of myoma by using the longer and shorter tumor diameters together with establishing their mean values) in 2D US technique, as well as the 6th examined US method in 3D US technique showed no significant measurement differences in comparison with control measurement in a gauge bowl containing water (p < 0.05), indicating acceptability of the US methods for verifying tumor volumes. The standard error in determining the volume of myomas by the above US methods varied

  16. Ultrasound elastography: the new frontier in direct measurement of muscle stiffness.

    PubMed

    Brandenburg, Joline E; Eby, Sarah F; Song, Pengfei; Zhao, Heng; Brault, Jeffrey S; Chen, Shigao; An, Kai-Nan

    2014-11-01

    The use of brightness-mode ultrasound and Doppler ultrasound in physical medicine and rehabilitation has increased dramatically. The continuing evolution of ultrasound technology has also produced ultrasound elastography, a cutting-edge technology that can directly measure the mechanical properties of tissue, including muscle stiffness. Its real-time and direct measurements of muscle stiffness can aid the diagnosis and rehabilitation of acute musculoskeletal injuries and chronic myofascial pain. It can also help monitor outcomes of interventions affecting muscle in neuromuscular and musculoskeletal diseases, and it can better inform the functional prognosis. This technology has implications for even broader use of ultrasound in physical medicine and rehabilitation practice, but more knowledge about its uses and limitations is essential to its appropriate clinical implementation. In this review, we describe different ultrasound elastography techniques for studying muscle stiffness, including strain elastography, acoustic radiation force impulse imaging, and shear-wave elastography. We discuss the basic principles of these techniques, including the strengths and limitations of their measurement capabilities. We review the current muscle research, discuss physiatric clinical applications of these techniques, and note directions for future research. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. Ultrasound Elastography: The New Frontier in Direct Measurement of Muscle Stiffness

    PubMed Central

    Brandenburg, Joline E.; Eby, Sarah F.; Song, Pengfei; Zhao, Heng; Brault, Jeffrey S.; Chen, Shigao; An, Kai-Nan

    2014-01-01

    The use of brightness-mode ultrasound and Doppler ultrasound in physical medicine and rehabilitation has increased dramatically. The continuing evolution of ultrasound technology has also produced ultrasound elastography, a cutting-edge technology that can directly measure the mechanical properties of tissue, including muscle stiffness. Its real-time and direct measurements of muscle stiffness can aid the diagnosis and rehabilitation of acute musculoskeletal injuries and chronic myofascial pain. It can also help monitor outcomes of interventions affecting muscle in neuromuscular and musculoskeletal diseases, and it can better inform the functional prognosis. This technology has implications for even broader use of ultrasound in physical medicine and rehabilitation practice, but more knowledge about its uses and limitations is essential to its appropriate clinical implementation. In this review, we describe different ultrasound elastography techniques for studying muscle stiffness, including strain elastography, acoustic radiation force impulse imaging, and shear-wave elastography. We discuss the basic principles of these techniques, including the strengths and limitations of their measurement capabilities. We review the current muscle research, discuss physiatric clinical applications of these techniques, and note directions for future research. PMID:25064780

  18. Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging.

    PubMed

    Notomi, Yuichi; Lysyansky, Peter; Setser, Randolph M; Shiota, Takahiro; Popović, Zoran B; Martin-Miklovic, Maureen G; Weaver, Joan A; Oryszak, Stephanie J; Greenberg, Neil L; White, Richard D; Thomas, James D

    2005-06-21

    We sought to examine the accuracy/consistency of a novel ultrasound speckle tracking imaging (STI) method for left ventricular torsion (LVtor) measurement in comparison with tagged magnetic resonance imaging (MRI) (a time-domain method similar to STI) and Doppler tissue imaging (DTI) (a velocity-based approach). Left ventricular torsion from helically oriented myofibers is a key parameter of cardiac performance but is difficult to measure. Ultrasound STI is potentially suitable for measurement of angular motion because of its angle-independence. We acquired basal and apical short-axis left ventricular (LV) images in 15 patients to estimate LVtor by STI and compare it with tagged MRI and DTI. Left ventricular torsion was defined as the net difference of LV rotation at the basal and apical planes. For the STI analysis, we used high-frame (104 +/- 12 frames/s) second harmonic two-dimensional images. Data on 13 of 15 patients were usable for STI analysis, and LVtor profile estimated by STI strongly correlated with those by tagged MRI (y = 0.95x + 0.19, r = 0.93, p < 0.0001, analyzed by repeated-measures regression models). The STI torsional velocity profile also correlated well with that by the DTI method (y = 0.79x + 2.4, r = 0.76, p < 0.0001, by repeated-measures regression models) with acceptable bias. The STI estimation of LVtor is concordant with those analyzed by tagged MRI (data derived from tissue displacement) and also showed good agreement with those by DTI (data derived from tissue velocity). Ultrasound STI is a promising new method to assess LV torsional deformation and may make the assessment more available in clinical and research cardiology.

  19. Reducing Unnecessary Shoulder MRI Examinations Within a Capitated Health Care System: A Potential Role for Shoulder Ultrasound.

    PubMed

    Sheehan, Scott E; Coburn, John A; Singh, Hardeep; Vanness, David J; Sittig, Dean F; Moberg, D Paul; Safdar, Nasia; Lee, Kenneth S; Brunner, Michael C

    2016-07-01

    MRI is frequently overused. The aim of this study was to analyze shoulder MRI ordering practices within a capitated health care system and explore the potential effects of shoulder ultrasound substitution. We reviewed medical records of 237 consecutive shoulder MRI examinations performed in 2013 at a Department of Veterans Affairs tertiary care hospital. Using advanced imaging guidelines, we assessed ordering appropriateness of shoulder MRI and estimated the proportion of examinations for which musculoskeletal ultrasound could have been an acceptable substitute, had it been available. We then reviewed MRI findings and assessed if ultrasound with preceding radiograph would have been adequate for diagnosis, based on literature reports of shoulder ultrasound diagnostic performance. Of the 237 examinations reviewed, 106 (45%) were deemed to be inappropriately ordered, most commonly because of an absent preceding radiograph (n = 98; 92%). Nonorthopedic providers had a higher frequency of inappropriate ordering (44%) relative to orthopedic specialists (17%) (P = .016; odds ratio = 3.15, 95% confidence interval = 1.24-8.01). In the 237 examinations, ultrasound could have been the indicated advanced imaging modality for 157 (66%), and most of these (133/157; 85%) could have had all relevant pathologies characterized when combined with radiographs. Regardless of indicated modality, ultrasound could have characterized 80% of all cases ordered by nonorthopedic providers and 50% of cases ordered by orthopedic specialists (P = .007). Advanced shoulder imaging is often not ordered according to published appropriateness criteria. While nonorthopedic provider orders were more likely to be inappropriate, inappropriateness persisted among orthopedic providers. A combined ultrasound and radiograph evaluation strategy could accurately characterize shoulder pathologies for most cases. Published by Elsevier Inc.

  20. Adding ultrasound to clinical examination reduced frequency of enthesitis in primary care psoriasis patients with musculoskeletal complaints.

    PubMed

    van der Ven, Myrthe; Karreman, Maren C; Weel, Angelique E A M; Tchetverikov, Ilja; Vis, Marijn; Nijsten, Tamar E C; Hazes, Johanna M W; Luime, Jolanda J

    2016-01-01

    Part of the psoriasis patients with musculoskeletal complaints will have inflammation of the entheses. Entheseal inflammation is difficult to assess by clinical examination only. Therefore, we aimed to determine the frequency of clinically relevant ultrasound inflammation at the most commonly assessed entheses (MASEI; Madrid Sonographic Enthesis Index) in primary care psoriasis patients with one or more tender entheses. Adult primary care psoriasis patients with musculoskeletal complaints (tender enthesis or arthritis at physical examination) had an ultrasound examination of seven entheses according to the MASEI. Clinically relevant ultrasound inflammation was defined as active inflammation on ultrasound in combination with at least one clinical feature at the same enthesis. Active ultrasound inflammation contained positive power Doppler signal or in case of the plantar aponeurosis increased thickness. Structural changes entailed calcifications, enthesophytes, increased thickness, hypoechogeneicity indicating irregular fibre structure and erosions. Clinically, an enthesis was scored positive by a tender enthesis at clinical examination, reported pain in the history or self-reported pain in the questionnaires. Of 542 primary care psoriasis patient, 111 patients had tender entheses and/or arthritis. These patients were both clinically and ultrasonographically evaluated. Active ultrasound inflammation accompanied with pain or tenderness at the enthesis was found in 36% of the patients (n=40). Most common were inflammation at the knee (n=11) and at the plantar aponeurosis (n=10). Structural changes were observed in 95% of the psoriasis patients independent of their clinical manifestation. We found concurrent presence of ultrasound inflammatory changes and clinical symptoms in 36% of the primary care psoriasis patients who had tenderness at one or more entheseal sites.

  1. Comparison of ophthalmic measurements obtained via high-frequency ultrasound imaging in four species of snakes.

    PubMed

    Hollingsworth, Steven R; Holmberg, Bradford J; Strunk, Anneliese; Oakley, Alicia D; Sickafoose, Leann M; Kass, Philip H

    2007-10-01

    To measure the dimensions of the eyes of living snakes by use of high-frequency ultrasound imaging and correlate those measurements with age, length, and weight. Animals-14 clinically normal snakes. Species, age, length, weight, and horizontal spectacle diameter were recorded, and each snake underwent physical and ophthalmic examinations; ultrasonographic examination of both eyes was performed by use of a commercially available ultrasound unit and a 50-MHz transducer. Ultrasonographic measurements included spectacle thickness, subspectacular space depth, corneal thickness, anterior chamber depth, lens thickness, vitreous cavity depth, and globe length. All measurements were made along the visual axis. 2 corn snakes, 5 California king snakes, 1 gopher snake, and 6 ball pythons were examined. There were no significant differences within or between the species with regard to mean spectacle thickness, corneal thickness, or subspectacular space depth. However, mean horizontal spectacle diameter, anterior chamber depth, and axial globe length differed among the 4 species; for each measurement, ball pythons had significantly larger values than California king snakes. Spectacle thickness, subspectacular space depth, and corneal thickness were similar among the species of snake examined and did not vary significantly with age, length, or weight. Measurements of these dimensions can potentially serve as baseline values to evaluate snakes of these species with a retained spectacle, subspectacular abscess, or subspectacular fluid accumulation. Anterior chamber depth and axial length appeared variable among species, but axial length did not vary with age, length, or weight in the species studied.

  2. An ergonomic, instrumented ultrasound probe for 6-axis force/torque measurement.

    PubMed

    Gilbertson, Matthew W; Anthony, Brian W

    2013-01-01

    An ergonomic, instrumented ultrasound probe has been developed for medical imaging applications. The device, which fits compactly in the hand of sonographers and permits rapid attachment & removal of the ultrasound probe, measures ultrasound probe-to-patient contact forces and torques in all six axes. The device was used to measure contact forces and torques applied by ten professional sonographers on five patients during thirty-six abdominal exams. Of the three contact forces, those applied along the probe axis were found to be largest, averaging 7.0N. Measurement noise was quantified for each axis, and found to be small compared with the axial force. Understanding the range of forces applied during ultrasound imaging enables the design of more accurate robotic imaging systems and could also improve understanding of the correlation between contact force and sonographer fatigue and injury.

  3. [Carpal canal ultrasound examination in patients with mild hand-arm vibration disease].

    PubMed

    Liu, Y Z; Ye, Z H; Yang, W L; Zhu, J X; Lu, Q J; Su, W L

    2016-08-20

    Objective: To investigate the clinical value of ultrasound examination of carpal canal structure in patients with mild hand-arm vibration disease. Methods: A total of 29 patients (58 wrists) with mild hand-arm vibration disease who were treated in Shenzhen Prevention and Treatment Center for Occupational Diseases from May to December, 2015 were enrolled as observation group, and 20 healthy volunteers (40 wrists) were enrolled as the control group. Color Doppler ultrasound was used to observe the morphology and echo of the median nerve in the carpal canal and 9 muscle tendons and transverse carpal ligament. The thickness of transverse carpal ligament and diameter of the median nerve at the level of the hamulus of hamate bone were measured, as well as the cross-sectional area of the median nerve at the level of pisiform bone. Results: In the 29 patients with hand-arm vibration disease patients in the observation group, 8 experienced entrapment of the median nerve in the carpal canal, among whom 5 had entrapment in both wrists; there were 13 wrists (23%) with nerve entrapment and 45 wrists (77%) without nerve entrapment. Compared with the control group, the patients with hand-arm vibration disease and nerve entrapment in the observation group showed significant thickening of the transverse carpal ligament at the level of the hamulus of hamate bone and a significant increase in the cross-sectional area of the median nerve at the level of pisiform bone ( P <0.05) , while there were no significant differences in the thickness of transverse carpal ligament at the level of the hamulus of hamate bone and the cross-sectional area of the median nerve at the level of pisiform bone ( t=- 9.397 and -4.385, both P >0.05) . Conclusion: Ultrasound examination can clearly show the radiological changes of carpal canal contents in patients with mild hand-arm vibration disease and has a certain diagnostic value in nerve damage in patients with hand-arm vibration disease.

  4. Effect of Heat Generation of Ultrasound Transducer on Ultrasonic Power Measured by Calorimetric Method

    NASA Astrophysics Data System (ADS)

    Uchida, Takeyoshi; Kikuchi, Tsuneo

    2013-07-01

    Ultrasonic power is one of the key quantities closely related to the safety of medical ultrasonic equipment. An ultrasonic power standard is required for establishment of safety. Generally, an ultrasonic power standard below approximately 20 W is established by the radiation force balance (RFB) method as the most accurate measurement method. However, RFB is not suitable for high ultrasonic power because of thermal damage to the absorbing target. Consequently, an alternative method to RFB is required. We have been developing a measurement technique for high ultrasonic power by the calorimetric method. In this study, we examined the effect of heat generation of an ultrasound transducer on ultrasonic power measured by the calorimetric method. As a result, an excessively high ultrasonic power was measured owing to the effect of heat generation from internal loss in the transducer. A reference ultrasound transducer with low heat generation is required for a high ultrasonic power standard established by the calorimetric method.

  5. Tele-ultrasound and paramedics: real-time remote physician guidance of the Focused Assessment With Sonography for Trauma examination.

    PubMed

    Boniface, Keith S; Shokoohi, Hamid; Smith, E Reed; Scantlebury, Kari

    2011-06-01

    The aim of this study was to examine the capability of ultrasound-naïve paramedics to obtain interpretable Focused Assessment With Sonography for Trauma (FAST) images under the remote direction of emergency physicians (EPs). Paramedics without experience using ultrasound participated in a 20-minute lecture covering orientation to the ultrasound machine and the FAST examination. The paramedics subsequently performed FAST examinations on a model patient, whereas the EP remained in another room, out of visual contact. The EP communicated with the paramedic via radio, viewing video from the ultrasound machine on a monitor and directing the probe movements to obtain the views of the FAST examination. We examined the success rate, time to complete the examinations, and adequacy of images from the paramedics' first FAST examination. Fifty-one paramedics performed their first FAST examinations and were able to successfully complete 100% of the views of the FAST. The median time from probe placement to examination completion was 262 seconds (interquartile range, 206-343 seconds). The median time to complete right upper quadrant (RUQ) versus left upper quadrant (LUQ) views was 39 and 50 seconds, respectively. The time to complete the LUQ scan took significantly longer than the RUQ (P < .01). Paramedics completed cardiac and pelvic view in a median time of 42 and 25 seconds, respectively. The study demonstrated that paramedics with no prior ultrasound experience could obtain FAST images under remote guidance from experienced EPs in less than 5 minutes. Given rapidly evolving data transmission technology, this has applicability in battlefield, remote, and rural prehospital settings. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. An examination of polyvinylidene fluoride capacitive sensors as ultrasound transducer for imaging applications

    NASA Astrophysics Data System (ADS)

    Reyes-Ramírez, B.; García-Segundo, C.; García-Valenzuela, A.

    2014-05-01

    We investigate theoretically and experimentally the performance of low-noise capacitive sensors based on polyvinylidene fluoride (PVDF) piezoelectric films to sense water-borne ultrasound signals for their use in photoacoustic tomography. We derive a mechanical-to-electrical transfer function of a piezoelectric capacitor sensor of infinite lateral dimensions and arbitrary thickness assuming that an ultrasound wave is normally incident. Then, we analyse the response for obliquely incident ultrasound waves on sensors of large but finite area and derive an expression for the angle dependence of the sensor's response. We also present experimental different measurements with home-made sensors and compare with our theoretical model. We present measurements of the sensors' response to harmonic signals of variable frequency in the range from 0.5 to 50 MHz and of the angular-dependence factor at 6 MHz. Additionally, because of the scope of interest in these kinds of sensors, we also tested the sensors' response for photoacoustic perturbations. These are generated by laser pulses from directly impinging on the sensor and from ultrasound perturbations produced on neoprene by the same kind of laser pulses and then travelling through water to the sensor.

  7. Dual-plane ultrasound flow measurements in liquid metals

    NASA Astrophysics Data System (ADS)

    Büttner, Lars; Nauber, Richard; Burger, Markus; Räbiger, Dirk; Franke, Sven; Eckert, Sven; Czarske, Jürgen

    2013-05-01

    An ultrasound measurement system for dual-plane, two-component flow velocity measurements especially in opaque liquids is presented. Present-day techniques for measuring local flow structures in opaque liquids disclose considerable drawbacks concerning line-wise measurement of single ultrasound probes. For studying time-varying flow patterns, conventional ultrasound techniques are either limited by time-consuming mechanical traversing or by the sequential operation of single probes. The measurement system presented within this paper employs four transducer arrays with a total of 100 single elements which allows for flow mapping without mechanical traversing. A high frame rate of several 10 Hz has been achieved due to an efficient parallelization scheme using time-division multiplexing realized by a microcontroller-based electronic switching matrix. The functionality and capability of the measurement system are demonstrated on a liquid metal flow at room temperature inside a cube driven by a rotating magnetic field (RMF). For the first time, the primary and the secondary flow have been studied in detail and simultaneously using a configuration with two crossed measurement planes. The experimental data confirm predictions made by numeric simulation. After a sudden switching on of the RMF, inertial oscillations of the secondary flow were observed by means of a time-resolved measurement with a frame rate of 3.4 Hz. The experiments demonstrate that the presented measurement system is able to investigate complex and transient flow structures in opaque liquids. Due to its ability to study the temporal evolution of local flow structures, the measurement system could provide considerable progress for fluid dynamics research, in particular for applications in the food industry or liquid metal technologies.

  8. Frequency and number of ultrasound lung rockets (B-lines) using a regionally based lung ultrasound examination named vet BLUE (veterinary bedside lung ultrasound exam) in dogs with radiographically normal lung findings.

    PubMed

    Lisciandro, Gregory R; Fosgate, Geoffrey T; Fulton, Robert M

    2014-01-01

    Lung ultrasound is superior to lung auscultation and supine chest radiography for many respiratory conditions in human patients. Ultrasound diagnoses are based on easily learned patterns of sonographic findings and artifacts in standardized images. By applying the wet lung (ultrasound lung rockets or B-lines, representing interstitial edema) versus dry lung (A-lines with a glide sign) concept many respiratory conditions can be diagnosed or excluded. The ultrasound probe can be used as a visual stethoscope for the evaluation of human lungs because dry artifacts (A-lines with a glide sign) predominate over wet artifacts (ultrasound lung rockets or B-lines). However, the frequency and number of wet lung ultrasound artifacts in dogs with radiographically normal lungs is unknown. Thus, the primary objective was to determine the baseline frequency and number of ultrasound lung rockets in dogs without clinical signs of respiratory disease and with radiographically normal lung findings using an 8-view novel regionally based lung ultrasound examination called Vet BLUE. Frequency of ultrasound lung rockets were statistically compared based on signalment, body condition score, investigator, and reasons for radiography. Ten left-sided heart failure dogs were similarly enrolled. Overall frequency of ultrasound lung rockets was 11% (95% confidence interval, 6-19%) in dogs without respiratory disease versus 100% (95% confidence interval, 74-100%) in those with left-sided heart failure. The low frequency and number of ultrasound lung rockets observed in dogs without respiratory disease and with radiographically normal lungs suggests that Vet BLUE will be clinically useful for the identification of canine respiratory conditions. © 2014 American College of Veterinary Radiology.

  9. [Correction of respiratory movement using ultrasound for cardiac nuclear medicine examinations: fundamental study using an X-ray TV machine].

    PubMed

    Yoda, Kazushige; Umeda, Tokuo; Hasegawa, Tomoyuki

    2003-11-01

    Organ movements that occur naturally as a result of vital functions such as respiration and heartbeat cause deterioration of image quality in nuclear medicine imaging. Among these movements, respiration has a large effect, but there has been no practical method of correcting for this. In the present study, we examined a method of correction that uses ultrasound images to correct baseline shifts caused by respiration in cardiac nuclear medicine examinations. To evaluate the validity of this method, simulation studies were conducted with an X-ray TV machine instead of a nuclear medicine scanner. The X-ray TV images and ultrasound images were recorded as digital movies and processed with public domain software (Scion Image). Organ movements were detected in the ultrasound images of the subcostal four-chamber view mode using slit regions of interest and were measured on a two-dimensional image coordinate. Then translational shifts were applied to the X-ray TV images to correct these movements by using macro-functions of the software. As a result, respiratory movements of about 20.1 mm were successfully reduced to less than 2.6 mm. We conclude that this correction technique is potentially useful in nuclear medicine cardiology.

  10. Parental expectations, experiences and reactions, sense of coherence and grade of anxiety related to routine ultrasound examination with normal findings during pregnancy.

    PubMed

    Ekelin, M; Crang Svalenius, E; Larsson, A-K; Nyberg, P; Marsál, K; Dykes, A-K

    2009-10-01

    To investigate parents' expectations, experiences and reactions, sense of coherence and anxiety before and after a second-trimester routine ultrasound examination, with normal findings. Before and after ultrasound questionnaires including the scales parents' expectations, experiences and reactions to routine ultrasound examination (PEER-U state of mind index), sense of coherence (SOC) and state and trait anxiety inventory (STAI), were sent to a 1-year cohort of women and their partners. Replies received were 2183. Both parents had significantly less worried state of mind (PEER-U) after the examination than before. Women had a lower grade of state anxiety after than before, but for men there was no significant change. Before the ultrasound, women had a higher degree of worried state of mind, as well as a higher grade of state and trait anxiety and a lower sense of coherence, than men. The women showed a greater reduction in worried state of mind than the men after the ultrasound examination. There were no significant differences in sense of coherence before and after ultrasound. Women and men are affected in their psychological well-being in relation to a routine ultrasound examination, but their sense of coherence remains stable.

  11. Ultrasound transmission measurements for tensile strength evaluation of tablets.

    PubMed

    Simonaho, Simo-Pekka; Takala, T Aleksi; Kuosmanen, Marko; Ketolainen, Jarkko

    2011-05-16

    Ultrasound transmission measurements were performed to evaluate the tensile strength of tablets. Tablets consisting of one ingredient were compressed from dibasic calcium phosphate dehydrate, two grades of microcrystalline cellulose and two grades of lactose monohydrate powders. From each powder, tablets with five different tensile strengths were directly compressed. Ultrasound transmission measurements were conducted on every tablet at frequencies of 2.25 MHz, 5 MHz and 10 MHz and the speed of sound was calculated from the acquired waveforms. The tensile strength of the tablets was determined using a diametrical mechanical testing machine and compared to the calculated speed of sound values. It was found that the speed of sound increased with the tensile strength for the tested excipients. There was a good correlation between the speed of sound and tensile strength. Moreover, based on the statistical tests, the groups with different tensile strengths can be differentiated from each other by measuring the speed of sound. Thus, the ultrasound transmission measurement technique is a potentially useful method for non-destructive and fast evaluation of the tensile strength of tablets. Copyright © 2011 Elsevier B.V. All rights reserved.

  12. Refining enamel thickness measurements from B-mode ultrasound images.

    PubMed

    Hua, Jeremy; Chen, Ssu-Kuang; Kim, Yongmin

    2009-01-01

    Dental erosion has been growing increasingly prevalent with the rise in consumption of heavy starches, sugars, coffee, and acidic beverages. In addition, various disorders, such as Gastroenterological Reflux Disease (GERD), have symptoms of rapid rates of tooth erosion. The measurement of enamel thickness would be important for dentists to assess the progression of enamel loss from all forms of erosion, attrition, and abrasion. Characterizing enamel loss is currently done with various subjective indexes that can be interpreted in different ways by different dentists. Ultrasound has been utilized since the 1960s to determine internal tooth structure, but with mixed results. Via image processing and enhancement, we were able to refine B-mode dental ultrasound images for more accurate enamel thickness measurements. The mean difference between the measured thickness of the occlusal enamel from ultrasound images and corresponding gold standard CT images improved from 0.55 mm to 0.32 mm with image processing (p = 0.033). The difference also improved from 0.62 to 0.53 mm at the buccal/lingual enamel surfaces, but not significantly (p = 0.38).

  13. Regional repeatability measures of corneal thickness: Orbscan II and ultrasound.

    PubMed

    Jonuscheit, Sven; Doughty, Michael J

    2007-01-01

    To compare repeatability of the measures of corneal thickness obtained by slit-scanning light method (Orbscan II) with those obtained by an ultrasound pachymeter, with special interest in the peripheral region of the cornea. On 24 normal adults, aged 20 to 58 years (average 36 years) with up to -8.5 DS refractive error, three measures of corneal thickness were taken using Orbscan II and then by ultrasound pachymetry (under topical anesthesia with benoxinate 0.4%). The Orbscan central sample zone of 1 mm was selected, or the numerical maps were used to extract single point data along the horizontal corneal meridian to the nasal and temporal sides out to 4.5 mm. Ultrasound readings were taken from the central cornea and at the periphery just inside the limbus (4.5 mm from center) with a 2.4-mm diameter probe. For a central 1-mm diameter zone, the coefficient of variation (CV) for three consecutive corneal thickness measures was 0.81%+/-0.44%, but was marginally higher (p=0.004), if just the central single point data was taken with Orbscan (0.86%+/-0.45%). Similar repeatability was noted for the numerical output across the temporal side along the horizontal meridian out to 2.5 mm from the center, but farther out to 4 mm and on the nasal side the repeatability was slightly less and around 1.0% (p<0.001). Orbscan point readings of thickness could only sometimes be obtained at 4.5 mm temporally (with a poorer CV of 1.32%) and very rarely at 4.5 mm on the nasal side. No absolute differences in Orbscan repeatability were noted when comparing emmetropic with myopic subjects (p>or=0.5). Ultrasound pachymetry readings across the central zone were repeatable to 0.82%+/-0.67%. When measured with the edge of the ultrasound probe just touching the limbus, the repeatability of ultrasound readings was 1.37%+/-1.10% temporally and 1.49%+/-1.02% nasally, but neither was statistically worse that the most peripheral readings for Orbscan (p>or=0.210). However, it was also noted that the

  14. Ultrasound Metrology in Mexico: a round robin test for medical diagnostics

    NASA Astrophysics Data System (ADS)

    Amezola Luna, R.; López Sánchez, A. L.; Elías Juárez, A. A.

    2011-02-01

    This paper presents preliminary statistical results from an on-going imaging medical ultrasound study, of particular relevance for gynecology and obstetrics areas. Its scope is twofold, firstly to compile the medical ultrasound infrastructure available in cities of Queretaro-Mexico, and second to promote the use of traceable measurement standards as a key aspect to assure quality of ultrasound examinations performed by medical specialists. The experimental methodology is based on a round robin test using an ultrasound phantom for medical imaging. The physician, using its own ultrasound machine, couplant and facilities, measures the size and depth of a set of pre-defined reflecting and absorbing targets of the reference phantom, which simulate human illnesses. Measurements performed give the medical specialist an objective feedback regarding some performance characteristics of their ultrasound examination systems, such as measurement system accuracy, dead zone, axial resolution, depth of penetration and anechoic targets detection. By the end of March 2010, 66 entities with medical ultrasound facilities, from both public and private institutions, have performed measurements. A network of medical ultrasound calibration laboratories in Mexico, with traceability to The International System of Units via national measurement standards, may indeed contribute to reduce measurement deviations and thus attain better diagnostics.

  15. Ultrasonographic examination of plantar fasciitis: a comparison of patient positions during examination.

    PubMed

    Ahn, Jae Hoon; Lee, Choong Woo; Park, ChanJoo; Kim, Yoon-Chung

    2016-01-01

    Musculoskeletal ultrasound is a non-invasive and low-cost modality for real-time visualisation of the plantar fascia. Ultrasound examination for plantar fasciitis is generally performed with the patient in a prone position, although the rational for using a prone position has not been validated. The aim of the study was to investigate if ultrasound examination in a supine position, which is more comfortable than the prone position, is valid. We conducted a prospective study of 30 participants with plantar fasciitis, 8 men (27 %) and 22 women (73 %), with a mean age of 53.9 ± 12.6 (range, 32 to 77) years, and an equal distribution of left and right feet. The plantar heel was divided into three portions for ultrasound examination: medial, central and lateral. Two measurements of plantar fascia thickness were obtained for each portion, with participants in 2 positions (supine and prone) and for 2 ankle postures (neutral and 15° of plantarflexion). Mean measurements of plantar fascia thickness were compared between the two positions (Wilcoxon signed rank tests for non-normally distributed data and paired t-tests for normally distributed data). Participants were asked to report their preferred position for examination, supine or prone. The measured thickness was comparable for both supine and prone positions, for both ankle postures, neutral and 15° of plantarflexion (p > 0.05). A specific self-reported preferred position was not identified. Ultrasound examination of plantar fasciitis can be performed in the supine position without any significant difference in measurement compared to examination in the conventional prone position. The Catholic Medical Center Office of Human Research Protection Program (CMC-OHRP)/Institutional Review Board approved the current study (Approval No. KC12DISI0338), and all participants provided their written informed consent for participation and publication.

  16. Point-of-care ultrasound performed by a medical student compared to physical examination by vascular surgeons in the detection of abdominal aortic aneurysms.

    PubMed

    Mai, Trinh; Woo, Michael Y; Boles, Kim; Jetty, Prasad

    2018-05-16

    To determine the test characteristics of point-of-care ultrasonography performed by a medical student versus physical examination by vascular surgeons compared to a gold standard reference scan for the detection of abdominal aortic aneurysms. We conducted a prospective, observer-blinded study recruiting patients from an outpatient vascular surgery clinic. Participants were screened for abdominal aortic aneurysms by standardized physical examination by a blinded vascular surgeon, followed by a point-of-care ultrasound examination by a blinded medical student. The student underwent prior training by a vascular sonographer and emergency physician on 60 patients (16 were supervised). Ultrasonography was used to visualize and measure the proximal, mid, and distal aortic diameters. The maximal aortic diameter was noted and compared to measurements obtained by the reference scan (CT scan or vascular sonographer-performed ultrasound). Reference scans were completed within 3 months of the recruitment visit. A total of 57 patients were enrolled over a 5-month period between October 2015 and March 2016. Mean age of recruited patients was 71 years and 61% were male. Mean body mass index was 27.9 ± 4.3 and mean waist-hip ratio was 0.96 ± 0.10. Sixteen abdominal aortic aneurysms were detected by the reference scan, with an average maximal aortic diameter of 44.9 mm. Physical examination by a vascular surgeon detected 11 of 16 abdominal aortic aneurysms with 2 false positives (sensitivity and specificity of 66.7% (95% CI 38.4-88.2) and 94.4% (95% CI 81.3-99.3), respectively). Point-of-care ultrasound detected 15 of 16 abdominal aortic aneurysms (sensitivity and specificity of 93.3% (95% CI 68.1-99.8) and 100% (95% CI 88.4-100), respectively). Seven of the 64 point-of-care ultrasound scans were indeterminate (>1 cm of the aorta was not visualized). Average time to conduct the physical examination was 35 seconds vs. 4.0 minutes for point-of-care ultrasonography. There was a

  17. Feasibility and reliability of pocket-size ultrasound examinations of the pleural cavities and vena cava inferior performed by nurses in an outpatient heart failure clinic.

    PubMed

    Dalen, Havard; Gundersen, Guri H; Skjetne, Kyrre; Haug, Hilde H; Kleinau, Jens O; Norekval, Tone M; Graven, Torbjorn

    2015-08-01

    Routine assessment of volume state by ultrasound may improve follow-up of heart failure patients. We aimed to study the feasibility and reliability of focused pocket-size ultrasound examinations of the pleural cavities and the inferior vena cava performed by nurses to assess volume state at an outpatient heart failure clinic. Ultrasound examinations were performed in 62 included heart failure patients by specialized nurses with a pocket-size imaging device (PSID). Patients were then re-examined by a cardiologist with a high-end scanner for reference within 1 h. Specialized nurses were able to obtain and interpret images from both pleural cavities and the inferior vena cava and estimate the volume status in all patients. Time consumption for focused ultrasound examination was median 5 min. In total 26 patients had any kind of pleural effusion (in 39 pleural cavities) by reference. The sensitivity, specificity, positive and negative predictive values were high, all ≥ 92%. The correlations with reference were high for all measurements, all r ≥ 0.79. Coefficients of variation for end-expiratory dimension of inferior vena cava and quantification of pleural effusion were 10.8% and 12.7%, respectively. Specialized nurses were, after a dedicated training protocol, able to obtain reliable recordings of both pleural cavities and the inferior vena cava by PSID and interpret the images in a reliable way. Implementing focused ultrasound examinations to assess volume status by nurses in an outpatient heart failure clinic may improve diagnostics, and thus improve therapy. © The European Society of Cardiology 2014.

  18. Non-Invasive Measurement of Intracranial Pressure Pulsation using Ultrasound

    NASA Technical Reports Server (NTRS)

    Ueno, Toshiaki; Ballard, R. E.; Yost, W. T.; Hargens, A. R.

    1997-01-01

    Exposure to microgravity causes a cephalad fluid shift which may elevate intracranial pressure (ICP). Elevation in ICP may affect cerebral hemodynamics in astronauts during space flight. ICP is, however, a difficult parameter to measure due to the invasiveness of currently available techniques. We already reported our development of a non-invasive ultrasound device for measurement of ICP. We recently modified the device so that we might reproducibly estimate ICP changes in association with cardiac cycles. In the first experiment, we measured changes in cranial distance with the ultrasound device in cadavera while changing ICP by infusing saline into the lateral ventricle. In the second experiment, we measured changes in cranial distance in five healthy volunteers while placing them in 60 deg, 30 deg head-up tilt, supine, and 10 deg head-down tilt position. In the cadaver study, fast Fourier transformation revealed that cranial pulsation is clearly associated with ICP pulsation. The ratio of cranial distance and ICP pulsation is 1.3microns/mmHg. In the tilting study, the magnitudes of cranial pulsation are linearly correlated to tilt angles (r=0.87). The ultrasound device has sufficient sensitivity to detect cranial pulsation in association with cardiac cycles. By analyzing the magnitude of cranial pulsation, estimates of ICP during space flight are possible.

  19. Development of Ultrasound to Measure In-Vivo Dynamic Cervical Spine Intervertebral Disc Mechanics

    DTIC Science & Technology

    2016-01-01

    Award Number: W81XWH-13-1-0050 TITLE: Development of Ultrasound to Measure In-vivo Dynamic Cervical Spine Intervertebral Disc Mechanics PRINCIPAL...CONTRACT NUMBER W81XWH-13-1-0050 Development of Ultrasound to Measure In-vivo Dynamic Cervical Spine Intervertebral Disc Mechanics 5b. GRANT NUMBER 5c...elasticity during compression or tension. As a portable, low cost imaging modality, the dual ultrasound system quantified cervical spine IVD displacement and

  20. Fuzzy similarity measures for ultrasound tissue characterization

    NASA Astrophysics Data System (ADS)

    Emara, Salem M.; Badawi, Ahmed M.; Youssef, Abou-Bakr M.

    1995-03-01

    Computerized ultrasound tissue characterization has become an objective means for diagnosis of diseases. It is difficult to differentiate diffuse liver diseases, namely cirrhotic and fatty liver from a normal one, by visual inspection from the ultrasound images. The visual criteria for differentiating diffused diseases is rather confusing and highly dependent upon the sonographer's experience. The need for computerized tissue characterization is thus justified to quantitatively assist the sonographer for accurate differentiation and to minimize the degree of risk from erroneous interpretation. In this paper we used the fuzzy similarity measure as an approximate reasoning technique to find the maximum degree of matching between an unknown case defined by a feature vector and a family of prototypes (knowledge base). The feature vector used for the matching process contains 8 quantitative parameters (textural, acoustical, and speckle parameters) extracted from the ultrasound image. The steps done to match an unknown case with the family of prototypes (cirr, fatty, normal) are: Choosing the membership functions for each parameter, then obtaining the fuzzification matrix for the unknown case and the family of prototypes, then by the linguistic evaluation of two fuzzy quantities we obtain the similarity matrix, then by a simple aggregation method and the fuzzy integrals we obtain the degree of similarity. Finally, we find that the similarity measure results are comparable to the neural network classification techniques and it can be used in medical diagnosis to determine the pathology of the liver and to monitor the extent of the disease.

  1. Test-retest reliability of 3D ultrasound measurements of the thoracic spine.

    PubMed

    Fölsch, Christian; Schlögel, Stefanie; Lakemeier, Stefan; Wolf, Udo; Timmesfeld, Nina; Skwara, Adrian

    2012-05-01

    To explore the reliability of the Zebris CMS 20 ultrasound analysis system with pointer application for measuring end-range flexion, end-range extension, and neutral kyphosis angle of the thoracic spine. The study was performed within the School of Physiotherapy in cooperation with the Orthopedic Department at a University Hospital. The thoracic spines of 28 healthy subjects were measured. Measurements for neutral kyphosis angle, end-range flexion, and end-range extension were taken once at each time point. The bone landmarks were palpated by one examiner and marked with a pointer containing 2 transmitters using a frequency of 40 kHz. A third transmitter was fixed to the pelvis, and 3 microphones were used as receiver. The real angle was calculated by the software. Bland-Altman plots with 95% limits of agreement, intraclass correlations (ICC), standard deviations of mean measurements, and standard error of measurements were used for statistical analyses. The test-retest reliability in this study was measured within a 24-hour interval. Statistical parameters were used to judge reliability. The mean kyphosis angle was 44.8° with a standard deviation of 17.3° at the first measurement and a mean of 45.8° with a standard deviation of 16.2° the following day. The ICC was high at 0.95 for the neutral kyphosis angle, and the Bland-Altman 95% limits of agreement were within clinical acceptable margins. The ICC was 0.71 for end-range flexion and 0.34 for end-range extension, whereas the Bland-Altman 95% limits of agreement were wider than with the static measurement of kyphosis. Compared with static measurements, the analysis of motion with 3-dimensional ultrasound showed an increased standard deviation for test-retest measurements. The test-retest reliability of ultrasound measuring of the neutral kyphosis angle of the thoracic spine was demonstrated within 24 hours. Bland-Altman 95% limits of agreement and the standard deviation of differences did not appear to be

  2. Diffusing-wave spectroscopy in an inhomogeneous object: Local viscoelastic spectra from ultrasound-assisted measurement of correlation decay arising from the ultrasound focal volume

    NASA Astrophysics Data System (ADS)

    Chandran, R. Sriram; Sarkar, Saikat; Kanhirodan, Rajan; Roy, Debasish; Vasu, Ram Mohan

    2014-07-01

    We demonstrate diffusing-wave spectroscopy (DWS) in a localized region of a viscoelastically inhomogeneous object by measurement of the intensity autocorrelation [g2(τ)] that captures only the decay introduced by the temperature-induced Brownian motion in the region. The region is roughly specified by the focal volume of an ultrasound transducer which introduces region specific mechanical vibration owing to insonification. Essential characteristics of the localized non-Markovian dynamics are contained in the decay of the modulation depth [M(τ)], introduced by the ultrasound forcing in the focal volume selected, on g2(τ). The modulation depth M (τi) at any delay time τi can be measured by short-time Fourier transform of g2(τ) and measurement of the magnitude of the spectrum at the ultrasound drive frequency. By following the established theoretical framework of DWS, we are able to connect the decay in M (τ) to the mean-squared displacement (MSD) of scattering centers and the MSD to G*(ω), the complex viscoelastic spectrum. A two-region composite polyvinyl alcohol phantom with different viscoelastic properties is selected for demonstrating local DWS-based recovery of G*(ω) corresponding to these regions from the measured region specific M (τi)vsτi. The ultrasound-assisted measurement of MSD is verified by simulating, using a generalized Langevin equation (GLE), the dynamics of the particles in the region selected as well as by the usual DWS experiment without the ultrasound. It is shown that whereas the MSD obtained by solving the GLE without the ultrasound forcing agreed with its experimental counterpart covering small and large values of τ, the match was good only in the initial transients in regard to experimental measurements with ultrasound.

  3. Metatarsophalangeal joint extension changes ultrasound measurements for plantar fascia thickness.

    PubMed

    Granado, Michael J; Lohman, Everett B; Gordon, Keith E; Daher, Noha S

    2018-01-01

    Ultrasound is an inexpensive method for quantifying plantar fascia thickness, especially in those with plantar fasciitis. Ultrasound has also been used to assess the effectiveness of various treatments for plantar fasciitis by comparing plantar fascia thickness before and after an intervention period. While a plantar fascia thickness over 4 mm via ultrasound has been proposed to be consistent with plantar fasciitis, some researchers believe the 4 mm plantar fascia thickness level to be a dubious guideline for diagnosing plantar fasciitis due to the lack of standardization of the measurement process for plantar fascia thickness. In particular, no universal guidelines exist on the positioning of the metatarsophalangeal (MTP) joints during the procedure and the literature also has inconsistent protocols. The purpose of this study is to investigate and compare the influence of MTP joint extension on plantar fascia thickness in healthy participants and those with unilateral plantar fasciitis. The plantar fascia thickness of forty participants (20 with unilateral plantar fasciitis and 20 control) was measured via ultrasound three times at three different MTP joint positions: 1) at rest, 2) 30° of extension from the plantar surface, and 3) maximal extension possible. The plantar fascia became significantly thinner as MTP joint extension increased in both the plantar fasciitis group ( p  < 0.001) and the control group ( p  < 0.001). In the plantar fasciitis group, the involved plantar fascia was 1.2 to 1.3 mm thicker (p < 0.001) than the uninvolved side depending on the MTP joint position. In the control group, the difference in plantar fascia thickness between the two sides was less than 0.1 mm ( p  < 0.92) at any MTP joint position. MTP joint position can influence the ultrasound measurement of plantar fascia thickness. It is recommended that plantar fascia thickness measurements be performed with the toes at rest. If MTP joints must be extended

  4. First-year medical students use of ultrasound or physical examination to diagnose hepatomegaly and ascites: a randomized controlled trial.

    PubMed

    Arora, Samantha; Cheung, Angela C; Tarique, Usman; Agarwal, Arnav; Firdouse, Mohammed; Ailon, Jonathan

    2017-09-01

    To compare point-of-care ultrasound and physical examination (PEx), each performed by first-year medical students after brief teaching, for assessing ascites and hepatomegaly. Ultrasound and PEx were compared on: (1) reliability, validity and performance, (2) diagnostic confidence, ease of use, utility, and applicability. A single-center, randomized controlled trial was performed at a tertiary centre. First-year medical students were randomized to use ultrasound or PEx to assess for ascites and hepatomegaly. Cohen's kappa and interclass coefficient (ICC) were used to measure interrater reliability between trainee assessments and the reference standard (a same day ultrasound by a radiologist). Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were compared. A ten-point Likert scale was used to assess trainee diagnostic confidence and perceptions of utility. There were no significant differences in interobserver reliability, sensitivity, specificity, accuracy, PPV, or NPV between the ultrasound and PEx groups. However, students in the ultrasound group provided higher scores for perceived utility (ascites 8.38 ± 1.35 vs 7.08 ± 1.86, p  = 0.008; hepatomegaly 7.68 ± 1.52 vs 5.36 ± 2.48, p  < 0.001) and likelihood of adoption (ascites 8.67 ± 1.61 vs 7.46 ± 1.79, p  = 0.02; hepatomegaly 8.12 ± 1.90 vs 5.92 ± 2.32, p  = 0.001). When performed by first-year medical students, the validity and reliability of ultrasound is comparable to PEx, but with greater perceived utility and likelihood of adoption. With similarly brief instruction, point-of-care ultrasonography can be as effectively learned and performed as PEx, with a high degree of interest from trainees.

  5. Diagnostic image quality in gynaecological ultrasound: Who should measure it, what should we measure and how?

    PubMed Central

    Knapp, Karen

    2013-01-01

    Assessment of diagnostic image quality in gynaecological ultrasound is an important aspect of imaging department quality assurance. This may be addressed through audit, but who should undertake the audit, what should be measured and how, remains contentious. The aim of this study was to identify whether peer audit is a suitable method of assessing the diagnostic quality of gynaecological ultrasound images. Nineteen gynaecological ultrasound studies were independently assessed by six sonographers utilising a pilot version of an audit tool. Outcome measures were levels of inter-rater agreement using different data collection methods (binary scores, Likert scale, continuous scale), effect of ultrasound study difficulty on study score and whether systematic differences were present between reviewers of different clinical grades and length of experience. Inter-rater agreement ranged from moderate to good depending on the data collection method. A continuous scale gave the highest level of inter-rater agreement with an intra-class correlation coefficient of 0.73. A strong correlation (r = 0.89) between study difficulty and study score was yielded. Length of clinical experience between reviewers had no effect on the audit scores, but individuals of a higher clinical grade gave significantly lower scores than those of a lower grade (p = 0.04). Peer audit is a promising tool in the assessment of ultrasound image quality. Continuous scales seem to be the best method of data collection implying a strong element of heuristically driven decision making by reviewing ultrasound practitioners. PMID:27433192

  6. Automated assessment of joint synovitis activity from medical ultrasound and power doppler examinations using image processing and machine learning methods.

    PubMed

    Cupek, Rafal; Ziębiński, Adam

    2016-01-01

    Rheumatoid arthritis is the most common rheumatic disease with arthritis, and causes substantial functional disability in approximately 50% patients after 10 years. Accurate measurement of the disease activity is crucial to provide an adequate treatment and care to the patients. The aim of this study is focused on a computer aided diagnostic system that supports an assessment of synovitis severity. This paper focus on a computer aided diagnostic system that was developed within joint Polish-Norwegian research project related to the automated assessment of the severity of synovitis. Semiquantitative ultrasound with power Doppler is a reliable and widely used method of assessing synovitis. Synovitis is estimated by ultrasound examiner using the scoring system graded from 0 to 3. Activity score is estimated on the basis of the examiner's experience or standardized ultrasound atlases. The method needs trained medical personnel and the result can be affected by a human error. The porotype of a computer-aided diagnostic system and algorithms essential for an analysis of ultrasonic images of finger joints are main scientific output of the MEDUSA project. Medusa Evaluation System prototype uses bone, skin, joint and synovitis area detectors for mutual structural model based evaluation of synovitis. Finally, several algorithms that support the semi-automatic or automatic detection of the bone region were prepared as well as a system that uses the statistical data processing approach in order to automatically localize the regions of interest. Semiquantitative ultrasound with power Doppler is a reliable and widely used method of assessing synovitis. Activity score is estimated on the basis of the examiner's experience and the result can be affected by a human error. In this paper we presented the MEDUSA project which is focused on a computer aided diagnostic system that supports an assessment of synovitis severity.

  7. Exploratory Analysis of Carbon Dioxide Levels and Ultrasound Measures of the Eye During ISS Missions

    NASA Technical Reports Server (NTRS)

    Schaefer, C.; Young, M.; Mason, S.; Coble, C.; Wear, M. L.; Sargsyan, A.; Garcia, K.; Law. J.; Alexander, D.; Ryder, V. Myers; hide

    2016-01-01

    Carbon dioxide (CO2) levels on ISS have typically averaged 2.3 to 5.3mm Hg, with large fluctuations occurring over periods of hours and days. CO2 has effects on cerebral vascular tone, resulting in vasodilation and alteration of cerebral blood flow(CBF). Increased CBF leads to elevated intracranial pressure(ICP), which is a factor leading to visual disturbance, headaches, and other central nervous system symptoms. Ultrasound of the optic nerve provides a surrogate measurement of ICP. Inflight ultrasounds were implemented as an enhanced screening tool for the Visual Impairment/Intracranial Pressure (VIIP) Syndrome. This analysis examines the relationships between ambient CO2 levels on ISS and ultrasound measures of the eye in an effort to understand how CO2 may be associated with VIIP and to inform future analysis of inflight VIIP data. Results as shown in Figure2, there was a large timeframe where CO2 readings were removed due to sensor fault errors(see Limitations), from June 2011 to January 2012. After extensive cleaning of the CO2 data, metrics for all of the data were calculated (Table2). Preliminary analyses showed possible associations between variability measures of CO2 and AP diameter (Figure3),and average CO2 exposure and ONSD(Figure4). Adjustments for multiple comparisons were not made due to the exploratory nature of the analysis.

  8. Temperature measurement by thermal strain imaging with diagnostic power ultrasound, with potential for thermal index determination.

    PubMed

    Liang, Hai-Dong; Zhou, Li-Xia; Wells, Peter N T; Halliwell, Michael

    2009-05-01

    Over the years, there has been a substantial increase in acoustic exposure in diagnostic ultrasound as new imaging modalities with higher intensities and frame rates have been introduced; and more electronic components have been packed into the probe head, so that there is a tendency for it to become hotter. With respect to potential thermal effects, including those which may be hazardous occurring during ultrasound scanning, there is a correspondingly growing need for in vivo techniques to guide the operator as to the actual temperature rise occurring in the examined tissues. Therefore, an in vivo temperature estimator would be of considerable practical value. The commonly-used method of tissue thermal index (TI) measurement with a hydrophone in water could underestimate the actual value of TI (in one report by as much as 2.9 times). To obtain meaningful results, it is necessary to map the temperature elevation in 2-D (or 3-D) space. We present methodology, results and validation of a 2-D spatial and temporal thermal strain ultrasound temperature estimation technique in phantoms, and its apparently novel application in tracking the evolution of heat deposition at diagnostic exposure levels. The same ultrasound probe is used for both transmission and reception. The displacement and thermal strain estimation methods are similar to those used in high-intensity focused ultrasound thermal monitoring. The use of radiofrequency signals permits the application of cross correlation as a similarity measurement for tracking feature displacement. The displacement is used to calculate the thermal strain directly related to the temperature rise. Good agreement was observed between the temperature rise and the ultrasound power and scan duration. Thermal strain up to 1.4% was observed during 4000-s scan. Based on the results obtained for the temperature range studied in this work, the technique demonstrates potential for applicability in phantom (and possibly in vivo tissue

  9. Ultrasound Velocity Measurement in a Liquid Metal Electrode

    PubMed Central

    Perez, Adalberto; Kelley, Douglas H.

    2015-01-01

    A growing number of electrochemical technologies depend on fluid flow, and often that fluid is opaque. Measuring the flow of an opaque fluid is inherently more difficult than measuring the flow of a transparent fluid, since optical methods are not applicable. Ultrasound can be used to measure the velocity of an opaque fluid, not only at isolated points, but at hundreds or thousands of points arrayed along lines, with good temporal resolution. When applied to a liquid metal electrode, ultrasound velocimetry involves additional challenges: high temperature, chemical activity, and electrical conductivity. Here we describe the experimental apparatus and methods that overcome these challenges and allow the measurement of flow in a liquid metal electrode, as it conducts current, at operating temperature. Temperature is regulated within ±2 °C using a Proportional-Integral-Derivative (PID) controller that powers a custom-built furnace. Chemical activity is managed by choosing vessel materials carefully and enclosing the experimental setup in an argon-filled glovebox. Finally, unintended electrical paths are carefully prevented. An automated system logs control settings and experimental measurements, using hardware trigger signals to synchronize devices. This apparatus and these methods can produce measurements that are impossible with other techniques, and allow optimization and control of electrochemical technologies like liquid metal batteries. PMID:26273726

  10. Sports Ultrasound: Applications Beyond the Musculoskeletal System.

    PubMed

    Finnoff, Jonathan T; Ray, Jeremiah; Corrado, Gianmichael; Kerkhof, Deanna; Hill, John

    2016-09-01

    Traditionally, ultrasound has been used to evaluate musculoskeletal injuries in athletes; however, ultrasound applications extend well beyond musculoskeletal conditions, many of which are pertinent to athletes. Articles were identified in PubMed using the search terms ultrasound, echocardiogram, preparticipation physical examination, glycogen, focused assessment with sonography of trauma, optic nerve, and vocal cord dysfunction. No date restrictions were placed on the literature search. Clinical review. Level 4. Several potential applications of nonmusculoskeletal ultrasound in sports medicine are presented, including extended Focused Assessment with Sonography for Trauma (eFAST), limited echocardiographic screening during preparticipation physical examinations, assessment of muscle glycogen stores, optic nerve sheath diameter measurements in athletes with increased intracranial pressure, and assessment of vocal cord dysfunction in athletes. Ultrasound can potentially be used to assist athletes with monitoring their muscle glycogen stores and the diagnosis of multiple nonmusculoskeletal conditions within sports medicine. © 2016 The Author(s).

  11. Validation of Greyscale-Based Quantitative Ultrasound in Manual Wheelchair Users

    PubMed Central

    Collinger, Jennifer L.; Fullerton, Bradley; Impink, Bradley G.; Koontz, Alicia M.; Boninger, Michael L.

    2010-01-01

    Objective The primary aim of this study is to establish the validity of greyscale-based quantitative ultrasound (QUS) measures of the biceps and supraspinatus tendons. Design Nine QUS measures of the biceps and supraspinatus tendons were computed from ultrasound images collected from sixty-seven manual wheelchair users. Shoulder pathology was measured using questionnaires, physical examination maneuvers, and a clinical ultrasound grading scale. Results Increased age, duration of wheelchair use, and body mass correlated with a darker, more homogenous tendon appearance. Subjects with pain during physical examination tests for biceps tenderness and acromioclavicular joint tenderness exhibited significantly different supraspinatus QUS values. Even when controlling for tendon depth, QUS measures of the biceps tendon differed significantly between subjects with healthy tendons, mild tendinosis, and severe tendinosis. Clinical grading of supraspinatus tendon health was correlated with QUS measures of the supraspinatus tendon. Conclusions Quantitative ultrasound is valid method to quantify tendinopathy and may allow for early detection of tendinosis. Manual wheelchair users are at a high risk for developing shoulder tendon pathology and may benefit from quantitative ultrasound-based research that focuses on identifying interventions designed to reduce this risk. PMID:20407304

  12. Can a limited double reading/second opinion of initially recalled breast ultrasound screening examinations improve radiologists' performances?

    NASA Astrophysics Data System (ADS)

    Gur, David; Harnist, Kimberly; Gizienski, Terri-Ann; Zuley, Margarita; Hakim, Christiane; Lu, Amy; Sumkin, Jules; Abrams, Gordon; Ganott, Marie A.; Kelly, Amy E.; Tyma, Cathy S.; Chang, Thomas; BÓ§hm-Vélez, Marcella; Sobolewski, Robin

    2018-03-01

    Interpretations of breast ultrasound screening examinations result in high recall rates and large inter-radiologist variability, frequently leading to "conservative" recommendations. Double reading of all breast ultrasound screening examinations is cost prohibitive, but double reading of only "initially recalled" cases may prove efficacious. We assessed changes in recommendations, if any, by providing a consensus second opinion in a limited subset of examinations initially recommended for recall. We performed a retrospective reader study with 197 ultrasound examinations (97 not recalled and 100 recalled clinically). First, we generated a consensus "second opinion" consisting of the majority vote of three independent readings of each case by experienced ultrasound interpreters. During the reader study that followed, if the reader recommended a "recall" and the "consensus second opinion" did not, a message to that effect was displayed and the reader was asked to re-review the exam and re-assess if, knowing the second opinion, a re-rating of the case was warranted. We compared performance levels pre- and post- the second opinion. The second opinion resulted in "no recall" recommendations of 141 cases in the entire set, including four cancer cases missed by all three readers. On average, radiologists received "warning" messages in 30 cases (range 15-50), or in 15% of cases. Rating changes (downgrades to no recall) occurred in 36 of these cases. These changes resulted in a possible recall rate reduction of 28% in prompted cases or 14% overall recall reduction, while increasing the false negative rate by only one case missed by 2 readers ( 1%).

  13. Estimation of Measurement Characteristics of Ultrasound Fetal Heart Rate Monitor

    NASA Astrophysics Data System (ADS)

    Noguchi, Yasuaki; Mamune, Hideyuki; Sugimoto, Suguru; Yoshida, Atsushi; Sasa, Hidenori; Kobayashi, Hisaaki; Kobayashi, Mitsunao

    1995-05-01

    Ultrasound fetal heart rate monitoring is very useful to determine the status of the fetus because it is noninvasive. In order to ensure the accuracy of the fetal heart rate (FHR) obtained from the ultrasound Doppler data, we measure the fetal electrocardiogram (ECG) directly and obtain the Doppler data simultaneously. The FHR differences of the Doppler data from the direct ECG data are concentrated at 0 bpm (beats per minute), and are practically symmetrical. The distribution is found to be very close to the Student's t distribution by the test of goodness of fit with the chi-square test. The spectral density of the FHR differences shows the white noise spectrum without any dominant peaks. Furthermore, the f-n (n>1) fluctuation is observed both with the ultrasound Doppler FHR and with the direct ECG FHR. Thus, it is confirmed that the FHR observation and observation of the f-n (n>1) fluctuation using the ultrasound Doppler FHR are as useful as the direct ECG.

  14. Comparison of simulated and measured nonlinear ultrasound fields

    NASA Astrophysics Data System (ADS)

    Du, Yigang; Jensen, Henrik; Jensen, Jørgen Arendt

    2011-03-01

    In this paper results from a non-linear AS (angular spectrum) based ultrasound simulation program are compared to water-tank measurements. A circular concave transducer with a diameter of 1 inch (25.4 mm) is used as the emitting source. The measured pulses are first compared with the linear simulation program Field II, which will be used to generate the source for the AS simulation. The generated non-linear ultrasound field is measured by a hydrophone in the focal plane. The second harmonic component from the measurement is compared with the AS simulation, which is used to calculate both fundamental and second harmonic fields. The focused piston transducer with a center frequency of 5 MHz is excited by a waveform generator emitting a 6-cycle sine wave. The hydrophone is mounted in the focal plane 118 mm from the transducer. The point spread functions at the focal depth from Field II and measurements are illustrated. The FWHM (full width at half maximum) values are 1.96 mm for the measurement and 1.84 mm for the Field II simulation. The fundamental and second harmonic components of the experimental results are plotted compared with the AS simulations. The RMS (root mean square) errors of the AS simulations are 7.19% and 10.3% compared with the fundamental and second harmonic components of the measurements.

  15. [Size of testes and epididymes in boys up to 17 years of life assessed by ultrasound method and method of external linear measurements].

    PubMed

    Osemlak, Paweł

    2011-01-01

    1. Determination of the size of testes and epididymes on the right and left side, in healthy boys in various age groups with use of non-invasive ultrasound examination method and the method of external linear measurements. 2. Determination of age, when intensive growth of testicular and epididymal size starts. 3. Determination whether there are statistically significant differences between the size of the right and the left testis, as well as between the right and left epididymis. 4. Evaluation of the ultrasound method and method of external linear measurements in their use for scientific investigations. 309 boys, aged from 1 day to 17 years of life, treated in the Clinical Department of Paediatric Surgery and Traumatology of the Medical University in Lublin from 2009 to 2010 due to diseases needed to be treated surgically, but not the scrotum, were examined in this study. No pathologies influencing the development of genital organs were found in these boys. Dimension of the testes was studied with ultrasound method and with method of external linear measurements. Dimension of epididymes was only examined with ultrasound method. In every age group the author calculated mean arithmetical values for: testiscular length, thickness, width and volume, as well as epididymal depth and basis. With consideration of standard deviation (X+/-1 SD) it was possible to define the range of dimension of healthy testes and epididymes and their change with age. Final dimensions of the right and left testis as well as of the right and left epididymis were compared. Dimensions of the testis on the same side of body acquired with the ultrasound method and acquired with the method of external linear measurements were compared. Statistical work-up with Wilcoxon test for two dependent groups was implemented. Ultrasound evaluation pointed to intensive 2.5-times increase in testicular length and width, and 2-times increase in testicular thickness in boys aged 10 to 17 years. Mean volume of

  16. Clinical versus ultrasound examination of the thyroid gland in common clinical practice.

    PubMed

    Brander, A; Viikinkoski, P; Tuuhea, J; Voutilainen, L; Kivisaari, L

    1992-01-01

    In a prospective series of 72 patients, clinical and ultrasonographic examination of the thyroid gland were compared in detail. Normal-sized lobes were differentiated from enlarged ones both by inspection and by palpation. When lobar size was assessed by palpation, the estimate was most clearly influenced by increase in width. The correlation between two examiners in lobe size assessment was significant. In the classification of thyroid disease as diffuse, solitary, or multinodular, clinical examination and ultrasonography correlated significantly. However, only one third of the clinically solitary nodules proved to be solitary by ultrasound examination. Of 77 separate nodules, 43 escaped detection on clinical examination. Of these 43, 14 nodules exceeded 2 cm in diameter. It is concluded that the use of ultrasonography frequently alters the primary evaluation of thyroid nodularity based on palpation.

  17. Heated Ultrasound Gel and Patient Satisfaction with Bedside Ultrasound Studies: The HUGS Trial

    PubMed Central

    Krainin, Benjamin M.; Thaut, Lane C.; April, Michael D.; Curtis, Ryan A.; Kaelin, Andrea L.; Hardy, Garrett B.; Weymouth, Wells L.; Srichandra, Jonathan; Chin, Eric J.; Summers, Shane M.

    2017-01-01

    Introduction Our goal was to determine if heated gel for emergency department (ED) bedside ultrasonography improves patient satisfaction compared to room-temperature gel. Methods We randomized a convenience sample of ED patients determined by their treating physician to require a bedside ultrasound (US) study to either heated gel (102.0° F) or room-temperature gel (82.3° F). Investigators performed all US examinations. We informed all subjects that the study entailed investigation into various measures to improve patient satisfaction with ED US examinations but did not inform them of our specific focus on gel temperature. Investigators wore heat-resistant gloves while performing the examinations to blind themselves to the gel temperature. After completion of the US, subjects completed a survey including the primary outcome measure of patient satisfaction as measured on a 100-mm visual analogue scale (VAS). A secondary outcome was patient perceptions of sonographer professionalism measured by an ordinal scale (1–5). Results We enrolled 124 subjects; 120 completed all outcome measures. Of these, 59 underwent randomization to US studies with room-temperature gel and 61 underwent randomization to heated US gel. Patient 100-mm VAS satisfaction scores were 83.9 among patients undergoing studies with room-temperature gel versus 87.6 among subjects undergoing studies with heated gel (effect size 3.7, 95% confidence interval −1.3–8.6). There were similarly no differences between the two arms with regard to patient perceptions of sonographer professionalism. Conclusion The use of heated ultrasound gel appears to have no material impact on the satisfaction of ED patients undergoing bedside ultrasound studies. PMID:29085538

  18. Influence of anthropometric parameters on ultrasound measurements of Os calcis.

    PubMed

    Hans, D; Schott, A M; Arlot, M E; Sornay, E; Delmas, P D; Meunier, P J

    1995-01-01

    Few data have been published concerning the influence of height, weight and body mass index (BMI) on broadband ultrasound attenuation (BUA), speed of sound (SOS) and Lunar "stiffness" index, and always in small population samples. The first ain of the present cross-sectional study was to determine whether anthropometric factors have a significant influence on ultrasound measurements. The second objective was to establish whether these parameters have real effect on whether their influence is due only to measurement errors. We measured, in 271 healthy French women (mean age 77 +/- 11 years; range 31-97 years), the following parameters: age, height, weight, lean and fat body mass, heel width, foot length, knee height and external malleolus (HEM). Simple linear regression analyses between ultrasound and anthropometric parameters were performed. Age, height, and heel width were significant predictors of SOS; age, height, weight, foot length, heel width, HEM, fat mass and lean mass were significant predictors of BUA; age, height, weight, heel width, HEM, fat mass and lean mass were significant predictors of stiffness. In the multiple regression analysis, once the analysis had been adjusted for age, only heel width was a significant predictor for SOS (p = 0.0007), weight for BUA (p = 0.0001), and weight (p = 0.0001) and heel width (p = 0.004) for the stiffness index. Besides their statistical meaning, the regression coefficients have a more clinically relevant interpretation which is developed in the text. These results confirm the influence of anthropometric factors on the ultrasonic parameter values, because BUA and SOS were in part dependent on heel width and weight. The influence of the position of the transducer on the calcaneus should be taken into account to optimize the methods of measurement using ultrasound.

  19. Design of a Thermoacoustic Sensor for Low Intensity Ultrasound Measurements Based on an Artificial Neural Network.

    PubMed

    Xing, Jida; Chen, Jie

    2015-06-23

    In therapeutic ultrasound applications, accurate ultrasound output intensities are crucial because the physiological effects of therapeutic ultrasound are very sensitive to the intensity and duration of these applications. Although radiation force balance is a benchmark technique for measuring ultrasound intensity and power, it is costly, difficult to operate, and compromised by noise vibration. To overcome these limitations, the development of a low-cost, easy to operate, and vibration-resistant alternative device is necessary for rapid ultrasound intensity measurement. Therefore, we proposed and validated a novel two-layer thermoacoustic sensor using an artificial neural network technique to accurately measure low ultrasound intensities between 30 and 120 mW/cm2. The first layer of the sensor design is a cylindrical absorber made of plexiglass, followed by a second layer composed of polyurethane rubber with a high attenuation coefficient to absorb extra ultrasound energy. The sensor determined ultrasound intensities according to a temperature elevation induced by heat converted from incident acoustic energy. Compared with our previous one-layer sensor design, the new two-layer sensor enhanced the ultrasound absorption efficiency to provide more rapid and reliable measurements. Using a three-dimensional model in the K-wave toolbox, our simulation of the ultrasound propagation process demonstrated that the two-layer design is more efficient than the single layer design. We also integrated an artificial neural network algorithm to compensate for the large measurement offset. After obtaining multiple parameters of the sensor characteristics through calibration, the artificial neural network is built to correct temperature drifts and increase the reliability of our thermoacoustic measurements through iterative training about ten seconds. The performance of the artificial neural network method was validated through a series of experiments. Compared to our previous

  20. Design of a Thermoacoustic Sensor for Low Intensity Ultrasound Measurements Based on an Artificial Neural Network

    PubMed Central

    Xing, Jida; Chen, Jie

    2015-01-01

    In therapeutic ultrasound applications, accurate ultrasound output intensities are crucial because the physiological effects of therapeutic ultrasound are very sensitive to the intensity and duration of these applications. Although radiation force balance is a benchmark technique for measuring ultrasound intensity and power, it is costly, difficult to operate, and compromised by noise vibration. To overcome these limitations, the development of a low-cost, easy to operate, and vibration-resistant alternative device is necessary for rapid ultrasound intensity measurement. Therefore, we proposed and validated a novel two-layer thermoacoustic sensor using an artificial neural network technique to accurately measure low ultrasound intensities between 30 and 120 mW/cm2. The first layer of the sensor design is a cylindrical absorber made of plexiglass, followed by a second layer composed of polyurethane rubber with a high attenuation coefficient to absorb extra ultrasound energy. The sensor determined ultrasound intensities according to a temperature elevation induced by heat converted from incident acoustic energy. Compared with our previous one-layer sensor design, the new two-layer sensor enhanced the ultrasound absorption efficiency to provide more rapid and reliable measurements. Using a three-dimensional model in the K-wave toolbox, our simulation of the ultrasound propagation process demonstrated that the two-layer design is more efficient than the single layer design. We also integrated an artificial neural network algorithm to compensate for the large measurement offset. After obtaining multiple parameters of the sensor characteristics through calibration, the artificial neural network is built to correct temperature drifts and increase the reliability of our thermoacoustic measurements through iterative training about ten seconds. The performance of the artificial neural network method was validated through a series of experiments. Compared to our previous

  1. Toward predicting tensile strength of pharmaceutical tablets by ultrasound measurement in continuous manufacturing.

    PubMed

    Razavi, Sonia M; Callegari, Gerardo; Drazer, German; Cuitiño, Alberto M

    2016-06-30

    An ultrasound measurement system was employed as a non-destructive method to evaluate its reliability in predicting the tensile strength of tablets and investigate the benefits of incorporating it in a continuous line, manufacturing solid dosage forms. Tablets containing lactose, acetaminophen, and magnesium stearate were manufactured continuously and in batches. The effect of two processing parameters, compaction force and level of shear strain were examined. Young's modulus and tensile strength of tablets were obtained by ultrasound and diametrical mechanical testing, respectively. It was found that as the blend was exposed to increasing levels of shear strain, the speed of sound in the tablets decreased and the tablets became both softer and mechanically weaker. Moreover, the results indicate that two separate tablet material properties (e.g., relative density and Young's modulus) are necessary in order to predict tensile strength. A strategy for hardness prediction is proposed that uses the existing models for Young's modulus and tensile strength of porous materials. Ultrasound testing was found to be very sensitive in differentiating tablets with similar formulation but produced under different processing conditions (e.g., different level of shear strain), thus, providing a fast, and non-destructive method for hardness prediction that could be incorporated to a continuous manufacturing process. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. [Ultrasound in the emergency department as an extension of the practitioner's clinical examination].

    PubMed

    Schmit, Aline; Pécoul, David; Lebret, Yannick; Dussoix, Philippe

    2018-01-31

    Ultrasound in the emergency department and general practice can be used as an extension of the physical examination, answering simple questions. It requires a short basic training that is easily accessible. This article illustrates with a few examples (kidney, lung and fractures) the interest of this formidable tool becoming unavoidable in the emergency department and general practice.

  3. Localization of the transverse processes in ultrasound for spinal curvature measurement

    NASA Astrophysics Data System (ADS)

    Kamali, Shahrokh; Ungi, Tamas; Lasso, Andras; Yan, Christina; Lougheed, Matthew; Fichtinger, Gabor

    2017-03-01

    PURPOSE: In scoliosis monitoring, tracked ultrasound has been explored as a safer imaging alternative to traditional radiography. The use of ultrasound in spinal curvature measurement requires identification of vertebral landmarks such as transverse processes, but as bones have reduced visibility in ultrasound imaging, skeletal landmarks are typically segmented manually, which is an exceedingly laborious and long process. We propose an automatic algorithm to segment and localize the surface of bony areas in the transverse process for scoliosis in ultrasound. METHODS: The algorithm uses cascade of filters to remove low intensity pixels, smooth the image and detect bony edges. By applying first differentiation, candidate bony areas are classified. The average intensity under each area has a correlation with the possibility of a shadow, and areas with strong shadow are kept for bone segmentation. The segmented images are used to reconstruct a 3-D volume to represent the whole spinal structure around the transverse processes. RESULTS: A comparison between the manual ground truth segmentation and the automatic algorithm in 50 images showed 0.17 mm average difference. The time to process all 1,938 images was about 37 Sec. (0.0191 Sec. / Image), including reading the original sequence file. CONCLUSION: Initial experiments showed the algorithm to be sufficiently accurate and fast for segmentation transverse processes in ultrasound for spinal curvature measurement. An extensive evaluation of the method is currently underway on images from a larger patient cohort and using multiple observers in producing ground truth segmentation.

  4. Ultrasound Applied to Subcutaneous Fat Tissue Measurements in International Elite Canoeists.

    PubMed

    Kopinski, S; Engel, T; Cassel, M; Fröhlich, K; Mayer, F; Carlsohn, A

    2015-12-01

    Subcutaneous adipose tissue (SAT) measurements with ultrasound have recently been introduced to assess body fat in elite athletes. However, appropriate protocols and data on various groups of athletes are missing. We investigated intra-rater reliability of SAT measurements using ultrasound in elite canoe athletes. 25 international level canoeists (18 male, 7 female; 23±4 years; 81±11 kg; 1.83±0.09 m; 20±3 training h/wk) were measured on 2 consecutive days. SAT was assessed with B-mode ultrasound at 8 sites (ISAK): triceps, subscapular, biceps, iliac crest, supraspinal, abdominal, front thigh, medial calf, and quantified using image analysis software. Data was analyzed descriptively (mean±SD, [range]). Coefficient of variation (CV%), intraclass correlation coefficient (ICC, 2.1) and absolute (LoA) and ratio limits of agreement (RLoA) were calculated for day-to-day reliability. Mean sum of SAT thickness was 30.0±19.4 mm [8.0, 80.1 mm], with 3.9±1.8 mm [1.2 mm subscapular, 8.0 mm abdominal] for individual sites. CV for the sum of sites was 4.7%, ICC 0.99, LoA 1.7±3.6 mm, RLoA 0.940 ( *  /÷1.155). Measuring SAT with ultrasound has proved to have excellent day-to-day reliability in elite canoe athletes. Recommendations for standardization of the method will further increase accuracy and reproducibility. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Development of Ultrasound to Measure In-vivo Dynamic Cervical Spine Intervertebral Disc Mechanics

    DTIC Science & Technology

    2015-01-01

    1 AD_________ Award Number: W81XWH-13-1-0050 TITLE: Development of Ultrasound to Measure In-vivo Dynamic Cervical Spine Intervertebral Disc...COVERED 27 Dec 2013 - 26 Dec 2014 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Development of Ultrasound to Measure In-vivo Dynamic Cervical Spine...Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Neck pain is pervasive problems in military population

  6. Ultrasound measures of tendon thickness: Intra-rater, Inter-rater and Inter-machine reliability.

    PubMed

    Del Baño-Aledo, María Elena; Martínez-Payá, Jacinto Javier; Ríos-Díaz, José; Mejías-Suárez, Silvia; Serrano-Carmona, Sergio; de Groot-Ferrando, Ana

    2017-01-01

    Ultrasound imaging is often used by physiotherapists and other healthcare professionals but the reliability of image acquisition with different ultrasound machines is unknown. The objective was to compare the intra-rater, inter-rater and intermachine reliability of thickness measurements of the plantar fascia (PF), Achilles tendon (AT), patellar tendon (PT) and elbow common extensor tendon (ECET) with musculoskeletal ultrasound imaging (MSUS). Tendon thickness was measured in four anatomical structures (14 participants, 28 images per tendon) by two sonographers and with two different ultrasound machines. Intraclass Correlation Coefficients (ICCs) and Bland-Altman plots were calculated. The standard error of measurement (SEM) and minimum detectable difference (MDD) were calculated. Inter-rater reliability was excellent for AT (ICC=0.98; 95% CI= 0.96-0.99) and very good for PT (ICC=0.85; 95% CI = 0.67-0.93) and ECET (ICC=0.81; 95% CI= 0.72-0.94). Reliability for PF was moderate, with an ICC of 0.63 (CI 95%= 0.20-0.83). Bland-Altman plot for inter-machine reliability showed a mean difference of 1 m for PF measurements and a mean difference of 4 m and 20 m for AT and PT. The relative SEMs were below 7% and the MDCs were below 0.7 mm. The MSUS reliability in measuring thickness of the four tendons is confirmed by the homogeneous readings intra sonographers, between operators and between different machines. Level of evidence: Tendon thickness can be measured reliably on different ultrasound devices, which is an important step forward in the use of this technique in daily clinical practice and research. III.

  7. Ultrasound Findings on Hands and Wrists of Patients with Systemic Lupus Erythematosus: Relationship with Physical Examination.

    PubMed

    Lins, Carolina Freitas; Lima de Sá Ribeiro, Daniel; Dourado Santos, Willer Gonçalves; Rosa, Genevievi; Machicado, Viviane; Pedreira, Ana Luisa; Pimenta da Fonseca, Emanuela; Mota Duque Sousa, Anna Paula; Rodrigues Silva, Carla Baleeiro; Matos, Marcos Antonio Almeida; Santiago, Mittermayer Barreto

    2017-09-01

    Diagnosis of synovitis/tenosynovitis by physical examination can be difficult. Ultrasound (US) can be an effective tool for the evaluation of joint involvement in systemic lupus erythematosus (SLE). This study will describe musculoskeletal findings by US in SLE patients and the evaluation of their correlation with physical examination. SLE patients underwent clinical/sonographic evaluation of hand/wrists. In total, 896 joints were evaluated: at least 1 change on physical examination was found in 136 joints and at least 1 US abnormality was found in 65 of 896 joints. Out of the 65 joints with US changes, only 13 had findings on physical examination. Conversely, 111 joints had tenderness on physical examination with no sonographic abnormalities. Tenosynovitis was statistically significant more frequently with joint edema (41%) (p = 0.0003). US can detect musculoskeletal changes in only a minority of symptomatic SLE patients. Clinical findings may be related to some reasons that cannot be explained using US. Copyright © 2017 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  8. Ultrasound measurement of transcranial distance during head-down tilt

    NASA Technical Reports Server (NTRS)

    Torikoshi, S.; Wilson, M. H.; Ballard, R. E.; Watenpaugh, D. E.; Murthy, G.; Yost, W. T.; Cantrell, J. H.; Chang, D. S.; Hargens, A. R.

    1995-01-01

    Exposure to microgravity elevates blood pressure and flow in the head, which may increase intracranial volume (ICV) and intracranial pressure (ICP). Rhesus monkeys exposed to simulated microgravity in the form of 6 degree head-down tilt (HDT) experience elevated ICP. With humans, twenty-four hours of 6 degree HDT bed rest increases cerebral blood flow velocity relative to pre-HDT upright posture. Humans exposed to acute 6 degree HDT experiments increased ICP, measured with the tympanic membrane displacement (TMD) technique. Other studies suggest that increased ICP in humans and cats causes measurable cranial bone movement across the sagittal suture. Due to the slightly compliant nature of the cranium, elevation of the ICP will increase ICV and transcranial distance. Currently, several non-invasive approaches to monitor ICP are being investigated. Such techniques include TMD and modal analysis of the skull. TMD may not be reliable over a large range of ICP and neither method is capable of measuring the small changes in pressure. Ultrasound, however, may reliably measure small distance changes that accompany ICP fluctuations. The purpose of our study was to develop and evaluate an ultrasound technique to measure transcranial distance changes during HDT.

  9. Novel Use of Ultrasound to Teach Reproductive System Physical Examination Skills and Pelvic Anatomy.

    PubMed

    Parikh, Tejal; Czuzak, Maria; Bui, Naomi; Wildner, Corinna; Koch, Bryna; Leko, Elizabeth; Rappaport, William; Adhikari, Srikar; Gordon, Paul; Gura, Mike; Ellis, Susan

    2018-03-01

    To determine whether integration of ultrasound (US) into a reproductive system examination clinical skills lab can increase confidence in palpating key reproductive structures during testicular and bimanual pelvic examinations, reduce anxiety about conducting testicular and bimanual pelvic examinations, and improve performance on multiple-choice questions based on structure identification using US images. Second-year medical students enrolled in the Life Cycle preclinical course participated in this cross-sectional study. A single learning activity was developed to pair the teaching of the reproductive system physical examination with the use of US in the clinical skills lab. The evaluation of the teaching session consisted of a pre-post analysis of student self-reported knowledge, confidence, and anxiety. The response rate for the pre survey was 82% (n = 96), and the rate for the post survey was 79% (n = 93). Students' confidence in their ability to identify reproductive system structures on US images increased from pre to post survey. Their confidence in their ability to palpate the epididymis, uterus, and ovary during a physical examination improved, and their anxiety about conducting testicular and bimanual pelvic examinations decreased. Student satisfaction with the session was high. Students' performance on multiple-choice questions based on structure identification using US images was at 96% or higher. Our study findings support the integration of US into a reproductive system examination clinical skills lab. Medical students acquire competency and confidence in reproductive system physical examination skills with US integration. © 2017 by the American Institute of Ultrasound in Medicine.

  10. Reliability of panoramic ultrasound imaging in simultaneously examining muscle size and quality of the hamstring muscles in young, healthy males and females.

    PubMed

    Palmer, Ty B; Akehi, Kazuma; Thiele, Ryan M; Smith, Doug B; Thompson, Brennan J

    2015-03-01

    The purpose of this study was to examine the reliability of ultrasound (US) measures of cross-sectional area (CSA), muscle thickness (MT) and echo intensity (EI) of the hamstrings, with comparisons between males and females. In 20 healthy participants (10 males, 10 females), CSA, MT and EI were measured from panoramic US scans of the hamstrings on 2 separate days. The intra-class correlation coefficients and standard errors of measurement as a percentage of the mean for CSA, MT and EI ranged from 0.715 to 0.984 and from 3.145 to 12.541% in the males and from 0.724 to 0.977 and from 4.571 to 17.890% in the females, respectively. The males had greater CSAs and MTs and lower EIs than the females (p = 0.002-0.049), and significant relationships were observed between CSA and MT (r = 0.714-0.938, p ≤ 0.001-0.023). From an overall reliability standpoint, these findings suggest that panoramic US may be a reliable technique for examining muscle size and quality of the hamstrings in both males and females. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  11. Exploratory Analysis of Carbon Dioxide Levels, Ultrasound and Optical Coherence Tomography Measures of the Eye During ISS Missions

    NASA Technical Reports Server (NTRS)

    Schaefer, C.; Coble, C.; Mason, S.; Young, M.; Wear, M. L.; Sargsyan, A.; Garcia, K.; Patel, N.; Gibson, C.; Alexander, D.; hide

    2017-01-01

    Carbon dioxide (CO2) levels on board the International Space Station (ISS) have typically averaged 2.3 to 5.3 mmHg, with large fluctuations occurring over periods of hours and days. CO2 has effects on cerebral vascular tone, resulting in vasodilation and alteration of cerebral blood flow (CBF). Increased CBF leads to elevated intracranial pressure (ICP), a factor leading to visual disturbances, headaches, and other central nervous system symptoms. Ultrasound of the optic nerve and optical coherence tomography (OCT) provide surrogate measurements of ICP; in-flight measurements of both were implemented as enhanced screening tools for the Visual Impairment/Intracranial Pressure (VIIP) syndrome. This analysis examines the relationships between ambient CO2 levels on ISS, ultrasound and OCT measures of the eye in an effort to understand how CO2 may possibly be associated with VIIP and to inform future analysis of in-flight VIIP data.

  12. Ophthalmic applications of laser-generated ultrasound

    NASA Astrophysics Data System (ADS)

    Payne, Peter A.; Sadr, Ali; Rosen, Emanuel S.; Dewhurst, Richard J.

    2000-06-01

    Laser-generated ultrasound has found a number of niche applications in non-destructive testing and evaluation and there is now a growing trend to examine potential applications for materials characterization in medicine. Conventional ultrasound techniques for measuring various important dimensions within the eye are in extensive use. However, one problem remains outstanding, which is that the dimensions of the cornea, anterior chamber and lens can be measured using a high frequency, high resolution transducer, but the dimensions of the overall eyeball (i.e., cornea to retina) have to be measured with a lower frequency transducer in order to achieve the necessary penetration. We have conducted a number of in vitro studies using bovine eyes to determine whether the use of laser induced ultrasound would be able to overcome the aforementioned problem. The results of these measurements will be presented, together with a discussion of the many difficulties that remain to be overcome. In addition, our studies involve the potential use of laser ultrasound to quantify the degree of cataract formation, both primary and secondary. This paper will also consider the work accomplished to data in this area.

  13. Comparison of translabial three-dimensional ultrasound with magnetic resonance imaging for measurement of levator hiatal biometry at rest.

    PubMed

    Vergeldt, T F M; Notten, K J B; Stoker, J; Fütterer, J J; Beets-Tan, R G; Vliegen, R F A; Schweitzer, K J; Mulder, F E M; van Kuijk, S M J; Roovers, J P W R; Kluivers, K B; Weemhoff, M

    2016-05-01

    To compare translabial three-dimensional (3D) ultrasound with magnetic resonance imaging (MRI) for the measurement of levator hiatal biometry at rest in women with pelvic organ prolapse, and to determine the interobserver reliability between two independent observers for ultrasound and MRI measurements. Data were derived from a multicenter prospective cohort study in which women scheduled for conventional anterior colporrhaphy underwent translabial 3D ultrasound and MRI prior to surgery. Intraclass correlation coefficients (ICCs) were calculated to estimate interobserver reliability between two independent observers and determine the agreement between ultrasound and MRI measurements. Bland-Altman plots were created to assess the agreement between ultrasound and MRI measurements. Data from 139 women from nine hospitals were included in the study. The interobserver reliability of ultrasound assessment at rest, during Valsalva maneuver and during contraction and of MRI assessment at rest were moderate or good. The agreement between ultrasound and MRI for the measurement of levator hiatal biometry at rest was moderate, with ICCs of 0.52 (95%CI, 0.32-0.66) for levator hiatal area, 0.44 (95%CI, 0.21-0.60) for anteroposterior diameter and 0.44 (95%CI, 0.22-0.60) for transverse diameter. Levator hiatal biometry measurements were statistically significantly larger on MRI than on translabial 3D ultrasound. The agreement between translabial 3D ultrasound and MRI for measurement of the levator hiatus at rest in women with pelvic organ prolapse was only moderate. The results of translabial 3D ultrasound and MRI should therefore not be used interchangeably in daily practice or in clinical research. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  14. Cognitive load imposed by ultrasound-facilitated teaching does not adversely affect gross anatomy learning outcomes.

    PubMed

    Jamniczky, Heather A; Cotton, Darrel; Paget, Michael; Ramji, Qahir; Lenz, Ryan; McLaughlin, Kevin; Coderre, Sylvain; Ma, Irene W Y

    2017-03-01

    Ultrasonography is increasingly used in medical education, but its impact on learning outcomes is unclear. Adding ultrasound may facilitate learning, but may also potentially overwhelm novice learners. Based upon the framework of cognitive load theory, this study seeks to evaluate the relationship between cognitive load associated with using ultrasound and learning outcomes. The use of ultrasound was hypothesized to facilitate learning in anatomy for 161 novice first-year medical students. Using linear regression analyses, the relationship between reported cognitive load on using ultrasound and learning outcomes as measured by anatomy laboratory examination scores four weeks after ultrasound-guided anatomy training was evaluated in consenting students. Second anatomy examination scores of students who were taught anatomy with ultrasound were compared with historical controls (those not taught with ultrasound). Ultrasound's perceived utility for learning was measured on a five-point scale. Cognitive load on using ultrasound was measured on a nine-point scale. Primary outcome was the laboratory examination score (60 questions). Learners found ultrasound useful for learning. Weighted factor score on "image interpretation" was negatively, but insignificantly, associated with examination scores [F (1,135) = 0.28, beta = -0.22; P = 0.61]. Weighted factor score on "basic knobology" was positively and insignificantly associated with scores; [F (1,138) = 0.27, beta = 0.42; P = 0.60]. Cohorts exposed to ultrasound had significantly higher scores than historical controls (82.4% ± SD 8.6% vs. 78.8% ± 8.5%, Cohen's d = 0.41, P < 0.001). Using ultrasound to teach anatomy does not negatively impact learning and may improve learning outcomes. Anat Sci Educ 10: 144-151. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  15. Usefulness of ultrasound examination in the evaluation of a neonate's body fluid status.

    PubMed

    Kieliszczyk, Joanna; Baranowski, Wojciech; Kosiak, Wojciech

    2016-06-01

    Appropriate hydration is a very important prognostic factor for the patient's health. Ultrasonographic assessment of hydration status is rarely used in pediatric medicine and it is not used at all in neonates due to the fact that no reference values have been established for this age group. The aim of the paper was to establish reference values for neonates. The study included 50 neonates from two hospitals in the Lower Silesia region of Poland; 25 of them were healthy patients (full-term newborns with no perinatal complications) and 25 were sick patients (newborns with heart defects such as ostium secundum atrial septal defect, ventricular septal defect, permanent foramen ovale and patent ductus arteriosus as well as newborns with neonatal jaundice or pneumonia that occurred during the first days of life). The ultrasound scans were conducted during the first days of the children's life. For every child inferior vena cava diameter was measured in the substernal area, longitudinal plane, M-mode in two respiratory phases: inhalation and exhalation. In addition, abdominal aorta diameter was determined (substernal area, transverse plane). The study demonstrated a statistically significant difference in the calculated inferior vena cava collapsibility index between both groups. Two other indices included the ratio of the inferior vena cava diameter during the expiratory phase to the diameter of the aorta and the ratio of the inferior vena cava diameter during the inspiratory phase to the diameter of the aorta; a statistically significant difference between both groups was found only for the measurements in the inspiratory phase. Based on the study results normal ranges for hydration indices in neonates were established. The need for the measurement of the abovementioned parameters in the inspiratory phase was determined. In addition, the usefulness of the ultrasound examination for the evaluation of body fluid status in this pediatric age group, particularly in preterm

  16. Should a detailed ultrasound examination of the complete urinary tract be routinely performed in women with suspected pelvic endometriosis?

    PubMed

    Pateman, K; Holland, T K; Knez, J; Derdelis, G; Cutner, A; Saridogan, E; Jurkovic, D

    2015-12-01

    Is there any benefit to including the routine examination by ultrasound of the bladder, ureters and kidneys of women with endometriosis? The benefit of examination of the complete urinary tract of women with suspected endometriosis is that ureteric endometriosis, with or without hydronephrosis, can be detected which facilitates early intervention to prevent nephropathy. Women with endometriosis can get ureteric obstruction but there is no clear consensus on the correct diagnostic technique. Ultrasound is accurate at detecting women with bladder endometriosis but ureteric involvement has not been assessed previously. This was a prospective observational study, conducted at a teaching hospital over a period of 14 months. A total of 848 women presenting with chronic pelvic pain were included into the study. All women with chronic pelvic pain underwent a detailed transvaginal and transabdominal pelvic ultrasound examination to investigate possible causes of their symptoms. This included a systematic assessment of the urinary bladder, pelvic sections of the ureters and kidneys. The ultrasound findings were compared with findings at surgery and the results of targeted urological imaging and interventions. A total of 848 women presenting with chronic pelvic pain were included into the study. 28/848 women (3.3% 95% CI 2.1-4.5) had evidence of urinary tract abnormalities on initial ultrasound scan. Among these 17/848 (2.0% 95% CI 1.06-2.94) had evidence of urinary tract endometriosis, whilst 11/848 (1.3% 95% CI 0.54-2.06) women had other urinary tract abnormalities. Among women with urinary tract endometriosis 11/17 (65%) had evidence of ureteric involvement, 3/17 (18%) had both ureteric and bladder disease and 3/17 (18%) had bladder disease only. 12/17 (59%) women with urinary tract endometriosis also had evidence of hydronephrosis. The diagnosis of ureteral endometriosis had a sensitivity of 12/13 (92%) (95% CI 63.9-99.8), specificity 151/151 100% (95% CI 97.6-100), PPV

  17. The use of ultrasound measurements in environmental epidemiological studies of air pollution and fetal growth

    PubMed Central

    Smarr, Melissa M.; Vadillo-Ortega, Felipe; Castillo-Castrejon, Marisol; O’Neill, Marie S.

    2015-01-01

    Purpose of review Recently, several international research groups have suggested that studies about environmental contaminants and adverse pregnancy outcomes should be designed to elucidate potential underlying biological mechanisms. The purpose of this review is to examine the epidemiological studies addressing maternal exposure to air pollutants and fetal growth during gestation as assessed by ultrasound measurements. Recent findings The six studies published to date found that exposure to certain ambient air pollutants during pregnancy is negatively associated with the growth rates and average attained size of fetal parameters belonging to the growth profile. Fetal parameters may respond to maternal air pollution exposures uniquely, and this response may vary by pollutant and timing of gestational exposure. Current literature suggests that mean changes in head circumference, abdominal circumference, femur length, and biparietal diameter are negatively associated with early-pregnancy exposures to ambient and vehicle-related air pollution. Summary The use of more longitudinal studies, employing ultrasound measures to assess fetal outcomes, may assist with the better understanding of mechanisms responsible for air pollution-related pregnancy outcomes. PMID:23399571

  18. Guidance and examination by ultrasound versus landmark and radiographic method for placement of subclavian central venous catheters: study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Central venous catheters play an important role in patient care. Real-time ultrasound-guided subclavian central venous (SCV) cannulation may reduce the incidence of complications and the time between skin penetration and the aspiration of venous blood into the syringe. Ultrasonic diagnosis of catheter misplacement and pneumothorax related to central venous catheterization is rapid and accurate. It is unclear, however, whether ultrasound real-time guidance and examination can reduce procedure times and complication rates when compared with landmark guidance and radiographic examination for SCV catheterization. Methods/Design The Subclavian Central Venous Catheters Guidance and Examination by UltraSound (SUBGEUS) study is an investigator-initiated single center, randomized, controlled two-arm trial. Three hundred patients undergoing SCV catheter placement will be randomized to ultrasound real-time guidance and examination or landmark guidance and radiographic examination. The primary outcome is the time between the beginning of the procedure and control of the catheter. Secondary outcomes include the times required for the six components of the total procedure, the occurrence of complications (pneumothorax, hemothorax, or misplacement), failure of the technique and occurrence of central venous catheter infections. Discussion The SUBGEUS trial is the first randomized controlled study to investigate whether ultrasound real-time guidance and examination for SCV catheter placement reduces all procedure times and the rate of complications. Trial registration ClinicalTrials.gov Identifier: NCT01888094 PMID:24885789

  19. Preoperative ultrasound measurements predict the feasibility of gallbladder extraction during transgastric natural orifice translumenal endoscopic surgery cholecystectomy.

    PubMed

    Santos, Byron F; Auyang, Edward D; Hungness, Eric S; Desai, Kush R; Chan, Edward S; van Beek, Darren B; Wang, Edward C; Soper, Nathaniel J

    2011-04-01

    Extraction of a gallbladder through an endoscopic overtube during natural orifice translumenal endoscopic surgery (NOTES) transgastric cholecystectomy avoids potential injury to the esophagus. This study examined the rate of successful gallbladder specimen extraction through an overtube and hypothesized that preoperative ultrasound findings could predict successful specimen passage. Gallbladder specimens from patients undergoing laparoscopic cholecystectomy were measured, and an attempt was made to pull the specimens through a commercially available overtube with an inner diameter of 16.7-mm. A radiologist blinded to the outcomes reviewed the available preoperative ultrasound measurements from these patients. Ultrasound dimensions including gallbladder length, width, and depth; wall thickness; common bile duct diameter; and size of the largest gallstone (LGS) were recorded. Multiple logistic regression analysis was performed to determine whether ultrasound findings and patient characteristics (age, body mass index [BMI], and sex) could predict the ability of a specimen to pass through the overtube. Of 57 patients, 44 (77%) who had preoperative ultrasounds available for electronic review were included in the final analysis. Gallstones were present in 35 (79%) of these 44 patients. Intraoperative gallbladder perforation occurred in 18 (41%) of the 44 patients, and 16 (36%) of the 44 gallbladders could be extracted through the overtube. Measurement of LGS was possible for 23 patients, and indeterminate gallstone size (IGS) was determined for 12 patients. The rate for passage of perforated versus intact gallbladders was similar (40% vs. 23%; p = 0.054). The LGS (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.02-1.33; p = 0.021) and IGS (OR, 22.97; 95% CI, 1.99-265.63; p = 0.025) predicted failed passage on multivariate logistic regression analysis. The passage rate was 80% for LGS smaller than 10 mm or no stones present, 18% for LGS 10 mm or larger, and 8% for

  20. HOCUS: The Haskins optically-corrected ultrasound system for measuring speech articulation

    NASA Astrophysics Data System (ADS)

    Whalen, D. H.; Iskarous, Khalil; Tiede, Mark K.; Ostry, David J.

    2004-05-01

    The tongue is the most important supralaryngeal articulator for speech, yet, because it is typically out of view, its movements have been difficult to quantify. Here is described a new combination of techniques involving ultrasound in conjunction with an optoelectric motion measurement system (Optotrak). Combining these, the movements of the tongue are imaged and simultaneously corrected for motion of the head and of the ultrasound transceiver. Optotrak's infrared-emitting diodes are placed on the transceiver and the speakers head in order to localize the ultrasound image of the tongue relative to the hard palate. The palate can be imaged with ultrasound by having the ultrasound signal penetrate a water bolus held against the palate by the tongue. This trace is coregistered with the head and potentially with the same talker's sagittal MR image, to provide additional information on the unimaged remainder of the tract. The tongue surface, from the larynx to near the tip, can then be localized in relationship to the hard palate. The result is a fairly complete view of the tongue within the vocal tract at sampling rates appropriate for running speech. A comparison with other imaging vocal tract systems will be presented. [Work supported by NIH Grant DC-02717.

  1. Prenatal air pollution exposure and ultrasound measures of fetal growth in Los Angeles, California.

    PubMed

    Ritz, Beate; Qiu, Jiaheng; Lee, Pei-Chen; Lurmann, Fred; Penfold, Bryan; Erin Weiss, Robert; McConnell, Rob; Arora, Chander; Hobel, Calvin; Wilhelm, Michelle

    2014-04-01

    Few previous studies examined the impact of prenatal air pollution exposures on fetal development based on ultrasound measures during pregnancy. In a prospective birth cohort of more than 500 women followed during 1993-1996 in Los Angeles, California, we examined how air pollution impacts fetal growth during pregnancy. Exposure to traffic related air pollution was estimated using CALINE4 air dispersion modeling for nitrogen oxides (NOx) and a land use regression (LUR) model for nitrogen monoxide (NO), nitrogen dioxide (NO2) and NOx. Exposures to carbon monoxide (CO), NO2, ozone (O3) and particles <10μm in aerodynamic diameter (PM10) were estimated using government monitoring data. We employed a linear mixed effects model to estimate changes in fetal size at approximately 19, 29 and 37 weeks gestation based on ultrasound. Exposure to traffic-derived air pollution during 29 to 37 weeks was negatively associated with biparietal diameter at 37 weeks gestation. For each interquartile range (IQR) increase in LUR-based estimates of NO, NO2 and NOx, or freeway CALINE4 NOx we estimated a reduction in biparietal diameter of 0.2-0.3mm. For women residing within 5km of a monitoring station, we estimated biparietal diameter reductions of 0.9-1.0mm per IQR increase in CO and NO2. Effect estimates were robust to adjustment for a number of potential confounders. We did not observe consistent patterns for other growth endpoints we examined. Prenatal exposure to traffic-derived pollution was negatively associated with fetal head size measured as biparietal diameter in late pregnancy. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Prenatal Air Pollution Exposure and Ultrasound Measures of Fetal Growth in Los Angeles, California

    PubMed Central

    Ritz, Beate; Qiu, Jiaheng; Lee, Pei-Chen; Lurmann, Fred; Penfold, Bryan; Weiss, Robert Erin; McConnell, Rob; Arora, Chander; Hobel, Calvin; Wilhelm, Michelle

    2014-01-01

    Background Few previous studies examined the impact of prenatal air pollution exposures on fetal development based on ultrasound measures during pregnancy. Methods In a prospective birth cohort of more than 500 women followed during 1993-1996 in Los Angeles, California, we examined how air pollution impacts fetal growth during pregnancy. Exposure to traffic related air pollution was estimated using CALINE4 air dispersion modeling for nitrogen oxides (NOx) and a land use regression (LUR) model for nitrogen monoxide (NO), nitrogen dioxide (NO2) and NOx. Exposures to carbon monoxide (CO), NO2, ozone (O3) and particles <10 μm in aerodynamic diameter (PM10) were estimated using government monitoring data. We employed a linear mixed effects model to estimate changes in fetal size at approximately 19, 29 and 37 weeks gestation based on ultrasound. Results Exposure to traffic-derived air pollution during 29 to 37 weeks was negatively associated with biparietal diameter at 37 weeks gestation. For each interquartile range (IQR) increase in LUR-based estimates of NO, NO2 and NOx, or freeway CALINE4 NOx we estimated a reduction in biparietal diameter of 0.2-0.3 mm. For women residing within 5 km of a monitoring station, we estimated biparietal diameter reductions of 0.9-1.0 mm per IQR increase in CO and NO2. Effect estimates were robust to adjustment for a number of potential confounders. We did not observe consistent patterns for other growth endpoints we examined. Conclusions Prenatal exposure to traffic-derived pollution was negatively associated with fetal head size measured as biparietal diameter in late pregnancy. PMID:24517884

  3. New heights in ultrasound: first report of spinal ultrasound from the international space station.

    PubMed

    Marshburn, Thomas H; Hadfield, Chris A; Sargsyan, Ashot E; Garcia, Kathleen; Ebert, Douglas; Dulchavsky, Scott A

    2014-01-01

    Changes in the lumbar and sacral spine occur with exposure to microgravity in astronauts; monitoring these alterations without radiographic capabilities on the International Space Station (ISS) requires novel diagnostic solutions to be developed. We evaluated the ability of point-of-care ultrasound, performed by nonexpert-operator astronauts, to provide accurate anatomic information about the spine in long-duration crewmembers in space. Astronauts received brief ultrasound instruction on the ground and performed in-flight cervical and lumbosacral ultrasound examinations using just-in-time training and remote expert tele-ultrasound guidance. Ultrasound examinations on the ISS used a portable ultrasound device with real-time communication/guidance with ground experts in Mission Control. The crewmembers were able to obtain diagnostic-quality examinations of the cervical and lumbar spine that would provide essential information about acute or chronic changes to the spine. Spinal ultrasound provides essential anatomic information in the cervical and lumbosacral spine; this technique may be extensible to point-of-care situations in emergency departments or resource-challenged areas without direct access to additional radiologic capabilities. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. The use of three-dimensional ultrasound does not improve training in fetal biometric measurements.

    PubMed

    Chan, Lin W; Ting, Yuen H; Lao, Terence T; Chau, Macy M C; Fung, Tak Y; Leung, Tak Y; Sahota, Daljit S; Lau, Tze K

    2011-09-01

    To investigate whether three-dimensional (3D) technology offers any advantage over two-dimensional (2D) ultrasound in fetal biometric measurement training. Ten midwives with no hands-on experience in ultrasound were randomized to receive training on 2D or 3D ultrasound fetal biometry assessment. Midwives were taught how to obtain fetal biometric measurements (biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL)) by a trainer. Subsequently, each midwife measured the parameters on another 10 fetuses. The same set of measurements was repeated by the trainer. The percentage deviation between the midwives' and the trainer's measurements was determined and compared between training groups. Time required for completion was recorded. Frozen images were reviewed by another sonographer to assess the image quality using a standardized scoring system. The median time for the complete set of measurements was significantly shorter in the 2D than in 3D group (13.4 min versus 17.8 min, P = 0.03). The mean percentage deviations did not reach statistical significance between the two groups except for FL (3.83% in 2D group versus 2.23% in 3D group (P = 0.046)). There were no significant differences in the quality scores. This study showed that the only demonstrable advantage of 3D ultrasound was a slightly more accurate measurement of FL, at the expense of a significantly longer time required.

  5. The accuracy of ultrasound for measurement of mobile- bearing motion.

    PubMed

    Aigner, Christian; Radl, Roman; Pechmann, Michael; Rehak, Peter; Stacher, Rudolf; Windhager, Reinhard

    2004-04-01

    After anterior cruciate ligament-sacrificing total knee replacement, mobile bearings sometimes have paradoxic movement but the implications of such movement on function, wear, and implant survival are not known. To study this potential problem accurate, reliable, and widely available inexpensive tools for in vivo mobile-bearing motion analyses are needed. We developed a method using an 8-MHz ultrasound to analyze mobile-bearing motion and ascertained accuracy, precision, and reliability compared with plain and standard digital radiographs. The anterior rim of the mobile bearing was the target for all methods. The radiographs were taken in a horizontal plane at neutral rotation and incremental external and internal rotations. Five investigators examined four positions of the mobile bearing with all three methods. The accuracy and precision were: ultrasound, 0.7 mm and 0.2 mm; digital radiograph, 0.4 mm and 0.2 mm; and plain radiographs, 0.7 mm and 0.3 mm. The interrater and intrarater reliability ranged between 0.3 to 0.4 mm and 0.1 to 0.2 mm, respectively. The difference between the methods was not significant for neutral rotation but ultrasound was significantly more accurate than any one degree of rotation or higher. Ultrasound of 8 MHz provides an accuracy and reliability that is suitable for evaluation of in vivo meniscal bearing motion. Whether this method or others are sufficiently accurate to detect motion leading to abnormal wear is not known.

  6. Strain measurement of abdominal aortic aneurysm with real-time 3D ultrasound speckle tracking.

    PubMed

    Bihari, P; Shelke, A; Nwe, T H; Mularczyk, M; Nelson, K; Schmandra, T; Knez, P; Schmitz-Rixen, T

    2013-04-01

    Abdominal aortic aneurysm rupture is caused by mechanical vascular tissue failure. Although mechanical properties within the aneurysm vary, currently available ultrasound methods assess only one cross-sectional segment of the aorta. This study aims to establish real-time 3-dimensional (3D) speckle tracking ultrasound to explore local displacement and strain parameters of the whole abdominal aortic aneurysm. Validation was performed on a silicone aneurysm model, perfused in a pulsatile artificial circulatory system. Wall motion of the silicone model was measured simultaneously with a commercial real-time 3D speckle tracking ultrasound system and either with laser-scan micrometry or with video photogrammetry. After validation, 3D ultrasound data were collected from abdominal aortic aneurysms of five patients and displacement and strain parameters were analysed. Displacement parameters measured in vitro by 3D ultrasound and laser scan micrometer or video analysis were significantly correlated at pulse pressures between 40 and 80 mmHg. Strong local differences in displacement and strain were identified within the aortic aneurysms of patients. Local wall strain of the whole abdominal aortic aneurysm can be analysed in vivo with real-time 3D ultrasound speckle tracking imaging, offering the prospect of individual non-invasive rupture risk analysis of abdominal aortic aneurysms. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  7. Agreement and reliability of pelvic floor measurements during contraction using three-dimensional pelvic floor ultrasound and virtual reality.

    PubMed

    Speksnijder, L; Rousian, M; Steegers, E A P; Van Der Spek, P J; Koning, A H J; Steensma, A B

    2012-07-01

    Virtual reality is a novel method of visualizing ultrasound data with the perception of depth and offers possibilities for measuring non-planar structures. The levator ani hiatus has both convex and concave aspects. The aim of this study was to compare levator ani hiatus volume measurements obtained with conventional three-dimensional (3D) ultrasound and with a virtual reality measurement technique and to establish their reliability and agreement. 100 symptomatic patients visiting a tertiary pelvic floor clinic with a normal intact levator ani muscle diagnosed on translabial ultrasound were selected. Datasets were analyzed using a rendered volume with a slice thickness of 1.5 cm at the level of minimal hiatal dimensions during contraction. The levator area (in cm(2)) was measured and multiplied by 1.5 to get the levator ani hiatus volume in conventional 3D ultrasound (in cm(3)). Levator ani hiatus volume measurements were then measured semi-automatically in virtual reality (cm(3) ) using a segmentation algorithm. An intra- and interobserver analysis of reliability and agreement was performed in 20 randomly chosen patients. The mean difference between levator ani hiatus volume measurements performed using conventional 3D ultrasound and virtual reality was 0.10 (95% CI, - 0.15 to 0.35) cm(3). The intraclass correlation coefficient (ICC) comparing conventional 3D ultrasound with virtual reality measurements was > 0.96. Intra- and interobserver ICCs for conventional 3D ultrasound measurements were > 0.94 and for virtual reality measurements were > 0.97, indicating good reliability for both. Levator ani hiatus volume measurements performed using virtual reality were reliable and the results were similar to those obtained with conventional 3D ultrasonography. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

  8. Ceramic membrane ultrafiltration of natural surface water with ultrasound enhanced backwashing.

    PubMed

    Boley, A; Narasimhan, K; Kieninger, M; Müller, W-R

    2010-01-01

    Ultrafiltration membrane cleaning with ultrasound enhanced backwashing was investigated with two ceramic membrane systems in parallel. One of them was subjected to ultrasound during backwashing, the other acted as a reference system. The feed water was directly taken from a creek with a sedimentation process as only pre-treatment. The cleaning performance was improved with ultrasound but after 3 weeks of operation damages occurred on the membranes. These effects were studied with online measurements of flux, trans-membrane-pressure and temperature, but also with integrity tests, turbidity measurements and visual examination.

  9. Impact of vaginal-rectal ultrasound examinations with covered and low-level disinfected transducers on infectious transmissions in france.

    PubMed

    Leroy, Sandrine; M'Zali, Fatima; Kann, Michael; Weber, David J; Smith, David D

    2014-12-01

    The risk of cross-infection from shared ultrasound probes in endorectal and vaginal ultrasonography due to low-level disinfection (LLD) is difficult to estimate because potential infections are also sexually transmitted diseases, and route of contamination is often difficult to establish. In France, the widely used standard for prevention of infections is through the use of probe covers and LLD of the ultrasound transducer by disinfectant wipes. We performed an in silico simulation based on a systematic review to estimate the number of patients infected after endorectal or vaginal ultrasonography examination using LLD for probes. We performed a stochastic Monte Carlo computer simulation to produce hypothetical cohorts for a population of 4 million annual ultrasound examinations performed in France, and we estimated the number of infected patients for human immunodeficiency virus (HIV), herpes simplex virus, hepatitis B virus, hepatitis C virus, human papilloma virus, cytomegalovirus, and Chlamydia trachomatis. Modeling parameters were estimated by meta-analysis when possible. The probability of infection from a contaminated probe ranged from 1% to 6%, depending on the pathogen. For cases of HIV infection, this would result in approximately 60 infected patients per year. For other common viral infections, the number of new cases ranged from 1,600 to 15,000 per year that could be attributable directly to ultrasound and LLD procedures. Our simulation results showed that, despite cumulative use of probe cover and LLD, there were still some cases of de novo infection that may be attributable to ultrasound procedures. These cases are preventable by reviewing the currently used LLD and/or upgrading LLD to high-level disinfection, as recommended by the US Centers for Disease Control and Prevention.

  10. Split-screen display system and standardized methods for ultrasound image acquisition and multi-frame data processing

    NASA Technical Reports Server (NTRS)

    Selzer, Robert H. (Inventor); Hodis, Howard N. (Inventor)

    2011-01-01

    A standardized acquisition methodology assists operators to accurately replicate high resolution B-mode ultrasound images obtained over several spaced-apart examinations utilizing a split-screen display in which the arterial ultrasound image from an earlier examination is displayed on one side of the screen while a real-time "live" ultrasound image from a current examination is displayed next to the earlier image on the opposite side of the screen. By viewing both images, whether simultaneously or alternately, while manually adjusting the ultrasound transducer, an operator is able to bring into view the real-time image that best matches a selected image from the earlier ultrasound examination. Utilizing this methodology, dynamic material properties of arterial structures, such as IMT and diameter, are measured in a standard region over successive image frames. Each frame of the sequence has its echo edge boundaries automatically determined by using the immediately prior frame's true echo edge coordinates as initial boundary conditions. Computerized echo edge recognition and tracking over multiple successive image frames enhances measurement of arterial diameter and IMT and allows for improved vascular dimension measurements, including vascular stiffness and IMT determinations.

  11. Portable Bladder Ultrasound

    PubMed Central

    2006-01-01

    L are considered an indication for urinary retention, requiring intermittent catheterization, whereas a PVR urine volume of 100 mL to 150 mL or less is generally considered an acceptable result of bladder training. Urinary retention has been associated with poor outcomes including UTI, bladder overdistension, and higher hospital mortality rates. The standard method of determining PVR urine volumes is intermittent catheterization, which is associated with increased risk of UTI, urethral trauma and discomfort. The Technology Being Reviewed Portable bladder ultrasound products are transportable ultrasound devices that use automated technology to register bladder volume digitally, including PVR volume, and provide three-dimensional images of the bladder. The main clinical use of portable bladder ultrasound is as a diagnostic aid. Health care professionals (primarily nurses) administer the device to measure PVR volume and prevent unnecessary catheterization. An adjunctive use of the bladder ultrasound device is to visualize the placement and removal of catheters. Also, portable bladder ultrasound products may improve the diagnosis and differentiation of urological problems and their management and treatment, including the establishment of voiding schedules, study of bladder biofeedback, fewer UTIs, and monitoring of potential urinary incontinence after surgery or trauma. Review Strategy To determine the effectiveness and clinical utility of portable bladder ultrasound as reported in the published literature, the Medical Advisory Secretariat used its standard search strategy to retrieve international health technology assessments and English-language journal articles from selected databases. Nonsystematic reviews, nonhuman studies, case reports, letters, editorials, and comments were excluded. Summary of Findings Of the 4 included studies that examined the clinical utility of portable bladder ultrasound in the elderly population, all found the device to be acceptable. One

  12. Towards an Optimal Interest Point Detector for Measurements in Ultrasound Images

    NASA Astrophysics Data System (ADS)

    Zukal, Martin; Beneš, Radek; Číka, Petr; Říha, Kamil

    2013-12-01

    This paper focuses on the comparison of different interest point detectors and their utilization for measurements in ultrasound (US) images. Certain medical examinations are based on speckle tracking which strongly relies on features that can be reliably tracked frame to frame. Only significant features (interest points) resistant to noise and brightness changes within US images are suitable for accurate long-lasting tracking. We compare three interest point detectors - Harris-Laplace, Difference of Gaussian (DoG) and Fast Hessian - and identify the most suitable one for use in US images on the basis of an objective criterion. Repeatability rate is assumed to be an objective quality measure for comparison. We have measured repeatability in images corrupted by different types of noise (speckle noise, Gaussian noise) and for changes in brightness. The Harris-Laplace detector outperformed its competitors and seems to be a sound option when choosing a suitable interest point detector for US images. However, it has to be noted that Fast Hessian and DoG detectors achieved better results in terms of processing speed.

  13. Thigh muscle and subcutaneous tissue thickness measured using ultrasound imaging in older females living in extended care: a preliminary study.

    PubMed

    Welch, Daniella; Ndanyo, Laetitia Sungu; Brown, Simon; Agyapong-Badu, Sandra; Warner, Martin; Stokes, Maria; Samuel, Dinesh

    2018-05-01

    Thigh tissue thickness has not been examined in older females living in extended care in UK as an indicator of musculoskeletal health. This study examined the feasibility of using ultrasound imaging to measure the thickness of superficial (fat) and deep layers (muscle) of the thigh in older females living in extended care. In ten older females in extended care (aged 80-98 years, mean 88 ± 6.8; body mass: 56.5 ± 12.6 kg) images of the anterior thigh (dominant) were taken in supine using B-mode ultrasound imaging. Superficial and deep layers were measured and percentage thickness was calculated. Independent t tests compared data from those in extended care to ten sedentary females living independently (aged 80-90 years, mean 84 ± 3.6; body mass: 61.6 ± 10.0 kg). Thickness of the superficial layers was not significantly different between the two groups (CI -0.017 to 0.815, p = 0.059). However, those living in extended care had greater (p < 0.001) muscle thickness (mean 2.75 ± 0.48 cm) than those living independently (mean 1.83 ± 0.3 cm), which was similarly significant when normalised for body mass (extended care 0.51 ± 0.16; independent living 0.30 ± 0.06). These novel findings showed it is feasible to use ultrasound to measure muscles in older females in extended care and that muscle thickness was larger than in those living independently. The reason for the difference seen between groups would need to be confirmed by a larger study that also examined factors related to risk of sarcopenia and frailty, such as nutrition and physical activity levels.

  14. Exploration Analysis of Carbon Dioxide Levels and Ultrasound Measures of the Eye During ISS Missions

    NASA Technical Reports Server (NTRS)

    Young, M.; Mason, S.; Schaefer, C.; Wear, M. L.; Sargsyan, A.; Garcia, K.; Coble, C.; Gruschkus, S.; Law, J.; Alexander, D.; hide

    2016-01-01

    Enhanced screening for the Visual Impairment/Intracranial Pressure (VIIP) Syndrome, including in-flight ultrasound, was implemented in 2010 to better characterize the changes in vision observed in some long-duration crewmembers. Suggested possible risk factors for VIIP include cardiovascular changes, diet, anatomical and genetic factors, and environmental conditions. As a potent vasodilator, carbon dioxide (CO (sub 2)), which is chronically elevated on the International Space Station (ISS) relative to typical indoor and outdoor ambient levels on Earth, seems a plausible contributor to VIIP. In an effort to understand the possible associations between CO (sub 2) and VIIP, this study analyzes the relationship between ambient CO (sub 2) levels on ISS and ultrasound measures of the eye obtained from ISS fliers. CO (sub 2) measurements will be pulled directly from Operational Data Reduction Complex for the Lab and Node 3 major constituent analyzers (MCAs) on ISS or from sensors located in the European Columbus module, as available. CO (sub 2) measures between ultrasound sessions will be summarized using standard time series class metrics in MATLAB including time-weighted means and variances. Cumulative CO (sub 2) exposure metrics will also be developed. Regression analyses will be used to quantify the relationships between the CO (sub 2) metrics and specific ultrasound measures. Generalized estimating equations will adjust for the repeated measures within individuals. Multiple imputation techniques will be used to adjust for any possible biases in missing data for either CO (sub 2) or ultrasound measures. These analyses will elucidate the possible relationship between CO (sub 2) and changes in vision and also inform future analysis of inflight VIIP data.

  15. Validation of an ultrasound dilution technology for cardiac output measurement and shunt detection in infants and children.

    PubMed

    Lindberg, Lars; Johansson, Sune; Perez-de-Sa, Valeria

    2014-02-01

    To validate cardiac output measurements by ultrasound dilution technology (COstatus monitor) against those obtained by a transit-time ultrasound technology with a perivascular flow probe and to investigate ultrasound dilution ability to estimate pulmonary to systemic blood flow ratio in children. Prospective observational clinical trial. Pediatric cardiac operating theater in a university hospital. In 21 children (6.1 ± 2.6 kg, mean ± SD) undergoing heart surgery, cardiac output was simultaneously recorded by ultrasound dilution (extracorporeal arteriovenous loop connected to existing arterial and central venous catheters) and a transit-time ultrasound probe applied to the ascending aorta, and when possible, the main pulmonary artery. The pulmonary to systemic blood flow ratio estimated from ultrasound dilution curve analysis was compared with that estimated from transit-time ultrasound technology. Bland-Altman analysis of the whole cohort (90 pairs, before and after surgery) showed a bias between transit-time ultrasound (1.01 ± 0.47 L/min) and ultrasound dilution technology (1.03 ± 0.51 L/min) of -0.02 L/min, limits of agreement -0.3 to 0.3 L/min, and percentage error of 31%. In children with no residual shunts, the bias was -0.04 L/min, limits of agreement -0.28 to 0.2 L/min, and percentage error 19%. The pooled co efficient of variation was for the whole cohort 3.5% (transit-time ultrasound) and 6.3% (ultrasound dilution), and in children without shunt, it was 2.9% (transit-time ultrasound) and 4% (ultrasound dilution), respectively. Ultrasound dilution identified the presence of shunts (pulmonary to systemic blood flow ≠ 1) with a sensitivity of 100% and a specificity of 92%. Mean pulmonary to systemic blood flow ratio by transit-time ultrasound was 2.6 ± 1.0 and by ultrasound dilution 2.2 ± 0.7 (not significant). The COstatus monitor is a reliable technique to measure cardiac output in children with high sensitivity and specificity for detecting the

  16. Design and implementation of a smartphone-based portable ultrasound pulsed-wave Doppler device for blood flow measurement.

    PubMed

    Huang, Chih-Chung; Lee, Po-Yang; Chen, Pay-Yu; Liu, Ting-Yu

    2012-01-01

    Blood flow measurement using Doppler ultrasound has become a useful tool for diagnosing cardiovascular diseases and as a physiological monitor. Recently, pocket-sized ultrasound scanners have been introduced for portable diagnosis. The present paper reports the implementation of a portable ultrasound pulsed-wave (PW) Doppler flowmeter using a smartphone. A 10-MHz ultrasonic surface transducer was designed for the dynamic monitoring of blood flow velocity. The directional baseband Doppler shift signals were obtained using a portable analog circuit system. After hardware processing, the Doppler signals were fed directly to a smartphone for Doppler spectrogram analysis and display in real time. To the best of our knowledge, this is the first report of the use of this system for medical ultrasound Doppler signal processing. A Couette flow phantom, consisting of two parallel disks with a 2-mm gap, was used to evaluate and calibrate the device. Doppler spectrograms of porcine blood flow were measured using this stand-alone portable device under the pulsatile condition. Subsequently, in vivo portable system verification was performed by measuring the arterial blood flow of a rat and comparing the results with the measurement from a commercial ultrasound duplex scanner. All of the results demonstrated the potential for using a smartphone as a novel embedded system for portable medical ultrasound applications. © 2012 IEEE

  17. Objective measurement of accommodative biometric changes using ultrasound biomicroscopy

    PubMed Central

    Ramasubramanian, Viswanathan; Glasser, Adrian

    2015-01-01

    PURPOSE To demonstrate that ultrasound biomicroscopy (UBM) can be used for objective quantitative measurements of anterior segment accommodative changes. SETTING College of Optometry, University of Houston, Houston, Texas, USA. DESIGN Prospective cross-sectional study. METHODS Anterior segment biometric changes in response to 0 to 6.0 diopters (D) of accommodative stimuli in 1.0 D steps were measured in eyes of human subjects aged 21 to 36 years. Imaging was performed in the left eye using a 35 MHz UBM (Vumax) and an A-scan ultrasound (A-5500) while the right eye viewed the accommodative stimuli. An automated Matlab image-analysis program was developed to measure the biometry parameters from the UBM images. RESULTS The UBM-measured accommodative changes in anterior chamber depth (ACD), lens thickness, anterior lens radius of curvature, posterior lens radius of curvature, and anterior segment length were statistically significantly (P < .0001) linearly correlated with accommodative stimulus amplitudes. Standard deviations of the UBM-measured parameters were independent of the accommodative stimulus demands (ACD 0.0176 mm, lens thickness 0.0294 mm, anterior lens radius of curvature 0.3350 mm, posterior lens radius of curvature 0.1580 mm, and anterior segment length 0.0340 mm). The mean difference between the A-scan and UBM measurements was −0.070 mm for ACD and 0.166 mm for lens thickness. CONCLUSIONS Accommodating phakic eyes imaged using UBM allowed visualization of the accommodative response, and automated image analysis of the UBM images allowed reliable, objective, quantitative measurements of the accommodative intraocular biometric changes. PMID:25804579

  18. Initial Experience Using a Telerobotic Ultrasound System for Adult Abdominal Sonography.

    PubMed

    Adams, Scott J; Burbridge, Brent E; Badea, Andreea; Langford, Leanne; Vergara, Vincent; Bryce, Rhonda; Bustamante, Luis; Mendez, Ivar M; Babyn, Paul S

    2017-08-01

    The study sought to assess the feasibility of performing adult abdominal examinations using a telerobotic ultrasound system in which radiologists or sonographers can control fine movements of a transducer and all ultrasound settings from a remote location. Eighteen patients prospectively underwent a conventional sonography examination (using EPIQ 5 [Philips] or LOGIQ E9 [GE Healthcare]) followed by a telerobotic sonography examination (using the MELODY System [AdEchoTech] and SonixTablet [BK Ultrasound]) according to a standardized abdominal imaging protocol. For telerobotic examinations, patients were scanned remotely by a sonographer 2.75 km away. Conventional examinations were read independently from telerobotic examinations. Image quality and acceptability to patients and sonographers was assessed. Ninety-two percent of organs visualized on conventional examinations were sufficiently visualized on telerobotic examinations. Five pathological findings were identified on both telerobotic and conventional examinations, 3 findings were identified using only conventional sonography, and 2 findings were identified using only telerobotic sonography. A paired sample t test showed no significant difference between the 2 modalities in measurements of the liver, spleen, and diameter of the proximal aorta; however, telerobotic assessments overestimated distal aorta and common bile duct diameters and underestimated kidney lengths (P values < .05). All patients responded that they would be willing to have another telerobotic examination. A telerobotic ultrasound system is feasible for performing abdominal ultrasound examinations at a distant location with minimal training and setup requirements and a moderate learning curve. Telerobotic sonography (robotic telesonography) may open up the possibility of remote ultrasound clinics for communities that lack skilled sonographers and radiologists, thereby improving access to care. Copyright © 2016 Canadian Association of

  19. Ultrasound Velocity Measurements in High-Chromium Steel Under Plastic Deformation

    NASA Astrophysics Data System (ADS)

    Lunev, Aleksey; Bochkareva, Anna; Barannikova, Svetlana; Zuev, Lev

    2016-04-01

    In the present study, the variation of the propagation velocity of ultrasound in the plastic deformation of corrosion-resistant high-chromium steel 40X13 with ferrite-carbide (delivery status), martensitic (quenched) and sorbitol (after high-temperature tempering) structures have beem studied/ It is found that each state shows its view of the loading curve. In the delivery state diagram loading is substantially parabolic throughout, while in the martensitic state contains only linear strain hardening step and in the sorbitol state the plastic flow curve is three-step. The velocity of ultrasonic surface waves (Rayleigh waves) was measured simultaneously with the registration of the loading curve in the investigated steel in tension. It is shown that the dependence of the velocity of ultrasound in active loading is determined by the law of plastic flow, that is, the staging of the corresponding diagram of loading. Structural state of the investigated steel is not only changing the type of the deformation curve under uniaxial tension, but also changes the nature of ultrasound speed of deformation.

  20. Impact of Music in Reducing Patient Anxiety During Pediatric Ultrasound

    PubMed Central

    Kesselman, Andrew; Bergen, Michael; Stefanov, Dimitre; Goldfisher, Rachelle; Amodio, John

    2016-01-01

    The use of noninvasive ultrasound examinations can potentially result in significant anxiety in the pediatric population. The purpose of this study was to assess the influence of music during pediatric ultrasound examinations to reduce anxiety measured by heart rate. A total of 44 patients were recruited; 21 controls and 23 experimental. Each participant was randomized to either music or no music (control) after parental consent was obtained. Pulse oximeters were used to monitor heart rate at 15 second intervals for a total of 1 minute, with mean values calculated prior to entering the procedure room, during the middle of the procedure, and after the procedure was completed. The total scan time was determined from the initial image acquisition until the last image recorded by the ultrasound technologist. At the completion of each procedure, the ultrasound technologist scored the ease of performance for the scan on a subjective scale of 1-10 based on prior experience. When utilizing music during pediatric ultrasounds examinations, our study demonstrated significantly decreased heart rate variability from pre-procedural to post-procedural periods. There was no statistical significant difference in total scan time or ultrasound technologist scoring between the two groups. This study demonstrates that music is an inexpensive and effective means of reducing anxiety during pediatric ultrasound as indicated by heart rate. PMID:27114817

  1. Noncontact measurement of vibration using airborne ultrasound.

    PubMed

    Mater, O B; Remenieras, J P; Bruneel, C; Roncin, A; Patat, F

    1998-01-01

    A noncontact ultrasonic method for measuring the surface normal vibration of objects was studied. The instrument consists of a pair of 420 kHz ultrasonic air transducers. One is used to emit ultrasounds toward the moving surface, and the other receives the ultrasound reflected from the object under test. Two effects induce a phase modulation on the received signal. The first effect results from the variation of the round trip time interval tau required for the wavefront to go from the emitter to the moving surface and back to the receiver. This is the Doppler effect directly proportional to the surface displacement. The second effect results from the nonlinear parametric interactions of the ultrasonic beams (forward and backward) with the low frequency sound field emitted in the air by the vibrating surface. This latter phenomenon, which is a volume effect, is proportional to the velocity of the vibrating surface and increases with the distance between the transducers and the surface under test. The relative contribution of the Doppler and parametric effects are evaluated, and both have to be taken into account for ultrasonic interferometry in air.

  2. Automated 3D ultrasound measurement of the angle of progression in labor.

    PubMed

    Montaguti, Elisa; Rizzo, Nicola; Pilu, Gianluigi; Youssef, Aly

    2018-01-01

    To assess the feasibility and reliability of an automated technique for the assessment of the angle of progression (AoP) in labor by using three-dimensional (3D) ultrasound. AoP was assessed by using 3D transperineal ultrasound by two operators in 52 women in active labor to evaluate intra- and interobserver reproducibility. Furthermore, intermethod agreement between automated and manual techniques on 3D images, and between automated technique on 3D vs 2D images were evaluated. Automated measurements were feasible in all cases. Automated measurements were considered acceptable in 141 (90.4%) out of the 156 on the first assessments and in all 156 after repeating measurements for unacceptable evaluations. The automated technique on 3D images demonstrated good intra- and interobserver reproducibility. The 3D-automated technique showed a very good agreement with the 3D manual technique. Notably, AoP calculated with the 3D automated technique were significantly wider in comparison with those measured manually on 3D images (133 ± 17° vs 118 ± 21°, p = 0.013). The assessment of the angle of progression through 3D ultrasound is highly reproducible. However, automated software leads to a systematic overestimation of AoP in comparison with the standard manual technique thus hindering its use in clinical practice in its present form.

  3. Pocket ultrasound device as a complement to physical examination for ascites evaluation and guided paracentesis.

    PubMed

    Keil-Ríos, Daniel; Terrazas-Solís, Hiram; González-Garay, Alejandro; Sánchez-Ávila, Juan Francisco; García-Juárez, Ignacio

    2016-04-01

    The pocket ultrasound device (PUD) is a new tool that may be of use in the early detection of ascites. Abdominal ultrasound-guided paracentesis has been reported to decrease the rate of complications due to the procedure, but must be performed in a healthcare setting; this new tool may be a useful on an ambulatory basis. The aim of this study was to determine the diagnostic usefulness of the PUD in the diagnosis of ascites and the safety of guided paracentesis. We conducted a retrospective study that included adult patients suspected of having ascites and in whom an evaluation was performed with the PUD to identify it. Concordance with abdominal ultrasound (AUS) was determined with the Kappa coefficient. Sensitivity (Se), specificity (Sp) and likelihood ratios (LR) were determined and compared with physical examination, AUS, computed tomography and procurement of fluid by paracentesis. Complications resulting from the guided paracentesis were analyzed. 89 participants were included and 40 underwent a paracentesis. The PUD for ascites detection had 95.8 % Se, 81.8 % Sp, 5.27 +LR and 0.05 -LR. It had a concordance with AUS of 0.781 (p < 0.001). Technical problems during the guided paracentesis were present in only two participants (5 %) and three patients (7.5 %) developed minor complications that required no further intervention. There were no severe complications or deaths. This study suggests that the PUD is a reliable tool for ascites detection as a complement to physical examination and appears to be a safe method to perform guided paracentesis.

  4. A continuous-wave ultrasound system for displacement amplitude and phase measurement.

    PubMed

    Finneran, James J; Hastings, Mardi C

    2004-06-01

    A noninvasive, continuous-wave ultrasonic technique was developed to measure the displacement amplitude and phase of mechanical structures. The measurement system was based on a method developed by Rogers and Hastings ["Noninvasive vibration measurement system and method for measuring amplitude of vibration of tissue in an object being investigated," U.S. Patent No. 4,819,643 (1989)] and expanded to include phase measurement. A low-frequency sound source was used to generate harmonic vibrations in a target of interest. The target was simultaneously insonified by a low-power, continuous-wave ultrasonic source. Reflected ultrasound was phase modulated by the target motion and detected with a separate ultrasonic transducer. The target displacement amplitude was obtained directly from the received ultrasound frequency spectrum by comparing the carrier and sideband amplitudes. Phase information was obtained by demodulating the received signal using a double-balanced mixer and low-pass filter. A theoretical model for the ultrasonic receiver field is also presented. This model coupled existing models for focused piston radiators and for pulse-echo ultrasonic fields. Experimental measurements of the resulting receiver fields compared favorably with theoretical predictions.

  5. Does endoscopic ultrasound improve detection of locally recurrent anal squamous-cell cancer?

    PubMed

    Peterson, Carrie Y; Weiser, Martin R; Paty, Philip B; Guillem, Jose G; Nash, Garrett M; Garcia-Aguilar, Julio; Patil, Sujata; Temple, Larissa K

    2015-02-01

    Evaluating patients for recurrent anal cancer after primary treatment can be difficult owing to distorted anatomy and scarring. Many institutions incorporate endoscopic ultrasound to improve detection, but the effectiveness is unknown. The aim of this study is to compare the effectiveness of digital rectal examination and endoscopic ultrasound in detecting locally recurrent disease during routine follow-up of patients with anal cancer. This study is a retrospective, single-institution review. This study was conducted at an oncologic tertiary referral center. Included were 175 patients with nonmetastatic anal squamous-cell cancer, without persistent disease after primary chemoradiotherapy, who had at least 1 posttreatment ultrasound and examination by a colorectal surgeon. The primary outcomes measured were the first modality to detect local recurrence, concordance, crude cancer detection rate, sensitivity, specificity, and predictive value. Eight hundred fifty-five endoscopic ultrasounds and 873 digital rectal examinations were performed during 35 months median follow-up. Overall, ultrasound detected 7 (0.8%) mesorectal and 32 (3.7%) anal canal abnormalities; digital examination detected 69 (7.9%) anal canal abnormalities. Locally recurrent disease was found on biopsy in 8 patients, all detected first or only with digital examination. Four patients did not have an ultrasound at the time of diagnosis of recurrence. The concordance of ultrasound and digital examination in detecting recurrent disease was fair at 0.37 (SE, 0.08; 95% CI, 0.21-0.54), and there was no difference in crude cancer detection rate, sensitivity, specificity, and negative or positive predictive values. The heterogeneity of follow-up timing and examinations is not standardized in this study but is reflective of general practice. Endoscopic ultrasound did not provide any advantage over digital rectal examination in identifying locally recurrent anal cancer, and should not be recommended for

  6. Fetal head detection and measurement in ultrasound images by an iterative randomized Hough transform

    NASA Astrophysics Data System (ADS)

    Lu, Wei; Tan, Jinglu; Floyd, Randall C.

    2004-05-01

    This paper describes an automatic method for measuring the biparietal diameter (BPD) and head circumference (HC) in ultrasound fetal images. A total of 217 ultrasound images were segmented by using a K-Mean classifier, and the head skull was detected in 214 of the 217 cases by an iterative randomized Hough transform developed for detection of incomplete curves in images with strong noise without user intervention. The automatic measurements were compared with conventional manual measurements by sonographers and a trained panel. The inter-run variations and differences between the automatic and conventional measurements were small compared with published inter-observer variations. The results showed that the automated measurements were as reliable as the expert measurements and more consistent. This method has great potential in clinical applications.

  7. Power Doppler ultrasonography and synovitis: correlating ultrasound imaging with histopathological findings and evaluating the performance of ultrasound equipments.

    PubMed

    Koski, J M; Saarakkala, S; Helle, M; Hakulinen, U; Heikkinen, J O; Hermunen, H

    2006-12-01

    To examine the validity of power Doppler ultrasound imaging to identify synovitis, using histopathology as gold standard, and to assess the performance of ultrasound equipments. 44 synovial sites in small and large joints, bursae and tendon sheaths were depicted with ultrasound. A synovial biopsy was performed on the site depicted and a synovial sample was taken for histopathological evaluation. The performance of three ultrasound devices was tested using flow phantoms. A positive Doppler signal was detected in 29 of 35 (83%) of the patients with active histological inflammation. In eight additional samples, histological examination showed other pathological synovial findings and a Doppler signal was detected in five of them. No significant correlation was found between the amount of Doppler signal and histological synovitis score (r = 0.239, p = NS). The amount of subsynovial infiltration of polymorphonuclear leucocytes and surface fibrin correlated significantly with the amount of power Doppler signal: r = 0.397 (p<0.01) and 0.328 (p<0.05), respectively. The ultrasound devices differed in showing the smallest detectable flow. A negative Doppler signal does not exclude the possibility of synovitis. A positive Doppler signal in the synovium is an indicator of an active synovial inflammation in patients. A Doppler signal does not correlate with the extent of the inflammation and it can also be seen in other synovial reactions. It is important that the quality measurements of ultrasound devices are reported, because the results should be evaluated against the quality of the device used.

  8. Comparison of two methods of cervical cerclage by ultrasound cervical measurement.

    PubMed

    Rozenberg, P; Sénat, M V; Gillet, A; Ville, Y

    2003-05-01

    To compare the effects of cerclage performed with a modified Shirodkar procedure or with McDonald's technique using transvaginal ultrasound measurement of the distance between the external os and the suture. We performed a retrospective study of all patients who underwent a prophylactic cerclage with either the modified Shirodkar procedure or the McDonald's technique over a 3-year period. Physicians chose the cerclage technique according to their own preferences. Transvaginal ultrasound examination of the cervix was performed 2 weeks after the cerclage to measure its functional length and the distance between the external os and the cerclage. During the study period, 14 patients had a cerclage with the modified Shirodkar procedure and 19 patients with the McDonald's technique. Twelve of these 33 patients (36.4%) delivered before 37 weeks. The obstetric characteristics of the patients in both groups were similar. There were no significant differences between the Shirodkar and McDonald groups as to the functional cervical length before (31.3 +/- 8.7 vs. 35.6 +/- 9.7 mm, respectively) or after (37.0 +/- 7.3 vs. 36.1 +/- 7.9 mm) cerclage, the distance between the external os and cerclage (16.7 +/- 3.8 vs. 14.0 +/- 5.2 mm), or the number of deliveries before 32 (0 vs. 2) and 34 (1 vs. 3) weeks. The anterior colpotomy of the Shirodkar procedure increased the distance between the external os and the cerclage by a mean of 2.7 mm. This slight gain does not justify exposing the patient to the risks related to this procedure. When cerclage is necessary, McDonald's technique seems preferable.

  9. Rehabilitative ultrasound measurement of trapezius muscle contractile states in people with mild shoulder pain.

    PubMed

    O'Sullivan, Cliona; McCarthy Persson, Ulrik; Blake, Catherine; Stokes, Maria

    2012-04-01

    The utility of rehabilitative ultrasound imaging (RUSI) for assessing trapezius muscle contractile characteristics was investigated by examining whether muscle thickness changes during contraction (CT) differed between people with and without mild shoulder pain. In 18 subjects with mild shoulder pain (aged 28±8 years) and 18 matched controls, trapezius muscle thickness change was measured in prone at rest at 0° and during isometric CTs at 90° and 120° of shoulder abduction. Images were taken at four sites using a real-time ultrasound scanner (7-MHz linear transducer, 40 mm footprint). Percentage change in muscle thickness from rest was calculated. Differences between painful and non-painful shoulders and participant groups were examined by analysis of variance (ANOVA) and t-tests. There were no significant differences between groups or sides in trapezius muscle thickness change during CT. There was no significant difference in trapezius muscle resting thickness (RT) between painful and non-painful shoulders in the same subjects. Contractile ability of the trapezius muscle, assessed using RUSI was not impaired in subjects with mild shoulder pain during the test manoeuvres used. Further research is warranted involving patients with different severity of symptoms, using other test manoeuvres before RUSI can be advocated for assessing scapular muscle dysfunction. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Comparison of central corneal thickness measurements using ultrasound pachymetry, ultrasound biomicroscopy, and the Artemis-2 VHF scanner in normal eyes

    PubMed Central

    Al-Farhan, Haya M; Al-Otaibi, Wafa’a Majed

    2012-01-01

    Purpose To compare the precision of central corneal thickness (CCT) measurements taken with the handheld ultrasound pachymeter (USP), ultrasound biomicroscopy (UBM), and the Artemis-2 very high frequency ultrasound scanner (VHFUS) on normal subjects. Design Prospective study. Methods One eye from each of 61 normal subjects was randomly selected for this study. The measurements of the CCT were taken with the USP, VHFUS, and UBM. Results were compared statistically using repeated-measures analysis of variance (ANOVA), Pearson’s correlation coefficient, and limits of agreement. Results The average CCT (± standard deviation) was 530.1 ± 30.5 μm, 554.9 ± 31.7 μm, and 559.5 ± 30.7 μm for UBM, VHFUS, and USP respectively. The intraobserver repeatability analyses of variance are not significant for USP, UBM, and VHFUS. P-values were 0.17, 0.19, and 0.37 respectively. Repeated-measures ANOVA showed a significant difference between the three different methods of measuring CCT (P = 0.0001). The ANOVA test revealed no statistically significant difference between USP and VHFUS (P > 0.05), yet statistical significant differences with UBM versus USP and UBM versus VHFUS (P < 0.001). There were high correlations between the three instruments (P < 0.0001). The mean differences (and upper/lower limits of agreement) for CCT measurements were 29.4 ± 14.3 (2.7/56), 4.6 ± 8.6 (−14.7/23.8), and −24.8 ± 13.1 (−50.4/0.8) for USP versus UBM, USP versus VHFUS, and UBM versus VHFUS, respectively. Conclusion The UBM produces CCT measurements that vary significantly from those returned by the USP and the VHFUS, suggesting that the UBM may not be used interchangeably with either equipment for monitoring the CCT in the clinical setting. PMID:22848145

  11. Ultrasound examination and behavior scoring of captive broadnose sevengill sharks, Notorynchus cepedianus (Peron, 1807).

    PubMed

    Daly, Jonathan; Gunn, Ian; Kirby, Nick; Jones, Robert; Galloway, David

    2007-09-01

    Serial ultrasound examination of four mature female sevengill sharks (Notorynchus cepedianus) was carried out over 18 months. Monitoring the reproductive cycle and development of follicles and fetuses in sharks in a noninvasive manner using this technique has not been reported previously. Sharks were caught out of the "Oceanarium" tank by divers using a specially made catch-out bag, and brought to a holding area for examination. A behavior scoring system was used to monitor the impact of regular handling on the well-being of the animals. Ultrasound showed the growth and regression of follicles in sevengill ovaries, and allowed an approximation of the reproductive stage of these sharks. Monitoring behavior at five time points during the procedure showed that regular handling of sharks for clinical studies could be done with minimal impact on animal welfare. The ability to follow reproductive events in elasmobranches using ultrasonography is an important step in the application of assisted reproductive technology in these species. Assisted reproductive technology, such as monitoring female reproductive cycles and artificial insemination, could potentially be used to maintain genetic diversity and compliment aquaria-based breeding programs for endangered species such as the gray nurse shark (Carcharias taurus). Zoo Biol 26:383-395, 2007. (c) 2007 Wiley-Liss, Inc.

  12. Refixation of Osteochondral Fractures by an Ultrasound-Activated Pin System - An Ovine In Vivo Examination Using CT and Scanning Electron Microscope.

    PubMed

    H, Neumann; A P, Schulz; S, Breer; A, Unger; B, Kienast

    2015-01-01

    Osteochondral injuries, if not treated appropriately, often lead to severe osteoarthritis of the affected joint. Without refixation of the osteochondral fragment, human cartilage only repairs these defects imperfectly. All existing refixation systems for chondral defects have disadvantages, for instance bad MRI quality in the postoperative follow-up or low anchoring forces. To address the problem of reduced stability in resorbable implants, ultrasound-activated pins were developed. By ultrasound-activated melting of the tip of these implants a higher anchoring is assumed. Aim of the study was to investigate, if ultrasound-activated pins can provide a secure refixation of osteochondral fractures comparing to conventional screw and conventional, resorbable pin osteosynthesis. CT scans and scanning electron microscopy should proovegood refixation results with no further tissue damage by the melting of the ultrasound-activated pins in comparison to conventional osteosynthesis. Femoral osteochondral fragments in sheep were refixated with ultrasound-activated pins (SonicPin™), Ethipins(®) and screws (Asnis™). The quality of the refixated fragments was examined after three month of full weight bearing by CT scans and scanning electron microscopy of the cartilage surface. The CT examination found almost no statistically significant difference in the quality of refixation between the three different implants used. Concerning the CT morphology, ultrasound-activated pins demonstrated at least the same quality in refixation of osteochondral fragments as conventional resorbable pins or screws. The scanning electron microscopy showed no major surface damage by the three implants, especially any postulated cartilage damage induced by the heat of the ultrasound-activated pin. The screws protruded above the cartilage surface, which may affect the opposingtibial surface. Using CT scans and scanning electron microscopy, the SonicPin™, the Ethipin(®) and screws were at least

  13. Abdominal ultrasound and medical education.

    PubMed

    García de Casasola Sánchez, G; Torres Macho, J; Casas Rojo, J M; Cubo Romano, P; Antón Santos, J M; Villena Garrido, V; Diez Lobato, R

    2014-04-01

    Ultrasound is a very versatile diagnostic modality that permits real-time visualization of multiple internal organs. It is of invaluable help for the physical examination of the patients. To assess if ultrasound can be incorporated into medical education and if the students can perform a basic abdominal ultrasound examination without the necessity of a long period of training. Twelve medical students were trained in basic abdominal ultrasound during a 15-h training program including a 5-h theoretical and practical course and supervised practice in 20 selected patients. Subsequently, we conducted an evaluation test that assessed the ability of students to obtain the ultrasound views and to detect various pathologies in five different patients. The students were able to correctly identify the abdominal views more than 90% of the times. This percentage was only lower (80%) in the right subcostal view to locate the gallbladder. The accuracy or global efficiency of the ultrasound for the diagnosis of relevant pathological findings of the patients was greater than 90% (91.1% gallstones, abdominal aortic aneurysm 100%; splenomegaly 98.3%, ascites 100%; dilated inferior vena cava 100%; acute urinary retention 100%). The ultrasound may be a feasible learning tool in medical education. Ultrasound can help students to improve the physical examination. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  14. Effect of ultrasound on electrochemical chloride extraction from mortar

    NASA Astrophysics Data System (ADS)

    Chen, Yiqun; Yao, Wu; Zuo, Junqing

    2018-03-01

    In this paper, the effect of auxiliary ultrasound on electrochemical chloride extraction (ECE) was studied. The chloride removal efficiency was investigated by examining the chloride content with ultrasound-assisted ECE and changing the introducing time of ultrasound. The experimental results showed that removal of chloride ions was noted to be more effective in ECE treatment assisted with ultrasound treatment (UT). In addition, the lower w/c ratio led to more distinct effect of ultrasonic cavitation on chloride removal. Electrochemical behaviors measured with different treatment revealed that UT treatment was effective on moderating the corrosion condition. Microstructural analyses revealed a significant alteration in composition and morphology of cementitious phases with UT treatment. Pull-out tests indicated that ultrasound had a certain negative impact on the bond strength. Although the effect of introducing ultrasound in the first 2 weeks or the last 2 weeks on the extraction efficiency was not obvious, intermittent ultrasound could not only ensure the chloride extraction efficiency, but also reduce the adverse effect of ultrasound on the bond strength.

  15. Role of ultrasound in colorectal diseases.

    PubMed

    Bor, Renáta; Fábián, Anna; Szepes, Zoltán

    2016-11-21

    Ultrasound is an undervalued non-invasive examination in the diagnosis of colonic diseases. It has been replaced by the considerably more expensive magnetic resonance imaging and computed tomography, despite the fact that, as first examination, it can usefully supplement the diagnostic process. Transabdominal ultrasound can provide quick information about bowel status and help in the choice of adequate further examinations and treatment. Ultrasonography, as a screening imaging modality in asymptomatic patients can identify several colonic diseases such as diverticulosis, inflammatory bowel disease or cancer. In addition, it is widely available, cheap, non-invasive technique without the use of ionizing radiation, therefore it is safe to use in childhood or during pregnancy, and can be repeated at any time. New ultrasound techniques such as elastography, contrast enhanced and Doppler ultrasound, mini-probes rectal and transperineal ultrasonography have broadened the indication. It gives an overview of the methodology of various ultrasound examinations, presents the morphology of normal bowel wall and the typical changes in different colonic diseases. We will pay particular attention to rectal and transperineal ultrasound because of their outstanding significance in the diagnosis of rectal and perineal disorders. This article seeks to overview the diagnostic impact and correct indications of bowel ultrasound.

  16. Imaging of idle breast implants with ultrasound-strain elastography- A first experimental study to establish criteria for accurate imaging of idle implants via ultrasound-strain elastography.

    PubMed

    Kuehlmann, Britta; Prantl, Lukas; Michael Jung, Ernst

    2016-01-01

    To investigate whether there are fundamental sonographic and elastographic criteria to precisely assess different surfaces and fillings of idle breast implants and to determine their most distinctive parameters. This was a comparative study of different unused breast implant materials, neighter in animals nor in humans. This knowledge should be transferred in vivo to develop an objective measurement tool. Nine idle breast implants-silicone and polyurethane (PU)-were examined in an experimental study by using ultrasound B-mode with tissue harmonic imaging (THI), speckle reduction imaging (SRI, level 0-4), cross-beam (CB, low, medium, high), photopic and the colour coded ultrasound-strain elastography with a multifrequency probe (9-15 MHz).Using a standardised protocol the implants' centre as well as the edge were analysed by one experienced examiner. Two independent readers performed analysis and evaluation. For image interpretation a score was created (score 0:inadequate image, score 5:best image quality). The highest score result for the centre was achieved by using ultrasound with B-mode in addition with CB level medium, SRI level 2, THI and photopic (mean:3.22±SD:1.56), but without any statistic significant difference (t-value = 0.71). With elastography the implants' edge in general was represented without disruptive artefacts (3.89±0.60) with statistic significant difference (t-value = 5.29). Implants filled with inner cohesive silicone gel II° showed best imaging conditions for their centre via ultrasound (5±0) as well as for their edge via elastography (4.50±0.71). Ultrasound-strain elastography and high resolution ultrasound represent a valuable measurement tool to evaluate different properties of idle breast implants. These modified ultrasound examinations could be an additional help for clinical investigations and be correlated with Baker's Classification.

  17. The measurement of ultrasound scattering from individual micron-sized objects and its application in single cell scattering.

    PubMed

    Falou, Omar; Rui, Min; El Kaffas, Ahmed; Kumaradas, J Carl; Kolios, Michael C

    2010-08-01

    The measurement of the ultrasound backscatter from individual micron-sized objects such as cells is required for various applications such as tissue characterization. However, performing such a measurement remains a challenge. For example, the presence of air bubbles in a suspension of cells during the measurements may lead to the incorrect interpretation of the acoustic signals. This work introduces a technique for measuring the ultrasound backscatter from individual micron-sized objects by combining a microinjection system with a co-registered optical microscope and an ultrasound imaging device. This allowed the measurement of the ultrasound backscatter response from a single object under optical microscope guidance. The optical and ultrasonic data were used to determine the size of the object and to deduce its backscatter responses, respectively. In order to calibrate the system, the backscatter frequency responses from polystyrene microspheres were measured and compared to theoretical predictions. A very good agreement was found between the measured backscatter responses of individual microspheres and theoretical predictions of an elastic sphere. The backscatter responses from single OCI-AML-5 cells were also investigated. It was found that the backscatter responses from AML cells are best modeled using the fluid sphere model. The advantages, limitations, and future applications of the developed technique are discussed.

  18. Effect of ultrasound sonication on electroplating of iridium.

    PubMed

    Ohsaka, Takashi; Isaka, Motohiro; Hirano, Katsuhiko; Ohishi, Tomoji

    2008-04-01

    Effect of ultrasound sonication was examined on the electroplating of iridium in aqueous hexabromoiridate(III) solution. The electrodeposits were evaluated by observing the defects of the iridium deposits by means of voltammetry, in which the current-potential curves of the iridium deposits on copper were measured. Applying ultrasound sonication to the electroplating of iridium decreased the defects including the cracks in the deposit whenever the glycerol as the additives was contained or not in the electrolyte.

  19. Ultrasound evaluation of cortical brain development in fetuses with intrauterine growth restriction.

    PubMed

    Businelli, Caterina; de Wit, Charlotte; Visser, Gerard H A; Pistorius, Lourens R

    2014-09-10

    Abstract Objective: We evaluated the ultrasound appearance of brain volume and cortical development in fetuses with early growth restriction and placental insufficiency. Methods: We examined a cohort of 20 fetuses with severe intrauterine growth restriction (IUGR) and evidence of placental insufficiency by three-dimensional (3D) ultrasound between 24 and 34 weeks. We graded cortical development and measured the supratentorial intracranial volume. The cortical grading and volume were compared to data obtained from a reference population of 28 adequate for gestational age (AGA) fetuses. Results: Ultrasound examinations were performed in 20 fetuses with IUGR. The biometry and brain volume were significantly reduced in IUGR fetuses. There was evidence of accelerated cortical development in IUGR fetuses. Conclusion: This study confirms that the smaller brain volume in IUGR fetuses, with normal or accelerated cortical maturation as previously depicted with postnatal MRI examination, can be demonstrated by prenatal 3D ultrasound.

  20. Ultrasound measures of supraspinatus tendon thickness and acromiohumeral distance in rotator cuff tendinopathy are reliable.

    PubMed

    McCreesh, Karen M; Anjum, Shakeel; Crotty, James M; Lewis, Jeremy S

    2016-01-01

    Rotator cuff (RC) tendinopathy has been widely ascribed to impingement of the supraspinatus tendon (SsT) in the subacromial space, measured as the acromiohumeral distance (AHD). Ultrasound (US) is suitable for measuring AHD and SsT thickness, but few reliability studies have been carried out in symptomatic populations, and interrater reliability is unconfirmed. This study aimed to examine the intrarater and interrater reliability of US measurements of AHD and SsT thickness in asymptomatic control subjects and patients with RC tendinopathy. Seventy participants were recruited and grouped as healthy controls (n = 25) and RC tendinopathy (n = 45). Repeated US measurements of AHD and SsT thickness were obtained by one rater in both groups and by two raters in the RC tendinopathy group. Intrarater and interrater reliability coefficients were excellent for both measurements (intraclass correlation > 0.92), but the intrarater reliability was superior. The minimal detectable change values in the symptomatic group were 0.7 mm for AHD and 0.6 mm for SsT thickness for a single experienced examiner; the values rose to 1.2 mm and 1.3 mm, respectively, for the pair of examiners. The results support the reliability of US for the measurement of AHD and SsT thickness in patients with symptomatic RC tendinopathy and provide minimal detectable change values for use in future research studies. © 2015 Wiley Periodicals, Inc.

  1. Measurement of carotid pulse wave velocity using ultrafast ultrasound imaging in hypertensive patients.

    PubMed

    Li, Xiaopeng; Jiang, Jue; Zhang, Hong; Wang, Hua; Han, Donggang; Zhou, Qi; Gao, Ya; Yu, Shanshan; Qi, Yanhua

    2017-04-01

    The study aimed to assess the utility of ultrafast ultrasound imaging for evaluation of carotid pulse wave velocity (PWV) in newly diagnosed hypertension patients. This prospective non-randomized study enrolled 90 hypertensive patients in our hospital from September to December 2013 as a hypertension group. An age- and sex-matched cohort of 50 healthy adults in our hospital from September to December 2013 was also included in the study as a control group. Carotid PWV at the beginning and at the end of systole (PWV-BS and PWV-ES, respectively) and intima-media thickness (IMT) were measured by ultrafast ultrasound imaging technology. The associations of PWV-BS, PWV-ES, and IMT with hypertension stage were evaluated by Spearman correlation analysis. PWV-BS and PWV-ES in the hypertension group were significantly elevated compared with those in control group. Different hypertension stages significantly differed in PWV-BS and PWV-ES. PWV-BS and PWV-ES appeared to increase with the hypertension stage. Moreover, IMT, PWV-BS, and PWV-ES were positively correlated with the hypertension stage in hypertensive patients. Ultrafast ultrasound imaging was a valid and convenient method for the measurement of carotid PWV in hypertensive patients. Ultrafast ultrasound imaging might be recommended as a promising alternative method for early detection of arterial abnormality in clinical practice.

  2. Model based inversion of ultrasound data in composites

    NASA Astrophysics Data System (ADS)

    Roberts, R. A.

    2018-04-01

    Work is reported on model-based defect characterization in CFRP composites. The work utilizes computational models of ultrasound interaction with defects in composites, to determine 1) the measured signal dependence on material and defect properties (forward problem), and 2) an assessment of defect properties from analysis of measured ultrasound signals (inverse problem). Work is reported on model implementation for inspection of CFRP laminates containing multi-ply impact-induced delamination, in laminates displaying irregular surface geometry (roughness), as well as internal elastic heterogeneity (varying fiber density, porosity). Inversion of ultrasound data is demonstrated showing the quantitative extraction of delamination geometry and surface transmissivity. Additionally, data inversion is demonstrated for determination of surface roughness and internal heterogeneity, and the influence of these features on delamination characterization is examined. Estimation of porosity volume fraction is demonstrated when internal heterogeneity is attributed to porosity.

  3. Learning process for performing and analyzing 3D/4D transperineal ultrasound imaging and interobserver reliability study.

    PubMed

    Siafarikas, F; Staer-Jensen, J; Braekken, I H; Bø, K; Engh, M Ellström

    2013-03-01

    To evaluate the learning process for acquiring three- and four-dimensional (3D/4D) transperineal ultrasound volumes of the levator hiatus (LH) dimensions at rest, during pelvic floor muscle (PFM) contraction and on Valsalva maneuver, and for analyzing the ultrasound volumes, as well as to perform an interobserver reliability study between two independent ultrasound examiners. This was a prospective study including 22 women. We monitored the learning process of an inexperienced examiner (IE) performing 3D/4D transperineal ultrasonography and analyzing the volumes. The examination included acquiring volumes during three PFM contractions and three Valsalva maneuvers. LH dimensions were determined in the axial plane. The learning process was documented by estimating agreement between the IE and an experienced examiner (E) using the intraclass correlation coefficient. Agreement was calculated in blocks of 10 ultrasound examinations and analyzed volumes. After the learning process was complete the interobserver reliability for the technique was calculated between these two independent examiners. For offline analysis of the first 10 ultrasound volumes obtained by E, good to very good agreement between E and IE was achieved for all LH measurements except for the left and right levator-urethra gap and pubic arc. For the next 10 analyzed volumes, agreement improved for all LH measurements. Volumes that had been obtained by IE and E were then re-evaluated by IE, and good to very good agreement was found for all LH measurements indicating consistency in volume acquisition. The interobserver reliability study showed excellent ICC values (ICC, 0.81-0.97) for all LH measurements except the pubic arc (ICC = 0.67). 3D/4D transperineal ultrasound is a reliable technique that can be learned in a short period of time. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

  4. Musculoskeletal ultrasound in rheumatology in Korea: targeted ultrasound initiative survey.

    PubMed

    Kang, Taeyoung; Wakefield, Richard J; Emery, Paul

    2016-04-01

    In collaboration with the Targeted Ultrasound Initiative (TUI), to conduct the first study in Korea to investigate current practices in ultrasound use among Korean rheumatologists. We translated the TUI Global Survey into Korean and added questions to better understand the specific challenges facing rheumatologists in Korea. To target as many rheumatologists in Korea as possible, we created an on-line version of this survey, which was conducted from March to April 2013. Rheumatologists are in charge of ultrasound in many Korean hospitals. Rheumatologists in hospitals and private clinics use ultrasound to examine between one and five patients daily; they use ultrasound for diagnosis more than monitoring and receive compensation of about US$30-50 per patient. There are marked differences in the rates of ultrasound usage between rheumatologists who work in private practice compared with tertiary hospitals. Korean rheumatologists not currently using ultrasound in their practice appear eager to do so. This survey provides important insights into the current status of ultrasound in rheumatology in Korea and highlights several priorities; specifically, greater provision of formal training, standardization of reporting and accrual of greater experience among ultrasound users. If these needs are addressed, all rheumatology departments in Korea are likely to use ultrasound or have access to it in the future. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  5. Measurement of Transcranial Distance During Head-Down Tilt Using Ultrasound

    NASA Technical Reports Server (NTRS)

    Torikoshi, Shigeyo; Ballard, R. E.; Watenpaugh, D. E.; Murthy, G.; Bowley, S.; Yost, W. T.; Hargens, Alan R.

    1995-01-01

    Exposure to microgravity probably elevates blood pressure and flow in the head which may increase intracranial volume (ICV) and pressure (ICP). Due to the slightly compliant nature of the cranium, any increase of ICP will increase ICV and transcranial distance. We used a noninvasive ultrasound technique to measure transcranial distance (frontal to occipital) during head-down tilt. Seven subjects (ages 26-53) underwent the following tilt angles: 90 deg. upright, 30 deg., 0 deg., -6 deg., -10 deg., -6 deg., 0 deg., 30 deg., and 90 deg. Each angle was maintained for 1 min. Ultrasound wave frequency was collected continuously and transcranial distance was calculated (Delta(x) = x(Delta)f/f, where x is path length and f is frequency of the wave) for each tilt angle. Frequency decreased from 503.687 kHz (90 deg. upright) to 502.619 kHz (-10 deg.). These frequencies translated to an increased transcranial distance of 0.403 mm. Although our data suggest a significant increase in transcranial distance during head-down tilt, this apparent increase may result, in part, from head-down tilt-induced subcutaneous edema or cutaneous blood volume elevation. In three subjects, when the above protocol was repeated with an ace bandage wrapped around the head to minimize such edema, the increased transcranial distance from 90 deg. to -10 deg. was reduced by 0.174 mm. Further development of the technique to quantify bone-to-bone expansion unconfounded by cutaneous fluid is necessary. Therefore, this ultrasound technique may provide measurements of changes in cranial dimensions during microgravity.

  6. A Microfluidics-based Pulpal Arteriole Blood Flow Phantom for Validation of Doppler Ultrasound Devices in Pulpal Blood Flow Velocity Measurement.

    PubMed

    Kim, Dohyun; Park, Sung-Ho

    2016-11-01

    Recently, Doppler ultrasound has been used for the measurement of pulpal blood flow in human teeth. However, the reliability of this method has not been verified. In this study, we developed a model to simulate arteriole blood flow within the dental pulp by using microfluidics. This arteriole simulator, or flow phantom, was used to determine the reliability of measurements obtained by using a Doppler ultrasound device. A microfluidic chip was fabricated by using the soft lithography technique, and blood-mimicking fluid was pumped through the channel by a microfluidic system. A Doppler ultrasound device was used for the measurement of flow velocity. The peak, mean, and minimal flow velocities obtained from the phantom and the Doppler ultrasound device were compared by using linear regression analysis and Pearson correlation coefficient. Bland-Altman analyses were performed to evaluate the velocity differences between the flow generated by the phantom and the flow measurements made with the Doppler ultrasound device. The microfluidic system was able to generate the flow profiles as intended, and the fluid flow could be monitored and controlled by the software program. There were excellent linear correlations between the peak, mean, and minimal flow velocities of the phantom and those of the Doppler ultrasound device (r = 0.94-0.996, P < .001). However, the velocities were overestimated by the Doppler ultrasound device. This phantom provides opportunities for research and education involving the Doppler ultrasound technique in dentistry. Although Doppler ultrasound can be an effective tool for the measurement of pulpal blood flow velocity, it is essential to validate and calibrate the device before clinical use. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  7. Refixation of Osteochondral Fractures by an Ultrasound-Activated Pin System – An Ovine In Vivo Examination Using CT and Scanning Electron Microscope

    PubMed Central

    H, Neumann; A.P, Schulz; S, Breer; A, Unger; B, Kienast

    2015-01-01

    Background: Osteochondral injuries, if not treated appropriately, often lead to severe osteoarthritis of the affected joint. Without refixation of the osteochondral fragment, human cartilage only repairs these defects imperfectly. All existing refixation systems for chondral defects have disadvantages, for instance bad MRI quality in the postoperative follow-up or low anchoring forces. To address the problem of reduced stability in resorbable implants, ultrasound-activated pins were developed. By ultrasound-activated melting of the tip of these implants a higher anchoring is assumed. Aim of the study was to investigate, if ultrasound-activated pins can provide a secure refixation of osteochondral fractures comparing to conventional screw and conventional, resorbable pin osteosynthesis. CT scans and scanning electron microscopy should proovegood refixation results with no further tissue damage by the melting of the ultrasound-activated pins in comparison to conventional osteosynthesis. Methods: Femoral osteochondral fragments in sheep were refixated with ultrasound-activated pins (SonicPin™), Ethipins® and screws (Asnis™). The quality of the refixated fragments was examined after three month of full weight bearing by CT scans and scanning electron microscopy of the cartilage surface. Results: The CT examination found almost no statistically significant difference in the quality of refixation between the three different implants used. Concerning the CT morphology, ultrasound-activated pins demonstrated at least the same quality in refixation of osteochondral fragments as conventional resorbable pins or screws. The scanning electron microscopy showed no major surface damage by the three implants, especially any postulated cartilage damage induced by the heat of the ultrasound-activated pin. The screws protruded above the cartilage surface, which may affect the opposingtibial surface. Conclusion: Using CT scans and scanning electron microscopy, the Sonic

  8. Comparison of measurements of the uterus and cervix obtained by magnetic resonance and transabdominal ultrasound imaging to identify the brachytherapy target in patients with cervix cancer.

    PubMed

    van Dyk, Sylvia; Kondalsamy-Chennakesavan, Srinivas; Schneider, Michal; Bernshaw, David; Narayan, Kailash

    2014-03-15

    To compare measurements of the uterus and cervix obtained with magnetic resonance imaging (MRI) and transabdominal ultrasound to determine whether ultrasound can identify the brachytherapy target and be used to guide conformal brachytherapy planning and treatment for cervix cancer. Consecutive patients undergoing curative treatment with radiation therapy between January 2007 and March 2012 were included in the study. Intrauterine applicators were inserted into the uterine canal while patients were anesthetized. Images were obtained by MRI and transabdominal ultrasound in the longitudinal axis of the uterus with the applicator in treatment position. Measurements were taken at the anterior and posterior surface of the uterus at 2.0-cm intervals along the applicator, from the external os to the tip of the applicator. Data were analyzed using Bland Altman plots examining bias and 95% limits of agreement. A total of 192 patients contributed 1668 measurements of the cervix and uterus. Mean (± SD) differences of measurements between imaging modalities at the anterior and posterior uterine surface ranged from 1.5 (± 3.353) mm to 3.7 (± 3.856) mm, and -1.46 (± 3.308) mm to 0.47 (± 3.502) mm, respectively. The mean differences were less than 3 mm in the cervix. The mean differences were less than 1.5 mm at all measurement points on the posterior surface. Differences in the measurements of the cervix and uterus obtained by MRI and ultrasound were within clinically acceptable limits. Transabdominal ultrasound can be substituted for MRI in defining the target volume for conformal brachytherapy treatment of cervix cancer. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  9. Breast tumor size assessment: comparison of conventional ultrasound and contrast-enhanced ultrasound.

    PubMed

    Jiang, Yu-Xin; Liu, He; Liu, Ji-Bin; Zhu, Qing-Li; Sun, Qiang; Chang, Xiao-Yan

    2007-12-01

    Accurate assessment of tumor size is necessary when selecting patients for breast-conserving surgery. In the study of breast contrast-enhanced ultrasound (CEUS), we found that tumor size discrepancy between CEUS and conventional ultrasound (US) existed in some breast lesions, for which the reasons are not clear. Breast CEUS examinations were performed in 104 patients with breast lesions. The measurement of the 104 breast tumors on conventional US was obtained and compared with the measurement on CEUS. A difference in measuring tumor size of >3 mm for tumors up to 1.7 cm and 4 mm for tumors >or=1.7 cm, was defined as a significant discrepancy between conventional US and CEUS. The histopathological examination of size discrepancy was performed and the margin characteristics of breast cancers with larger measurements were compared with those with unchanged measurements. Among the 104 lesions (43 malignant, 60 benign, 1 borderline), the size of 27 breast cancers and one granulomatous mastitis appeared larger at CEUS. Pathologic examinations of the region corresponding to the measurement discrepancy were mainly ductal carcinomas in situ (DCIS), invasive carcinoma with a DCIS component, adenosis with lobular hyperplasia in breast cancers and inflammatory cell infiltration in one granulomatous mastitis. Well-defined margin characteristics were significantly different between breast cancers with larger measurements at CEUS and those with unchanged measurements of size (p = 0.002), whereas no significant difference was found between the two groups in ill-defined, spiculated, hyperechoic halo, microlobulated and angulated margins (p = 0.463, 0.117, 0.194, 0.666 and 0.780, respectively). This initial study suggests that significant discrepancy of breast lesion measurement between conventional US and CEUS is more likely presented in breast cancer than benign lesions. The pathologic findings corresponding to the region of size increased at CEUS are malignant in most malignant

  10. A new method for blood velocity measurements using ultrasound FMCW signals.

    PubMed

    Kunita, Masanori; Sudo, Masamitsu; Inoue, Shinya; Akahane, Mutsuhiro

    2010-05-01

    The low peak power of frequency-modulated continuous wave (FMCW) radar makes it attractive for various applications, including vehicle collision warning systems and airborne radio altimeters. This paper describes a new ultrasound Doppler measurement system that measures blood flow velocity based on principles similar to those of FMCW radar. We propose a sinusoidal wave for FM modulation and introduce a new demodulation technique for obtaining Doppler information with high SNR and range resolution. Doppler signals are demodulated with a reference FMCW signal to adjust delay times so that they are equal to propagation times between the transmitter and the receiver. Analytical results suggest that Doppler signals can be obtained from a selected position, as with a sample volume in pulse wave Doppler systems, and that the resulting SNR is nearly identical to that obtained with continuous wave (CW) Doppler systems. Additionally, clutter power is less than that of CW Doppler systems. The analytical results were verified by experiments involving electronic circuits and Doppler ultrasound phantoms.

  11. Numerical Calculation and Measurement of Nonlinear Acoustic Fields in Ultrasound Diagnosis

    NASA Astrophysics Data System (ADS)

    Kawagishi, Tetsuya; Saito, Shigemi; Mine, Yoshitaka

    2002-05-01

    In order to develop a tool for designing on the ultrasonic probe and its peripheral devices for tissue-harmonic-imaging systems, a study is carried out to compare the calculation and observation results of nonlinear acoustic fields for a diagnostic ultrasound system. The pulsed ultrasound with a center frequency of 2.5 MHz is emanated from a weakly focusing sector probe with a 6.5 mm aperture radius and a 50 mm focal length into an agar phantom with an attenuation coefficient of about 0.6 dB/cm/MHz or 1.2 dB/cm/MHz. The nonlinear acoustic field is measured using a needle-type hydrophone. The calculation is based on the Khokhlov-Zabolotskaya-Kuznetsov(KZK) equation which is modified so that the frequency dependence of the attenuation coefficient is the same as that in biological tissue. This equation is numerically solved with the implicit backward method employing the iterative method. The measured and calculated amplitude spectra show good agreement with each other.

  12. Superficial Ultrasound Shear Wave Speed Measurements in Soft and Hard Elasticity Phantoms: Repeatability and Reproducibility Using Two Different Ultrasound Systems

    PubMed Central

    Dillman, Jonathan R.; Chen, Shigao; Davenport, Matthew S.; Zhao, Heng; Urban, Matthew W.; Song, Pengfei; Watcharotone, Kuanwong; Carson, Paul L.

    2014-01-01

    Background There is a paucity of data available regarding the repeatability and reproducibility of superficial shear wave speed (SWS) measurements at imaging depths relevant to the pediatric population. Purpose To assess the repeatability and reproducibility of superficial shear wave speed (SWS) measurements acquired from elasticity phantoms at varying imaging depths using three different imaging methods, two different ultrasound systems, and multiple operators. Methods and Materials Soft and hard elasticity phantoms manufactured by Computerized Imaging Reference Systems, Inc. (Norfolk, VA) were utilized for our investigation. Institution #1 used an Acuson S3000 ultrasound system (Siemens Medical Solutions USA, Inc.) and three different shear wave imaging method/transducer combinations, while institution #2 used an Aixplorer ultrasound system (Supersonic Imagine) and two different transducers. Ten stiffness measurements were acquired from each phantom at three depths (1.0, 2.5, and 4.0 cm) by four operators at each institution. Student’s t-test was used to compare SWS measurements between imaging techniques, while SWS measurement agreement was assessed with two-way random effects single measure intra-class correlation coefficients and coefficients of variation. Mixed model regression analysis determined the effect of predictor variables on SWS measurements. Results For the soft phantom, the average of mean SWS measurements across the various imaging methods and depths was 0.84 ± 0.04 m/s (mean ± standard deviation) for the Acuson S3000 system and 0.90 ± 0.02 m/s for the Aixplorer system (p=0.003). For the hard phantom, the average of mean SWS measurements across the various imaging methods and depths was 2.14 ± 0.08 m/s for the Acuson S3000 system and 2.07 ± 0.03 m/s Aixplorer system (p>0.05). The coefficients of variation were low (0.5–6.8%), and inter-operator agreement was near-perfect (ICCs ≥0.99). Shear wave imaging method and imaging depth

  13. Evaluation of trainees' ability to perform obstetrical ultrasound using simulation: challenges and opportunities.

    PubMed

    Chalouhi, Gihad E; Bernardi, Valeria; Gueneuc, Alexandra; Houssin, Isabelle; Stirnemann, Julien J; Ville, Yves

    2016-04-01

    Evaluation of trainee's ability in obstetrical ultrasound is a time-consuming process, which requires involving patients as volunteers. With the use of obstetrical ultrasound simulators, virtual reality could help in assessing competency and evaluating trainees in this field. The objective of the study was to test the validity of an obstetrical ultrasound simulator as a tool for evaluating trainees following structured training by comparing scores obtained on obstetrical ultrasound simulator with those obtained on volunteers and by assessing correlations between scores of images and of dexterity given by 2 blinded examiners. Trainees, taking the 2013 French national examination for the practice of obstetrical ultrasound were asked to obtain standardized ultrasound planes both on volunteer pregnant women and on an obstetrical ultrasound simulator. These planes included measurements of biparietal diameter, abdominal circumference, and femur length as well as reference planes for cardiac 4-chamber and outflow tracts, kidneys, stomach/diaphragm, spine, and face. Images were stored and evaluated subsequently by 2 national examiners who scored each picture according to previously established quality criteria. Dexterity was also evaluated and subjectively scored between 0 and 10. The Raghunathan's modification of Pearson, Filon's z, Spearman's rank correlation, and analysis of variance tests were used to assess correlations between the scores by the 2 examiners and scores of dexterity and also to compare the final scores between the 2 different methods. We evaluated 29 trainees. The mean dexterity scores in simulation (6.5 ± 2.0) and real examination (5.9 ± 2.3) were comparable (P = .31). Scores with an obstetrical ultrasound simulator were significantly higher than those obtained on volunteers (P = .027). Nevertheless, there was a good correlation between the scores of the 2 examiners judging on simulation (R = 0.888) and on volunteers (R = 0.873) (P = .81). An

  14. Ultrasound Fracture Diagnosis in Space

    NASA Technical Reports Server (NTRS)

    Dulchavsky, Scott A.; Amponsah, David; Sargsyan, Ashot E.; Garcia, Kathleen M.; Hamilton, Douglas R.; vanHolsbeeck, Marnix

    2010-01-01

    Introduction: This ground-based investigation accumulated high-level clinical evidence on the sensitivity and specificity of point of care ultrasound performed by expert and novice users for the rapid diagnosis of musculoskeletal (MSK) injuries. We developed preliminary educational methodologies to provide just-in-time training of novice users by creating multi-media training tools and imaging procedures for non expert operators and evaluated the sensitivity and specificity of non-expert performed musculoskeletal ultrasound to diagnose acute injuries in a Level 1 Trauma Center. Methods: Patients with potential MSK injuries were identified in the emergency room. A focused MSK ultrasound was performed by expert operators and compared to standard radiographs. A repeat examination was performed by non-expert operators who received a short, just-in-time multimedia education aid. The sensitivity and specificity of the expert and novice ultrasound examinations were compared to gold standard radiography. Results: Over 800 patients were enrolled in this study. The sensitivity and specificity of expert performed ultrasound exceeded 98% for MSK injuries. Novice operators achieved 97% sensitivity and 99% specificity for targeted examinations with the greatest error in fractures involving the hand and foot. Conclusion: Point of care ultrasound is a sensitive and specific diagnostic test for MSK injury when performed by experts and just-in-time trained novice operators.

  15. Medical Ultrasound Imaging.

    ERIC Educational Resources Information Center

    Hughes, Stephen

    2001-01-01

    Explains the basic principles of ultrasound using everyday physics. Topics include the generation of ultrasound, basic interactions with material, and the measurement of blood flow using the Doppler effect. (Author/MM)

  16. Comparison of sound speed measurements on two different ultrasound tomography devices

    NASA Astrophysics Data System (ADS)

    Sak, Mark; Duric, Neb; Littrup, Peter; Bey-Knight, Lisa; Sherman, Mark; Gierach, Gretchen; Malyarenko, Antonina

    2014-03-01

    Ultrasound tomography (UST) employs sound waves to produce three-dimensional images of breast tissue and precisely measures the attenuation of sound speed secondary to breast tissue composition. High breast density is a strong breast cancer risk factor and sound speed is directly proportional to breast density. UST provides a quantitative measure of breast density based on three-dimensional imaging without compression, thereby overcoming the shortcomings of many other imaging modalities. The quantitative nature of the UST breast density measures are tied to an external standard, so sound speed measurement in breast tissue should be independent of specific hardware. The work presented here compares breast sound speed measurement obtained with two different UST devices. The Computerized Ultrasound Risk Evaluation (CURE) system located at the Karmanos Cancer Institute in Detroit, Michigan was recently replaced with the SoftVue ultrasound tomographic device. Ongoing clinical trials have used images generated from both sets of hardware, so maintaining consistency in sound speed measurements is important. During an overlap period when both systems were in the same exam room, a total of 12 patients had one or both of their breasts imaged on both systems on the same day. There were 22 sound speed scans analyzed from each system and the average breast sound speeds were compared. Images were either reconstructed using saved raw data (for both CURE and SoftVue) or were created during the image acquisition (saved in DICOM format for SoftVue scans only). The sound speed measurements from each system were strongly and positively correlated with each other. The average difference in sound speed between the two sets of data was on the order of 1-2 m/s and this result was not statistically significant. The only sets of images that showed a statistical difference were the DICOM images created during the SoftVue scan compared to the SoftVue images reconstructed from the raw data

  17. Virtual Guidance Ultrasound: A Tool to Obtain Diagnostic Ultrasound for Remote Environments

    NASA Technical Reports Server (NTRS)

    Caine,Timothy L.; Martin David S.; Matz, Timothy; Lee, Stuart M. C.; Stenger, Michael B.; Platts, Steven H.

    2012-01-01

    Astronauts currently acquire ultrasound images on the International Space Station with the assistance of real-time remote guidance from an ultrasound expert in Mission Control. Remote guidance will not be feasible when significant communication delays exist during exploration missions beyond low-Earth orbit. For example, there may be as much as a 20- minute delay in communications between the Earth and Mars. Virtual-guidance, a pre-recorded audio-visual tutorial viewed in real-time, is a viable modality for minimally trained scanners to obtain diagnostically-adequate images of clinically relevant anatomical structures in an autonomous manner. METHODS: Inexperienced ultrasound operators were recruited to perform carotid artery (n = 10) and ophthalmic (n = 9) ultrasound examinations using virtual guidance as their only instructional tool. In the carotid group, each each untrained operator acquired two-dimensional, pulsed, and color Doppler of the carotid artery. In the ophthalmic group, operators acquired representative images of the anterior chamber of the eye, retina, optic nerve, and nerve sheath. Ultrasound image quality was evaluated by independent imaging experts. RESULTS: Eight of the 10 carotid studies were judged to be diagnostically adequate. With one exception the quality of all the ophthalmic images were adequate to excellent. CONCLUSION: Diagnostically-adequate carotid and ophthalmic ultrasound examinations can be obtained by untrained operators with instruction only from an audio/video tutorial viewed in real time while scanning. This form of quick-response-guidance, can be developed for other ultrasound examinations, represents an opportunity to acquire important medical and scientific information for NASA flight surgeons and researchers when trained medical personnel are not present. Further, virtual guidance will allow untrained personnel to autonomously obtain important medical information in remote locations on Earth where communication is

  18. Application of ultrasound-tagged photons for measurement of amplitude of vibration of tissue caused by ultrasound: theory, simulation, and experiments.

    PubMed

    Devi, C Usha; Vasu, R M; Sood, A K

    2006-01-01

    We investigate the modulation of an optical field caused by its interaction with an ultrasound beam in a tissue mimicking phantom. This modulation appears as a modulation in the intensity autocorrelation, which is measured by a photon counting correlator. The factors contributing to the modulation are: 1. amplitude of vibration of the particles of the tissue, 2. refractive index modulation, and 3. absorption coefficient in the region of the tissue intercepted by the ultrasound beam and light. We show in this work that a significant part of the contribution to this modulation comes from displacement of the tissue particles, which in turn is governed by the elastic properties of the tissue. We establish, both through simulations and experiments using an optical elastography phantom, the effects of the elasticity and absorption coefficient variations on the modulation of intensity autocorrelation. In the case where there is no absorption coefficient variation, we suggest that the depth of modulation can be calibrated to measure the displacement of tissue particles that, in turn, can be used to measure the tissue elasticity.

  19. Evaluation of knee cartilage thickness: A comparison between ultrasound and magnetic resonance imaging methods.

    PubMed

    Schmitz, Randy J; Wang, Hsin-Min; Polprasert, Daniel R; Kraft, Robert A; Pietrosimone, Brian G

    2017-03-01

    Establishing clinically accessible measures of cartilage health is critical for assessing effectiveness of protocols to reduce risk of osteoarthritis (OA) development and progression. Cartilage thickness is one important measure in describing both OA development and progression. The objective was to determine the relationship between ultrasound and MRI measures of cartilage thickness in the medial femoral condyle. Mean cartilage thicknesses of the left medial femoral cartilage were measured via T1 weighted MRI and ultrasound imaging from transverse, anterior, middle, and posterior medial femoral regions in 10 healthy females (Mean±Std Dev) (1.66±0.08m, 59.5±8.3kg, 21.6±1.4years) and nine healthy males (1.80±0.08m, 79.1±6.2kg, 21.7±1.5years). Pearson correlations examined relationships between MRI and ultrasound measures. Bland-Altman plots evaluated agreement between the imaging modalities. Transverse ultrasound thickness measures were significantly positively correlated with MRI middle (r=.67, P≤.05) and posterior thicknesses (r=.49, P≤.05) while the middle and posterior longitudinal ultrasound measures were significantly correlated to their respective MRI regions (r=.67, P≤.05 & r=.59 P≤.05, respectively). There was poor absolute agreement between correlated measures with ultrasound thickness measures being between 1.9 and 2.8mm smaller than MRI measures. These results suggest that ultrasound may be a viable clinical tool to assess relative cartilage thickness in the middle and posterior medial femoral regions. However, the absolute validity of the ultrasound measure is called into question due to the larger MRI-based thickness measures. Level IV. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Statistical shape modeling based renal volume measurement using tracked ultrasound

    NASA Astrophysics Data System (ADS)

    Pai Raikar, Vipul; Kwartowitz, David M.

    2017-03-01

    Autosomal dominant polycystic kidney disease (ADPKD) is the fourth most common cause of kidney transplant worldwide accounting for 7-10% of all cases. Although ADPKD usually progresses over many decades, accurate risk prediction is an important task.1 Identifying patients with progressive disease is vital to providing new treatments being developed and enable them to enter clinical trials for new therapy. Among other factors, total kidney volume (TKV) is a major biomarker predicting the progression of ADPKD. Consortium for Radiologic Imaging Studies in Polycystic Kidney Disease (CRISP)2 have shown that TKV is an early, and accurate measure of cystic burden and likely growth rate. It is strongly associated with loss of renal function.3 While ultrasound (US) has proven as an excellent tool for diagnosing the disease; monitoring short-term changes using ultrasound has been shown to not be accurate. This is attributed to high operator variability and reproducibility as compared to tomographic modalities such as CT and MR (Gold standard). Ultrasound has emerged as one of the standout modality for intra-procedural imaging and with methods for spatial localization has afforded us the ability to track 2D ultrasound in physical space which it is being used. In addition to this, the vast amount of recorded tomographic data can be used to generate statistical shape models that allow us to extract clinical value from archived image sets. In this work, we aim at improving the prognostic value of US in managing ADPKD by assessing the accuracy of using statistical shape model augmented US data, to predict TKV, with the end goal of monitoring short-term changes.

  1. Evaluation of ultrasound techniques for brain injury detection

    NASA Astrophysics Data System (ADS)

    Mobley, Joel; Kasili, Paul M.; Norton, Stephen J.; Vo-Dinh, Tuan

    1998-05-01

    In this work, we examine the physics underlying wave propagation in the head to evaluate various ultrasonic transducers for use in a brian injury detection device. The results of measurements of the attenuation coefficient and phase velocity for ultrasonic propagation in samples of brain tissue and skull bone from sheep are presented. The material properties are then used to investigate the propagation of ultrasonic pressure fields in the head. The ultrasound fields for three different transducers are calculated for propagation in a simulated brain/skull model. The model is constructed using speed-of-sound and mass density values of the two tissue types. The impact of the attenuation on the ultrasound fields is then examined. Finally, the relevant points drawn from these discussions are summarized. We hope to minimize the confounding effects of the skull by using sub-MHz ultrasound while maintaining the necessary temporal and spatial resolution to successfully detect injury in the brain.

  2. Consideration on suppression of cancer cell proliferation by ultrasound exposure using sonochemical and biological measurements

    NASA Astrophysics Data System (ADS)

    Watanabe, A.; Nishimura, H.; Kawashima, N.; Takeuchi, S.

    2004-01-01

    The suppression methods of cancer cells proliferation using ultrasound exposure are investigated to develop a new minimally invasive cancer treatment method. A stainless steel vibrating plate with a Langevin type transducer is attached to the bottom of a water tank of the ultrasound exposure system used in this study. Ultrasound was irradiated to cancer cells of mouse T lymphoma (EL-4) in a flask. A decreasing tendency of the number of viable cancer cells exposed to ultrasound of 150 kHz and acoustic intensity ISPTP of 750 mW/cm2 was confirmed in the culturing process. Then, the suppression mechanism of cancer cell proliferation by ultrasound exposure was considered through confirmation of apoptosis and necrosis with the exposed cancer cells by electrophoresis and enzyme activity measurements. It was found that the apoptosis was induced on the cancer cells after ultrasound exposure. We confirmed the generation of hydroxyl radical in water in the water tank by ESR device. When the hydroxyl radicals were scavenged by adding ethanol to the culture medium for cancer cells, the apoptosis was not induced and proliferation was not suppressed. Therefore, we found that generation of activated oxygen in the culturing medium by ultrasound exposure was caused to apoptosis induction and suppression of cancer cell proliferation. We will present the results of above consideration in this conference.

  3. Conditionally Increased Acoustic Pressures in Nonfetal Diagnostic Ultrasound Examinations Without Contrast Agents: A Preliminary Assessment.

    PubMed

    Nightingale, Kathryn R; Church, Charles C; Harris, Gerald; Wear, Keith A; Bailey, Michael R; Carson, Paul L; Jiang, Hui; Sandstrom, Kurt L; Szabo, Thomas L; Ziskin, Marvin C

    2015-07-01

    The mechanical index (MI) has been used by the US Food and Drug Administration (FDA) since 1992 for regulatory decisions regarding the acoustic output of diagnostic ultrasound equipment. Its formula is based on predictions of acoustic cavitation under specific conditions. Since its implementation over 2 decades ago, new imaging modes have been developed that employ unique beam sequences exploiting higher-order acoustic phenomena, and, concurrently, studies of the bioeffects of ultrasound under a range of imaging scenarios have been conducted. In 2012, the American Institute of Ultrasound in Medicine Technical Standards Committee convened a working group of its Output Standards Subcommittee to examine and report on the potential risks and benefits of the use of conditionally increased acoustic pressures (CIP) under specific diagnostic imaging scenarios. The term "conditionally" is included to indicate that CIP would be considered on a per-patient basis for the duration required to obtain the necessary diagnostic information. This document is a result of that effort. In summary, a fundamental assumption in the MI calculation is the presence of a preexisting gas body. For tissues not known to contain preexisting gas bodies, based on theoretical predications and experimentally reported cavitation thresholds, we find this assumption to be invalid. We thus conclude that exceeding the recommended maximum MI level given in the FDA guidance could be warranted without concern for increased risk of cavitation in these tissues. However, there is limited literature assessing the potential clinical benefit of exceeding the MI guidelines in these tissues. The report proposes a 3-tiered approach for CIP that follows the model for employing elevated output in magnetic resonance imaging and concludes with summary recommendations to facilitate Institutional Review Board (IRB)-monitored clinical studies investigating CIP in specific tissues. © 2015 by the American Institute of

  4. Pleural ultrasound as an adjunct to physical examination in the preoperative evaluation of lung cancer patients.

    PubMed

    Bah, Ismaël; Goudie, Eric; Khereba, Mohamed; Ferraro, Pasquale; Duranceau, André; Martin, Jocelyne; Thiffault, Vicky; Liberman, Moishe

    2014-05-01

    Preoperative evaluation of patients with suspected or confirmed lung cancer consists of clinical and radiological staging. Malignant pleural effusion is a poor prognosticator in non-small-cell lung cancer. Pleural ultrasound (PU) allows for the assessment of pleural effusion, providing real-time guidance for its aspiration and cytological analysis. Pleural Ultrasonography in Lung Cancer (PULC) as an adjunct to physical examination has the potential to improve preoperative staging of non-small-cell lung cancer during first surgical encounter by allowing the evaluation of previously unassessed pleural effusion. This study consisted of a prospective trial of surgeon-performed PU in the preoperative evaluation of lung cancer patients. All patients evaluated in the thoracic surgery clinic with the new or presumed diagnosis of lung cancer were eligible. A portable ultrasound machine was used to evaluate pleural fluid in the bilateral costophrenic sulci with pleural fluid aspiration for cytological analysis. Forty-five patients were prospectively enrolled over a 3-month period. Thirteen patients had ultrasound evidence of a pleural effusion, of which 3 were significant enough for aspiration. Cytological analysis of these effusions yielded malignant cells in 1 patient. Positive PULC evaluation led to a change in clinical staging (M0 to M1a) in 10 patients and a change in pathological staging (pleural fluid cytology positive) in 1 patient. The time required for PULC examination was 15 ± 7 min. There were no complications related to the procedures. Preoperative pleural ultrasonography is a rapid and effective way to improve precision of staging in patients with lung cancer. More precise staging may allow for more appropriate testing, patient prognostication and operative planning.

  5. Measuring the acoustoelectric interaction constant using ultrasound current source density imaging

    NASA Astrophysics Data System (ADS)

    Li, Qian; Olafsson, Ragnar; Ingram, Pier; Wang, Zhaohui; Witte, Russell

    2012-10-01

    Ultrasound current source density imaging (UCSDI) exploits the acoustoelectric (AE) effect, an interaction between ultrasound pressure and electrical resistivity, to map electrical conduction in the heart. The conversion efficiency for UCSDI is determined by the AE interaction constant K, a fundamental property of all materials; K directly affects the magnitude of the detected voltage signal in UCSDI. This paper describes a technique for measuring K in biological tissue, and reports its value for the first time in cadaver hearts. A custom chamber was designed and fabricated to control the geometry for estimating K, which was measured in different ionic salt solutions and seven cadaver rabbit hearts. We found K to be strongly dependent on concentration for the divalent salt CuSO4, but not for the monovalent salt NaCl, consistent with their different chemical properties. In the rabbit heart, K was determined to be 0.041±0.012%/MPa, similar to the measurement of K in physiological saline (0.034±0.003%/MPa). This study provides a baseline estimate of K for modeling and experimental studies that involve UCSDI to map cardiac conduction and reentry currents associated with arrhythmias.

  6. Doppler ultrasound to detect pulpal blood flow changes during local anaesthesia.

    PubMed

    Yoon, M J; Lee, S J; Kim, E; Park, S H

    2012-01-01

      To examine whether Doppler ultrasound can detect changes in pulpal blood flow after infiltration anaesthesia.   Changes in pulpal blood flow in maxillary central incisor teeth of 18 patients (mean age 26.7 years, 13 men, five women) after infiltration anaesthesia were examined. Before infiltration anaesthesia, the pulpal blood flow was measured using Doppler ultrasound. A local anaesthetic solution containing 2% lidocaine with 1:80,000 epinephrine was injected into the submucosa above the experimental tooth. The Doppler ultrasound test was carried out at 5, 10, 20, 30, 45 and 60 min after infiltration. The parameters were Vas (maximum linear velocity, cm s(-1) ), Vam (average linear velocity, cm s(-1) ) and Vakd (minimum linear velocity, cm s(-1) ), which are indicators of the level of blood flow. The mixed procedure at the 95% confidence interval was used to examine the changes in pulpal blood flow after the injection.   The linear velocity profiles (Vas, Vam, and Vakd) decreased sharply 5 min after anaesthesia and then reduced continuously for 30 min. The maximum degree of blood flow reduction in Vas, Vam and Vakd was 58%, 83% and 82%, respectively. After 30 min, the linear velocities increased gradually. The Vam returned to the pre-anaesthesia state at 60 minutes but the Vas and Vakd did not recover completely.   Doppler ultrasound can detect changes in pulpal blood flow after infiltration anaesthesia. In the future, Doppler ultrasound can be used as a tool for measuring pulpal blood flow. © 2011 International Endodontic Journal.

  7. Ultrasound for internal medicine physicians: the future of the physical examination.

    PubMed

    Dulohery, Megan M; Stoven, Samantha; Kurklinsky, Andrew K; Kurklinksy, Andrew; Halvorsen, Andrew; McDonald, Furman S; Bhagra, Anjali

    2014-06-01

    With the advent of compact ultrasound (US) devices, it is easier for physicians to enhance their physical examinations through the use of US. However, although this new tool is widely available, few internal medicine physicians have US training. This study sought to understand physicians' baseline knowledge and skill, provide education in US principles, and demonstrate that proper use of compact US devices is a skill that can be quickly learned. Training was performed at the Mayo Clinic in June 2010 and June 2011. The participants consisted of internal medicine residents. The workshop included didactics and hands-on US experiences with human and cadaver models in a simulation center. Pretests and posttests of residents' knowledge, attitudes, and skills with US were completed. We reassessed the 2010 group in the spring of 2012 with a long-term retention survey for knowledge and confidence in viewing images. A total of 136 interns completed the workshop. Thirty-nine residents completed the long-term retention survey. Posttest assessments showed a statistically significant improvement in the knowledge of US imaging, confidence in identifying structures, image identification, and image acquisition (P < .0001). In the long-term retention study, knowledge of US imaging and confidence in identifying structures did decline. This educational intervention resulted in improvement in US knowledge and image acquisition. However, the knowledge diminished over time, suggesting that further education is needed if US is to become an important component of internal medicine training and practice. © 2014 by the American Institute of Ultrasound in Medicine.

  8. Anterolateral ankle impingement: findings and diagnostic accuracy with ultrasound imaging.

    PubMed

    McCarthy, C L; Wilson, D J; Coltman, T P

    2008-03-01

    The objective was to evaluate the findings and diagnostic accuracy of ultrasound in antero-lateral ankle impingement (ALI) with clinical and arthroscopic correlation. Seventeen elite footballers with chronic ankle pain were referred for ultrasound with a clinical diagnosis of ALI (n = 8) or a control condition (n = 9; lateral mechanical instability, osteochondral defect, intra-articular bodies and osteoarthritis). Ultrasound examination included the antero-lateral gutter for abnormal synovial tissue (synovitic lesion), lateral ligament integrity, tibiotalar joint and osseous spurs of the distal tibia and talus. Ultrasound findings were correlated with subsequent arthroscopic appearance. Ultrasound examination detected a synovitic mass in the antero-lateral gutter in all 8 footballers with clinical ALI (100%) and in 2 patients with a control diagnosis (22%). Arthroscopic correlation of antero-lateral synovitis and fibrosis was present in all 10 cases (100%). The synovitic lesion was seen at ultrasound as a nodular soft tissue mass of mixed echogenicity within the antero-lateral gutter, which extruded anteriorly with manual compression of the distal fibula against the tibia. Increased blood supply was detected using power Doppler imaging in only 1 patient. The synovitic lesion measured >10 mm in its maximum dimension in 7 footballers with clinical ALI and <10 mm in the control group. Additional ultrasound findings in patients with abnormal antero-lateral synovial tissue included an anterior talofibular ligament injury in all patients (n = 10), a tibiotalar joint effusion (n = 6) and osseous spurs (n = 4). Antero-lateral synovitic tissue was accurately identified at ultrasound in the absence of an effusion (n = 4). No synovitic lesion was detected at ultrasound or arthroscopy in the remaining 7 patients with a control diagnosis. Ultrasound is accurate in detecting synovitic lesions within the antero-lateral gutter, demonstrating associated ligamentous injuries and in

  9. Biaxial Mechanical Testing of Posterior Sclera using High-Resolution Ultrasound Speckle Tracking for Strain Measurements

    PubMed Central

    Cruz-Perez, Benjamin; Tang, Junhua; Morris, Hugh J.; Palko, Joel R.; Pan, Xueliang; Hart, Richard T.; Liu, Jun

    2014-01-01

    This study aimed to characterize the mechanical responses of the sclera, the white outer coat of the eye, under equal-biaxial loading with unrestricted shear. An ultrasound speckle tracking technique was used to measure tissue deformation through sample thickness, expanding the capabilities of surface strain techniques. Eight porcine scleral samples were tested within 72 hours postmortem. High resolution ultrasound scans of scleral cross-sections along the two loading axes were acquired at 25 consecutive biaxial load levels. An additional repeat of the biaxial loading cycle was performed to measure a third normal strain emulating a strain gauge rosette for calculating the in-plane shear. The repeatability of the strain measurements during identical biaxial ramps was evaluated. A correlation-based ultrasound speckle tracking algorithm was used to compute the displacement field and determine the distributive strains in the sample cross-sections. A Fung type constitutive model including a shear term was used to determine the material constants of each individual specimen by fitting the model parameters to the experimental stress-strain data. A non-linear stress-strain response was observed in all samples. The meridian direction had significantly larger strains than the circumferential direction during equal-biaxial loadings (P’s<0.05). The stiffness along the two directions were also significantly different (P=0.02) but highly correlated (R2=0.8). These results showed that the mechanical properties of the porcine sclera were nonlinear and anisotropic under biaxial loading. This work has also demonstrated the feasibility of using ultrasound speckle tracking for strain measurements during mechanical testing. PMID:24438767

  10. The validity of ultrasound estimation of muscle volumes.

    PubMed

    Infantolino, Benjamin W; Gales, Daniel J; Winter, Samantha L; Challis, John H

    2007-08-01

    The purpose of this study was to validate ultrasound muscle volume estimation in vivo. To examine validity, vastus lateralis ultrasound images were collected from cadavers before muscle dissection; after dissection, the volumes were determined by hydrostatic weighing. Seven thighs from cadaver specimens were scanned using a 7.5-MHz ultrasound probe (SSD-1000, Aloka, Japan). The perimeter of the vastus lateralis was identified in the ultrasound images and manually digitized. Volumes were then estimated using the Cavalieri principle, by measuring the image areas of sets of parallel two-dimensional slices through the muscles. The muscles were then dissected from the cadavers, and muscle volume was determined via hydrostatic weighing. There was no statistically significant difference between the ultrasound estimation of muscle volume and that estimated using hydrostatic weighing (p > 0.05). The mean percentage error between the two volume estimates was 0.4% +/- 6.9. Three operators all performed four digitizations of all images from one randomly selected muscle; there was no statistical difference between operators or trials and the intraclass correlation was high (>0.8). The results of this study indicate that ultrasound is an accurate method for estimating muscle volumes in vivo.

  11. Technical characterization of an ultrasound source for noninvasive thermoablation by high-intensity focused ultrasound.

    PubMed

    Köhrmann, K U; Michel, M S; Steidler, A; Marlinghaus, E; Kraut, O; Alken, P

    2002-08-01

    To develop a generator for high-intensity focused ultrasound (HIFU, a method of delivering ultrasonic energy with resultant heat and tissue destruction to a tight focus at a selected depth within the body), designed for extracorporeal coupling to allow various parenchymal organs to be treated. The ultrasound generated by a cylindrical piezo-ceramic element is focused at a depth of 10 cm using a parabolic reflector with a diameter of 10 cm. A diagnostic B-mode ultrasonographic transducer is integrated into the source to allow the focus to be located in the target area. The field distribution of the sound pressure was measured in degassed water using a needle hydrophone. An ultrasound-force balance was used to determine the acoustic power. These measurements allowed the spatially averaged sound intensity to be calculated. The morphology and extent of tissue necrosis induced by HIFU was examined on an ex-vivo kidney model. The two-dimensional field distribution resulted in an approximately ellipsoidal focus of 32 x 4 mm (- 6 dB). The spatially maximum averaged sound intensity was 8591 W/cm2 at an electrical power of 400 W. The lesion caused to the ex-vivo kidney at this maximum generator power with a pulse duration of 2 s was a clearly delineated ellipsoidal coagulation necrosis up to 8.8 x 2.3 mm (length x width) and with central liquefied necrosis of 7.9 x 1.9 mm. This newly developed ultrasound generator with a focal length of 10 cm can induce clear necrosis in parenchymal tissue. Because of its specific configuration and the available power range of the ultrasound generator, there is potential for therapeutic noninvasive ablation of tissue deep within a patient's body.

  12. Holistic ultrasound in trauma: An update.

    PubMed

    Saranteas, Theodosios; Mavrogenis, Andreas F

    2016-10-01

    Holistic ultrasound is a total body examination using an ultrasound device aiming to achieve immediate patient care and decision making. In the setting of trauma, it is one of the most fundamental components of care of the injured patients. Ground-breaking imaging software allows physicians to examine various organs thoroughly, recognize imaging signs early, and potentially foresee the onset or the possible outcome of certain types of injuries. Holistic ultrasound can be performed on a routine basis at the bedside of the patients, at admission and during the perioperative period. Trauma care physicians should be aware of the diagnostic and guidance benefits of ultrasound and should receive appropriate training for the optimal management of their patients. In this paper, the findings of holistic ultrasound in trauma patients are presented, with emphasis on the lungs, heart, cerebral circulation, abdomen, and airway. Additionally, the benefits of ultrasound imaging in interventional anaesthesia techniques such as ultrasound-guided peripheral nerve blocks and central vein catheterization are described. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Accuracy of Medical Students in Detecting Pleural Effusion Using Lung Ultrasound as an Adjunct to the Physical Examination.

    PubMed

    Steinmetz, Peter; Oleskevich, Sharon; Dyachenko, Alina; McCusker, Jane; Lewis, John

    2018-03-25

    This study compared the accuracy of medical students in identifying pleural effusion in hospitalized patients using the physical examination versus lung ultrasound (US). Fourth-year medical students (n = 14) received 20 hours of general practical US training (including 2 hours of specialized lung US training) plus theoretical and video documentation. The students used the physical examination alone versus the physical examination plus lung US to document the presence or absence of pleural effusion in the right and left hemithoraces of hospitalized patients (n = 11 patients; 22 hemithoraces examined 544 times in total). The reference standard for identification of pleural effusion was a lung US examination by 2 expert point-of-care sonographers. The odds of correctly identifying the presence versus absence of pleural effusion was 5 times greater with lung US as an adjunct to the physical examination compared to the physical examination alone (odds ratio [OR], 5.1 from multivariate logistic regression; 95% confidence interval, 3.3-8.0). The addition of lung US to the physical examination resulted in an increase in sensitivity from 48% to 90%, in specificity from 73% to 86%, and in accuracy from 60% to 88%. The benefits of using US were greater when pleural effusion was present versus absent (OR, 10.8 versus 2.4) and when examining older versus younger patients (OR, 10.2 versus 2.8). These results demonstrate that medical students' ability to detect the presence or absence of pleural effusion is superior when using lung US as an adjunct to the physical examination than when using the physical examination alone. © 2018 by the American Institute of Ultrasound in Medicine.

  14. Ultrasound for the Anesthesiologists: Present and Future

    PubMed Central

    Terkawi, Abdullah S.; Karakitsos, Dimitrios; Elbarbary, Mahmoud; Blaivas, Michael; Durieux, Marcel E.

    2013-01-01

    Ultrasound is a safe, portable, relatively inexpensive, and easily accessible imaging modality, making it a useful diagnostic and monitoring tool in medicine. Anesthesiologists encounter a variety of emergent situations and may benefit from the application of such a rapid and accurate diagnostic tool in their routine practice. This paper reviews current and potential applications of ultrasound in anesthesiology in order to encourage anesthesiologists to learn and use this useful tool as an adjunct to physical examination. Ultrasound-guided peripheral nerve blockade and vascular access represent the most popular ultrasound applications in anesthesiology. Ultrasound has recently started to substitute for CT scans and fluoroscopy in many pain treatment procedures. Although the application of airway ultrasound is still limited, it has a promising future. Lung ultrasound is a well-established field in point-of-care medicine, and it could have a great impact if utilized in our ORs, as it may help in rapid and accurate diagnosis in many emergent situations. Optic nerve sheath diameter (ONSD) measurement and transcranial color coded duplex (TCCD) are relatively new neuroimaging modalities, which assess intracranial pressure and cerebral blood flow. Gastric ultrasound can be used for assessment of gastric content and diagnosis of full stomach. Focused transthoracic (TTE) and transesophageal (TEE) echocardiography facilitate the assessment of left and right ventricular function, cardiac valve abnormalities, and volume status as well as guiding cardiac resuscitation. Thus, there are multiple potential areas where ultrasound can play a significant role in guiding otherwise blind and invasive interventions, diagnosing critical conditions, and assessing for possible anatomic variations that may lead to plan modification. We suggest that ultrasound training should be part of any anesthesiology training program curriculum. PMID:24348179

  15. Broadband attenuation measurements of phospholipid-shelled ultrasound contrast agents.

    PubMed

    Raymond, Jason L; Haworth, Kevin J; Bader, Kenneth B; Radhakrishnan, Kirthi; Griffin, Joseph K; Huang, Shao-Ling; McPherson, David D; Holland, Christy K

    2014-02-01

    The aim of this study was to characterize the frequency-dependent acoustic attenuation of three phospholipid-shelled ultrasound contrast agents (UCAs): Definity, MicroMarker and echogenic liposomes. A broadband through-transmission technique allowed for measurement over 2 to 25 MHz with a single pair of transducers. Viscoelastic shell parameters of the UCAs were estimated using a linearized model developed by N. de Jong, L. Hoff, T. Skotland and N. Bom (Ultrasonics 1992; 30:95-103). The effect of diluent on the attenuation of these UCA suspensions was evaluated by performing attenuation measurements in 0.5% (w/v) bovine serum albumin and whole blood. Changes in attenuation and shell parameters of the UCAs were investigated at room temperature (25°C) and physiologic temperature (37°C). The attenuation of the UCAs diluted in 0.5% (w/v) bovine serum albumin was found to be identical to the attenuation of UCAs in whole blood. For each UCA, attenuation was higher at 37°C than at 25°C, underscoring the importance of conducting characterization studies at physiologic temperature. Echogenic liposomes exhibited a larger increase in attenuation at 37°C versus 25°C than either Definity or MicroMarker. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  16. Measurement of Mechanical Properties of Soft Tissue with Ultrasound Vibrometry

    NASA Astrophysics Data System (ADS)

    Nenadich, I.; Bernal, M.; Greenleaf, J. F.

    The cardiovascular diseases atherosclerosis, coronary artery disease, hypertension and heart failure have been related to stiffening of vessels and myocardium. Noninvasive measurements of mechanical properties of cardiovascular tissue would facilitate detection and treatment of disease in early stages, thus reducing mortality and possibly reducing cost of treatment. While techniques capable of measuring tissue elasticity have been reported, the knowledge of both elasticity and viscosity is necessary to fully characterize mechanical properties of soft tissues. In this article, we summarize the Shearwave Dispersion Ultrasound Vibrometry (SDUV) method developed by our group and report on advances made in characterizing stiffness of large vessels and myocardium. The method uses radiation forceFadiation force to excite shear waves in soft tissue and pulse echo ultrasound to measure the motion. The speed of propagation of shear waves at different frequencies is used to generate dispersions curves for excised porcine left-ventricular free-wall myocardium and carotid arteries. An antisymmetric Lamb wave model was fitted to the LV myocardium dispersion curves to obtain elasticity and viscosity moduli. The results suggest that the speed of shear wave propagation in four orthogonal directions on the surface of the excised myocardium is similar. These studies show that the SDUV method has potential for clinical application in noninvasive quantification of elasticity and viscosity of vessels and myocardium.

  17. Ultrasound findings in children with toxocariasis: report on 18 cases.

    PubMed

    Baldisserotto, M; Conchin, C F; Soares, M da G; Araujo, M A; Kramer, B

    1999-05-01

    To evaluate abdominal ultrasound (US) findings in children infected with Toxocara canis. Eighteen children, 18 months to 7 years of age, with serological diagnosis of T.canis infection underwent abdominal US. Eosinophil counts, hemoglobin levels and immunoglobulin E titers were measured for all patients. Abdominal ultrasound revealed multiple hypoechoic areas in the livers of 15 patients (83.3%). Hepatohilar lymph-node enlargement was present in 14 patients (77.7%), 2 of whom also showed peripancreatic lymph-node enlargement. Hepatomegaly was present in 13 patients (72.7%) and splenomegaly in 9 (50%). The most prevalent findings of abdominal ultrasound examination of children with T.canis infection are hepatic granulomas and abdominal lymph-node enlargement. This infection should be considered in the differential diagnosis of any children who exhibit these findings on abdominal US examination, especially for those with eosinophilia.

  18. Body Mass Normalization for Ultrasound Measurements of Adolescent Lateral Abdominal Muscle Thickness.

    PubMed

    Linek, Pawel; Saulicz, Edward; Wolny, Tomasz; Myśliwiec, Andrzej

    2017-04-01

    The purpose of this study was to determine the value of the allometric parameter for ultrasound measurements of the thickness of the oblique external (OE), internal (OI), and transversus abdominis (TrA) muscles in the adolescent population. The allometric parameter is the slope of the linear regression line between the log transformed body mass and log transformed muscle size measurement. The study included 321 adolescents between the ages of 10 and 17, consisting of 160 boys and 161 girls. The participants were recruited from local schools and attended regular school classes at normal grade levels. All individuals with no signs of scoliosis (screening with use of a scoliometer), and no surgical procedures performed on the trunk area were included. A real-time ultrasound B-scanner with a linear array transducer was used to obtain images of the lateral abdominal muscles from both sides of the body. The correlation between body mass and the OE muscle was r = 0.69; the OI muscle r = 0.68; and the TrA muscle r = 0.53 (in all cases, P < .0001). The allometric parameter for the OE was 0.88296; the OI 0.718756; and the TrA 0.60986. Using these parameters, no significant correlations were found between body mass and the allometric-scaled thickness of the lateral abdominal muscles. Significant positive correlations exist between body mass and lateral abdominal muscle thickness assessed by ultrasound imaging. Therefore, it is reasonable to advise that the values of the allometric parameters for OE, OI, and TrA obtained in this study should be used in other studies performed on adolescents. © 2016 by the American Institute of Ultrasound in Medicine.

  19. Gas hydrate property measurements in porous sediments with resonant ultrasound spectroscopy

    NASA Astrophysics Data System (ADS)

    McGrail, B. P.; Ahmed, S.; Schaef, H. T.; Owen, A. T.; Martin, P. F.; Zhu, T.

    2007-05-01

    Resonant ultrasound spectroscopy was used to characterize a natural geological core sample obtained from the Mallik 5L-38 gas hydrate research well at high pressure and subambient temperatures. Using deuterated methane gas to form gas hydrate in the core sample, it was discovered that resonance amplitudes are correlated with the fraction of the pore space occupied by the gas hydrate crystals. A pore water freezing model was developed that utilizes the known pore size distribution and pore water chemistry to predict gas hydrate saturation as a function of pressure and temperature. The model showed good agreement with the experimental measurements and demonstrated that pore water chemistry is the most important factor controlling equilibrium gas hydrate saturations in these sediments when gas hydrates are formed artificially in laboratory pressure vessels. With further development, the resonant ultrasound technique can provide a rapid, nondestructive, field portable means of measuring the equilibrium P-T properties and dissociation kinetics of gas hydrates in porous media, determining gas hydrate saturations, and may provide new insights into the nature of gas hydrate formation mechanisms in geologic materials.

  20. Systematic determination of thyroid volume by ultrasound examination from infancy to adolescence in Japan: the Fukushima Health Management Survey.

    PubMed

    Suzuki, Satoru; Midorikawa, Sanae; Fukushima, Toshihiko; Shimura, Hiroki; Ohira, Tetsuya; Ohtsuru, Akira; Abe, Masafumi; Shibata, Yoshisada; Yamashita, Shunichi; Suzuki, Shinichi

    2015-01-01

    Although several reports have defined normal thyroid volume depending on either age or body surface, there are no sequential reference values on childhood thyroid volume evaluated by using ultrasonography and epidemiological analysis in Japan. The aim of the present study was to establish updated reference values for thyroid volume by ultrasound examination and epidemiological analysis in 0-19 year-old Japanese children. It is based on a cross-sectional study conducted from October 9, 2011 to March 31, 2012. The subjects were 38,063 children who were examined by ultrasonography as the initial preliminary survey of the Fukushima Health Management Survey in October 9, 2011 to March 31, 2012. The width, thickness, and height of each lobe were measured and the volume of each lobe was calculated by the mean of the elliptical shape volume formula. The values of thyroid volume at the 2.5 and 97.5 percentiles of age and body surface area for each gender group were obtained from 0-19 year-old children. Positive correlation was observed between thyroid volume and either age or body surface. The right lobe was significantly larger than the left lobe. The thyroid volume in females was larger than that in males after adjusting body surface area. The reference values of childhood thyroid for each age or body surface area were obtained by this extensive survey using ultrasound. These reference values may be used to define the normal size of thyroid gland by echosonography in Japanese children, although thyroid volume may be affected by dimorphic factors such as sex hormones.

  1. Measurement of shear-wave velocity by ultrasound critical-angle reflectometry (UCR).

    PubMed

    Mehta, S; Antich, P

    1997-01-01

    There exists a growing body of research that relates the measurement of pressure-wave velocity in bone to different physiological conditions and treatment modalities. The shear-wave velocity has been less studied, although it is necessary for a more complete understanding of the mechanical properties of bone. Ultrasound critical-angle reflectometry (UCR) is a noninvasive and nondestructive technique previously used to measure pressure-wave velocities both in vitro and in vivo. This note describes its application to the measurement of shear-wave velocity in bone, whether directly accessible or covered by soft tissue.

  2. Measurement of shear-wave velocity by ultrasound critical-angle reflectometry (UCR)

    NASA Technical Reports Server (NTRS)

    Mehta, S.; Antich, P.; Blomqvist, C. G. (Principal Investigator)

    1997-01-01

    There exists a growing body of research that relates the measurement of pressure-wave velocity in bone to different physiological conditions and treatment modalities. The shear-wave velocity has been less studied, although it is necessary for a more complete understanding of the mechanical properties of bone. Ultrasound critical-angle reflectometry (UCR) is a noninvasive and nondestructive technique previously used to measure pressure-wave velocities both in vitro and in vivo. This note describes its application to the measurement of shear-wave velocity in bone, whether directly accessible or covered by soft tissue.

  3. In-vivo investigation of material quality of bone tissue by measuring apparent phalangeal ultrasound transmission velocity.

    PubMed

    Kann, P; Schulz, U; Klaus, D; Piepkorn, B; Beyer, J

    1995-01-01

    The square of ultrasound transmission velocity in a material is related to the modulus of elasticity, which is known to be an indicator of stability in bone. The aim of our study was to use ultrasound transmission velocity to obtain information about the material properties of bone tissue, keeping other factors possibly influencing ultrasound transmission as constant as possible. Apparent phalangeal ultrasound transmission velocity (APU) measured in 54 isolated, fresh pig phalanges was shown to be independent of bone mineral density (BMD) measured by SPA. Fastest sound transmission led exclusively through cortical bone so that intertrabecular connectivity in spongious bone could not influence the result. In humans APU was measured in the mediolateral direction at the midphalanx of the middle finger. In 53 healthy subjects (15-81 years old; 27 women, 26 men), there was a decrease of APU with age (r = -0.30, p < 0.05). Further, when comparing the results of both hands intraindividually almost identical values indicated constant intraindividual architecture of bone at this location. There was no evidence for a relation of APU to physical load comparing dominant and nondominant hand and relating the results to subjectively estimated physical load. In a second group of 43 perimenopausal women (47-60 years old), APU, which again decreased with age (r = -0.33, p < 0.05), was found not to be correlated to BMD measured by SPA at the distal forearm (cortical bone).(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Office-based ultrasound screening for abdominal aortic aneurysm

    PubMed Central

    Blois, Beau

    2012-01-01

    Abstract Objective To assess the efficacy of an office-based, family physician–administered ultrasound examination to screen for abdominal aortic aneurysm (AAA). Design A prospective observational study. Consecutive patients were approached by nonphysician staff. Setting Rural family physician offices in Grand Forks and Revelstoke, BC. Participants The Canadian Society for Vascular Surgery screening recommendations for AAA were used to help select patients who were at risk of AAA. All men 65 years of age or older were included. Women 65 years of age or older were included if they were current smokers or had diabetes, hypertension, a history of coronary artery disease, or a family history of AAA. Main outcome measures A focused “quick screen,” which measured the maximal diameter of the abdominal aorta using point-of-care ultrasound technology, was performed in the office by a resident physician trained in emergency ultrasonography. Each patient was then booked for a criterion standard scan (ie, a conventional abdominal ultrasound scan performed by a technician and interpreted by a radiologist). The maximal abdominal aortic diameter measured by ultrasound in the office was compared with that measured by the criterion standard method. The time to screen each patient was recorded. Results Forty-five patients were included in data analysis; 62% of participants were men. The mean age was 73 years. The mean pairwise difference between the office-based ultrasound scan and the criterion standard scan was not statistically significant. The mean absolute difference between the 2 scans was 0.20 cm (95% CI 0.15 to 0.25 cm). Correlation between the scans was 0.81. The office-based ultrasound scan had both a sensitivity and a specificity of 100%. The mean time to screen each patient was 212 seconds (95% CI 194 to 230 seconds). Conclusion Abdominal aortic aneurysm screening can be safely performed in the office by family physicians who are trained to use point

  5. Automatic segmentation and measurements of gestational sac using static B-mode ultrasound images

    NASA Astrophysics Data System (ADS)

    Ibrahim, Dheyaa Ahmed; Al-Assam, Hisham; Du, Hongbo; Farren, Jessica; Al-karawi, Dhurgham; Bourne, Tom; Jassim, Sabah

    2016-05-01

    Ultrasound imagery has been widely used for medical diagnoses. Ultrasound scanning is safe and non-invasive, and hence used throughout pregnancy for monitoring growth. In the first trimester, an important measurement is that of the Gestation Sac (GS). The task of measuring the GS size from an ultrasound image is done manually by a Gynecologist. This paper presents a new approach to automatically segment a GS from a static B-mode image by exploiting its geometric features for early identification of miscarriage cases. To accurately locate the GS in the image, the proposed solution uses wavelet transform to suppress the speckle noise by eliminating the high-frequency sub-bands and prepare an enhanced image. This is followed by a segmentation step that isolates the GS through the several stages. First, the mean value is used as a threshold to binarise the image, followed by filtering unwanted objects based on their circularity, size and mean of greyscale. The mean value of each object is then used to further select candidate objects. A Region Growing technique is applied as a post-processing to finally identify the GS. We evaluated the effectiveness of the proposed solution by firstly comparing the automatic size measurements of the segmented GS against the manual measurements, and then integrating the proposed segmentation solution into a classification framework for identifying miscarriage cases and pregnancy of unknown viability (PUV). Both test results demonstrate that the proposed method is effective in segmentation the GS and classifying the outcomes with high level accuracy (sensitivity (miscarriage) of 100% and specificity (PUV) of 99.87%).

  6. Imaging late capsular block syndrome: ultrasound biomicroscopy versus Scheimpflug camera.

    PubMed

    Kucukevcilioglu, Murat; Hurmeric, Volkan; Erdurman, Fazıl Cuneyt; Ceylan, Osman Melih

    2011-11-01

    We describe 2 patients with late capsular block syndrome whose anterior chamber morphology was evaluated with ultrasound biomicroscopy and Scheimpflug imaging before and after neodymium:YAG laser capsulotomy. Pretreatment ultrasound biomicroscopy examination showed significant capsular bag distension in both patients. Scheimpflug imaging failed to capture the posterior capsule displaced far behind the intraocular lens. Automatic anterior chamber depth measurements were incorrect with Scheimpflug imaging in 1 patient. Ultrasound biomicroscopy seems to be superior to Scheimpflug imaging in eyes with extremely distended capsular bags. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Integrated medical school ultrasound: development of an ultrasound vertical curriculum.

    PubMed

    Bahner, David P; Adkins, Eric J; Hughes, Daralee; Barrie, Michael; Boulger, Creagh T; Royall, Nelson A

    2013-07-02

    Physician-performed focused ultrasonography is a rapidly growing field with numerous clinical applications. Focused ultrasound is a clinically useful tool with relevant applications across most specialties. Ultrasound technology has outpaced the education, necessitating an early introduction to the technology within the medical education system. There are many challenges to integrating ultrasound into medical education including identifying appropriately trained faculty, access to adequate resources, and appropriate integration into existing medical education curricula. As focused ultrasonography increasingly penetrates academic and community practices, access to ultrasound equipment and trained faculty is improving. However, there has remained the major challenge of determining at which level is integrating ultrasound training within the medical training paradigm most appropriate. The Ohio State University College of Medicine has developed a novel vertical curriculum for focused ultrasonography which is concordant with the 4-year medical school curriculum. Given current evidenced-based practices, a curriculum was developed which provides medical students an exposure in focused ultrasonography. The curriculum utilizes focused ultrasonography as a teaching aid for students to gain a more thorough understanding of basic and clinical science within the medical school curriculum. The objectives of the course are to develop student understanding in indications for use, acquisition of images, interpretation of an ultrasound examination, and appropriate decision-making of ultrasound findings. Preliminary data indicate that a vertical ultrasound curriculum is a feasible and effective means of teaching focused ultrasonography. The foreseeable limitations include faculty skill level and training, initial cost of equipment, and incorporating additional information into an already saturated medical school curriculum. Focused ultrasonography is an evolving concept in medicine

  8. Carotid intima-media thickness: ultrasound measurement, prognostic value and role in clinical practice.

    PubMed

    Nair, Satheesh Balakrishnan; Malik, Rayaz; Khattar, Rajdeep S

    2012-12-01

    Ultrasound measurement of carotid intima-media thickness (IMT) has become a valuable tool for detecting and monitoring progression of atherosclerosis and recently published recommendations provide guidance for proper standardisation of these measurements. Important determinants of carotid IMT include age, gender, systolic blood pressure, diabetes mellitus and serum cholesterol levels. Many studies have shown carotid IMT to correlate with the severity of coronary atherosclerosis assessed by CT coronary calcification scores, coronary angiography and intravascular ultrasound. Consistent with its correlation with cardiovascular risk factors and coronary artery disease, a meta-analysis of large observational studies has shown carotid IMT to be a strong predictor of future cardiovascular events. Moreover, in patients with established coronary artery disease a reduction in carotid IMT has been shown to translate into a reduction in future cardiovascular events. Consensus statements now also recommend carotid IMT measurements to further refine the prognostic assessment of patients traditionally considered to be at an intermediate risk of cardiovascular disease.

  9. Ultrasound non-invasive measurement of intracranial pressure in neurointensive care: A prospective observational study

    PubMed Central

    Cardim, Danilo; Tajsic, Tamara; Bulman, Michael; Lavinio, Andrea; Gupta, Arun; Hutchinson, Peter J. A.; Czosnyka, Marek

    2017-01-01

    Background The invasive nature of the current methods for monitoring of intracranial pressure (ICP) has prevented their use in many clinical situations. Several attempts have been made to develop methods to monitor ICP non-invasively. The aim of this study is to assess the relationship between ultrasound-based non-invasive ICP (nICP) and invasive ICP measurement in neurocritical care patients. Methods and findings This was a prospective, single-cohort observational study of patients admitted to a tertiary neurocritical care unit. Patients with brain injury requiring invasive ICP monitoring were considered for inclusion. nICP was assessed using optic nerve sheath diameter (ONSD), venous transcranial Doppler (vTCD) of straight sinus systolic flow velocity (FVsv), and methods derived from arterial transcranial Doppler (aTCD) on the middle cerebral artery (MCA): MCA pulsatility index (PIa) and an estimator based on diastolic flow velocity (FVd). A total of 445 ultrasound examinations from 64 patients performed from 1 January to 1 November 2016 were included. The median age of the patients was 53 years (range 37–64). Median Glasgow Coma Scale at admission was 7 (range 3–14), and median Glasgow Outcome Scale was 3 (range 1–5). The mortality rate was 20%. ONSD and FVsv demonstrated the strongest correlation with ICP (R = 0.76 for ONSD versus ICP; R = 0.72 for FVsv versus ICP), whereas PIa and the estimator based on FVd did not correlate with ICP significantly. Combining the 2 strongest nICP predictors (ONSD and FVsv) resulted in an even stronger correlation with ICP (R = 0.80). The ability to detect intracranial hypertension (ICP ≥ 20 mm Hg) was highest for ONSD (area under the curve [AUC] 0.91, 95% CI 0.88–0.95). The combination of ONSD and FVsv methods showed a statistically significant improvement of AUC values compared with the ONSD method alone (0.93, 95% CI 0.90–0.97, p = 0.01). Major limitations are the heterogeneity and small number of patients

  10. A Multidimensional Investigation of Children's /r/ Productions: Perceptual, Ultrasound, and Acoustic Measures

    ERIC Educational Resources Information Center

    Klein, Harriet B.; McAllister Byun, Tara; Davidson, Lisa; Grigos, Maria I.

    2013-01-01

    Purpose: This study explored relationships among perceptual, ultrasound, and acoustic measurements of children's correct and misarticulated /r/ sounds. Longitudinal data documenting changes across these parameters were collected from 2 children who acquired /r/ over a period of intervention and were compared with data from children with typical…

  11. VALIDATION OF ULTRASOUND AS A NONINVASIVE TOOL TO MEASURE SUBCUTANEOUS FAT DEPTH IN LEATHERBACK SEA TURTLES (DERMOCHELYS CORIACEA).

    PubMed

    Harris, Heather S; Benson, Scott R; James, Michael C; Martin, Kelly J; Stacy, Brian A; Daoust, Pierre-Yves; Rist, Paul M; Work, Thierry M; Balazs, George H; Seminoff, Jeffrey A

    2016-03-01

    Leatherback turtles (Dermochelys coriacea) undergo substantial cyclical changes in body condition between foraging and nesting. Ultrasonography has been used to measure subcutaneous fat as an indicator of body condition in many species but has not been applied in sea turtles. To validate this technique in leatherback turtles, ultrasound images were obtained from 36 live-captured and dead-stranded immature and adult turtles from foraging and nesting areas in the Pacific and Atlantic oceans. Ultrasound measurements were compared with direct measurements from surgical biopsy or necropsy. Tissue architecture was confirmed histologically in a subset of turtles. The dorsal shoulder region provided the best site for differentiation of tissues. Maximum fat depth values with the front flipper in a neutral (45-90°) position demonstrated good correlation with direct measurements. Ultrasound-derived fat measurements may be used in the future for quantitative assessment of body condition as an index of health in this critically endangered species.

  12. Validation of ultrasound as a noninvasive tool to measure subcutaneous fat depth in leatherback sea turtles (Dermochelys coriacea)

    USGS Publications Warehouse

    Harris, Heather S.; Benson, Scott R.; James, Michael C.; Martin, Kelly J.; Stacy, Brian A.; Daoust, Pierre-Yves; Rist, Paul M.; Work, Thierry M.; Balazs, George H.; Seminoff, Jeffrey A.

    2016-01-01

    Leatherback turtles (Dermochelys coriacea) undergo substantial cyclical changes in body condition between foraging and nesting. Ultrasonography has been used to measure subcutaneous fat as an indicator of body condition in many species but has not been applied in sea turtles. To validate this technique in leatherback turtles, ultrasound images were obtained from 36 live-captured and dead-stranded immature and adult turtles from foraging and nesting areas in the Pacific and Atlantic oceans. Ultrasound measurements were compared with direct measurements from surgical biopsy or necropsy. Tissue architecture was confirmed histologically in a subset of turtles. The dorsal shoulder region provided the best site for differentiation of tissues. Maximum fat depth values with the front flipper in a neutral (45–90°) position demonstrated good correlation with direct measurements. Ultrasound-derived fat measurements may be used in the future for quantitative assessment of body condition as an index of health in this critically endangered species.

  13. Has 4D transperineal ultrasound additional value over 2D transperineal ultrasound for diagnosing obstructed defaecation syndrome?

    PubMed

    van Gruting, I M A; Kluivers, K; Sultan, A H; De Bin, R; Stankiewicz, A; Blake, H; Thakar, R

    2018-06-08

    To establish the diagnostic test accuracy of both two-dimensional (2D) and four-dimensional (4D) transperineal ultrasound, to assess if 4D ultrasound imaging provides additional value in the diagnosis of posterior pelvic floor disorders in women with obstructed defaecation syndrome. In this prospective cohort study, 121 consecutive women with obstructed defaecation syndrome were recruited. Symptoms of obstructed defaecation and signs of pelvic organ prolapse were assessed using validated methods. All women underwent both 2D transperineal ultrasound (Pro-focus, 8802 transducer, BK-medical) and 4D transperineal ultrasound (Voluson i, RAB4-8-RS transducer, GE). Imaging analysis was performed by two blinded observers. Pelvic floor disorders were dichotomised into presence or absence according pre-defined cut-off values. In the absence of a reference standard a composite reference standard was created from a combination of results of evacuation proctogram, magnetic resonance imaging and endovaginal ultrasound. Primary outcome measures were diagnostic test characteristics of 2D and 4D transperineal ultrasound for diagnosis or rectocele, enterocele, intussusception and anismus. Secondary outcome measures were interobserver agreement, agreement between the two techniques and correlation of signs and symptoms to imaging findings. For diagnosis of all four posterior pelvic floor disorders there was no difference in sensitivity and specificity between 2D and 4D TPUS (p= 0.131 - 1.000). A good agreement between 2D and 4D TPUS was found for the diagnosis of rectocele (ĸ 0.675) and a moderate agreement for diagnosis of enterocele, intussusception and anismus (ĸ 0.465 - 0.545). There was no difference in rectocele depth measurements between both TPUS techniques (19.9 mm vs 19.0 mm, p=0.802). Inter-observer agreement was comparable for both techniques, however 2D TPUS had an excellent interobserver agreement for diagnosis of enterocele and rectocele depth measurements. Diagnosis

  14. The measurement of medial knee gap width using ultrasound.

    PubMed

    Slane, Laura C; Slane, Josh A; Scheys, Lennart

    2017-08-01

    Medial knee instability is a key clinical parameter for assessing ligament injury and arthroplasty success, but current methods for measuring stability are typically either qualitative or involve ionizing radiation. The purpose of this study was to perform a preliminary analysis of whether ultrasound (US) could be used as an alternate approach for quantifying medial instability by comparing an US method with an approach mimicking the current gold standard fluoroscopy method. US data from the medial knee were collected, while cadaveric lower limbs (n = 8) were loaded in valgus (10 Nm). During post-processing, the US gap width was measured by identifying the medial edges of the femur and tibia and computing the gap width between these points. For comparison, mimicked fluoroscopy (mFluoro) images were created from specimen-specific bone models, developed from segmented CT scans, and from kinematic data collected during testing. Then, gap width was measured in the mFluoro images based on two different published approaches with gap width measured either at the most medial or at the most distal aspect of the femur. Gap width increased significantly with loading (p < 0.001), and there were no significant differences between the US method (unloaded: 8.7 ± 2.4 mm, loaded: 10.7 ± 2.2 mm) and the mFluoro method that measured gap width at the medial femur. In terms of the change in gap width with load, no correlation with the change in abduction angle was observed, with no correlation between the various methods. Inter-rater reliability for the US method was high (0.899-0.952). Ultrasound shows promise as a suitable alternative for quantifying medial instability without radiation exposure. However, the outstanding limitations of existing approaches and lack of true ground-truth data require that further validation work is necessary to better understand the clinical viability of an US approach for measuring medial knee gap width.

  15. Reliability of measuring sciatic and tibial nerve movement with diagnostic ultrasound during a neural mobilisation technique.

    PubMed

    Ellis, Richard; Hing, Wayne; Dilley, Andrew; McNair, Peter

    2008-08-01

    Diagnostic ultrasound provides a technique whereby real-time, in vivo analysis of peripheral nerve movement is possible. This study measured sciatic nerve movement during a "slider" neural mobilisation technique (ankle dorsiflexion/plantar flexion and cervical extension/flexion). Transverse and longitudinal movement was assessed from still ultrasound images and video sequences by using frame-by-frame cross-correlation software. Sciatic nerve movement was recorded in the transverse and longitudinal planes. For transverse movement, at the posterior midthigh (PMT) the mean value of lateral sciatic nerve movement was 3.54 mm (standard error of measurement [SEM] +/- 1.18 mm) compared with anterior-posterior/vertical (AP) movement of 1.61 mm (SEM +/- 0.78 mm). At the popliteal crease (PC) scanning location, lateral movement was 6.62 mm (SEM +/- 1.10 mm) compared with AP movement of 3.26 mm (SEM +/- 0.99 mm). Mean longitudinal sciatic nerve movement at the PMT was 3.47 mm (SEM +/- 0.79 mm; n = 27) compared with the PC of 5.22 mm (SEM +/- 0.05 mm; n = 3). The reliability of ultrasound measurement of transverse sciatic nerve movement was fair to excellent (Intraclass correlation coefficient [ICC] = 0.39-0.76) compared with excellent (ICC = 0.75) for analysis of longitudinal movement. Diagnostic ultrasound presents a reliable, noninvasive, real-time, in vivo method for analysis of sciatic nerve movement.

  16. A New Ultrasound Pulser Technique for Wide Range Measurements

    NASA Astrophysics Data System (ADS)

    Salim, M. S.; Abd Malek, M. F.; Noaman, N. M.; Sabri, Naseer; Mohamed, Latifah; Juni, K. M.

    2013-04-01

    The objective of this research was to design and implement a new ultrasonic pulse-power-decay technique that transmits multiple ultrasound pulses through slurry to determine the lowest concentration that can provide an accurate attenuation measurement. A wide measurement range is obtained using the pulsed-power-decay transmission technique, and regardless of the material used to construct the container. A signal in the receiver transducer provides the attenuation measurements, for each echo, a fast Fourier transform (FFT) of the appropriate signal was obtained and compared with the water signals to yield the attenuation as a function of frequency. The data show the feasibility of measuring a kaolin concentration of 5% wt. When using a commercial pulser with the same device setting, no detectable echo was observed. Therefore, new technique measurements may prove useful in detecting solid content in liquid. This study demonstrated that the proposed pulsed-power transmission technique is promising for evaluating low concentrations of solids in fluids and for measuring sedimentation in solid-liquid systems.

  17. Thickening of the inferior glenohumeral capsule: an ultrasound sign for shoulder capsular contracture.

    PubMed

    Michelin, Paul; Delarue, Yohann; Duparc, Fabrice; Dacher, Jean Nicolas

    2013-10-01

    The aim of this retrospective study was to measure the inferior glenohumeral capsule thickness of shoulders clinically affected by capsular contracture by comparison to the contralateral asymptomatic side. Bilateral shoulder ultrasound (US) examinations of 20 patients with clinically or MRI proven unilateral capsular contracture were retrospectively assessed. Inferior capsule evaluation was performed with a transducer placed within the axilla in maximally abducted shoulders. Measurements were symmetrically performed orthogonally to the inferior glenohumeral ligament (IGHL) in the axial plane; the coronal plane was used to ensure the tension of the IGHL. The significance of any difference in thickening was assessed with the Mann-Whitney test. The average thickness was 4.0 mm in shoulders with capsular contracture vs. 1.3 mm in asymptomatic contralateral shoulders (P < 0.0001). Twenty per cent of patients with capsular contracture and inferior capsule thickness increase showed US features of other painful diseases of the rotator cuff. The thickness of the inferior capsule is measurable through ultrasound examination and appears to be increased in shoulders with capsular contracture. Exploration of the inferior aspect of the shoulder joint could be added to shoulder US examination protocols for capsular contracture assessment even if other rotator cuff abnormalities are diagnosed by US. • Ultrasound is increasingly used to diagnose shoulder problems. • The thickness of the inferior glenohumeral ligament is measurable in the axilla. • The inferior glenohumeral ligament appears thickened in shoulders with capsular contracture. • Capsular contracture ultrasound features can be associated with other rotator cuff problems.

  18. Fetal head detection and measurement in ultrasound images by a direct inverse randomized Hough transform

    NASA Astrophysics Data System (ADS)

    Lu, Wei; Tan, Jinglu; Floyd, Randall C.

    2005-04-01

    Object detection in ultrasound fetal images is a challenging task for the relatively low resolution and low signal-to-noise ratio. A direct inverse randomized Hough transform (DIRHT) is developed for filtering and detecting incomplete curves in images with strong noise. The DIRHT combines the advantages of both the inverse and the randomized Hough transforms. In the reverse image, curves are highlighted while a large number of unrelated pixels are removed, demonstrating a "curve-pass filtering" effect. Curves are detected by iteratively applying the DIRHT to the filtered image. The DIRHT was applied to head detection and measurement of the biparietal diameter (BPD) and head circumference (HC). No user input or geometric properties of the head were required for the detection. The detection and measurement took 2 seconds for each image on a PC. The inter-run variations and the differences between the automatic measurements and sonographers" manual measurements were small compared with published inter-observer variations. The results demonstrated that the automatic measurements were consistent and accurate. This method provides a valuable tool for fetal examinations.

  19. The Influence of the Manner of Performing the Thyroid Ultrasound Examination on the Reliability of the Assessment of the Thyroid Size in School-Aged Children.

    PubMed

    Zygmunt, Arkadiusz; Adamczewski, Zbigniew; Zygmunt, Agnieszka; Karbownik-Lewinska, Malgorzata; Lewinski, Andrzej

    2017-01-01

    Goitre incidence in school-aged children evaluated using ultrasonography is one of the essential indicators of iodine intake in a given area. The aim of the study was to examine what the difference is between the volume of the thyroid gland measured in the supine and sitting position and to determine the intra-observer, inter-observer, and inter-position variations. The survey was conducted among 87 children (56 girls and 31 boys aged 7-13 years, mean age 10.44 ± 1.72 years). The thyroid volume measured in a sitting position was significantly lower than that measured in the supine position. The intra-observer variations for the total thyroid volume equalled 9.56-9.65%. The inter-observer variations were significantly higher and amounted to 34.5-35.7%. The way in which ultrasound evaluation is performed is important for the analysis of the results. It is crucial to aim for the smallest inter-observer variation, which can be achieved by strictly defining the methods of the thyroid measurement and comparing one's measuring techniques with the reference method. The use of standards in ultrasound evaluation performed in the supine position, as well as the use of standards without a strict determination of the study method, can lead to erro-neous conclusions. © 2017 S. Karger AG, Basel.

  20. Point-of-Care Ultrasound: A Trend in Health Care.

    PubMed

    Buerger, Anita M; Clark, Kevin R

    2017-11-01

    To discuss the current and growing use of point-of-care (POC) ultrasound in the management and care of patients. Several electronic research databases were searched to find articles that emphasized the use of POC ultrasound by health care providers who manage and treat critically ill or injured patients. Thirty-five relevant peer-reviewed journal articles were selected for this literature review. Common themes identified in the literature included the use of POC ultrasound in emergency medicine, military medicine, and remote care; comparison of POC ultrasound to other medical imaging modalities; investigation of the education and training required for nonimaging health care professionals who perform POC ultrasound in their practices; and discussion of the financial implications and limitations of POC ultrasound. POC ultrasound provides clinicians with real-time information to better manage and treat critically ill or injured patients in emergency medicine, military medicine, and remote care. In addition to providing immediate bedside diagnostic information, use of POC ultrasound has increased because of concerns regarding radiation protection. Finally, the expansion of POC ultrasound to other specialty areas requires nonimaging health care professionals to perform bedside ultrasound examinations and interpret the resulting images. Because POC ultrasound is user-dependent, adequate training is essential for all who perform and interpret the examinations. Research involving POC ultrasound will continue as innovations and confidence in ultrasound applications advance. Future research should continue to examine the broad use of POC ultrasound in patient care and management. ©2017 American Society of Radiologic Technologists.

  1. Demonstration of movement in the sacroiliac joint using ultrasound

    NASA Astrophysics Data System (ADS)

    Krupinski, Elizabeth A.; Brooks, William J.; Lund, Pamela J.

    1995-05-01

    The goal of this study was to demonstrate quantitatively, using ultrasound (US) recording techniques, the extent of motion of the sacroiliac joint achieved using manual medicine techniques. Initial judgements of perceived (i.e., felt) SI mobility during manual examination were made on 22 subjects. Baseline no movement ultrasound images (static) were obtained of the left and right SI joints at two levels-- posterior-superior-iliac-spine and inferior (PSIS, INF)--and two projections (AP and LAT). Manual medicine spring testing of the SI joint was then performed while ultrasound recordings (on video) were made. The differences between baseline separation of the SI joint and displacement distance during spring testing were measured by six radiologists who typically read US images. Significant movement of at least one SI joint was demonstrated in 91% of the subjects using ultrasound recordings. The extent of movement appeared to corroborate the experience of manual medicine practitioners.

  2. Objective diagnosis of arrested labor on transperineal ultrasound.

    PubMed

    Nishimura, Kazuaki; Yoshimura, Kazuaki; Kubo, Tatsuhiko; Hachisuga, Toru

    2016-07-01

    Recent developments in transperineal ultrasound imaging of the pelvis have prompted trials to objectively evaluate labor progression for labor management. We evaluated the accuracy of transperineal ultrasound in diagnosing arrest of labor. Transperineal ultrasound and digital pelvic examinations were performed simultaneously in 63 term laboring patients (singleton fetuses in cephalic presentation). We analyzed a total of 216 ultrasound images (Sonography Volume Computer Aided Display Labor [Sono VCAD Labor®] installed in Voluson E8 ultrasound). We examined the correlation between the three ultrasound parameters head direction (HD), progression distance (PD), and progression angle (PA), and digital pelvic examination findings during labor in a transvaginal delivery group and an arrested labor group. The coefficient of correlations between HD/PD/PA and cervical dilation/fetal station were 0.667/0.657/0.706 and 0.667/0.751/0.803, respectively. The three parameters had strong correlations with digital pelvic examination (P < 0.05). In the 11 cases (17%) of cesarean section due to arrested labor, the position of the fetal head was visually unchanged on sequential ultrasound images. According to receiver operating characteristic curves, the significant cut-offs for HD, PD, and PA for arrested labor were 105° (P = 0.048), 35 mm (P = 0.048), and 120° (P = 0.001), respectively. Transperineal ultrasound imaging is helpful for objective evaluation of labor progression and the diagnosis of arrested labor. © 2016 Japan Society of Obstetrics and Gynecology.

  3. Anthropomorphic cardiac ultrasound phantom.

    PubMed

    Smith, S W; Rinaldi, J E

    1989-10-01

    A new phantom is described which simulates the human cardiac anatomy for applications in ultrasound imaging, ultrasound Doppler, and color-flow Doppler imaging. The phantom consists of a polymer left ventricle which includes a prosthetic mitral and aortic valve and is connected to a mock circulatory loop. Aerated tap water serves as a blood simulating fluid and ultrasound contrast medium within the circulatory loop. The left ventricle is housed in a Lexan ultrasound visualization chamber which includes ultrasound viewing ports and acoustic absorbers. A piston pump connected to the visualization chamber by a single port pumps degassed water within the chamber which in turn pumps the left ventricle. Real-time ultrasound images and Doppler studies measure flow patterns through the valves and within the left ventricle.

  4. Automated kidney morphology measurements from ultrasound images using texture and edge analysis

    NASA Astrophysics Data System (ADS)

    Ravishankar, Hariharan; Annangi, Pavan; Washburn, Michael; Lanning, Justin

    2016-04-01

    In a typical ultrasound scan, a sonographer measures Kidney morphology to assess renal abnormalities. Kidney morphology can also help to discriminate between chronic and acute kidney failure. The caliper placements and volume measurements are often time consuming and an automated solution will help to improve accuracy, repeatability and throughput. In this work, we developed an automated Kidney morphology measurement solution from long axis Ultrasound scans. Automated kidney segmentation is challenging due to wide variability in kidney shape, size, weak contrast of the kidney boundaries and presence of strong edges like diaphragm, fat layers. To address the challenges and be able to accurately localize and detect kidney regions, we present a two-step algorithm that makes use of edge and texture information in combination with anatomical cues. First, we use an edge analysis technique to localize kidney region by matching the edge map with predefined templates. To accurately estimate the kidney morphology, we use textural information in a machine learning algorithm framework using Haar features and Gradient boosting classifier. We have tested the algorithm on 45 unseen cases and the performance against ground truth is measured by computing Dice overlap, % error in major and minor axis of kidney. The algorithm shows successful performance on 80% cases.

  5. Internal Medicine Residents' Retention of Knowledge and Skills in Bedside Ultrasound.

    PubMed

    Town, James A; Bergl, Paul A; Narang, Akhil; McConville, John F

    2016-10-01

    The long-term retention of knowledge and skills in bedside ultrasound by internal medicine residents after ultrasound training is not well understood. We sought to determine whether knowledge and skills acquired from focused training in bedside ultrasound are retained over time, and whether retention is related to independent practice. We conducted a prospective observational trial of 101 internal medicine residents at an academic medical center who participated in a bedside ultrasound workshop followed by 12 months of independent practice. Performance was measured on image-based knowledge and skills assessment using direct observation, both before the workshop and 12 months later. Individual usage data were obtained along with a survey on attitudes toward bedside ultrasound. Participants' mean knowledge assessment score increased from a baseline of 63.7% to 84.5% immediately after training ( P  < .001). At 12 months, mean knowledge score fell to 73.0%, significantly different from both prior assessments ( P  < .001). Despite knowledge decline, the mean skills assessment score improved from a baseline of 30.5% to 50.4% at 12 months ( P  < .001). Residents reporting more ultrasound use (> 25 examinations) had higher scores in baseline knowledge and skills assessments than those with lower usage (< 25 examinations). Change in knowledge and image acquisition skills between assessments was equal in both subgroups. Residents' knowledge of ultrasound improved after brief training but decayed over time, whereas skills showed marginal improvement over the study, with minimal support. Growth and retention of ultrasound abilities were not impacted by usage rates.

  6. Internal Medicine Residents' Retention of Knowledge and Skills in Bedside Ultrasound

    PubMed Central

    Town, James A.; Bergl, Paul A.; Narang, Akhil; McConville, John F.

    2016-01-01

    ABSTRACT Background  The long-term retention of knowledge and skills in bedside ultrasound by internal medicine residents after ultrasound training is not well understood. Objective  We sought to determine whether knowledge and skills acquired from focused training in bedside ultrasound are retained over time, and whether retention is related to independent practice. Methods  We conducted a prospective observational trial of 101 internal medicine residents at an academic medical center who participated in a bedside ultrasound workshop followed by 12 months of independent practice. Performance was measured on image-based knowledge and skills assessment using direct observation, both before the workshop and 12 months later. Individual usage data were obtained along with a survey on attitudes toward bedside ultrasound. Results  Participants' mean knowledge assessment score increased from a baseline of 63.7% to 84.5% immediately after training (P < .001). At 12 months, mean knowledge score fell to 73.0%, significantly different from both prior assessments (P < .001). Despite knowledge decline, the mean skills assessment score improved from a baseline of 30.5% to 50.4% at 12 months (P < .001). Residents reporting more ultrasound use (> 25 examinations) had higher scores in baseline knowledge and skills assessments than those with lower usage (< 25 examinations). Change in knowledge and image acquisition skills between assessments was equal in both subgroups. Conclusions  Residents' knowledge of ultrasound improved after brief training but decayed over time, whereas skills showed marginal improvement over the study, with minimal support. Growth and retention of ultrasound abilities were not impacted by usage rates. PMID:27777666

  7. Clinical Utility of Ultrasound Measurements of Plantar Fascia Width and Cross-Sectional AreaA Novel Technique.

    PubMed

    Bisi-Balogun, Adebisi; Rector, Michael

    2017-09-01

    We sought to develop a standardized protocol for ultrasound (US) measurements of plantar fascia (PF) width and cross-sectional area (CSA), which may serve as additional outcome variables during US examinations of both healthy asymptomatic PF and in plantar fasciopathy and determine its interrater and intrarater reliability. Ten healthy individuals (20 feet) were enrolled. Participants were assessed twice by two raters each to determine intrarater and interrater reliability. For each foot, three transverse scans of the central bundle of the PF were taken at its insertion at the medial calcaneal tubercle, identified in real time on the plantar surface of the foot, using a fine wire technique. Reliability was determined using intraclass correlation coefficients (ICC), standard errors of measurement (SEM), and limits of agreement (LOA) expressed as percentages of the mean. Reliability of PF width and CSA measurements was determined using PF width and CSA measurements from one sonogram measured once and the mean of three measurements from three sonograms each measured once. Ultrasound measurements of PF width and CSA showed a mean of 18.6 ± 2.0 mm and 69.20 ± 13.6 mm 2 respectively. Intra-reliability within both raters showed an ICC > 0.84 for width and ICC > 0.92 for CSA as well as a SEM% and LOA% < 10% for both width and CSA. Inter-rater reliability showed an ICC of 0.82 for width and 0.87 for CSA as well as a SEM% and LOA% < 10% for width and a SEM% < 10% and LOA% < 20% for CSA. Relative and absolute reliability within and between raters were higher when using the mean of three sonographs compared to one sonograph. Using this novel technique, PF CSA and width may be determined reliably using measurements from one sonogram or the mean of three sonograms. Measurement of PF CSA and width in addition to already established thickness and echogenicity measurements provides additional information on structural properties of the PF for clinicians and researchers in healthy

  8. Comparative ultrasound measurement of normal thyroid gland dimensions in school aged children in our local environment.

    PubMed

    Marchie, T T; Oyobere, O; Eze, K C

    2012-01-01

    The objective of this study was to determine the measurement of normal range of ultrasound (US) thyroid gland dimensions in school-aged children (6-16 years) in our environment and compared with what is obtained elsewhere. A prospective ultrasound measurement study done in University of Benin Teaching Hospital Benin, Nigeria. A prospective ultrasound (US) study of thyroid dimensions of 500 school-aged children in our environment consisting of 227 boys and 273 girls was done from 1 December 2006 to July 2007. The subjects were examined by the authors and subjects with palpable abnormal thyroid gland were excluded from the study. The thyroid dimensions (length, height, and diameter) were taken for each lobe by means of ultrasound (US). In addition volume of each thyroid lobe was calculated and the summation of volume of the lobes was taken as thyroid gland volume of each subject. Also height and weight of patients were documented from which the subject's body surface was calculated. Incidental thyroid gland lesion in US was excluded from the study. Using the Statistical program of social science (SPSS) and INSTAT (Graph Pad Inc. USA) the data were analyzed. Informed consent was obtained from all the subjects and the study was done in line with the ethical guidelines of the centers. The US thyroid gland volume in school-aged children in Benin City from this study ranges between 1.17 cm 3 and 7.19 cm 3 , mean volume range of 1.76-4.95 cm 3 , median volume range of 1.73-4.73 cm 3 , and range of standard deviation from 0.39 cm 3 to 1.49 cm 3 . The average mean thyroid volume is 2.32 cm 3 with the following average dimensions; anteroposterior right lobe =1.06 cm, mediolateral right lobe = 1.01 cm and craniocaudal right lobe = 2.34 cm, and anteroposterior left lobe = 1.01 cm, mediolateral left lobe = 1.04 cm and craniocaudal left lobe = 2.41 cm for both boys and girls respectively. These data are significantly lower than data obtained by European based World Health

  9. Is it Time to Replace Physical Examination with a Hand-Held Ultrasound Device?

    PubMed Central

    Kaul, Sanjiv

    2014-01-01

    Attempts at using physical examination (PE) go back centuries, with inspection, palpation, and percussion being the mainstay of this approach until 2 centuries ago when the stethoscope was invented and auscultation became probably the most important element of PE for patients with known or suspected cardiovascular disease (CVD). Despite its several limitations, PE is still used, sometimes as the only means, of evaluating and following patients with CVD. In this paper I shall argue for the substitution of this inaccurate and archaic approach by direct visualization of the heart using a hand-held ultrasound (HHU) device. I am not in any way suggesting the substitution of a comprehensive echocardiographic examination by an expert sonographer/echocardiographer by HHU in patients with significant CVD. Instead, I am arguing for the replacement of PE for evaluation of the heart at the point of care as well as at the bedside, simply because HHU is more accurate and provides more meaningful information. PMID:28465916

  10. Is it Time to Replace Physical Examination with a Hand-Held Ultrasound Device?

    PubMed

    Kaul, Sanjiv

    2014-01-01

    Attempts at using physical examination (PE) go back centuries, with inspection, palpation, and percussion being the mainstay of this approach until 2 centuries ago when the stethoscope was invented and auscultation became probably the most important element of PE for patients with known or suspected cardiovascular disease (CVD). Despite its several limitations, PE is still used, sometimes as the only means, of evaluating and following patients with CVD. In this paper I shall argue for the substitution of this inaccurate and archaic approach by direct visualization of the heart using a hand-held ultrasound (HHU) device. I am not in any way suggesting the substitution of a comprehensive echocardiographic examination by an expert sonographer/echocardiographer by HHU in patients with significant CVD. Instead, I am arguing for the replacement of PE for evaluation of the heart at the point of care as well as at the bedside, simply because HHU is more accurate and provides more meaningful information.

  11. Utility of Computed Tomography versus Abdominal Ultrasound Examination to Identify Iliosacral Lymphadenomegaly in Dogs with Apocrine Gland Adenocarcinoma of the Anal Sac.

    PubMed

    Palladino, S; Keyerleber, M A; King, R G; Burgess, K E

    2016-11-01

    Apocrine gland adenocarcinoma of the anal sac (AGAAS) is associated with high rates of iliosacral lymph node metastasis, which may influence treatment and prognosis. Magnetic resonance imaging (MRI) recently has been shown to be more sensitive than abdominal ultrasound examination (AUS) in affected patients. To compare the rate of detection of iliosacral lymphadenomegaly between AUS and computed tomography (CT) in dogs with AGAAS. Cohort A: A total of 30 presumed normal dogs. Cohort B: A total of 20 dogs with AGAAS that underwent AUS and CT. Using cohort A, mean normalized lymph node : aorta (LN : AO) ratios were established for medial iliac, internal iliac, and sacral lymph nodes. The CT images in cohort B then were reviewed retrospectively and considered enlarged if their LN : AO ratio measured 2 standard deviations above the mean normalized ratio for that particular node in cohort A. Classification and visibility of lymph nodes identified on AUS were compared to corresponding measurements obtained on CT. Computed tomography identified lymphadenomegaly in 13 of 20 AGAAS dogs. Of these 13 dogs, AUS correctly identified and detected all enlarged nodes in only 30.8%, and either misidentified or failed to detect additional enlarged nodes in the remaining dogs. Despite limitations in identifying enlargement in all affected lymph nodes, AUS identified at least 1 enlarged node in 100% of affected dogs. Abdominal ultrasound examination is an effective screening test for lymphadenomegaly in dogs with AGAAS, but CT should be considered in any patient in which an additional metastatic site would impact therapeutic planning. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  12. Breast density measurements using ultrasound tomography for patients undergoing tamoxifen treatment

    NASA Astrophysics Data System (ADS)

    Sak, Mark; Duric, Neb; Littrup, Peter; Li, Cuiping; Bey-Knight, Lisa; Sherman, Mark; Boyd, Norman; Gierach, Gretchen

    2013-03-01

    Women with high breast density have an increased risk of developing breast cancer. Women treated with the selective estrogen receptor modulator tamoxifen for estrogen receptor positive breast cancer experience a 50% reduction in risk of contralateral breast cancer and overall reduction of similar magnitude has been identified among high-risk women receiving the drug for prevention. Tamoxifen has been shown to reduce mammographic density, and in the IBIS-1 chemoprevention trial, risk reduction and decline in density were significantly associated. Ultrasound tomography (UST) is an imaging modality that can create tomographic sound speed images of the breast. These sound speed images are useful because breast density is proportional to sound speed. The aim of this work is to examine the relationship between USTmeasured breast density and the use of tamoxifen. So far, preliminary results for a small number of patients have been observed and are promising. Correlations between the UST-measured density and mammographic density are strong and positive, while relationships between UST density with some patient specific risk factors behave as expected. Initial results of UST examinations of tamoxifen treated patients show that approximately 45% of the patients have a decrease in density in the contralateral breast after only several months of treatment. The true effect of tamoxifen on UST-measured density cannot yet be fully determined until more data are collected. However, these promising results suggest that UST can be used to reliably assess quantitative changes in breast density over short intervals and therefore suggest that UST may enable rapid assessment of density changes associated with therapeutic and preventative interventions.

  13. The influence of dairy consumption and physical activity on ultrasound bone measurements in Flemish children.

    PubMed

    De Smet, Stephanie; Michels, Nathalie; Polfliet, Carolien; D'Haese, Sara; Roggen, Inge; De Henauw, Stefaan; Sioen, Isabelle

    2015-03-01

    The study's aim was to analyse whether children's bone status, assessed by calcaneal ultrasound measurements, is influenced by dairy consumption and objectively measured physical activity (PA). Moreover, the interaction between dairy consumption and PA on bone mass was studied. Participants of this cross-sectional study were 306 Flemish children (6-12 years). Body composition was measured with air displacement plethysmography (BodPod), dairy consumption with a Food Frequency Questionnaire, PA with an accelerometer (only in 234 of the 306 children) and bone mass with quantitative ultrasound, quantifying speed of sound (SOS), broadband ultrasound attenuation (BUA) and Stiffness Index (SI). Regression analyses were used to study the associations between dairy consumption, PA, SOS, BUA and SI. Total dairy consumption and non-cheese dairy consumption were positively associated with SOS and SI, but no significant association could be demonstrated with BUA. In contrast, milk consumption, disregarding other dairy products, had no significant effect on calcaneal bone measurements. PA [vigorous PA, moderate to vigorous physical activity (MVPA) and counts per minute] was positively associated and sedentary time was negatively associated with BUA and SI, but no significant influence on SOS could be detected. Dairy consumption and PA (sedentary time and MVPA) did not show any interaction influencing bone measurements. In conclusion, even at young age, PA and dairy consumption positively influence bone mass. Promoting PA and dairy consumption in young children may, therefore, maximize peak bone mass, an important protective factor against osteoporosis later in life.

  14. A system for real-time measurement of the brachial artery diameter in B-mode ultrasound images.

    PubMed

    Gemignani, Vincenzo; Faita, Francesco; Ghiadoni, Lorenzo; Poggianti, Elisa; Demi, Marcello

    2007-03-01

    The measurement of the brachial artery diameter is frequently used in clinical studies for evaluating the flow-mediated dilation and, in conjunction with the blood pressure value, for assessing arterial stiffness. This paper presents a system for computing the brachial artery diameter in real-time by analyzing B-mode ultrasound images. The method is based on a robust edge detection algorithm which is used to automatically locate the two walls of the vessel. The measure of the diameter is obtained with subpixel precision and with a temporal resolution of 25 samples/s, so that the small dilations induced by the cardiac cycle can also be retrieved. The algorithm is implemented on a standalone video processing board which acquires the analog video signal from the ultrasound equipment. Results are shown in real-time on a graphical user interface. The system was tested both on synthetic ultrasound images and in clinical studies of flow-mediated dilation. Accuracy, robustness, and intra/inter observer variability of the method were evaluated.

  15. The Use of B-Mode Ultrasound for Measuring Subcutaneous Fat Thickness on the Upper Arms.

    ERIC Educational Resources Information Center

    Weiss, Lawrence W.; Clark, Frank C.

    1985-01-01

    A study was carried out to investigate the potential use of B-mode ultrasound for measuring subcutaneous fat thickness at two arm sites. B-mode sonograms and skinfold measurements were found to be highly correlated for both men and women. (Author/MT)

  16. What is ultrasound?

    PubMed

    Leighton, Timothy G

    2007-01-01

    This paper is based on material presented at the start of a Health Protection Agency meeting on ultrasound and infrasound. In answering the question 'what is ultrasound?', it shows that the simple description of a wave which transports mechanical energy through the local vibration of particles at frequencies of 20 kHz or more, with no net transport of the particles themselves, can in every respect be misleading or even incorrect. To explain the complexities responsible for this, the description of ultrasound is first built up from the fundamental properties of these local particle vibrations. This progresses through an exposition of the characteristics of linear waves, in order to explain the propensity for, and properties of, the nonlinear propagation which occurs in many practical ultrasonic fields. Given the Health Protection environment which framed the original presentation, explanation and examples are given of how these complexities affect issues of practical importance. These issues include the measurement and description of fields and exposures, and the ability of ultrasound to affect tissue (through microstreaming, streaming, cavitation, heating, etc.). It is noted that there are two very distinct regimes, in terms of wave characteristics and potential for bioeffect. The first concerns the use of ultrasound in liquids/solids, for measurement or material processing. For biomedical applications (where these two processes are termed diagnosis and therapy, respectively), the issue of hazard has been studied in depth, although this has not been done to such a degree for industrial uses of ultrasound in liquids/solids (sonar, non-destructive testing, ultrasonic processing etc.). However, in the second regime, that of the use of ultrasound in air, although the waves in question tend to be of much lower intensities than those used in liquids/solids, there is a greater mismatch between the extent to which hazard has been studied, and the growth in commercial

  17. Measurement of pulmonary transit time in healthy cats by use of ultrasound contrast media "Sonovue®": feasibility, reproducibility, and values in 42 cats.

    PubMed

    Streitberger, Andrea; Hocke, Verena; Modler, Peter

    2013-09-01

    To evaluate the feasibility of measuring pulmonary transit time (PTT) in healthy cats by transthoracic echocardiography using the ultrasound contrast agent Sonovue(®). To determine normalized PTT (nPTT) values in 42 healthy cats and to estimate the interobserver variability and the within-day repeatability of nPTT measurements. Forty-two privately owned healthy cats of different breeds, gender and age presented for cardiac examination. A bolus injection of contrast agent (Sonovue(®)) was administered intravenously. The right parasternal short axis echocardiographic view was used to record the contrast agent's transit time from the pulmonary artery to the left atrium. Pulmonary transit time and nPTT were determined independently by three examiners with different levels of experience. Normalized PTT was 4.12 ± 1.0 (mean ± SD) in our population. The median interobserver variability across our population was 6.8%, the median within-day variability for the three observers were 13.1%, 12.7% and 13%. No effect of the observer's experience on nPTT measurement was identified. Age, sex and body weight did not significantly influence nPTT. This study demonstrates that nPTT measurement is feasible in cats using ultrasound and the blood pool contrast media Sonovue(®). Measurements of nPTT can be performed in a clinical setting. Normalized PTT values in healthy cats are comparable with those reported in healthy dogs. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Office-based ultrasound screening for abdominal aortic aneurysm.

    PubMed

    Blois, Beau

    2012-03-01

    To assess the efficacy of an office-based, family physician–administered ultrasound examination to screen for abdominal aortic aneurysm (AAA). A prospective observational study. Consecutive patients were approached by nonphysician staff. Rural family physician offices in Grand Forks and Revelstoke, BC. The Canadian Society for Vascular Surgery screening recommendations for AAA were used to help select patients who were at risk of AAA. All men 65 years of age or older were included. Women 65 years of age or older were included if they were current smokers or had diabetes, hypertension, a history of coronary artery disease, or a family history of AAA. A focused “quick screen”, which measured the maximal diameter of the abdominal aorta using point-of-care ultrasound technology, was performed in the office by a resident physician trained in emergency ultrasonography. Each patient was then booked for a criterion standard scan (i.e., a conventional abdominal ultrasound scan performed by a technician and interpreted by a radiologist). The maximal abdominal aortic diameter measured by ultrasound in the office was compared with that measured by the criterion standard method. The time to screen each patient was recorded. Forty-five patients were included in data analysis; 62% of participants were men. The mean age was 73 years. The mean pairwise difference between the office-based ultrasound scan and the criterion standard scan was not statistically significant. The mean absolute difference between the 2 scans was 0.20 cm (95% CI 0.15 to 0.25 cm). Correlation between the scans was 0.81. The office-based ultrasound scan had both a sensitivity and a specificity of 100%. The mean time to screen each patient was 212 seconds (95% CI 194 to 230 seconds). Abdominal aortic aneurysm screening can be safely performed in the office by family physicians who are trained to use point-of- care ultrasound technology. The screening test can be completed within the time constraints of a

  19. Contrast-enhanced and targeted ultrasound.

    PubMed

    Postema, Michiel; Gilja, Odd Helge

    2011-01-07

    Ultrasonic imaging is becoming the most popular medical imaging modality, owing to the low price per examination and its safety. However, blood is a poor scatterer of ultrasound waves at clinical diagnostic transmit frequencies. For perfusion imaging, markers have been designed to enhance the contrast in B-mode imaging. These so-called ultrasound contrast agents consist of microscopically small gas bubbles encapsulated in biodegradable shells. In this review, the physical principles of ultrasound contrast agent microbubble behavior and their adjustment for drug delivery including sonoporation are described. Furthermore, an outline of clinical imaging applications of contrast-enhanced ultrasound is given. It is a challenging task to quantify and predict which bubble phenomenon occurs under which acoustic condition, and how these phenomena may be utilized in ultrasonic imaging. Aided by high-speed photography, our improved understanding of encapsulated microbubble behavior will lead to more sophisticated detection and delivery techniques. More sophisticated methods use quantitative approaches to measure the amount and the time course of bolus or reperfusion curves, and have shown great promise in revealing effective tumor responses to anti-angiogenic drugs in humans before tumor shrinkage occurs. These are beginning to be accepted into clinical practice. In the long term, targeted microbubbles for molecular imaging and eventually for directed anti-tumor therapy are expected to be tested.

  20. Contrast-enhanced and targeted ultrasound

    PubMed Central

    Postema, Michiel; Gilja, Odd Helge

    2011-01-01

    Ultrasonic imaging is becoming the most popular medical imaging modality, owing to the low price per examination and its safety. However, blood is a poor scatterer of ultrasound waves at clinical diagnostic transmit frequencies. For perfusion imaging, markers have been designed to enhance the contrast in B-mode imaging. These so-called ultrasound contrast agents consist of microscopically small gas bubbles encapsulated in biodegradable shells. In this review, the physical principles of ultrasound contrast agent microbubble behavior and their adjustment for drug delivery including sonoporation are described. Furthermore, an outline of clinical imaging applications of contrast-enhanced ultrasound is given. It is a challenging task to quantify and predict which bubble phenomenon occurs under which acoustic condition, and how these phenomena may be utilized in ultrasonic imaging. Aided by high-speed photography, our improved understanding of encapsulated microbubble behavior will lead to more sophisticated detection and delivery techniques. More sophisticated methods use quantitative approaches to measure the amount and the time course of bolus or reperfusion curves, and have shown great promise in revealing effective tumor responses to anti-angiogenic drugs in humans before tumor shrinkage occurs. These are beginning to be accepted into clinical practice. In the long term, targeted microbubbles for molecular imaging and eventually for directed anti-tumor therapy are expected to be tested. PMID:21218081

  1. Physics and instrumentation of ultrasound.

    PubMed

    Lawrence, John P

    2007-08-01

    A thorough understanding of the physics of ultrasound waves and the instrumentation will provide the user with a better understanding of the capabilities and limitations of ultrasound equipment. The ultrasound machine combines two technologies: image production (M-mode and 2-dimensional imaging) with Doppler assessment (continuous and pulse wave as well as color-flow mapping). These distinct technologies have been combined to provide the examiner with the ability to make accurate and comprehensive diagnoses and guide therapeutic intervention.

  2. Ultrasound is a reproducible and valid tool for measuring scar height in children with burn scars: A cross-sectional study of the psychometric properties and utility of the ultrasound and 3D camera.

    PubMed

    Simons, M; Kee, E Gee; Kimble, R; Tyack, Z

    2017-08-01

    The aim of this study was to investigate the reproducibility and validity of measuring scar height in children using ultrasound and 3D camera. Using a cross-sectional design, children with discrete burn scars were included. Reproducibility was tested using Intraclass Correlation Coefficient (ICC) for reliability, and percentage agreement within 1mm between test and re-test, standard error of measurement (SEM), smallest detectable change (SDC) and Bland Altman limits of agreement for agreement. Concurrent validity was tested using Spearman's rho for support of pre-specified hypotheses. Forty-nine participants (55 scars) were included. For ultrasound, test-retest and inter-rater reproducibility of scar thickness was acceptable for scarred skin (ICC=0.95, SDC=0.06cm and ICC=0.82, SDC=0.14cm). The ultrasound picked up changes of <1mm. Inter-rater reproducibility of maximal scar height using the 3D camera was acceptable (ICC=0.73, SDC=0.55cm). Construct validity of the ultrasound was supported with a strong correlation between the measure of scar thickness and observer ratings of thickness using the POSAS (ρ=0.61). Construct validity of the 3D camera was also supported with a moderate correlation (ρ=0.37) with the same measure using maximal scar height. The ultrasound is capable of detecting smaller changes or differences in scar thickness than the 3D camera, in children with burn scars. However agreement as part of reproducibility was lower than expected between raters for the ultrasound. Improving the accuracy of scar relocation may go some way to address agreement. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  3. Feasibility of Quantitative Ultrasound Measurement of the Heel Bone in People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Mergler, S.; Lobker, B.; Evenhuis, H. M.; Penning, C.

    2010-01-01

    Low bone mineral density (BMD) and fractures are common in people with intellectual disabilities (ID). Reduced mobility in case of motor impairment and the use of anti-epileptic drugs contribute to the development of low BMD. Quantitative ultrasound (QUS) measurement of the heel bone is a non-invasive and radiation-free method for measuring bone…

  4. [Apple-Macintosh compatible software for documentation, management and evaluation of ultrasound findings in obstetrics].

    PubMed

    Kurmanavicius, J; Huch, R; Huch, A

    1993-02-01

    The advantage of using a computer to automate routine calculations and print out charts of the obstetrical ultrasound examination is obvious. This report describes a software designed to simplify the documentation and analysis of ultrasound data in obstetrics. The system is easy to use, even for persons with little computer knowledge. The programme was written in FoxBase+/Mac (Fox Software, Inc., USA). FoxBase+/Mac takes full advantage of the easy-to-learn, easy-to-use Macintosh interface and is also very fast. Another advantage of this software is that it can be used in teaching. Non-experienced examinators can double-check the correctness of their scanning planes by observing the ultrasound pictures with the markers indicating the right measurement sites and the lists of standard values of biometrical parameters for the corresponding gestational age on the screen. In routine obstetrical ultrasound examinations it takes less than 5 min to enter the foetal biometry data and print out reports. These reports are informative and easy to interpret.

  5. Non-contact and through-clothing measurement of the heart rate using ultrasound vibrocardiography.

    PubMed

    Jeger-Madiot, Nathan; Gateau, Jérôme; Fink, Mathias; Ing, Ros-Kiri

    2017-12-01

    We present a novel non-contact system for monitoring the heart rate on human subjects with clothes. Our approach is based on vibrocardiography, and measures locally skin displacements. Vibrocardiography with a laser Doppler vibrometer already allows monitoring of this vital sign, but can only be used on bare skin and requires an expensive piece of equipment. We propose here to use an airborne pulse-Doppler ultrasound system operating in the 20-60 kHz range, and comprised of an emitter focusing the ultrasound pulses on skin and a microphone recording the reflected waves. Our implementation was validated in vitro and on two healthy human subjects, using simultaneously laser vibrocardiography and electrocardiography as references. Accurate measurements of the heart rate on clothed skin suggest that our non-contact ultrasonic method could be implemented both inside and outside the clinical environment, and therefore benefit both medical and safety applications. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

  6. Prospective cohort study of ultrasound-ultrasound and ultrasound-MR enterography agreement in the evaluation of pediatric small bowel Crohn disease.

    PubMed

    Dillman, Jonathan R; Smith, Ethan A; Sanchez, Ramon; DiPietro, Michael A; Dehkordy, Soudabeh Fazeli; Adler, Jeremy; DeMatos-Maillard, Vera; Khalatbari, Shokoufeh; Davenport, Matthew S

    2016-04-01

    There is a paucity of published literature describing ultrasound (US)-US and US-MR enterography (MRE) inter-radiologist agreement in pediatric small bowel Crohn disease. To prospectively assess US-US and US-MRE inter-radiologist agreement in pediatric small bowel Crohn disease. Institutional Review Board approval and informed consent/assent were obtained for this HIPAA-compliant prospective cohort study of children with newly diagnosed distal small bowel Crohn disease (July 2012 to December 2014). Enrolled subjects (n = 29) underwent two small bowel US examinations performed by blinded independent radiologists both before and at multiple time points after initiation of medical therapy (231 unique US examinations, in total); 134 US examinations were associated with concurrent MRE. The MRE examination was interpreted by a third blinded radiologist. The following was documented on each examination: involved length of ileum (cm); maximum bowel wall thickness (mm); amount of bowel wall and mesenteric Doppler signal, and presence of stricture, penetrating disease and/or abscess. Inter-radiologist agreement was assessed with single-measure, three-way, mixed-model intra-class correlation coefficients (ICC) and prevalence-adjusted, bias-adjusted kappa statistics (κ). Numbers in brackets are 95% confidence intervals. Ultrasound-US agreement was moderate for involved length (ICC: 0.41 [0.35-0.49]); substantial for maximum bowel wall thickness (ICC: 0.67 [0.64-0.70]); moderate for bowel wall Doppler signal (ICC: 0.53 [0.48-0.59]); slight for mesenteric Doppler signal (ICC: 0.25 [0.18-0.42]), and moderate to almost perfect for stricture (κ: 0.54), penetrating disease (κ: 0.80), and abscess (κ: 0.96). US-MRE agreement was moderate for involved length (ICC: 0.42 [0.37-0.49]); substantial for maximum bowel wall thickness (ICC: 0.66 [0.65-0.69]), and substantial to almost perfect for stricture (κ: 0.61), penetrating disease (κ: 0.72) and abscess (κ: 0.88). Ultrasound

  7. Can activity within the external abdominal oblique be measured using real-time ultrasound imaging?

    PubMed

    John, E K; Beith, I D

    2007-11-01

    Differences in the function of the anterolateral abdominal muscles have been the subject of much investigation, but primarily using electromyography. Recently changes in thickness of transversus abdominis and internal oblique measured from real-time ultrasound images have been shown to represent activity within these muscles. However it is still unclear if such a change in thickness in external oblique similarly represents activity within that muscle. The purpose of this study was to investigate the relationship between change in thickness and muscle activity in the external oblique using real-time ultrasound and surface electromyography. Simultaneous measurements of electromyography and real-time ultrasound images of external oblique were studied in up to 24 subjects during two tasks compared to the muscle at rest (1) isometric trunk rotation and (2) drawing in the lower abdomen. Changes in muscle thickness correlated significantly with electromyography during isometric trunk rotation in the majority of subjects but with a significant difference between subjects. In contrast, the relationship between change in thickness and electrical activity in the muscle when drawing in the lower abdomen was significant in less than 50% of subjects and the muscle often got thinner. Thickness changes of external oblique can be used as a valid indicator of electromyography activity during isometric trunk rotation, though the relationship is not as good as previously published data for transversus abdominis. Thickness changes of external oblique measured during lower abdominal drawing in cannot be used to detect activity within this muscle.

  8. [Ultrasound in monitoring of the second stage of labour].

    PubMed

    Fouché, C J; Simon, E G; Potin, J; Perrotin, F

    2012-11-01

    In the second stage of labor, fetal head rotation and fetal head position are determinant for the management of labor to attempt a vaginal delivery or a cesarean section. However, digital examination is highly subjective. Nowadays, delivery rooms are often equipped with compact and high performance ultrasound systems. The clinical examination can be easily completed by quantified and reproducible methods. Transabdominal ultrasonography is a well-known and efficient way to determine the fetal head position. Nevertheless, ultrasound approach to assess fetal head descent is less widespread. We can use translabial or transperineal way to evaluate fetal head position. We describe precisely two different types of methods: the linear methods (3 different types) and the angles of progression (4 different types of measurement). Among all those methods, the main pelvic landmarks are the symphysis pubis and the fetal skull. The angle of progression appears promising but the assessment was restricted to occipitoanterior fetal position cases. In the coming years, ultrasound will likely play a greater role in the management of labor. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  9. In-vivo fetal ultrasound exposimetry.

    PubMed

    Daft, C W; Siddiqi, T A; Fitting, D W; Meyer, R A; O'Brien, W R

    1990-01-01

    An instrument has been developed to measure the acoustic pressure field in vivo during an obstetric ultrasound examination. This provides for improved intensity values for exposure calculations, to assist in assessment of bioeffects. The ultrasonic field is sampled using a calibrated seven-element linear array hydrophone of poly(vinylidene difluoride) transducers, which is placed as close as possible to the ovary, embryo, or fetus using a vaginal approach. The RF signals from the hydrophone are digitized at 50 MHz, and the maximum amplitude waveform received in the examination is recorded. The output of the clinical B-scanner is calibrated by a measurement with the hydrophone in a water bath. From the hydrophone measurements, the in vivo I(SPTA), I(SPTP), and I(SPPA) are computed. Further analysis allows the frequency-dependent tissue attenuation to be assessed.

  10. Ultrasound measurements of live and carcass traits in Tswana goat kids raised under semi-intensive system in South-eastern Botswana.

    PubMed

    Monau, Phetogo Ineeleng; Nsoso, Shalaulani James; Waugh, Esau Emmanuel; Sharma, Surender Pal

    2013-03-01

    The aim of this study was to characterise ultrasound measurements of live and carcass traits in intact males, females and castrated Tswana goat kids from birth to 12 months of age raised under semi-intensive system in South-eastern Botswana. Measurements were recorded in 15 castrates, 15 intact males and 15 female Tswana goat kids randomly selected at birth. Ultrasonic fat and muscle depths were measured at the first, third/fourth, sixth/seventh, ninth/tenth and 12th/13th thoracic; first, third and fifth lumbar and first, second/third and fourth/fifth sternal vertebrae, fortnightly for the first 6 months and then monthly for the remaining 6 months. The animals were stunned and humanely slaughtered at 12 months of age, and ultrasound and shatterproof ruler were used to measure fat and muscle depths on the carcasses at similar sites as on live animals. A real-time B-mode ultrasound scanner fitted with LV2-1 probe operating at 7.5 MHz (Explorer V5 Vet Laptop B-Ultrasonic Scanner UMC Technology Development Co., Ltd, China) was used to predict ultrasound measurements on live animals and their carcasses. Data were analysed using general linear model in statistical analysis system. Muscle depth measurements increased significantly (p < 0.05) with age in all sites of measurements. However, there was no significant difference between the sexes at different sites of muscle depth measurements at the same age. Muscle depth at the sternal vertebrae was significantly deeper (almost 55 mm at 12 months of age) than 16 mm at thoracic and 16 mm at lumbar vertebrae at 12 and 8 months of age, respectively. No subcutaneous fat depth measurements were recorded in the lumbar vertebrae (0.00 ± 0.00) and the thoracic (0.00 ± 0.00) regions in all sex groups. However, fourth and fifth sternal vertebrae showed considerably deeper amount of subcutaneous fat suitable for taking fat measurements as age increases (2.07 ± 0.23 mm females, 1.50 ± 0.43 mm intact

  11. Ultrasound-enhanced bioscouring of greige cotton: regression analysis of process factors

    USDA-ARS?s Scientific Manuscript database

    Ultrasound-enhanced bioscouring process factors for greige cotton fabric are examined using custom experimental design utilizing statistical principles. An equation is presented which predicts bioscouring performance based upon percent reflectance values obtained from UV-Vis measurements of rutheniu...

  12. Ultrasound field measurement using a binary lens

    PubMed Central

    Clement, G.T.; Nomura, H.; Kamakura, T.

    2014-01-01

    Field characterization methods using a scattering target in the absence of a point-like receiver have been well described in which scattering is recorded by a relatively large receiver located outside the field of measurement. Unfortunately, such methods are prone to artifacts due to averaging across the receiver surface. To avoid this problem while simultaneously increasing the gain of a received signal, the present study introduces a binary plate lens designed to focus spherically-spreading waves onto a planar region having a nearly-uniform phase proportional to that of the target location. The lens is similar to a zone plate, but modified to produce a biconvex-like behavior, such that it focuses both planar and spherically spreading waves. A measurement device suitable for characterizing narrowband ultrasound signals in air is designed around this lens by coupling it to a target and planar receiver. A prototype device is constructed and used to characterize the field of a highly-focused 400 kHz air transducer along 2 radial lines. Comparison of the measurements with numeric predictions formed from nonlinear acoustic simulation showed good relative pressure correlation, with mean differences of 10% and 12% over center 3dB FWHM drop and 12% and 17% over 6dB. PMID:25643084

  13. Ultrasound Assessment of Human Meniscus.

    PubMed

    Viren, Tuomas; Honkanen, Juuso T; Danso, Elvis K; Rieppo, Lassi; Korhonen, Rami K; Töyräs, Juha

    2017-09-01

    The aim of the present study was to evaluate the applicability of ultrasound imaging to quantitative assessment of human meniscus in vitro. Meniscus samples (n = 26) were harvested from 13 knee joints of non-arthritic human cadavers. Subsequently, three locations (anterior, center and posterior) from each meniscus were imaged with two ultrasound transducers (frequencies 9 and 40 MHz), and quantitative ultrasound parameters were determined. Furthermore, partial-least-squares regression analysis was applied for ultrasound signal to determine the relations between ultrasound scattering and meniscus integrity. Significant correlations between measured and predicted meniscus compositions and mechanical properties were obtained (R 2  = 0.38-0.69, p < 0.05). The relationship between conventional ultrasound parameters and integrity of the meniscus was weaker. To conclude, ultrasound imaging exhibited a potential for evaluation of meniscus integrity. Higher ultrasound frequency combined with multivariate analysis of ultrasound backscattering was found to be the most sensitive for evaluation of meniscus integrity. Copyright © 2017 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  14. Reproducibility and interoperator reliability of obtaining images and measurements of the cervix and uterus with brachytherapy treatment applicators in situ using transabdominal ultrasound.

    PubMed

    van Dyk, Sylvia; Garth, Margaret; Oates, Amanda; Kondalsamy-Chennakesavan, Srinivas; Schneider, Michal; Bernshaw, David; Narayan, Kailash

    2016-01-01

    To validate interoperator reliability of brachytherapy radiation therapists (RTs) in obtaining an ultrasound image and measuring the cervix and uterine dimensions using transabdominal ultrasound. Patients who underwent MRI with applicators in situ after the first insertion were included in the study. Imaging was performed by three RTs (RT1, RT2, and RT3) with varying degrees of ultrasound experience. All RTs were required to obtain a longitudinal planning image depicting the applicator in the uterine canal and measure the cervix and uterus. The MRI scan, taken 1 hour after the ultrasound, was used as the reference standard against which all measurements were compared. Measurements were analyzed with intraclass correlation coefficient and Bland-Altman plots. All RTs were able to obtain a suitable longitudinal image for each patient in the study. Mean differences (SD) between MRI and ultrasound measurements obtained by RTs ranged from 3.5 (3.6) to 4.4 (4.23) mm and 0 (3.0) to 0.9 (2.5) mm on the anterior and posterior surface of the cervix, respectively. Intraclass correlation coefficient for absolute agreement between MRI and RTs was >0.9 for all posterior measurement points in the cervix and ranged from 0.41 to 0.92 on the anterior surface. Measurements were not statistically different between RTs at any measurement point. RTs with variable training attained high levels of interoperator reliability when using transabdominal ultrasound to obtain images and measurements of the uterus and cervix with brachytherapy applicators in situ. Access to training and use of a well-defined protocol assist in achieving these high levels of reliability. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  15. Ultrasound detection of placenta accreta in the first trimester of pregnancy.

    PubMed

    Rahimi-Sharbaf, Fatemeh; Jamal, Ashraf; Mesdaghinia, Elaheh; Abedzadeh-Kalahroudi, Masoumeh; Niroomanesh, Shirin; Atoof, Fatemeh

    2014-06-01

    Placenta accreta is considered a life-threatening condition and the main cause of maternal mortality. Prenatal diagnosis of placenta accreta usually is made by clinical presentation, imaging studies like ultrasound and MRI in the second and third trimester. To determine accuracy of ultrasound findings for placenta accreta in the first trimester of pregnancy. In a longitudinal study 323 high risk patients for placenta accreta were assessed. The eligible women were examined by vaginal and abdominal ultrasound for gestational sac and placental localization and they were followed up until the end of pregnancy. The ultrasound findings were compared with histopathological examinations as a gold standard. The sensitivity, specificity, positive and negative predictive value of ultrasound were estimated for the first trimester and compared with other 2 trimesters in the case of repeated ultrasound examination. Ultrasound examinations in the first trimester revealed that 28 cases had the findings in favor of placenta accreta which ultimately was confirmed in 7 cases. The ultrasound sensitivity and specificity for detecting placenta accreta in the first trimester was 41% [95% CI: 16.2-62.7] and 88% [95% CI: 88.2-94.6] respectively. Ultrasound screening for placenta accreta in the first trimester of pregnancy could not achieve the high sensitivity as second and third trimester of pregnancy.

  16. Ultrasound Contrast Agents

    NASA Astrophysics Data System (ADS)

    Cachard, Christian; Basset, Olivier

    While the use of contrast agents in other imaging modalities (X ray, MRI, PET, …) has been routinely accepted for many years, the development and commercialization of contrast agents designed specifically for ultrasound imaging has occurred only very recently. As in the other imaging modalities, the injection of contrast agents during an ultrasound examination is intended to facilitate the detection and diagnosis of specific pathologies. Contrast agents efficiency is based on the backscattering of ultrasound by microbubbles. These microparticules are intravenously injected in the blood flow. After an introduction and generalities on ultrasound contrast agents (UCA) the microbubble physics in an acoustic field will be developed. Second, physics characteristics of contrast agents will be compared (bubbles with or without shell, gas nature, size distribution). Influence of acoustic pressure on the behaviour of the microparticules (linear, non linear and destruction) will be discussed. Finally, a review of specific imaging adapted to contrast agent properties as harmonic imaging, pulse inversion imaging will be presented.

  17. Quantitative Measures for Evaluation of Ultrasound Therapies of the Prostate

    NASA Astrophysics Data System (ADS)

    Kobelevskiy, Ilya; Burtnyk, Mathieu; Bronskill, Michael; Chopra, Rajiv

    2010-03-01

    Development of non-invasive techniques for prostate cancer treatment requires implementation of quantitative measures for evaluation of the treatment results. In this paper. we introduce measures that estimate spatial targeting accuracy and potential thermal damage to the structures surrounding the prostate. The measures were developed for the technique of treating prostate cancer with a transurethral ultrasound heating applicators guided by active MR temperature feedback. Variations of ultrasound element length and related MR imaging parameters such as MR slice thickness and update time were investigated by performing numerical simulations of the treatment on a database of ten patient prostate geometries segmented from clinical MR images. Susceptibility of each parameter configuration to uncertainty in MR temperature measurements was studied by adding noise to the temperature measurements. Gaussian noise with zero mean and standard deviation of 0, 1, 3 and 5° C was used to model different levels of uncertainty in MR temperature measurements. Results of simulations for each parameter configuration were averaged over the database of the ten prostate patient geometries studied. Results have shown that for update time of 5 seconds both 3- and 5-mm elements achieve appropriate performance for temperature uncertainty up to 3° C, while temperature uncertainty of 5° C leads to noticeable reduction in spatial accuracy and increased risk of damaging rectal wall. Ten-mm elements lacked spatial accuracy and had higher risk of damaging rectal wall compared to 3- and 5-mm elements, but were less sensitive to the level of temperature uncertainty. The effect of changing update time was studied for 5-mm elements. Simulations showed that update time had minor effects on all aspects of treatment for temperature uncertainty of 0° C and 1° C, while temperature uncertainties of 3° C and 5° C led to reduced spatial accuracy, increased potential damage to the rectal wall, and

  18. Pattern of asymmetry of paraspinal muscle size in adolescent idiopathic scoliosis examined by real-time ultrasound imaging. A preliminary study.

    PubMed

    Kennelly, K P; Stokes, M J

    1993-06-01

    The symmetry of lumbar multifidus size was examined in 20 patients with adolescent idiopathic scoliosis, aged 12-19 years. With the subject prone, bilateral real-time ultrasound images were obtained at the level of the 4th lumbar vertebra. Cross-sectional area and linear (horizontal and vertical) measurements were made using on-screen calipers. A pattern of asymmetry of lumbar multifidus cross-sectional area was shown to exist for the different curve types. The cross-sectional area was smaller (P < 0.0001) on the opposite side to the convexity of a primary thoracic curve, and on the convex side of a lumbar or thoracolumbar curve. The combined linear measurements (multiplied) correlated with cross-sectional area (r = 0.95) and could therefore be used for rapid clinical assessment of multifidus size. These preliminary findings provide a basis for further investigation of the role of the musculature in the pathogenesis of adolescent idiopathic scoliosis.

  19. Measured acoustic intensities for clinical diagnostic ultrasound transducers and correlation with thermal index.

    PubMed

    Retz, K; Kotopoulis, S; Kiserud, T; Matre, K; Eide, G E; Sande, R

    2017-08-01

    To investigate if the thermal index for bone (TIB) displayed on screen is an adequate predictor for the derated spatial-peak temporal-average (I SPTA .3 ) and spatial-peak pulse-average (I SPPA .3 ) acoustic intensities in a selection of clinical diagnostic ultrasound machines and transducers. We calibrated five clinical diagnostic ultrasound scanners and 10 transducers, using two-dimensional grayscale, color Doppler and pulsed-wave Doppler, both close to and far from the transducer, with a TIB between 0.1 and 4.0, recording 103 unique measurements. Acoustic measurements were performed in a bespoke three-axis computer-controlled scanning tank, using a 200-μm-diameter calibrated needle hydrophone. There was significant but poor correlation between the acoustic intensities and the on-screen TIB. At a TIB of 0.1, the I SPTA .3 range was 0.51-50.49 mW/cm 2 and the I SPPA .3 range was 0.01-207.29 W/cm 2 . At a TIB of 1.1, the I SPTA .3 range was 19.02-309.44 mW/cm 2 and the I SPPA .3 range was 3.87-51.89 W/cm 2 . TIB is a poor predictor for I SPTA .3 and I SPPA .3 and for the potential bioeffects of clinical diagnostic ultrasound scanners. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

  20. [Anterior segment tumor imaging: advantages of ultrasound (10, 20 and 50 MHz) and optical coherence tomography].

    PubMed

    Siahmed, K; Berges, O; Desjardins, L; Lumbroso, L; Brasseur, G

    2004-02-01

    Detail the role of different imaging techniques for diagnosis of tumors of the iris. Sixty-one tumors of the iris were explored using ultrasound at 10 and 20MHz (Cinescan, BVI Quantel Medical) and 50MHz (UBM, Paradigm) and optical coherence tomography (OCT) (Humphrey Zeiss). Ultrasound should be used at frequencies of 20MHz or greater to precisely characterize, localize and measure a lesion. Ultrasound biomicroscopy (UBM) is inadequate to measure large tumors (extending toward the back of the ciliary body), because of the transducer and the considerably lower image quality caused by the lesion. Ultrasound alone cannot characterize a solid lesion, and moreover cannot differentiate benign and malignant lesions. Clinical notions are also important in diagnosis and patient management. OCT recognizes whether a lesion is liquid or solid in certain cases. With a tumor that seems solid, a 50MHz examination must be done rapidly, and if the entire lesion is difficult to see, a 20MHz ultrasound should be used. With a protruding iris, high-frequency ultrasound and OCT differentiate a cystic lesion from a solid mass, but only BMU provides a precise measurement and regular surveillance capabilities.

  1. Evaluation of diagnostic value of CT scan, physical examination and ultrasound based on pathological findings in patients with pelvic masses.

    PubMed

    Firoozabadi, Razieh Dehghani; Karimi Zarchi, Mojgan; Mansurian, Hamid Reza; Moghadam, Bita Rafiei; Teimoori, Soraya; Naseri, Ali

    2011-01-01

    Because benign and malignant cervical and ovarian masses occur with different percentages in different age groups, the importance of primary diagnosis and selection of a suitable surgical procedure is underlined. Diagnosis of pelvic masses is carried out using ultrasound, physical examination, CT scan and MRI. The objective of this study is to evaluate the diagnostic value of CT scan in pelvic masses in comparison with physical examination-ultrasound based on pathology of the lesion in patients undergoing laparotomic surgery. This analytic-descriptive study focused on age, sonographic findings, physical examinations, CT scan and pathological findings in 139 patients with pelvic mass, gathered with questionnaires and statistically analayzed using the SPSS software programme. Of 139 patients with pelvic mass (patients aged from 17 to 75 years old), 62 (44%) cases were diagnosed as benign and 77 (55.4%) as malignant; among them malignant tratoma serocyst adenocarsinoma with 33 (23.7%) cases and benign myoma with 21 (15.2%) cases comprised the most frequent cases. The sensitivity and specificity of sonography-physical examination were 51.9% and 87.9% respectively and the sensitivity and specificity of CT scan images were 79.2% and 91.6% respectively. It was shown that CT scan images were more consistant with pathological findings in predicting appropriate surgical procedures than do sonography-physical examinations. The sensitivity of CT scan is far higher than that of sonography-physical examination in the diagnosis of pelvic mass malignancy.

  2. The protocol and preliminary baseline survey results of the thyroid ultrasound examination in Fukushima [Rapid Communication].

    PubMed

    Suzuki, Shinichi; Yamashita, Shunichi; Fukushima, Toshihiko; Nakano, Keiichi; Midorikawa, Sanae; Ohtsuru, Akira; Yasumura, Seiji; Hosoya, Mitsunori; Kamiya, Kenji; Shimura, Hiroki; Suzuki, Satoru; Nakamura, Izumi; Abe, Masafumi

    2016-01-01

    After the Fukushima nuclear power plant accident on March 11, 2011, the public of Japan became particularly concerned about the possibility of an increased risk of childhood thyroid cancer, similar to what was observed after the Chernobyl's accident. Due to serious public health perception, there was an urgency to evaluate the baseline levels of childhood thyroid status in Fukushima prefecture. Therefore we have commenced a thyroid ultrasound examination (TUE) survey of the approximately 360,000 pediatric inhabitants (0 to 18 years of age) who lived in Fukushima at the time of the accident in October 2011. The subjects were divided into three categories according to the standardized diagnostic criteria of ultrasound findings. Category A contained the subjects whose TUE findings were intact or benign. Category B were recommended a confirmatory TUE. Category C was recommended an immediate confirmatory TUE. The survey of 40,302 subjects in the first year was completed in March, 2013. There were 40,097 (99.5%), 205 (0.50%) and 0 subjects in categories A, B and C, respectively. Of the 82 category B subjects who underwent fine needle aspiration cytology (FNAC), 12 were diagnosed with a malignant tumor or were suspected to have malignancy. The 12 subjects received thyroid surgery and 11 thyroid cancers and one benign nodule were confirmed histologically after surgery. This is the first large-scaled TUE survey to employ sophisticated ultrasound screening and aim to evaluate the baseline frequency of childhood thyroid nodules and cysts. The results will become the golden standard of future comparative TUE in Fukushima, Japan.

  3. Impact of ultrasound video transfer on the practice of ultrasound

    NASA Astrophysics Data System (ADS)

    Duerinckx, Andre J.; Hayrapetian, Alek S.; Grant, Edward G.; Valentino, Daniel J.; Rahbar, Darius; Kiszonas, Mike; Franco, Ricky; Melany, Michelle; Narin, Sherelle L.; Ragavendra, Nagesh

    1996-05-01

    Sonography can be highly dependent on real-time imaging and as such is highly physician intensive. Such situations arise mostly during complicated ultrasound radiology studies or echocardiology examinations. Under those circumstances it would be of benefit to transmit real-time images beyond the immediate area of the ultrasound laboratory when a physician is not on location. We undertook this study to determine if both static and dynamic image transfer to remote locations might be accomplished using an ultrafast ATM network and PACS. Image management of the local image files was performed by a commercial PACS from AGFA corporation. The local network was Ethernet based, and the global network was based on Asynchronous Transfer Mode (ATM, rates up to 100 Mbits/sec). Real-time image transfer involved two teaching hospitals, one of which had 2 separate ultrasound facilities. Radiologists consulted with technologists via telephone while the examinations were being performed. The applications of ATM network providing real time video for ultrasound imaging in a clinical environment and its potential impact on health delivery and clinical teaching. This technology increased technologist and physician productivity due to the elimination of commute time for physicians and waiting time for technologists and patients. Physician confidence in diagnosis increased compared to reviewing static images alone. This system provided instant access for radiologists to real-time scans from remote sites. Image quality and frame rate were equivalent to the original. The system increased productivity by allowing physicians to monitor studies at multiple sites simultaneously.

  4. Ultrasound diagnosis of penile fracture.

    PubMed

    Nomura, Jason T; Sierzenski, Paul R

    2010-04-01

    Rupture of the corpus cavernosum, penile fracture, is an uncommon occurrence. Diagnosis is straightforward when classical historical and physical examination findings are present. However, atypical presentations can make the diagnosis difficult. Review the literature supporting use of ultrasound for the diagnosis of penile fracture. Review of the ultrasonographic findings in patients with penile fracture. A 32-year-old man presented with penile ecchymosis after sex but lacking several historical and physical examination elements for a diagnosis of penile fracture. Ultrasound performed by the treating physician revealed rupture of the tunica albuginea and presence of a hematoma, leading to a diagnosis of penile fracture. Ultrasound is a simple, efficient, and non-invasive imaging method to assist in the diagnosis of penile fracture. Copyright 2010 Elsevier Inc. All rights reserved.

  5. Automatic measurement of pennation angle and fascicle length of gastrocnemius muscles using real-time ultrasound imaging.

    PubMed

    Zhou, Guang-Quan; Chan, Phoebe; Zheng, Yong-Ping

    2015-03-01

    Muscle imaging is a promising field of research to understand the biological and bioelectrical characteristics of muscles through the observation of muscle architectural change. Sonomyography (SMG) is a technique which can quantify the real-time architectural change of muscles under different contractions and motions with ultrasound imaging. The pennation angle and fascicle length are two crucial SMG parameters to understand the contraction mechanics at muscle level, but they have to be manually detected on ultrasound images frame by frame. In this study, we proposed an automatic method to quantitatively identify pennation angle and fascicle length of gastrocnemius (GM) muscle based on multi-resolution analysis and line feature extraction, which could overcome the limitations of tedious and time-consuming manual measurement. The method started with convolving Gabor wavelet specially designed for enhancing the line-like structure detection in GM ultrasound image. The resulting image was then used to detect the fascicles and aponeuroses for calculating the pennation angle and fascicle length with the consideration of their distribution in ultrasound image. The performance of this method was tested on computer simulated images and experimental images in vivo obtained from normal subjects. Tests on synthetic images showed that the method could identify the fascicle orientation with an average error less than 0.1°. The result of in vivo experiment showed a good agreement between the results obtained by the automatic and the manual measurements (r=0.94±0.03; p<0.001, and r=0.95±0.02, p<0.001). Furthermore, a significant correlation between the ankle angle and pennation angle (r=0.89±0.05; p<0.001) and fascicle length (r=-0.90±0.04; p<0.001) was found for the ankle plantar flexion. This study demonstrated that the proposed method was able to automatically measure the pennation angle and fascicle length of GM ultrasound images, which made it feasible to investigate

  6. Finite element simulation of crack depth measurements in concrete using diffuse ultrasound

    NASA Astrophysics Data System (ADS)

    Seher, Matthias; Kim, Jin-Yeon; Jacobs, Laurence J.

    2012-05-01

    This research simulates the measurements of crack depth in concrete using diffuse ultrasound. The finite element method is employed to simulate the ultrasonic diffusion process around cracks with different geometrical shapes, with the goal of gaining physical insight into the data obtained from experimental measurements. The commercial finite element software Ansys is used to implement the two-dimensional concrete model. The model is validated with an analytical solution and experimental results. It is found from the simulation results that preliminary knowledge of the crack geometry is required to interpret the energy evolution curves from measurements and to correctly determine the crack depth.

  7. Measurement of the ultrasound attenuation and dispersion in whole human blood and its components from 0-70 MHz.

    PubMed

    Treeby, Bradley E; Zhang, Edward Z; Thomas, Alison S; Cox, Ben T

    2011-02-01

    The ultrasound attenuation coefficient and dispersion from 0-70 MHz in whole human blood and its components (red blood cells and plasma) at 37°C is reported. The measurements are made using a fixed path substitution technique that exploits optical mechanisms for the generation and detection of ultrasound. This allows the measurements to cover a broad frequency range with a single source and receiver. The measured attenuation coefficient and dispersion in solutions of red blood cells and physiological saline for total haemoglobin concentrations of 10, 15 and 20 g/dL are presented. The attenuation coefficient and dispersion in whole human blood taken from four healthy volunteers by venipuncture is also reported. The power law dependence of the attenuation coefficient is shown to vary across the measured frequency range. This is due to the varying frequency dependence of the different mechanisms responsible for the attenuation. The attenuation coefficient measured at high frequencies is found to be significantly higher than that predicted by historical power law parameters. A review of the attenuation mechanisms in blood along with previously reported experimental measurements is given. Values for the sound speed and density in the tested samples are also presented. Copyright © 2011 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  8. Molecular Ultrasound Imaging for the Detection of Neural Inflammation

    NASA Astrophysics Data System (ADS)

    Volz, Kevin R.

    performed while targeting three early inflammatory markers (P-selectin, VCAM-1, ICAM-1). Imaging protocols and outcome measures of previous TCEUS investigations of inflammation were replicated to aid in comparisons of outcomes. Signal intensity data was used to generate time intensity curves for qualitative and quantitative analysis of contrast agent temporal behavior. A proof of principle study established preclinical evidence to support the ability of TCEUS to detect acute neural inflammation. Substantial increases in signal intensities were observed while targeting inflammatory markers compared to controls. Further investigations consisted of examining molecular ultrasound sensitivity, and were accomplished by examining targeted contrast agent dosing parameters, and the ability of TCEUS to longitudinally evaluate neural inflammation. Qualitative analysis of TCEUS imaging performed with both administered doses revealed marked increases in signal intensities during acute inflammation, where inflammatory marker expression was presumably at its highest. This was in comparison to measures obtained in the absence of, and during, chronic inflammation. This research contributes much needed empirical evidence to the molecular ultrasound body of literature, and represents the first steps towards advancing this TCEUS application to clinical practice. Future studies are necessary to further these findings and effectively build upon this evidence. Increasing evidence of TCEUS use for the detection of neural inflammation will aid in its eventual clinical translation, where it will likely have a positive impact on patient care.

  9. Accurate acoustic power measurement for low-intensity focused ultrasound using focal axial vibration velocity

    NASA Astrophysics Data System (ADS)

    Tao, Chenyang; Guo, Gepu; Ma, Qingyu; Tu, Juan; Zhang, Dong; Hu, Jimin

    2017-07-01

    Low-intensity focused ultrasound is a form of therapy that can have reversible acoustothermal effects on biological tissue, depending on the exposure parameters. The acoustic power (AP) should be chosen with caution for the sake of safety. To recover the energy of counteracted radial vibrations at the focal point, an accurate AP measurement method using the focal axial vibration velocity (FAVV) is proposed in explicit formulae and is demonstrated experimentally using a laser vibrometer. The experimental APs for two transducers agree well with theoretical calculations and numerical simulations, showing that AP is proportional to the square of the FAVV, with a fixed power gain determined by the physical parameters of the transducers. The favorable results suggest that the FAVV can be used as a valuable parameter for non-contact AP measurement, providing a new strategy for accurate power control for low-intensity focused ultrasound in biomedical engineering.

  10. Portable bladder ultrasound: an evidence-based analysis.

    PubMed

    2006-01-01

    retention, requiring intermittent catheterization, whereas a PVR urine volume of 100 mL to 150 mL or less is generally considered an acceptable result of bladder training. Urinary retention has been associated with poor outcomes including UTI, bladder overdistension, and higher hospital mortality rates. The standard method of determining PVR urine volumes is intermittent catheterization, which is associated with increased risk of UTI, urethral trauma and discomfort. Portable bladder ultrasound products are transportable ultrasound devices that use automated technology to register bladder volume digitally, including PVR volume, and provide three-dimensional images of the bladder. The main clinical use of portable bladder ultrasound is as a diagnostic aid. Health care professionals (primarily nurses) administer the device to measure PVR volume and prevent unnecessary catheterization. An adjunctive use of the bladder ultrasound device is to visualize the placement and removal of catheters. Also, portable bladder ultrasound products may improve the diagnosis and differentiation of urological problems and their management and treatment, including the establishment of voiding schedules, study of bladder biofeedback, fewer UTIs, and monitoring of potential urinary incontinence after surgery or trauma. To determine the effectiveness and clinical utility of portable bladder ultrasound as reported in the published literature, the Medical Advisory Secretariat used its standard search strategy to retrieve international health technology assessments and English-language journal articles from selected databases. Nonsystematic reviews, nonhuman studies, case reports, letters, editorials, and comments were excluded. Of the 4 included studies that examined the clinical utility of portable bladder ultrasound in the elderly population, all found the device to be acceptable. One study reported that the device underestimated catheterized bladder volume In patients with urology problems, 2 of

  11. Improved accuracy of ultrasound-guided therapies using electromagnetic tracking: in-vivo speed of sound measurements

    NASA Astrophysics Data System (ADS)

    Samboju, Vishal; Adams, Matthew; Salgaonkar, Vasant; Diederich, Chris J.; Cunha, J. Adam M.

    2017-02-01

    The speed of sound (SOS) for ultrasound devices used for imaging soft tissue is often calibrated to water, 1540 m/s1 , despite in-vivo soft tissue SOS varying from 1450 to 1613 m/s2 . Images acquired with 1540 m/s and used in conjunction with stereotactic external coordinate systems can thus result in displacement errors of several millimeters. Ultrasound imaging systems are routinely used to guide interventional thermal ablation and cryoablation devices, or radiation sources for brachytherapy3 . Brachytherapy uses small radioactive pellets, inserted interstitially with needles under ultrasound guidance, to eradicate cancerous tissue4 . Since the radiation dose diminishes with distance from the pellet as 1/r2 , imaging uncertainty of a few millimeters can result in significant erroneous dose delivery5,6. Likewise, modeling of power deposition and thermal dose accumulations from ablative sources are also prone to errors due to placement offsets from SOS errors7 . This work presents a method of mitigating needle placement error due to SOS variances without the need of ionizing radiation2,8. We demonstrate the effects of changes in dosimetry in a prostate brachytherapy environment due to patientspecific SOS variances and the ability to mitigate dose delivery uncertainty. Electromagnetic (EM) sensors embedded in the brachytherapy ultrasound system provide information regarding 3D position and orientation of the ultrasound array. Algorithms using data from these two modalities are used to correct bmode images to account for SOS errors. While ultrasound localization resulted in >3 mm displacements, EM resolution was verified to <1 mm precision using custom-built phantoms with various SOS, showing 1% accuracy in SOS measurement.

  12. High pulse repetition frequency ultrasound system for ex vivo measurement of mechanical properties of crystalline lenses with laser-induced microbubble interrogated by acoustic radiation force

    PubMed Central

    Yoon, Sangpil; Aglyamov, Salavat; Karpiouk, Andrei; Emelianov, Stanislav

    2012-01-01

    A high pulse repetition frequency ultrasound system for ex vivo measurement of mechanical properties of animal crystalline lens was developed and validated. We measured the bulk displacement of laser-induced microbubbles created at different positions within the lens using nanosecond laser pulses. An impulsive acoustic radiation force was applied to the microbubble, and spatio-temporal measurements of the microbubble displacement were assessed using a custom-made high pulse repetition frequency ultrasound system consisting of two 25 MHz focused ultrasound transducers. One of these transducers was used to emit a train of ultrasound pulses and another transducer was used to receive the ultrasound echoes reflected from the microbubble. The developed system was operating at 1 MHz pulse repetition frequency. Based on measured motion of the microbubble, the Young’s moduli of surrounding tissue were reconstructed and the values were compared with those measured using indentation test. Measured values of Young’s moduli of 4 bovine lenses ranged from 2.6±0.1 to 26±1.4 kPa and there was good agreement between the two methods. Therefore, our studies, utilizing the high pulse repetition frequency ultrasound system, suggest that the developed approach can be used to assess the mechanical properties of ex vivo crystalline lenses. Furthermore, the potential of the presented approach for in vivo measurements is discussed. PMID:22797709

  13. Ultrasound in twin pregnancies.

    PubMed

    Morin, Lucie; Lim, Kenneth

    2011-06-01

    and normal assessment. (III) 2. There are insufficient data to recommend a routine preterm labour surveillance protocol in terms of frequency, timing, and optimal cervical length thresholds. (II-2) 3. Singleton growth curves currently provide the best predictors of adverse outcome in twins and may be used for evaluating growth abnormalities. (III) 4. It is suggested that growth discordance be defined using either a difference (20 mm) in absolute measurement in abdominal circumference or a difference of 20% in ultrasound-derived estimated fetal weight. (II-2) 5. Although there is insufficient evidence to recommend a specific schedule for ultrasound assessment of twin gestation, most experts recommend serial ultrasound assessment every 2 to 3 weeks, starting at 16 weeks of gestation for monochorionic pregnancies and every 3 to 4 weeks, starting from the anatomy scan (18 to 22 weeks) for dichorionic pregnancies. (II-1) 6. Umbilical artery Doppler may be useful in the surveillance of twin gestations when there are complications involving the placental circulation or fetal hemodynamic physiology. (II-2) 7. Although many methods of evaluating the level of amniotic fluid in twins (deepest vertical pocket, single pocket, amniotic fluid index) have been described, there is not enough evidence to suggest that one method is more predictive than the others of adverse pregnancy outcome. (II-3) 8. Referral to an appropriate high-risk pregnancy centre is indicated when complications unique to twins are suspected on ultrasound. (II-2) These complications include: 1. Twin-to-twin transfusion syndrome 2. Monoamniotic twins gestation 3. Conjoined twins 4. Twin reversed arterial perfusion sequence 5. Single fetal death in the second or third trimester 6. Growth discordance in monochorionic twins. Recommendations 1. All patients who are suspected to have a twin pregnancy on first trimester physical examination or who are at risk (e.g., pregnancies resulting from assisted reproductive

  14. Comparison of grey scale median (GSM) measurement in ultrasound images of human carotid plaques using two different softwares.

    PubMed

    Östling, Gerd; Persson, Margaretha; Hedblad, Bo; Gonçalves, Isabel

    2013-11-01

    Grey scale median (GSM) measured on ultrasound images of carotid plaques has been used for several years now in research to find the vulnerable plaque. Centres have used different software and also different methods for GSM measurement. This has resulted in a wide range of GSM values and cut-off values for the detection of the vulnerable plaque. The aim of this study was to compare the values obtained with two different softwares, using different standardization methods, for the measurement of GSM on ultrasound images of carotid human plaques. GSM was measured with Adobe Photoshop(®) and with Artery Measurement System (AMS) on duplex ultrasound images of 100 consecutive medium- to large-sized carotid plaques of the Beta-blocker Cholesterol-lowering Asymptomatic Plaque Study (BCAPS). The mean values of GSM were 35·2 ± 19·3 and 55·8 ± 22·5 for Adobe Photoshop(®) and AMS, respectively. Mean difference was 20·45 (95% CI: 19·17-21·73). Although the absolute values of GSM differed, the agreement between the two measurements was good, correlation coefficient 0·95. A chi-square test revealed a kappa value of 0·68 when studying quartiles of GSM. The intra-observer variability was 1·9% for AMS and 2·5% for Adobe Photoshop. The difference between softwares and standardization methods must be taken into consideration when comparing studies. To avoid these problems, researcher should come to a consensus regarding software and standardization method for GSM measurement on ultrasound images of plaque in the arteries. © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  15. [The development and utility of new uroflowmetry measurement by wearable airborne ultrasound Doppler system].

    PubMed

    Matsumoto, Seiji; Kakizaki, Hidehiro

    2012-09-01

    The conventional concept of uroflowmetry (UFM) is to equip the urine-receiving container like a toilet device (s) with various sensors. A UFM device based on an airborne ultrasound continuous wave Doppler system was developed to satisfy the need of measuring urinary flow anytime and anywhere in an easy, natural, and repeated manner. It is a non-contact, indirect measuring device that can be easily worn by the test subjects who urinate. The prototype of the new UFM device was used to collect urination data from normal adult volunteers. Data could be collected with the new UFM device, and the Doppler spectrum (urination pattern) could be evaluated in chronological order for each volunteer's urination. It was confirmed from the examination of effectiveness that there is a potential for the clinical application of the new device, but at the present stage it is not yet clinically applicable. The results obtained suggest that the device may greatly change the concept of urodynamics, depending on future progress. However, accuracy in collecting samples and analyzing data will have to be further improved using the latest engineering technology.

  16. Feasibility of a focused ultrasound training programme for medical undergraduate students.

    PubMed

    Wong, Ivan; Jayatilleke, Thilina; Kendall, Richard; Atkinson, Paul

    2011-03-01

    Although ultrasound is a core skill for many clinical specialties, UK medical schools are not currently required to teach this skill. The College of Emergency Medicine (CEM) has championed the use of ultrasound to answer focused clinical questions in emergency settings. We have designed and piloted an ultrasound training course for undergraduate medical students addressing one important indication: ultrasound assessment of the abdominal aorta. Fourteen clinical students, who had no prior experience of using ultrasound, received focused ultrasound training in the form of didactic instruction, a short bedside practical workshop and self-directed learning over a 20-day period. At the end of this period, the students were assessed by a structured viva and an observed structured clinical examination (OSCE) used for accreditation by the CEM. The primary endpoint was the number of students who passed the assessment. The secondary endpoint was the accuracy of the students' anatomical measurements. Thirteen of the 14 (93%) students completed the training and assessment. Eight of the 13 (62%) students passed both the viva and OSCE, and were deemed to have achieved the CEM standard. The measurements by the competent students were not statistically different from those of experienced practitioners. We have shown for the first time that it is feasible to train inexperienced undergraduate students to scan the abdominal aorta to a professional standard using a focused training course. It is time for the medical education community to address whether focused ultrasound training should accompany traditional clinical skills, such as using a stethoscope, in UK medical school curricula. © Blackwell Publishing Ltd 2011.

  17. A hybrid FDTD-Rayleigh integral computational method for the simulation of the ultrasound measurement of proximal femur.

    PubMed

    Cassereau, Didier; Nauleau, Pierre; Bendjoudi, Aniss; Minonzio, Jean-Gabriel; Laugier, Pascal; Bossy, Emmanuel; Grimal, Quentin

    2014-07-01

    The development of novel quantitative ultrasound (QUS) techniques to measure the hip is critically dependent on the possibility to simulate the ultrasound propagation. One specificity of hip QUS is that ultrasounds propagate through a large thickness of soft tissue, which can be modeled by a homogeneous fluid in a first approach. Finite difference time domain (FDTD) algorithms have been widely used to simulate QUS measurements but they are not adapted to simulate ultrasonic propagation over long distances in homogeneous media. In this paper, an hybrid numerical method is presented to simulate hip QUS measurements. A two-dimensional FDTD simulation in the vicinity of the bone is coupled to the semi-analytic calculation of the Rayleigh integral to compute the wave propagation between the probe and the bone. The method is used to simulate a setup dedicated to the measurement of circumferential guided waves in the cortical compartment of the femoral neck. The proposed approach is validated by comparison with a full FDTD simulation and with an experiment on a bone phantom. For a realistic QUS configuration, the computation time is estimated to be sixty times less with the hybrid method than with a full FDTD approach. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Repeatability of Doppler ultrasound measurements of hindlimb blood flow in halothane anaesthetised horses.

    PubMed

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

    2000-05-01

    The purpose of this study was to determine the repeatability of femoral blood flow recorded using Doppler ultrasound in anaesthetised horses. Doppler ultrasound of the femoral artery and vein was performed in 6 horses anaesthetised with halothane and positioned in left lateral recumbency. Velocity spectra, recorded using low pulse repetition frequency, were used to calculate time-averaged mean velocity (TAV), velocity of component a (TaVa), velocity of component b (TaVb), volumetric flow, early diastolic deceleration slope (EDDS) and pulsatility index (PI). Within-patient variability was determined for sequential Doppler measurements recorded during a single standardised anaesthetic episode. Within-patient variability was also determined for Doppler and cardiovascular measurements recorded during 4 separate standardised anaesthetic episodes performed at intervals of at least one month. Within-patient variation during a single anaesthetic episode was small. Coefficients of variation (cv) were <12.5% for arterial measurements and <17% for venous measurements. Intraclass correlation coefficient was >0.75 for all measurements. No significant change was observed in measurements of cardiovascular function suggesting that within-patient variation observed during a single anaesthetic episode was due to measurement error. In contrast, within-patient variation during 4 separate anaesthetic episodes was marked (cv>17%) for most Doppler measurements obtained from arteries and veins. Variation in measurements of cardiovascular function were marked (cv>20%), suggesting that there is marked biological variation in central and peripheral observed. Further studies are warranted to determine the ability of this technique to detect differences in blood flow during administration of different anaesthetic agents.

  19. Cognitive load predicts point-of-care ultrasound simulator performance.

    PubMed

    Aldekhyl, Sara; Cavalcanti, Rodrigo B; Naismith, Laura M

    2018-02-01

    The ability to maintain good performance with low cognitive load is an important marker of expertise. Incorporating cognitive load measurements in the context of simulation training may help to inform judgements of competence. This exploratory study investigated relationships between demographic markers of expertise, cognitive load measures, and simulator performance in the context of point-of-care ultrasonography. Twenty-nine medical trainees and clinicians at the University of Toronto with a range of clinical ultrasound experience were recruited. Participants answered a demographic questionnaire then used an ultrasound simulator to perform targeted scanning tasks based on clinical vignettes. Participants were scored on their ability to both acquire and interpret ultrasound images. Cognitive load measures included participant self-report, eye-based physiological indices, and behavioural measures. Data were analyzed using a multilevel linear modelling approach, wherein observations were clustered by participants. Experienced participants outperformed novice participants on ultrasound image acquisition. Ultrasound image interpretation was comparable between the two groups. Ultrasound image acquisition performance was predicted by level of training, prior ultrasound training, and cognitive load. There was significant convergence between cognitive load measurement techniques. A marginal model of ultrasound image acquisition performance including prior ultrasound training and cognitive load as fixed effects provided the best overall fit for the observed data. In this proof-of-principle study, the combination of demographic and cognitive load measures provided more sensitive metrics to predict ultrasound simulator performance. Performance assessments which include cognitive load can help differentiate between levels of expertise in simulation environments, and may serve as better predictors of skill transfer to clinical practice.

  20. The Role of Ultrasound Imaging of Callus Formation in the Treatment of Long Bone Fractures in Children.

    PubMed

    Wawrzyk, Magdalena; Sokal, Jan; Andrzejewska, Ewa; Przewratil, Przemysław

    2015-01-01

    In the process of diagnosis and treatment of fractures, an X-ray study is typically performed. In modern medicine very important is the development of new diagnostic methods without adverse effects on the body. One of such techniques is ultrasound imaging. It has a high value in imaging most areas of the body, including the musculoskeletal system. Reports on the use of ultrasound in the evaluation of the callus are rare and this could be a method equivalent to or even better than standard radiographs. The aim of the study was to analyze the correlation of ultrasound with radiographs in imaging of callus formation after fractures of long bones in children and to analyze the correlation of vascular resistance index (RI) and the degree of vascularization of the callus with a subjective radiological assessment of the bone union quality. The prospective study was planned to qualify 50 children treated for long bones fractures of the arm, forearm, thigh and lower leg. Ultrasound diagnosis was carried out using a Philips iU22 camera equipped with a linear probe with 17-5-MHz resolution and MSK Superficial program. During ultrasound examination measurements of the callus were performed. Using the Power Doppler callus vascularity was visualized and vascular resistance index (RI) was measured. The same measurements were made within the corresponding area of the healthy limb. The results obtained by ultrasound were compared with radiograph measurements and with the subjective assessment of the callus quality. Preliminary results were developed on a group of 24 patients, where 28 fractured bones and 28 corresponding healthy bones were examined. Fifteen boys and 9 girls participated in the study. The average age at injury was, respectively, 11 and 9 years. In both groups fractures without displacement were the most frequent. A similar frequency was observed in fractures requiring reposition and subperiosteal fractures. In contrast, fractures with a slight displacement of the

  1. Conditionally Increased Acoustic Pressures in Nonfetal Diagnostic Ultrasound Examinations Without Contrast Agents: A Preliminary Assessment

    PubMed Central

    Nightingale, Kathryn R.; Church, Charles C.; Harris, Gerald; Wear, Keith A.; Bailey, Michael R.; Carson, Paul L.; Jiang, Hui; Sandstrom, Kurt L.; Szabo, Thomas L.; Ziskin, Marvin C.

    2016-01-01

    The mechanical index (MI) has been used by the US Food and Drug Administration (FDA) since 1992 for regulatory decisions regarding the acoustic output of diagnostic ultrasound equipment. Its formula is based on predictions of acoustic cavitation under specific conditions. Since its implementation over 2 decades ago, new imaging modes have been developed that employ unique beam sequences exploiting higher-order acoustic phenomena, and, concurrently, studies of the bioeffects of ultrasound under a range of imaging scenarios have been conducted. In 2012, the American Institute of Ultrasound in Medicine Technical Standards Committee convened a working group of its Output Standards Subcommittee to examine and report on the potential risks and benefits of the use of conditionally increased acoustic pressures (CIP) under specific diagnostic imaging scenarios. The term “conditionally” is included to indicate that CIP would be considered on a per-patient basis for the duration required to obtain the necessary diagnostic information. This document is a result of that effort. In summary, a fundamental assumption in the MI calculation is the presence of a preexisting gas body. For tissues not known to contain preexisting gas bodies, based on theoretical predications and experimentally reported cavitation thresholds, we find this assumption to be invalid. We thus conclude that exceeding the recommended maximum MI level given in the FDA guidance could be warranted without concern for increased risk of cavitation in these tissues. However, there is limited literature assessing the potential clinical benefit of exceeding the MI guidelines in these tissues. The report proposes a 3-tiered approach for CIP that follows the model for employing elevated output in magnetic resonance imaging and concludes with summary recommendations to facilitate Institutional Review Board (IRB)-monitored clinical studies investigating CIP in specific tissues. PMID:26112617

  2. Ultrasound detection of placenta accreta in the first trimester of pregnancy

    PubMed Central

    Rahimi-Sharbaf, Fatemeh; Jamal, Ashraf; Mesdaghinia, Elaheh; Abedzadeh- Kalahroudi, Masoumeh; Niroomanesh, Shirin; Atoof, Fatemeh

    2014-01-01

    Background: Placenta accreta is considered a life-threatening condition and the main cause of maternal mortality. Prenatal diagnosis of placenta accreta usually is made by clinical presentation, imaging studies like ultrasound and MRI in the second and third trimester. Objective: To determine accuracy of ultrasound findings for placenta accreta in the first trimester of pregnancy. Materials and Methods: In a longitudinal study 323 high risk patients for placenta accreta were assessed. The eligible women were examined by vaginal and abdominal ultrasound for gestational sac and placental localization and they were followed up until the end of pregnancy. The ultrasound findings were compared with histopathological examinations as a gold standard. The sensitivity, specificity, positive and negative predictive value of ultrasound were estimated for the first trimester and compared with other 2 trimesters in the case of repeated ultrasound examination. Results: Ultrasound examinations in the first trimester revealed that 28 cases had the findings in favor of placenta accreta which ultimately was confirmed in 7 cases. The ultrasound sensitivity and specificity for detecting placenta accreta in the first trimester was 41% [95% CI: 16.2-62.7] and 88% [95% CI: 88.2-94.6] respectively. Conclusion: Ultrasound screening for placenta accreta in the first trimester of pregnancy could not achieve the high sensitivity as second and third trimester of pregnancy. PMID:25071851

  3. Transvaginal ultrasound in threatened abortions with empty gestational sacs.

    PubMed

    Tongsong, T; Wanapirak, C; Srisomboon, J; Sirichotiyakul, S; Polsrisuthikul, T; Pongsatha, S

    1994-09-01

    To determine whether transvaginal ultrasound criteria alone can distinguish viable from non-viable gestational sacs at a single examination. A prospective descriptive study was undertaken and analysis performed on 211 pregnancies complicated by threatened abortion and empty gestation sacs diagnosed by transvaginal ultrasound. The main outcome measure was the final diagnosis of viable or non-viable gestation on subsequent transvaginal sonography. The study shows that a single transvaginal ultrasound examination is useful in differentiating viable from non-viable gestation sacs. The mean sac diameter (MSD) was found to be the most useful criterion for determining non-viability. An MSD of > or = 17 mm that lacked an embryo and an MSD of > or = 13 mm without visible yolk sac were reliable predictors of non-viable gestation sacs at a single examination with 100% specificity and 100% positive predictive value. An MSD > or = 13 mm without visible yolk sac was the most sensitive criterion. Using MSD criteria, 73% of non-viable gestations could be reliably identified without any false-positive diagnoses. Deformed shape, low position and thin decidual reaction are strong indicators of non-viable gestations but are not 100% accurate. There is still a significant proportion of empty sacs, where no accurate distinction between viable and non-viable can be made according to one criterion at a single examination and in these cases serial examinations should be carried out before any active management is advocated. In most cases, transvaginal sonographic criteria alone can distinguish viable from non-viable empty gestational sacs at a single examination.

  4. Standards of ultrasound imaging of the adrenal glands

    PubMed Central

    Jakubowski, Wiesław S.; Dobruch-Sobczak, Katarzyna; Kasperlik-Załuska, Anna A.

    2015-01-01

    Adrenal glands are paired endocrine glands located over the upper renal poles. Adrenal pathologies have various clinical presentations. They can coexist with the hyperfunction of individual cortical zones or the medulla, insufficiency of the adrenal cortex or retained normal hormonal function. The most common adrenal masses are tumors incidentally detected in imaging examinations (ultrasound, tomography, magnetic resonance imaging), referred to as incidentalomas. They include a range of histopathological entities but cortical adenomas without hormonal hyperfunction are the most common. Each abdominal ultrasound scan of a child or adult should include the assessment of the suprarenal areas. If a previously non-reported, incidental solid focal lesion exceeding 1 cm (incidentaloma) is detected in the suprarenal area, computed tomography or magnetic resonance imaging should be conducted to confirm its presence and for differentiation and the tumor functional status should be determined. Ultrasound imaging is also used to monitor adrenal incidentaloma that is not eligible for a surgery. The paper presents recommendations concerning the performance and assessment of ultrasound examinations of the adrenal glands and their pathological lesions. The article includes new ultrasound techniques, such as tissue harmonic imaging, spatial compound imaging, three-dimensional ultrasound, elastography, contrast-enhanced ultrasound and parametric imaging. The guidelines presented above are consistent with the recommendations of the Polish Ultrasound Society. PMID:26807295

  5. Ultrasound of the Brachial Plexus.

    PubMed

    Griffith, James F

    2018-07-01

    Examination of the brachial plexus with ultrasound is efficient because it allows many parts of the brachial plexus as well as the surrounding soft tissues to be assessed with high spatial resolution. The key to performing good ultrasound of the brachial plexus is being familiar with the anatomy and the common variants. That makes it possible to concentrate solely on the ultrasound appearances free of simultaneously wondering about the anatomy. Ultrasound of the brachial plexus is particularly good for assessing nerve sheath tumor, perineural fibrosis, metastases, some inflammatory neuropathies, neuralgic amyotrophy, and posttraumatic sequalae. It is limited in the assessment of thoracic outlet syndrome and in the acute/subacute trauma setting. This review addresses the anatomy, ultrasound technique, as well as pathology of the brachial plexus from the cervical foramina to the axilla. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  6. Hyperechogenicity during high intensity focused ultrasound (HIFU)

    NASA Astrophysics Data System (ADS)

    Crum, Lawrence; Bailey, Michael; Rabkin, Brian; Khokhlova, Vera; Vaezy, Shahram

    2005-09-01

    Ultrasound guidance of HIFU therapy is attractive because of its portability, low cost, real-time image processing, simple integration with HIFU instruments, and the extensive availability of diagnostic ultrasound; however, the use of ultrasound visualization for the guidance and monitoring of HIFU therapy often relies on the appearance of a hyperechoic region in the ultrasound image. It is often assumed that the formation of a hyperechoic region at the HIFU treatment site results from bubble activity generated during HIFU exposure. However, it has been determined that this region can be generated with relatively short bursts of HIFU (on the order of 30 ms), bursts so short that negligible temperature elevations are expected to occur. In examining the histology associated with these hyperechoes, there is little evidence of traditional cavitation damage; rather, it appears as if there are many bubbles generated within the individuals cells, suggesting a thermal mechanism. Thermocouple measurements of the temperature elevation were inaccurate due to the short insonation period, but showed only a few-degree temperature rise. These anomalous results will be presented, along with additional data on HIFU hyperechogenicity, and a hypothesis given for the phenomenological origins of this effect. [Work supported in part by the NSBRI, U.S. Army, and the NIH.

  7. Comparison of Two Devices for Intraoperative Portal Venous Flow Measurement in Living-Donor Liver Transplantation: Transit Time Ultrasound and Conventional Doppler Ultrasound.

    PubMed

    Wang, H-K; Chen, C-Y; Lin, N-C; Liu, C-S; Loong, C-C; Lin, Y-H; Lai, Y-C; Chiou, H-J

    2018-05-01

    Intraoperative portal venous flow measurement provides surgeons with instant guidance for portal flow modulation during living-donor liver transplantation (LDLT). In this study, we compared the agreement of portal flow measurement obtained by 2 devices: transit time ultrasound (TTU) and conventional Doppler ultrasound (CDU). Fifty-four recipients of LDLT underwent intraoperative measurement of portal flow after completion of vascular anastomosis of the implanted partial liver graft. Both TTU and CDU were used concurrently. Agreement of TTU and CDU was assessed by intraclass correlation coefficient using a model of 2-way random effects, absolute agreement, and single measurement. A Bland-Altman plot was applied to assess the variability between the 2 devices. The mean, median, and range of portal venous flow was 1456, 1418, and 117 to 2776 mL/min according to TTU; and 1564, 1566, and 119 to 3216 mL/min according to CDU. The intraclass correlation coefficient of portal venous flow between TTU and CDU was 0.68 (95% confidence interval, 0.51-0.80). The Bland-Altman plots revealed an average variation of 4.8% between TTU and CDU but with a rather wide 95% confidence interval of variation ranging from -57.7% to 67.4%. Intraoperative TTU and CDU showed moderate agreement in portal flow measurement. However, a relatively wide range of variation exists between TTU and CDU, indicating that data obtained from the 2 devices may not be interchangeable. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Muscle thickness measurements of the lower trapezius with rehabilitative ultrasound imaging are confounded by scapular dyskinesis.

    PubMed

    Seitz, Amee L; Baxter, Caralyn J; Benya, Kristen

    2015-08-01

    Alterations in scapular muscle activity have been theorized to contribute to abnormal scapular motion and shoulder pain, but pose challenges to quantify in the clinic. Rehabilitative Ultrasound Imaging (RUSI) has proved useful identifying dysfunction of lumbar regional stabilizing muscle activity, specifically contractile behavior. Although, recent examinations of scapular stabilizing trapezius muscle function using RUSI did not detect alterations individuals with shoulder pain or differences in muscle thickness between varying external loads in asymptomatic individuals, a potential confounder to prior results, scapular dyskinesis has not been controlled. It is unknown if dyskinesis alters scapular muscle thickness during activation measured with RUSI. Thus, the purpose of this study was to compare change in scapular muscle thickness between individuals with and without scapular dyskinesis. Thirty-nine asymptomatic adults with (n = 19) and without (n = 20) scapular dyskinesis, defined with a reliable and validated method, participated. Two separate ultrasound images of the serratus anterior (SA) and lower trapezius (LT) were captured under two randomized conditions, rest and isometric contraction against gravity, and saved for blinded measurement. Change in thickness with contraction was calculated and expressed as a percentage. The dyskinesis group demonstrated a greater increase (p = 0.005) in LT thickness with the isometric contraction than the group without (mean difference = 31.6%; 95%CI = 10.3, 53.0). No differences in SA or resting thickness of either muscle were found between groups. The presence of scapular dyskinesis alters thickness changes of the lower trapezius during activation. Furthermore, potential underlying reasons beyond muscle contractile behavior must be considered. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Assessment of pelvic floor muscle contraction with palpation, perineometry and transperineal ultrasound: a cross-sectional study.

    PubMed

    Volløyhaug, I; Mørkved, S; Salvesen, Ø; Salvesen, K Å

    2016-06-01

    To study the correlation between palpation, perineometry and transperineal ultrasound for assessment of pelvic floor muscle contraction and to define a contraction scale for ultrasound measurements. This was a cross-sectional study of 608 women examined with palpation of pelvic floor muscle contraction, using the Modified Oxford Scale, and measurement of the vaginal squeeze pressure with a vaginal balloon connected to a fiber-optic microtip transducer (perineometry). Transperineal ultrasound was used for measurements of levator hiatal area and anteroposterior (AP) diameter in the plane of minimal hiatal dimensions, at rest and on contraction. The pelvic floor muscle contraction was expressed as the percentage difference between values at rest and on contraction. Spearman's rank was used to test for correlation between the different methods of assessment. Significant correlations were found between all assessment methods (P < 0.001). Palpation correlated with perineometry (rs = 0.74) and with proportional change in hiatal area (rs = 0.67) and AP diameter (rs = 0.69) on ultrasound. Perineometry correlated with proportional change in hiatal area (rs = 0.60) and AP diameter (rs = 0.66) on ultrasound. We defined a contraction scale based on the proportional change in AP diameter. In this population, a change in AP diameter of < 7% corresponded to absence of contractions, 7-18% corresponded to weak contractions, 18-35% corresponded to normal contractions and > 35% corresponded to strong contractions. We found moderate to strong correlation between ultrasound measurements, palpation and perineometry for assessing pelvic floor muscle contraction. The proportional change in levator hiatal AP diameter was the ultrasound measurement with strongest correlation to palpation and perineometry and formed the basis for the contraction scale for ultrasound measurements. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley

  10. Ultrasound-Guided Regional Anesthesia Simulation Training: A Systematic Review.

    PubMed

    Chen, Xiao Xu; Trivedi, Vatsal; AlSaflan, AbdulHadi A; Todd, Suzanne Clare; Tricco, Andrea C; McCartney, Colin J L; Boet, Sylvain

    Ultrasound-guided regional anesthesia (UGRA) has become the criterion standard of regional anesthesia practice. Ultrasound-guided regional anesthesia teaching programs often use simulation, and guidelines have been published to help guide URGA education. This systematic review aimed to examine the effectiveness of simulation-based education for the acquisition and maintenance of competence in UGRA. Studies identified in MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were included if they assessed simulation-based UGRA teaching with outcomes measured at Kirkpatrick level 2 (knowledge and skills), 3 (transfer of learning to the workplace), or 4 (patient outcomes). Two authors independently reviewed all identified references for eligibility, abstracted data, and appraised quality. After screening 176 citations and 45 full-text articles, 12 studies were included. Simulation-enhanced training improved knowledge acquisition (Kirkpatrick level 2) when compared with nonsimulation training. Seven studies measuring skill acquisition (Kirkpatrick level 2) found that simulation-enhanced UGRA training was significantly more effective than alternative teaching methods or no intervention. One study measuring transfer of learning into the clinical setting (Kirkpatrick level 3) found no difference between simulation-enhanced UGRA training and non-simulation-based training. However, this study was discontinued early because of technical challenges. Two studies examined patient outcomes (Kirkpatrick level 4), and one of these found that simulation-based UGRA training improved patient outcomes compared with didactic teaching. Ultrasound-guided regional anesthesia knowledge and skills significantly improved with simulation training. The acquired UGRA skills may be transferred to the clinical setting; however, further studies are required to confirm these changes translate to improved patient outcomes.

  11. Ultrasound pregnancy

    MedlinePlus

    Pregnancy sonogram; Obstetric ultrasonography; Obstetric sonogram; Ultrasound - pregnancy; IUGR - ultrasound; Intrauterine growth - ultrasound; Polyhydramnios - ultrasound; Oligohydramnios - ultrasound; Placenta previa - ultrasound; Multiple pregnancy - ultrasound; ...

  12. Assessment of a Novel Point-of-Care Ultrasound Curriculum's Effect on Competency Measures in Family Medicine Graduate Medical Education.

    PubMed

    Bornemann, Paul

    2017-06-01

    Point-of-care ultrasound has been shown to decrease the use of expensive diagnostic studies and improve quality outcome measures. Currently, there is a large desire for training in family medicine residencies, but very few programs have established curricula. We sought to develop a family medicine residency curriculum and evaluate it with tools we developed. We wanted our curriculum to be easy to adopt by other residency programs, even if they did not have many well-trained ultrasound faculty. We developed a curriculum in the form of a 4-week rotation in a family medicine residency program. It consisted of self-study videos, hands-on training, and image review. We followed residents in postgraduate years 1 to 3 over a 12-month period. We developed tools, including a knowledge exam, to test image interpretation and clinical decision making, an observed structured clinical exam to assess scanning skills, and a survey to assess perceptions of point-of-care ultrasound in family medicine. The assessments were administered before and after each resident's rotation. Seventeen residents completed the rotation. The average knowledge test score improved significantly, from 62 to 84%. The average observed structured clinical exam scores also improved significantly, from 41 to 85%. The average perception survey scores improved slightly from 4.4 to 4.6. We developed a point-of-care ultrasound curriculum for family medicine residency programs that improves measures of resident attitude, skills, and knowledge. This curriculum can be adopted by residency programs with few faculty members who are experienced in ultrasound. © 2017 by the American Institute of Ultrasound in Medicine.

  13. Ultrasound transducer shape has no effect on measurements of lumbar multifidus muscle size.

    PubMed

    Worsley, Peter R; Smith, Nicholas; Warner, Martin B; Stokes, Maria

    2012-04-01

    Evidence is currently lacking for guidance on ultrasound transducer configuration (shape) when imaging muscle to measure its size. This study compared measurements made of lumbar multifidus on images obtained using curvilinear and linear transducers. Fifteen asymptomatic males (aged 21-32 years) had their right lumbar multifidus imaged at L3. Two transverse images were taken with two transducers (5 MHz curvilinear and 6 MHz linear), and linear and cross-sectional area (CSA) measurements were made off-line. Reliability of image interpretation was shown using intra-class correlation coefficients (0.78-0.99). Muscle measurements were compared between transducers using Bland and Altman plots and paired t-tests. Relationships between CSA and linear measurements were examined using Pearson's Correlation Coefficients. There were no significant differences (p > 0.05) in the measurements of the two transducers. Thickness and CSA measurements had small differences between transducers, with mean differences of 0.01 cm (SDdiff = 0.21 cm) and 0.03 cm(2) (SDdiff = 0.58 cm(2)) respectively. Width measures had a mean difference of 0.14 cm, with the linear transducer giving larger measures. Significant correlations (p < 0.001) were found between all linear measures and CSA, with both transducers (r = 0.78-0.89). Measurements of multifidus at L3 were not influenced by the configuration of transducers of similar frequency. For the purposes of image interpretation, the curvilinear transducer produced better definition of the lateral muscle border, suggesting it as the preferable transducer for imaging lumbar multifidus. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. 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

  15. Ultrasound Imaging of the Musculoskeletal System.

    PubMed

    Cook, Cristi R

    2016-05-01

    Musculoskeletal ultrasound is a rapidly growing field within veterinary medicine. Ultrasound for musculoskeletal disorders has been commonly used in equine and human medicine and is becoming more commonly performed in small animal patients due to the increase in the recognition of soft tissue injuries. Ultrasound is widely available, cost-effective, but technically difficult to learn. Advantages of musculoskeletal ultrasound are the opposite limb is commonly used for comparison to evaluate symmetry of the tendinous structures and the ease of repeat examinations to assess healing. The article discusses the major areas of shoulder, stifle, iliopsoas, gastrocnemius, and musculoskeletal basics. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Ultrasound during mid-gestation: Agreement with physical foetal and placental measurements and use in predicting gestational age in sheep.

    PubMed

    Jones, A K; Gately, R E; McFadden, K K; Hoffman, M L; Pillai, S M; Zinn, S A; Govoni, K E; Reed, S A

    2017-08-01

    To determine the effects of poor maternal nutrition and litter size on foetal growth during mid-gestation, pregnant ewes (n = 82) were fed 100%, 60% or 140% of NRC TDN beginning at day 30.2 ± 0.2 of gestation. Transabdominal ultrasound was performed weekly between day 46.0 ± 0.4 and 86.0 ± 0.7 to monitor foetal heart width (HW), umbilical diameter (UMB), rib width (RW) and placentome outer (OD) and inner diameter (ID). Data were analysed with repeated-measures using the mixed procedure for effects of maternal diet, litter size and gestation, and equations predictive of gestational age were generated using the regression procedure. To determine the agreement of ultrasound measurement and actual size, ewes (n = 20-21) were euthanized at day 45 or 90 to obtain corresponding postmortem measurements for Bland-Altman analysis. The HW, UMB and placentome OD and ID increased with gestation (p < .0001) but were unaffected by maternal diet or litter size (p ≥ .12). Ultrasound underestimated postmortem measurements of HW (14.8%), UMB (7.3%), placentome OD (4.5%) and ID (37.3%) at day 90 of gestation. Ultrasound underestimated RW at day 45 (7.7%) but overestimated RW (23.8%) at day 90, indicating inconsistent bias when reporting RW by ultrasound. Combining the HW, UMB, RW and placentome OD generated the strongest equation predictive of gestational age (R 2  = .91). These findings indicate that during mid-gestation, maternal diet or litter size did not affect HW, UMB or placentome diameters and these factors can be used to estimate gestational age. © 2017 Blackwell Verlag GmbH.

  17. Exploratory Analysis of Carbon Dioxide Levels, Ultrasound and Optical Coherence Tomography Measures of the Eye During ISS Missions

    NASA Technical Reports Server (NTRS)

    Schaefer, C.; Young, M.; Mason, S.; Coble, C.; Wear, M. L.; Sargsyan, A.; Garcia, K.; Patel, N.; Gibson, C.; Alexander, D.; hide

    2017-01-01

    Enhanced screening for the Visual Impairment/Intracranial Pressure (VIIP) syndrome has been implemented to better characterize the ocular and vision changes observed in some long-duration crewmembers. This includes implementation of in-flight ultrasound in 2010 and optical coherence tomography (OCT) in 2013. Potential risk factors for VIIP include cardiovascular health, diet, anatomical and genetic factors, and environmental conditions. Carbon dioxide (CO2), a potent vasodilator, is chronically elevated on the International Space Station (ISS) relative to ambient levels on Earth, and is a plausible risk factor for VIIP. In an effort to understand the possible associations between CO2 and VIIP, this study explores the relationship of ambient CO2 levels on ISS compared to inflight ultrasound and OCT measures of the eye obtained from ISS crewmembers. CO2 measurements were aggregated from Operational Data Reduction Complex and Node 3 major constituent analyzers (MCAs) on ISS or from sensors located in the European Columbus module, as available. CO2 levels in the periods between each ultrasound and OCT session are summarized using timeseries metrics, including time-weighted means and variances. Partial least squares regression analyses are used to quantify the complex relationship between specific ultrasound and OCT measures and the CO2 metrics simulataneously. These analyses will enhance our understanding of the possible associations between CO2 levels and structural changes to the eye which will in turn inform future analysis of inflight VIIP data.

  18. Ultrasound of the small joints of the hands and feet: current status

    PubMed Central

    2007-01-01

    The aim of this article was to review the current status of ultrasound imaging of patients with rheumatological disorders of the hands and feet. Ultrasound machines with high-resolution surface probes are readily available in most radiology departments and can be used to address important clinical questions posed by the rheumatologist and sports and rehabilitation physician. There is increasing evidence that ultrasound detects synovitis that is silent to clinical examination. Detection and classification of synovitis and the early detection of bone erosions are important in clinical decision making. Ultrasound has many advantages over other imaging techniques with which it is compared, particularly magnetic resonance. The ability to carry out a rapid assessment of many widely spaced joints, coupled with clinical correlation, the ability to move and stress musculoskeletal structures and the use of ultrasound to guide therapy accurately are principal amongst these. The use of colour flow Doppler studies provides a measure of neovascularisation within the synovial lining of joints and tendons, and within tendons themselves, that is not available with other imaging techniques. Disadvantages compared to MRI include small field of view, poor image presentation, and difficulty in demonstrating cartilage and deep joints in their entirety. Contrast-enhanced magnetic resonance provides a better measure of capillary permeability and extracellular fluid than does ultrasound. The ability to image simultaneously multiple small joints in the hands and feet and their enhancement characteristics cannot be matched with ultrasound, though future developments in 3-D ultrasound may narrow this gap. Magnetic resonance provides a more uniform and reproducible image for long-term follow-up studies. PMID:17712556

  19. Transvaginal ultrasound

    MedlinePlus

    Endovaginal ultrasound; Ultrasound - transvaginal; Fibroids - transvaginal ultrasound; Vaginal bleeding - transvaginal ultrasound; Uterine bleeding - transvaginal ultrasound; Menstrual bleeding - transvaginal ultrasound; ...

  20. Reliability and Validity of Ultrasound Cross Sectional Area Measurements for Long-Duration Spaceflight

    NASA Technical Reports Server (NTRS)

    Scott, Jessica M.; Martin, David S.; Cunningham, David; Matz, Timothy; Caine, Timothy; Hackney, Kyle J.; Arzeno, Natalia; Ploutz-Snyder, Lori

    2010-01-01

    Limb muscle atrophy and the accompanying decline in function can adversely affect the performance of astronauts during mission-related activities and upon re-ambulation in a gravitational environment. Previous characterization of space flight-induced muscle atrophy has been performed using pre and post flight magnetic resonance imaging (MRI). In addition to being costly and time consuming, MRI is an impractical methodology for assessing in-flight changes in muscle size. Given the mobility of ultrasound (US) equipment, it may be more feasible to evaluate changes in muscle size using this technique. PURPOSE: To examine the reliability and validity of using a customized template to acquire panoramic ultrasound (US) images for determining quadriceps and gastrocnemius anatomical cross sectional area (CSA). METHODS: Vastus lateralis (VL), rectus femoris (RF), medial gastrocnemius (MG), and lateral gastrocnemius (LG) CSA were assessed in 10 healthy individuals (36+/-2 yrs) using US and MRI. Panoramic US images were acquired by 2 sonographers using a customized template placed on the thigh and calf and analyzed by the same 2 sonographers (CX50 Philips). MRI images of the leg were acquired while subjects were supine in a 1.5T scanner (Signa Horizon LX, General Electric) and were analyzed by 3 trained investigators. The average of the 2 US and 3 MRI values were used for validity analysis. RESULTS: High inter-experimenter reliability was found for both the US template and MRI analysis as coefficients of variation across muscles ranged from 2.4 to 4.1% and 2.8 to 3.8%, respectively. Significant correlations were found between US and MRI CSA measures (VL, r = 0.85; RF, r = 0.60; MG, r = 0.86; LG, r = 0.73; p < 0.05). Furthermore, the standard error of measurement between US and MRI ranged from 0.91 to 2.09 sq cm with high limits of agreement analyzed by Bland-Altman plots. However, there were significant differences between absolute values of MRI and US for all muscles

  1. Design and characterization of a high-power ultrasound driver with ultralow-output impedance

    NASA Astrophysics Data System (ADS)

    Lewis, George K.; Olbricht, William L.

    2009-11-01

    We describe a pocket-sized ultrasound driver with an ultralow-output impedance amplifier circuit (less than 0.05 Ω) that can transfer more than 99% of the voltage from a power supply to the ultrasound transducer with minimal reflections. The device produces high-power acoustical energy waves while operating at lower voltages than conventional ultrasound driving systems because energy losses owing to mismatched impedance are minimized. The peak performance of the driver is measured experimentally with a PZT-4, 1.54 MHz, piezoelectric ceramic, and modeled using an adjusted Mason model over a range of transducer resonant frequencies. The ultrasound driver can deliver a 100 Vpp (peak to peak) square-wave signal across 0-8 MHz ultrasound transducers in 5 ms bursts through continuous wave operation, producing acoustic powers exceeding 130 W. Effects of frequency, output impedance of the driver, and input impedance of the transducer on the maximum acoustic output power of piezoelectric transducers are examined. The small size, high power, and efficiency of the ultrasound driver make this technology useful for research, medical, and industrial ultrasonic applications.

  2. Thoracic ultrasound: Potential new tool for physiotherapists in respiratory management. A narrative review.

    PubMed

    Le Neindre, Aymeric; Mongodi, Silvia; Philippart, François; Bouhemad, Bélaïd

    2016-02-01

    The use of diagnostic ultrasound by physiotherapists is not a new concept; it is frequently performed in musculoskeletal physiotherapy. Physiotherapists currently lack accurate, reliable, sensitive, and valid measurements for the assessment of the indications and effectiveness of chest physiotherapy. Thoracic ultrasound may be a promising tool for the physiotherapist and could be routinely performed at patients' bedsides to provide real-time and accurate information on the status of pleura, lungs, and diaphragm; this would allow for assessment of lung aeration from interstitial syndrome to lung consolidation with much better accuracy than chest x-rays or auscultation. Diaphragm excursion and contractility may also be assessed by ultrasound. This narrative review refers to lung and diaphragm ultrasound semiology and describes how physiotherapists could use this tool in their clinical decision-making processes in various cases of respiratory disorders. The use of thoracic ultrasound semiology alongside typical examinations may allow for the guiding, monitoring, and evaluating of chest physiotherapy treatments. Thoracic ultrasound is a potential new tool for physiotherapists. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Design and characterization of a high-power ultrasound driver with ultralow-output impedance.

    PubMed

    Lewis, George K; Olbricht, William L

    2009-11-01

    We describe a pocket-sized ultrasound driver with an ultralow-output impedance amplifier circuit (less than 0.05 ohms) that can transfer more than 99% of the voltage from a power supply to the ultrasound transducer with minimal reflections. The device produces high-power acoustical energy waves while operating at lower voltages than conventional ultrasound driving systems because energy losses owing to mismatched impedance are minimized. The peak performance of the driver is measured experimentally with a PZT-4, 1.54 MHz, piezoelectric ceramic, and modeled using an adjusted Mason model over a range of transducer resonant frequencies. The ultrasound driver can deliver a 100 V(pp) (peak to peak) square-wave signal across 0-8 MHz ultrasound transducers in 5 ms bursts through continuous wave operation, producing acoustic powers exceeding 130 W. Effects of frequency, output impedance of the driver, and input impedance of the transducer on the maximum acoustic output power of piezoelectric transducers are examined. The small size, high power, and efficiency of the ultrasound driver make this technology useful for research, medical, and industrial ultrasonic applications.

  4. Medical Imaging with Ultrasound: Some Basic Physics.

    ERIC Educational Resources Information Center

    Gosling, R.

    1989-01-01

    Discussed are medical applications of ultrasound. The physics of the wave nature of ultrasound including its propagation and production, return by the body, spatial and contrast resolution, attenuation, image formation using pulsed echo ultrasound techniques, measurement of velocity and duplex scanning are described. (YP)

  5. Reliability of ultrasound thickness measurement of the abdominal muscles during clinical isometric endurance tests.

    PubMed

    ShahAli, Shabnam; Arab, Amir Massoud; Talebian, Saeed; Ebrahimi, Esmaeil; Bahmani, Andia; Karimi, Noureddin; Nabavi, Hoda

    2015-07-01

    The study was designed to evaluate the intra-examiner reliability of ultrasound (US) thickness measurement of abdominal muscles activity when supine lying and during two isometric endurance tests in subjects with and without Low back pain (LBP). A total of 19 women (9 with LBP, 10 without LBP) participated in the study. Within-day reliability of the US thickness measurements at supine lying and the two isometric endurance tests were assessed in all subjects. The intra-class correlation coefficient (ICC) was used to assess the relative reliability of thickness measurement. The standard error of measurement (SEM), minimal detectable change (MDC) and the coefficient of variation (CV) were used to evaluate the absolute reliability. Results indicated high ICC scores (0.73-0.99) and also small SEM and MDC scores for within-day reliability assessment. The Bland-Altman plots of agreement in US measurement of the abdominal muscles during the two isometric endurance tests demonstrated that 95% of the observations fall between the limits of agreement for test and retest measurements. Together the results indicate high intra-tester reliability for the US measurement of the thickness of abdominal muscles in all the positions tested. According to the study's findings, US imaging can be used as a reliable method for assessment of abdominal muscles activity in supine lying and the two isometric endurance tests employed, in participants with and without LBP. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Performance of chest ultrasound in pediatric pneumonia.

    PubMed

    Claes, Anne-Sophie; Clapuyt, Philippe; Menten, Renaud; Michoux, Nicolas; Dumitriu, Dana

    2017-03-01

    The objective of this study was to evaluate the performance of ultrasound in detecting lung consolidation in children suspected of pneumonia, in comparison to the current gold standard, chest X-rays. From September 2013 to June 2014, a monocentric prospective study was performed on all children between 0 and 16 years-old, referred for chest X-ray for suspected pneumonia. Each child was examined by chest ultrasound by an examiner blinded to the chest X-ray. The presence or absence of areas of consolidation, their number and location were noted for each technique. The size of the consolidations identified only on ultrasound was compared with that of consolidations visible on both techniques. 143 children (mean age 3 years; limits between 8days and 14 years) were included. Ultrasound detected at least one area of consolidation in 44 out of 45 patients with positive X-rays. Of the 59 areas of consolidation on X-ray, ultrasound identified 54. In the 8 patients with negative X-ray, ultrasound revealed 17 areas of consolidation. The mean size of consolidations visible only on ultrasound was 9.4mm; for consolidations visible on both techniques the mean size was 26mm (p<0.0001). The sensitivity and specificity of ultrasound were calculated at 98% and 92%. PPV and NPV were 85% and 99%, respectively. Chest ultrasound is a fast, non-ionizing and feasible technique. With its high negative predictive value, it can replace X-rays in order to exclude lung consolidation in children, thus reducing radiation exposure in this population. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Is uterine depth measurement by trans-vaginal ultrasound alone as accurate as measurement carried out by trans-abdominal ultrasound-guided trial transfer?

    PubMed

    Edris, Fawaz E

    2014-10-01

    To assess the reliability of trans-vaginal-scan (TVS) in measuring the uterine depth (UD) in comparison with ultrasound-guided trial-transfer (UTT). This prospective study was conducted in 66 consecutive patients undergoing in-vitro fertilization and embryo transfer (IVF-ET). The study took place in a private IVF center in Jeddah, Saudi Arabia between November 2013 and January 2014. The patients underwent UD measurements using TVS and UTT, sequentially. All scans were performed by a single sonographer, and all UTT were carried out by a single physician who was blinded to the TVS measurement. The median (95% confidence interval) UD measurement using the TVS method was 6.9 cm (5.0-12.5) and UTT was 7.1 cm (5.9-13.5), (p<0.0001). Fifteen patients (22.7%) had a difference of >1 cm between the 2 measurement modalities (group-B). When measured by UTT, 93.3% of patients in group-B had UD >/-8cm, compared with 9.8% of patients in group-A, (p<0.0001). Group-B had a significantly longer uterine cavity when measured by UTT (p<0.0001), and a trend towards significance when measured by TVS (p=0.055). The TVS measurements generally underestimated UD when compared with UTT. Trans-vaginal-scan is less reliable than UTT and should not be used as a substitute. Larger sample-size studies involving different personnel, and equipment is needed. 

  8. Fetal growth and air pollution - A study on ultrasound and birth measures.

    PubMed

    Malmqvist, Ebba; Liew, Zeyan; Källén, Karin; Rignell-Hydbom, Anna; Rittner, Ralf; Rylander, Lars; Ritz, Beate

    2017-01-01

    Air pollution has been suggested to affect fetal growth, but more data is needed to assess the timing of exposure effects by using ultrasound measures. It is also important to study effects in low exposure areas to assess eventual thresholds of effects. The MAPSS (Maternal Air Pollution in Southern Sweden) cohort consists of linked registry data for around 48,000 pregnancies from an ultrasound database, birth registry and exposure data based on residential addresses. Measures of air pollution exposure were obtained through dispersion modelling with input data from an emissions database (NO x ) with high resolution (100-500m grids). Air pollution effects were assessed with linear regressions for the following endpoints; biparietal diameter, femur length, abdominal diameter and estimated fetal weight measured in late pregnancy and birth weight and head circumference measured at birth. We estimated negative effects for NO x ; in the adjusted analyses the decrease of abdominal diameter and femur length were -0.10 (-0.17, -0.03) and -0.13 (-0.17, -0.01)mm, respectively, per 10µg/m 3 increment of NO x . We also estimated an effect of NO x -exposures on birth weight by reducing birth weight by 9g per 10µg/m 3 increment of NO x . We estimated small but statistically significant effects of air pollution on late fetal and birth size and reduced fetal growth late in pregnancy in a geographic area with levels below current WHO air quality guidelines. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  9. Mapping cardiac fiber orientations from high-resolution DTI to high-frequency 3D ultrasound

    NASA Astrophysics Data System (ADS)

    Qin, Xulei; Wang, Silun; Shen, Ming; Zhang, Xiaodong; Wagner, Mary B.; Fei, Baowei

    2014-03-01

    The orientation of cardiac fibers affects the anatomical, mechanical, and electrophysiological properties of the heart. Although echocardiography is the most common imaging modality in clinical cardiac examination, it can only provide the cardiac geometry or motion information without cardiac fiber orientations. If the patient's cardiac fiber orientations can be mapped to his/her echocardiography images in clinical examinations, it may provide quantitative measures for diagnosis, personalized modeling, and image-guided cardiac therapies. Therefore, this project addresses the feasibility of mapping personalized cardiac fiber orientations to three-dimensional (3D) ultrasound image volumes. First, the geometry of the heart extracted from the MRI is translated to 3D ultrasound by rigid and deformable registration. Deformation fields between both geometries from MRI and ultrasound are obtained after registration. Three different deformable registration methods were utilized for the MRI-ultrasound registration. Finally, the cardiac fiber orientations imaged by DTI are mapped to ultrasound volumes based on the extracted deformation fields. Moreover, this study also demonstrated the ability to simulate electricity activations during the cardiac resynchronization therapy (CRT) process. The proposed method has been validated in two rat hearts and three canine hearts. After MRI/ultrasound image registration, the Dice similarity scores were more than 90% and the corresponding target errors were less than 0.25 mm. This proposed approach can provide cardiac fiber orientations to ultrasound images and can have a variety of potential applications in cardiac imaging.

  10. Repeatability and reproducibility of measurements of the suburethral tape location obtained in pelvic floor ultrasound performed with a transvaginal probe

    PubMed Central

    Dresler, Maria Magdalena; Kociszewski, Jacek; Pędraszewski, Piotr; Trzeciak, Agnieszka; Surkont, Grzegorz

    2017-01-01

    Introduction Implants used to treat patients with urogynecological conditions are well visible in US examination. The position of the suburethral tape (sling) is determined in relation to the urethra or the pubic symphysis. Aim of the study The study was aimed at assessing the accuracy of measurements determining suburethral tape location obtained in pelvic US examination performed with a transvaginal probe. Material and methods The analysis covered the results of sonographic measurements obtained according to a standardized technique in women referred for urogynecological diagnostics. Data from a total of 68 patients were used to analyse the repeatability and reproducibility of results obtained on the same day. Results The intraclass correlation coefficient for the repeatability and reproducibility of the sonographic measurements of suburethral tape location obtained with a transvaginal probe ranged from 0.6665 to 0.9911. The analysis of the measurements confirmed their consistency to be excellent or good. Conclusions Excellent and good repeatability and reproducibility of the measurements of the suburethral tape location obtained in a pelvic ultrasound performed with a transvaginal probe confirm the test’s validity and usefulness for clinical and academic purposes. PMID:28856017

  11. ULTRASOUND MEASUREMENTS AND OBJECTIVE FORCES OF GLENOHUMERAL TRANSLATIONS DURING SHOULDER ACCESSORY PASSIVE MOTION TESTING IN HEALTHY INDIVIDUALS

    PubMed Central

    Worst, Haley; Decarreau, Ryan; Davies, George

    2016-01-01

    Background Clinical examination of caspuloligamentous structures of the glenohumeral joint has historically been subjective in nature, as demonstrated by limited intra-rater and inter-rater reproducibility. Musculoskeletal diagnostic ultrasound was utilized to develop a clinically objective measurement technique for glenohumeral inferior and posterolateral translation. Purpose The purpose of this study was to measure the accessory passive force required to achieve end range glenohumeral posterolateral and inferior accessory translation, as well as, to quantify the amount of translation of the glenohumeral joint caused by the applied force. Study Design Cross-sectional descriptive correlational study Methods Twenty-five asymptomatic subjects between the ages of 18 and 30 were recruited via convenience sampling. Posterolateral and inferior shoulder accessory passive translation was assessed and measured using a GE LOGIQe ultrasound, while concurrently using a hand held dynamometer to quantify the passive force applied during assessment. Normative values for force and translation were described as means and standard deviations. Results Mean values for posterolateral translation were 6.5 +/− 4.0 mm on the right shoulder and 6.3 +/− 3.5 mm on the left with an associated mean force of 127.1 +/− 55.6 N and 114.4 +/− 50.7 N, respectively. Mean values for inferior translation were 4.8 +/− 1.7 mm on the right shoulder and 5.4 +/− 1.8 mm on the left with an associated mean force of 84.5 +/− 30.5 N and 76.1 +/− 30.1 N, respectively. There was a significant association between inferior translation and inferior force (r = .51). No significant association was found between posterolateral translation and posterolateral force. Significant differences were found between dominant and non-dominant shoulders for posterolateral translation, posterolateral force to produce translation, and inferior translation values

  12. Ultrasound

    MedlinePlus

    ... community Home > Pregnancy > Prenatal care > Ultrasound during pregnancy Ultrasound during pregnancy E-mail to a friend Please ... you. What are some reasons for having an ultrasound? Your provider uses ultrasound to do several things, ...

  13. Quantitative Contrast-Enhanced Ultrasound Parameters in Crohn Disease: Their Role in Disease Activity Determination With Ultrasound.

    PubMed

    Medellin-Kowalewski, Alexandra; Wilkens, Rune; Wilson, Alexandra; Ruan, Ji; Wilson, Stephanie R

    2016-01-01

    The primary objective of our study was to examine the association between contrast-enhanced ultrasound (CEUS) parameters and established gray-scale ultrasound with color Doppler imaging (CDI) for the determination of disease activity in patients with Crohn disease. Our secondary objective was to develop quantitative time-signal intensity curve thresholds for disease activity. One hundred twenty-seven patients with Crohn disease underwent ultrasound with CDI and CEUS. Reviewers graded wall thickness, inflammatory fat, and mural blood flow as showing remission or inflammation (mild, moderate, or severe). If both gray-scale ultrasound and CDI predicted equal levels of disease activity, the studies were considered concordant. If ultrasound images suggested active disease not supported by CDI findings, the ultrasound results for disease activity were indeterminate. Time-signal intensity curves from CEUS were acquired with calculation of peak enhancement (PE), and AUCs. Interobserver variation and associations between PE and ultrasound parameters were examined. Multiclass ROC analysis was used to develop CEUS thresholds for activity. Ninety-six (76%) studies were concordant, 19 of which showed severe disease, and 31 (24%) studies were indeterminate. Kappa analyses revealed good interobserver agreement on grades for CDI (κ = 0.76) and ultrasound (κ = 0.80) assessments. PE values on CEUS and wall thickness showed good association with the Spearman rank correlation coefficient for the entire population (ρ = 0.62, p < 0.01) and for the concordant group (ρ = 0.70, p < 0.01). Multiclass ROC analyses of the concordant group using wall thickness alone as the reference standard showed cutoff points of 18.2 dB for differentiating mild versus moderate activity (sensitivity, 89.0% and specificity, 87.0%) and 23.0 dB for differentiating moderate versus severe (sensitivity, 90% and specificity, 86.8%). Almost identical cutoff points were observed when using ultrasound global

  14. Acoustic characterization of high intensity focused ultrasound fields: A combined measurement and modeling approach

    PubMed Central

    Canney, Michael S.; Bailey, Michael R.; Crum, Lawrence A.; Khokhlova, Vera A.; Sapozhnikov, Oleg A.

    2008-01-01

    Acoustic characterization of high intensity focused ultrasound (HIFU) fields is important both for the accurate prediction of ultrasound induced bioeffects in tissues and for the development of regulatory standards for clinical HIFU devices. In this paper, a method to determine HIFU field parameters at and around the focus is proposed. Nonlinear pressure waveforms were measured and modeled in water and in a tissue-mimicking gel phantom for a 2 MHz transducer with an aperture and focal length of 4.4 cm. Measurements were performed with a fiber optic probe hydrophone at intensity levels up to 24 000 W∕cm2. The inputs to a Khokhlov–Zabolotskaya–Kuznetsov-type numerical model were determined based on experimental low amplitude beam plots. Strongly asymmetric waveforms with peak positive pressures up to 80 MPa and peak negative pressures up to 15 MPa were obtained both numerically and experimentally. Numerical simulations and experimental measurements agreed well; however, when steep shocks were present in the waveform at focal intensity levels higher than 6000 W∕cm2, lower values of the peak positive pressure were observed in the measured waveforms. This underrepresentation was attributed mainly to the limited hydrophone bandwidth of 100 MHz. It is shown that a combination of measurements and modeling is necessary to enable accurate characterization of HIFU fields. PMID:19062878

  15. Effect of modulated ultrasound parameters on ultrasound-induced thrombolysis.

    PubMed

    Soltani, Azita; Volz, Kim R; Hansmann, Doulas R

    2008-12-07

    The potential of ultrasound to enhance enzyme-mediated thrombolysis by application of constant operating parameters (COP) has been widely demonstrated. In this study, the effect of ultrasound with modulated operating parameters (MOP) on enzyme-mediated thrombolysis was investigated. The MOP protocol was applied to an in vitro model of thrombolysis. The results were compared to a COP with the equivalent soft tissue thermal index (TIS) over the duration of ultrasound exposure of 30 min (p < 0.14). To explore potential differences in the mechanism responsible for ultrasound-induced thrombolysis, a perfusion model was used to measure changes in average fibrin pore size of clot before, after and during exposure to MOP and COP protocols and cavitational activity was monitored in real time for both protocols using a passive cavitation detection system. The relative lysis enhancement by each COP and MOP protocol compared to alteplase alone yielded values of 33.69 +/- 12.09% and 63.89 +/- 15.02% in a thrombolysis model, respectively (p < 0.007). Both COP and MOP protocols caused an equivalent significant increase in average clot pore size of 2.09 x 10(-2) +/- 0.01 microm and 1.99 x 10(-2) +/- 0.004 microm, respectively (p < 0.74). No signatures of inertial or stable cavitation were observed for either acoustic protocol. In conclusion, due to mechanisms other than cavitation, application of ultrasound with modulated operating parameters has the potential to significantly enhance the relative lysis enhancement compared to application of ultrasound with constant operating parameters.

  16. A high pulse repetition frequency ultrasound system for the ex vivo measurement of mechanical properties of crystalline lenses with laser-induced microbubbles interrogated by acoustic radiation force.

    PubMed

    Yoon, Sangpil; Aglyamov, Salavat; Karpiouk, Andrei; Emelianov, Stanislav

    2012-08-07

    A high pulse repetition frequency ultrasound system for an ex vivo measurement of mechanical properties of an animal crystalline lens was developed and validated. We measured the bulk displacement of laser-induced microbubbles created at different positions within the lens using nanosecond laser pulses. An impulsive acoustic radiation force was applied to the microbubble, and spatio-temporal measurements of the microbubble displacement were assessed using a custom-made high pulse repetition frequency ultrasound system consisting of two 25 MHz focused ultrasound transducers. One of these transducers was used to emit a train of ultrasound pulses and another transducer was used to receive the ultrasound echoes reflected from the microbubble. The developed system was operating at 1 MHz pulse repetition frequency. Based on the measured motion of the microbubble, Young's moduli of surrounding tissue were reconstructed and the values were compared with those measured using the indentation test. Measured values of Young's moduli of four bovine lenses ranged from 2.6 ± 0.1 to 26 ± 1.4 kPa, and there was good agreement between the two methods. Therefore, our studies, utilizing the high pulse repetition frequency ultrasound system, suggest that the developed approach can be used to assess the mechanical properties of ex vivo crystalline lenses. Furthermore, the potential of the presented approach for in vivo measurements is discussed.

  17. Ultrasound biomicroscopic findings in hallerman-streiff syndrome.

    PubMed

    Sato, Miho; Terasaki, Hiroko; Amano, Emil; Okamoto, Yoko; Miyake, Yozo

    2002-01-01

    To demonstrate the usefulness of ultrasound biomicroscopy in detecting the morphological changes in the lens caused by the spontaneous absorption of lens material and to detect fundus abnormalities in a patient with Hallermann-Streiff syndrome. Case report of an infant diagnosed at the age of 2 months as having Hallermann-Streiff syndrome. Spontaneous lens absorption occurred during the course of follow-up and was detected only by ultrasound biomicroscopy after the patient was prepared for cataract surgery. The changes in the anterior chamber depth and lens shapes were documented by ultrasound biomicroscopy. Retinal folds that were barely observable by conventional ophthalmoscopy because of a dense cataract were clearly shown by ultrasound biomicroscopy. Ultrasound biomicroscopy can be used to examine the lenses of eyes that are not observable with conventional optical instruments. Ultrasound biomicroscopy can also be used to study the posterior segment of microphthalmic eyes. We recommend preoperative ultrasound biomicroscopy to prevent unnecessary anesthesia and surgical preparation.

  18. Routine obstetric ultrasound examinations in South Africa: cost and effect on perinatal outcome--a prospective randomised controlled trial.

    PubMed

    Geerts, L T; Brand, E J; Theron, G B

    1996-06-01

    To compare routine midtrimester with selective obstetric ultrasonography concerning the Health Service cost and the effect on perinatal outcome. A randomised controlled trial. Urban area served by Tygerberg Hospital, a tertiary referral centre in South Africa. Pregnant patients without risk factors for congenital anomalies referred for ultrasonography between 18 and 24 weeks of gestation. Between 18 and 24 weeks, a level one ultrasound examination was performed on study patients only. Except for the routine scan, both groups received the same antenatal care and could be referred later for additional scans as judged by their clinicians. Overall adverse perinatal outcome and use of antenatal and neonatal services. The groups did not differ significantly in their use of antenatal and neonatal services except for a greater number of ultrasound scans in the study group. More suspected postdate pregnancies occurred in control patients, as well as more amniocenteses for confirmation of lung maturity. More babies of low birthweight were born in the study group. The incidence of overall or major adverse perinatal outcome was comparable. Routine ultrasonography was accompanied by a considerable increase in costs. Selective use of obstetric ultrasonography did not increase the use of antenatal and neonatal services. Not routinely performing ultrasonography has led to considerable Health Service savings without increasing the risk for adverse perinatal outcome. It saved 75% of selected patients a referral to an ultrasound unit. Specific problems related to inaccurate gestational age determination need to be addressed.

  19. AMH MEASUREMENT VERSUS OVARIAN ULTRASOUND IN THE DIAGNOSIS OF POLYCYSTIC OVARY SYNDROME IN DIFFERENT PHENOTYPES.

    PubMed

    Carmina, Enrico; Campagna, Anna M; Fruzzetti, Franca; Lobo, Rogerio A

    2016-03-01

    This study was designed to assess the value of serum anti-Müllerian hormone (AMH) in the diagnosis of polycystic ovary syndrome (PCOS) in various phenotypes and to assess ovarian ultrasound parameters. We performed a retrospective matched controlled study of 113 females with various PCOS phenotypes and 47 matched controls. The diagnostic utility of AMH measurement and ovarian ultrasound were compared. Using receiver operating characteristic (ROC) curve analyses, the threshold for AMH (>4.7 ng/mL) and ultrasound parameters (follicle number per ovary [FNPO] >22 and ovarian volume [OV] >8 cc) were established. In the entire cohort, AMH had a low sensitivity of 79%; while FNPO and OV were 93% and 68%, respectively. Specificities ranged from 85 to 96%. In classic anovulatory PCOS, AMH exhibited a sensitivity of 91%, and for FNPO and OV the corresponding sensitivities were 92% and 72%. In the ovulatory phenotype, AMH sensitivity was only 50%, while FNPO and OV were 95% and 50%, respectively. In the nonhyperandrogenic phenotype, the sensitivity of AMH was 53% while those for FNPO and OV were 93% and 67%. AMH does not appear to be helpful for all subjects with PCOS but may be of some value in those who are anovulatory. However, FNPO was highly sensitive in all phenotypes, and was the single best criterion assessed for all subjects, suggesting the important role of ultrasound.

  20. [Ultrasound biomicroscopy of conjunctival lesions].

    PubMed

    Buchwald, Hans-Jürgen; Müller, Andreas; Spraul, Christoph W; Lang, Gerhard K

    2003-01-01

    The value of ultrasound biomicroscopy in the diagnosis of conjunctival lesions is not well established. For the examination of conjunctival lesions, we used an ultrasound biomicroscope (Humphrey, Zeiss, Oberkochen) with a high frequency transducer (30 MHz). Between January 2000 and August 2001, 28 patients (16 female, 12-male) with conjunctival lesions, aged 9 to 81 years, were available for this study. Histological examination of the excised tissue displayed the presence of a compound naevus (8/28), cysts (6/28), inflammatory processes (3/28), granulomatous processes (2/28), lymphomas (2/28), foreign bodies (2/28), a pterygium (2/28), a malignant melanoma (1/28), a primary acquired melanosis (1/28), and a conjunctival amyloidosis (1/28). Using ultrasound biomicroscopy we were able to demonstrate a cystic tumour in the six patients (21 %) with a cyst of the conjunctiva. In patients suffering from solid tumours of the conjunctiva the definite diagnosis could not be made with ultrasound biomicroscopy alone. The eight patients with compound naevus displayed a somewhat heterogeneous sonographic structure within the tumour. In the patient with a foreign body we were able to demonstrate posterior shadowing of the underlying tissue. For evaluation of conjunctival lesions caused by a cyst or a solid tumour, ultrasound biomicroscopy may be an additional diagnostic tool, e. g. for assessing the margins of the tumour. However, up to now it is not possible to differentiate between different lesions solely by means of ultrasonography.

  1. A step towards measuring the fetal head circumference with the use of obstetric ultrasound in a low resource setting

    NASA Astrophysics Data System (ADS)

    van den Heuvel, Thomas L. A.; Petros, Hezkiel; Santini, Stefano; de Korte, Chris L.; van Ginneken, Bram

    2017-03-01

    Worldwide, 99% of all maternal deaths occur in low-resource countries. Ultrasound imaging can be used to detect maternal risk factors, but requires a well-trained sonographer to obtain the biometric parameters of the fetus. One of the most important biometric parameters is the fetal Head Circumference (HC). The HC can be used to estimate the Gestational Age (GA) and assess the growth of the fetus. In this paper we propose a method to estimate the fetal HC with the use of the Obstetric Sweep Protocol (OSP). With the OSP the abdomen of pregnant women is imaged with the use of sweeps. These sweeps can be taught to somebody without any prior knowledge of ultrasound within a day. Both the OSP and the standard two-dimensional ultrasound image for HC assessment were acquired by an experienced gynecologist from fifty pregnant women in St. Luke's Hospital in Wolisso, Ethiopia. The reference HC from the standard two-dimensional ultrasound image was compared to both the manually measured HC and the automatically measured HC from the OSP data. The median difference between the estimated GA from the manual measured HC using the OSP and the reference standard was -1.1 days (Median Absolute Deviation (MAD) 7.7 days). The median difference between the estimated GA from the automatically measured HC using the OSP and the reference standard was -6.2 days (MAD 8.6 days). Therefore, it can be concluded that it is possible to estimate the fetal GA with simple obstetric sweeps with a deviation of only one week.

  2. Endoscopic ultrasound for the characterization and staging of rectal cancer. Current state of the method. Technological advances and perspectives.

    PubMed

    Gersak, Mariana M; Badea, Radu; Graur, Florin; Hajja, Nadim Al; Furcea, Luminita; Dudea, Sorin M

    2015-06-01

    Endoscopic ultrasound is the most accurate type of examination for the assessment of rectal tumors. Over the years, the method has advanced from gray-scale examination to intravenous contrast media administration and to different types of elastography. The multimodal approach of tumors (transrectal, transvaginal) is adapted to each case. 3D ultrasound is useful for spatial representation and precise measurement of tumor formations, using CT/MR image reconstruction; color elastography is useful for tumor characterization and staging; endoscopic ultrasound using intravenous contrast agents can help study the amount of contrast agent targeted at the level of the tumor formations and contrast wash-in/wash-out time, based on the curves displayed on the device. The transvaginal approach often allows better visualization of the tumor than the transrectal approach. Performing the procedure with the rectal ampulla distended with contrast agent may be seen as an optimization of the examination methodology. All these aspects are additional methods for gray-scale endoscopic ultrasound, capable of increasing diagnostic accuracy. This paper aims at reviewing the progress of transrectal and transvaginal ultrasound, generically called endoscopic ultrasound, for rectal tumor diagnosis and staging, with emphasis on the current state of the method and its development trends.

  3. Elasticity mapping of tissue mimicking phantoms by remote palpation with a focused ultrasound beam and intensity autocorrelation measurements

    NASA Astrophysics Data System (ADS)

    Usha Devi, C.; Bharat Chandran, R. S.; Vasu, R. M.; Sood, A. K.

    2007-05-01

    We use a focused ultrasound beam to load a region of interest (ROI) in a tissue-mimicking phantom and read out the vibration amplitude of phantom particles from the modulation depth in the intensity autocorrelation of a coherent light beam that intercepted the ROI. The modulation depth, which is also affected by the local light absorption coefficient, which is employed in ultrasound assisted optical tomography, to read out absorption coefficient is greatly influenced by the vibration amplitude, depends to a great extend on local elasticity. We scan a plane in an elastography phantom with an inhomogeneous inclusion, in elasticity with the focused ultrasound and from the measured modulation depth variation create a qualitative map of the elasticity variation in the interrogated plane.

  4. Measurement of Angle Kappa Using Ultrasound Biomicroscopy and Corneal Topography

    PubMed Central

    Yeo, Joon Hyung; Moon, Nam Ju

    2017-01-01

    Purpose To introduce a new convenient and accurate method to measure the angle kappa using ultrasound biomicroscopy (UBM) and corneal topography. Methods Data from 42 eyes (13 males and 29 females) were analyzed in this study. The angle kappa was measured using Orbscan II and calculated with UBM and corneal topography. The angle kappa of the dominant eye was compared with measurements by Orbscan II. Results The mean patient age was 36.4 ± 13.8 years. The average angle kappa measured by Orbscan II was 3.98° ± 1.12°, while the average angle kappa calculated with UBM and corneal topography was 3.19° ± 1.15°. The difference in angle kappa measured by the two methods was statistically significant (p < 0.001). The two methods showed good reliability (intraclass correlation coefficient, 0.671; p < 0.001). Bland-Altman plots were used to demonstrate the agreement between the two methods. Conclusions We designed a new method using UBM and corneal topography to calculate the angle kappa. This method is convenient to use and allows for measurement of the angle kappa without an expensive device. PMID:28471103

  5. Measurement of Angle Kappa Using Ultrasound Biomicroscopy and Corneal Topography.

    PubMed

    Yeo, Joon Hyung; Moon, Nam Ju; Lee, Jeong Kyu

    2017-06-01

    To introduce a new convenient and accurate method to measure the angle kappa using ultrasound biomicroscopy (UBM) and corneal topography. Data from 42 eyes (13 males and 29 females) were analyzed in this study. The angle kappa was measured using Orbscan II and calculated with UBM and corneal topography. The angle kappa of the dominant eye was compared with measurements by Orbscan II. The mean patient age was 36.4 ± 13.8 years. The average angle kappa measured by Orbscan II was 3.98° ± 1.12°, while the average angle kappa calculated with UBM and corneal topography was 3.19° ± 1.15°. The difference in angle kappa measured by the two methods was statistically significant (p < 0.001). The two methods showed good reliability (intraclass correlation coefficient, 0.671; p < 0.001). Bland-Altman plots were used to demonstrate the agreement between the two methods. We designed a new method using UBM and corneal topography to calculate the angle kappa. This method is convenient to use and allows for measurement of the angle kappa without an expensive device. © 2017 The Korean Ophthalmological Society

  6. Ultrasound in the diagnosis of palpable abdominal masses in children.

    PubMed

    Annuar, Z; Sakijan, A S; Annuar, N; Kooi, G H

    1990-12-01

    Ultrasound examinations were done to evaluate clinically palpable abdominal masses in 125 children. The examinations were normal in 21 patients. In 15 patients, the clinically palpable masses were actually anterior abdominal wall abscesses or hematomas. Final diagnosis was available in 87 of 89 patients with intraabdominal masses detected on ultrasound. The majority (71%) were retroperitoneal masses where two-thirds were of renal origin. Ultrasound diagnosis was correct in 68 patients (78%). All cases of hydronephrosis were correctly diagnosed based on characteristic ultrasound appearances. Correct diagnoses of all cases of adrenal hematoma, psoas abscess, liver hematoma, liver abscess and one case of liver metastases were achieved with correlation of relevant clinical information.

  7. The use of ultrasound in the assessment of the glenoid labrum of the glenohumeral joint. Part I: Ultrasound anatomy and examination technique

    PubMed Central

    2012-01-01

    The glenohumeral joint is a spherical articulation with a remarkable range of motion in several planes and decreased stability. The maintenance of joint stability is influenced by the functioning of specific muscle groups in the shoulder region, a complex system of ligaments reinforcing the joint capsule, and the labrum which augments the glenoid fossa. Lesions of the aforementioned structures require accurate diagnosis prior to a decision for operative treatment. Ultrasound is one of the imaging methods that has been widely used in the assessment of various shoulder pathologies. In the author opinion, this imaging modality may also be applied for the evaluation of labral tears. Being attached along the glenoid rim, the labrum forms a collar deepening the glenoid fossa thus increasing area of its contact with the head of the humerus. To better describe the location of lesions, the glenoid labrum is usually divided into certain zones. Most of them may be visualized sonographically. The US examination of the posterior labrum can be performed during evaluation of the infraspinatus and teres minor muscles. The anterior labrum along with capsulolabral complex is seen at the glenoid edge under the subscapularis tendon. Sonographic examination of the inferior labrum is best performed using axillar approach. The superior labrum is only partially available for US examination. A crucial part of the sonographic assessment of the labrum is the dynamic examination during rotation of the upper extremity. The paper presents normal sonographic anatomy of the glenoid labrum and technique of the examination. PMID:26673515

  8. Duplex ultrasound

    MedlinePlus

    Vascular ultrasound; Peripheral vascular ultrasound ... A duplex ultrasound combines: Traditional ultrasound: This uses sound waves that bounce off blood vessels to create pictures. Doppler ultrasound: This ...

  9. Implementation of a 4-Year Point-of-Care Ultrasound Curriculum in a Liaison Committee on Medical Education-Accredited US Medical School.

    PubMed

    Wilson, Sean P; Mefford, Jason M; Lahham, Shadi; Lotfipour, Shahram; Subeh, Mohammad; Maldonado, Gracie; Spann, Sophie; Fox, John C

    2017-02-01

    The established benefits of point-of-care ultrasound have given rise to multiple new and innovative curriculums to incorporate ultrasound teaching into medical education. This study sought to measure the educational success of a comprehensive and integrated 4-year point-of-care ultrasound curriculum. We integrated a curriculum consisting of traditional didactics combined with asynchronous learning modules and hands-on practice on live models with skilled sonographers into all 4 years of education at a Liaison Committee on Medical Education-accredited US Medical School. Each graduating student was administered an exit examination with 48 questions that corresponded to ultrasound milestones. Ninety-five percent (n = 84) of fourth-year medical students completed the exit examination. The mean score was 79.5% (SD, 10.2%), with mean scores on the ultrasound physics and anatomy subsections being 77.1% (SD, 11.0%) and 85.9% (SD, 21.0%), respectively. A comprehensive 4-year point-of-care ultrasound curriculum integrated into medical school may successfully equip graduating medical students with a fundamental understanding of ultrasound physics, anatomy, and disease recognition. © 2016 by the American Institute of Ultrasound in Medicine.

  10. Right Upper Quadrant Pain: Ultrasound First!

    PubMed

    Revzin, Margarita V; Scoutt, Leslie M; Garner, Joseph G; Moore, Christopher L

    2017-10-01

    Acute right upper quadrant (RUQ) pain is a common presenting symptom in emergency departments and outpatient medical practices, and is most commonly attributable to biliary and hepatic pathology. Ultrasound should be used as a first-line imaging modality for the diagnosis of gallstones and cholecystitis, as it allows the differentiation of medical and surgical causes of upper abdominal pathology, and in many circumstances is sufficient to guide patient management. Knowledge of strengths and limitations of ultrasound in the evaluation of RUQ is paramount in correct diagnosis. A spectrum of RUQ pathology for which a RUQ ultrasound examination should reasonably be considered as the initial imaging modality of choice will be reviewed. © 2017 by the American Institute of Ultrasound in Medicine.

  11. An uncovered risk factor of sonothrombolysis: Substantial fluctuation of ultrasound transmittance through the human skull.

    PubMed

    Wang, Zuojun; Komatsu, Teppei; Mitsumura, Hidetaka; Nakata, Norio; Ogawa, Takeki; Iguchi, Yasuyuki; Yokoyama, Masayuki

    2017-05-01

    Sonothrombolysis is one of the most feasible methods for enhancing clot lysis with a recombinant tissue plasminogen activator (rt-PA) in cases of acute ischemic strokes. For safe and efficient clinical practices of sonothrombolysis, accurate estimation of ultrasound transmittance through the human skull is critical. Previously, we reported substantial and periodic fluctuation of ultrasound transmittance through a bone-phantom plate following changes to ultrasound frequency, the thickness of the bone-phantom plate, and the distance between a transducer and the bone-phantom plate. In the present study, we clarify the transmittance behavior of medium-frequency ultrasound (from 400kHz to 600kHz) through the human skull, and examine reduction of the transmittance fluctuation. For the study, we measured transmittance of sinusoidal ultrasound waves at 400kHz, 500kHz, and 600kHz at 13 temple spots on 3 human skulls by changing the distance between a transducer and the skull bone, and found substantial and periodic fluctuation in the transmittance behaviors for these sinusoidal voltage excitations. Degrees of the fluctuation varied depending on the measurement spots. A fluctuation ratio between the maximum transmittance and the minimum transmittance reached 3 in some spots. This large transmittance fluctuation is considered to be a risk factor for sonothrombolysis therapies. We examined a modulated ultrasound wave to reduce the fluctuation, and succeeded in obtaining considerable reduction. The average fluctuation ratios for 400-kHz, 500-kHz, and 600-kHz waves were 2.38, 2.38, and 2.07, respectively. We successfully reduced the ratio to 1.72 by using a periodic selection of random frequency (PSRF)-type of modulation wave. The thus obtained results indicate that attention to the fluctuation in ultrasound transmittance through the skull is necessary for safe and effective sonothrombolysis therapies, and that modulated ultrasound waves constitute a powerful method for reducing

  12. Goal-directed ultrasound in the detection of long-bone fractures

    NASA Technical Reports Server (NTRS)

    Marshburn, Thomas H.; Legome, Eric; Sargsyan, Ashot; Li, Shannon Melton James; Noble, Vicki A.; Dulchavsky, Scott A.; Sims, Carrie; Robinson, David

    2004-01-01

    BACKGROUND: New portable ultrasound (US) systems are capable of detecting fractures in the remote setting. However, the accuracy of ultrasound by physicians with minimal ultrasound training is unknown. METHODS: After one hour of standardized training, physicians with minimal US experience clinically evaluated patients presenting with pain and trauma to the upper arm or leg. The investigators then performed a long-bone US evaluation, recording their impression of fracture presence or absence. Results of the examination were compared with routine plain or computer aided radiography (CT). RESULTS: 58 patients were examined. The sensitivity and specificity of US were 92.9% and 83.3%, and of the physical examination were 78.6% and 90.0%, respectively. US provided improved sensitivity with less specificity compared with physical examination in the detection of fractures in long bones. CONCLUSION: Ultrasound scans by minimally trained clinicians may be used to rule out a long-bone fracture in patients with a medium to low probability of fracture.

  13. Attenuation measuring ultrasound shearwave elastography and in vivo application in post-transplant liver patients

    NASA Astrophysics Data System (ADS)

    Nenadic, Ivan Z.; Qiang, Bo; Urban, Matthew W.; Zhao, Heng; Sanchez, William; Greenleaf, James F.; Chen, Shigao

    2017-01-01

    Ultrasound and magnetic resonance elastography techniques are used to assess mechanical properties of soft tissues. Tissue stiffness is related to various pathologies such as fibrosis, loss of compliance, and cancer. One way to perform elastography is measuring shear wave velocity of propagating waves in tissue induced by intrinsic motion or an external source of vibration, and relating the shear wave velocity to tissue elasticity. All tissues are inherently viscoelastic and ignoring viscosity biases the velocity-based estimates of elasticity and ignores a potentially important parameter of tissue health. We present attenuation measuring ultrasound shearwave elastography (AMUSE), a technique that independently measures both shear wave velocity and attenuation in tissue and therefore allows characterization of viscoelasticity without using a rheological model. The theoretical basis for AMUSE is first derived and validated in finite element simulations. AMUSE is validated against the traditional methods for assessing shear wave velocity (phase gradient) and attenuation (amplitude decay) in tissue mimicking phantoms and excised tissue. The results agreed within one standard deviation. AMUSE was used to measure shear wave velocity and attenuation in 15 transplanted livers in patients with potential acute rejection, and the results were compared with the biopsy findings in a preliminary study. The comparison showed excellent agreement and suggests that AMUSE can be used to separate transplanted livers with acute rejection from livers with no rejection.

  14. Comparison of Thermal Safety Practice Guidelines for Diagnostic Ultrasound Exposures.

    PubMed

    Harris, Gerald R; Church, Charles C; Dalecki, Diane; Ziskin, Marvin C; Bagley, Jennifer E

    2016-02-01

    This article examines the historical evolution of various practice guidelines designed to minimize the possibility of thermal injury during a diagnostic ultrasound examination, including those published by the American Institute of Ultrasound in Medicine, British Medical Ultrasound Society and Health Canada. The guidelines for prenatal/neonatal examinations are in general agreement, but significant differences were found for postnatal exposures. We propose sets of thermal index versus exposure time for these examination categories below which there is reasonable assurance that an examination can be conducted without risk of producing an adverse thermal effect under any scanning conditions. If it is necessary to exceed these guidelines, the occurrence of an adverse thermal event is still unlikely in most situations because of mitigating factors such as transducer movement and perfusion, but the general principle of "as low as reasonably achievable" should be followed. Some limitations of the biological effects studies underpinning the guidelines also are discussed briefly. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  15. Towards Dynamic Contrast Specific Ultrasound Tomography

    NASA Astrophysics Data System (ADS)

    Demi, Libertario; van Sloun, Ruud J. G.; Wijkstra, Hessel; Mischi, Massimo

    2016-10-01

    We report on the first study demonstrating the ability of a recently-developed, contrast-enhanced, ultrasound imaging method, referred to as cumulative phase delay imaging (CPDI), to image and quantify ultrasound contrast agent (UCA) kinetics. Unlike standard ultrasound tomography, which exploits changes in speed of sound and attenuation, CPDI is based on a marker specific to UCAs, thus enabling dynamic contrast-specific ultrasound tomography (DCS-UST). For breast imaging, DCS-UST will lead to a more practical, faster, and less operator-dependent imaging procedure compared to standard echo-contrast, while preserving accurate imaging of contrast kinetics. Moreover, a linear relation between CPD values and ultrasound second-harmonic intensity was measured (coefficient of determination = 0.87). DCS-UST can find clinical applications as a diagnostic method for breast cancer localization, adding important features to multi-parametric ultrasound tomography of the breast.

  16. Towards Dynamic Contrast Specific Ultrasound Tomography.

    PubMed

    Demi, Libertario; Van Sloun, Ruud J G; Wijkstra, Hessel; Mischi, Massimo

    2016-10-05

    We report on the first study demonstrating the ability of a recently-developed, contrast-enhanced, ultrasound imaging method, referred to as cumulative phase delay imaging (CPDI), to image and quantify ultrasound contrast agent (UCA) kinetics. Unlike standard ultrasound tomography, which exploits changes in speed of sound and attenuation, CPDI is based on a marker specific to UCAs, thus enabling dynamic contrast-specific ultrasound tomography (DCS-UST). For breast imaging, DCS-UST will lead to a more practical, faster, and less operator-dependent imaging procedure compared to standard echo-contrast, while preserving accurate imaging of contrast kinetics. Moreover, a linear relation between CPD values and ultrasound second-harmonic intensity was measured (coefficient of determination = 0.87). DCS-UST can find clinical applications as a diagnostic method for breast cancer localization, adding important features to multi-parametric ultrasound tomography of the breast.

  17. Towards Dynamic Contrast Specific Ultrasound Tomography

    PubMed Central

    Demi, Libertario; Van Sloun, Ruud J. G.; Wijkstra, Hessel; Mischi, Massimo

    2016-01-01

    We report on the first study demonstrating the ability of a recently-developed, contrast-enhanced, ultrasound imaging method, referred to as cumulative phase delay imaging (CPDI), to image and quantify ultrasound contrast agent (UCA) kinetics. Unlike standard ultrasound tomography, which exploits changes in speed of sound and attenuation, CPDI is based on a marker specific to UCAs, thus enabling dynamic contrast-specific ultrasound tomography (DCS-UST). For breast imaging, DCS-UST will lead to a more practical, faster, and less operator-dependent imaging procedure compared to standard echo-contrast, while preserving accurate imaging of contrast kinetics. Moreover, a linear relation between CPD values and ultrasound second-harmonic intensity was measured (coefficient of determination = 0.87). DCS-UST can find clinical applications as a diagnostic method for breast cancer localization, adding important features to multi-parametric ultrasound tomography of the breast. PMID:27703251

  18. Evaluation and comparison of current fetal ultrasound image segmentation methods for biometric measurements: a grand challenge.

    PubMed

    Rueda, Sylvia; Fathima, Sana; Knight, Caroline L; Yaqub, Mohammad; Papageorghiou, Aris T; Rahmatullah, Bahbibi; Foi, Alessandro; Maggioni, Matteo; Pepe, Antonietta; Tohka, Jussi; Stebbing, Richard V; McManigle, John E; Ciurte, Anca; Bresson, Xavier; Cuadra, Meritxell Bach; Sun, Changming; Ponomarev, Gennady V; Gelfand, Mikhail S; Kazanov, Marat D; Wang, Ching-Wei; Chen, Hsiang-Chou; Peng, Chun-Wei; Hung, Chu-Mei; Noble, J Alison

    2014-04-01

    This paper presents the evaluation results of the methods submitted to Challenge US: Biometric Measurements from Fetal Ultrasound Images, a segmentation challenge held at the IEEE International Symposium on Biomedical Imaging 2012. The challenge was set to compare and evaluate current fetal ultrasound image segmentation methods. It consisted of automatically segmenting fetal anatomical structures to measure standard obstetric biometric parameters, from 2D fetal ultrasound images taken on fetuses at different gestational ages (21 weeks, 28 weeks, and 33 weeks) and with varying image quality to reflect data encountered in real clinical environments. Four independent sub-challenges were proposed, according to the objects of interest measured in clinical practice: abdomen, head, femur, and whole fetus. Five teams participated in the head sub-challenge and two teams in the femur sub-challenge, including one team who tackled both. Nobody attempted the abdomen and whole fetus sub-challenges. The challenge goals were two-fold and the participants were asked to submit the segmentation results as well as the measurements derived from the segmented objects. Extensive quantitative (region-based, distance-based, and Bland-Altman measurements) and qualitative evaluation was performed to compare the results from a representative selection of current methods submitted to the challenge. Several experts (three for the head sub-challenge and two for the femur sub-challenge), with different degrees of expertise, manually delineated the objects of interest to define the ground truth used within the evaluation framework. For the head sub-challenge, several groups produced results that could be potentially used in clinical settings, with comparable performance to manual delineations. The femur sub-challenge had inferior performance to the head sub-challenge due to the fact that it is a harder segmentation problem and that the techniques presented relied more on the femur's appearance.

  19. Application of a Sub-set of Skinfold Sites for Ultrasound Measurement of Subcutaneous Adiposity and Percentage Body Fat Estimation in Athletes.

    PubMed

    O'Neill, D C; Cronin, O; O'Neill, S B; Woods, T; Keohane, D M; Molloy, M G; Falvey, E C

    2016-05-01

    Body composition assessment is an integral feature of elite sport as optimization facilitates successful performance. This study aims to refine the use of B-mode ultrasound in the assessment of athlete body composition by determining suitable sites for measurement. 67 elite athletes recruited from the Human Performance Laboratory, University College Cork, Ireland, underwent dual measurement of body composition. Subcutaneous adipose tissue thickness at 7 anatomical sites were measured using ultrasound and compared to percentage body fat values determined using Dual-Energy X-ray Absorptiometry. Multiple linear regressions were performed and an equation to predict percentage body fat was derived. The present study found subcutaneous adipose tissue depths at the triceps, biceps, anterior thigh and supraspinale sites correlated significantly with percentage body fat by X-ray absorptiometry (all p<0.05). Summation of the depths at these locations correlated strongly with percentage body fat by Dual-Energy X-ray Absorptiometry (R²=0.879). The triceps, biceps, anterior thigh and supraspinale sites are suitable anatomical landmarks for the estimation of %BF using B-mode ultrasound. Use of B-mode ultrasound in the assessment of athlete body composition confers many benefits including lack of ionising radiation and its potential to be used as a portable field tool. © Georg Thieme Verlag KG Stuttgart · New York.

  20. The relationship between experimental geometry, heat rate, and ultrasound wave speed measurement while observing phase changes in highly attenuative materials

    NASA Astrophysics Data System (ADS)

    Moore, David G.; Stair, Sarah L.; Jack, David A.

    2018-04-01

    Ultrasound techniques are capable of monitoring changes in the time-of-flight as a material is exposed to different thermal environments. The focus of the present study is to identify the phase of a material via ultrasound compression wave measurements in a through transmission experimental setup as the material is heated from a solid to a liquid and then allowed to re-solidify. The present work seeks to expand upon the authors' previous research, which proved this through transmission phase monitoring technique was possible, by considering different experimental geometries. The relationship between geometry, the measured speed of sound, and the temperature profile is presented. The use of different volumes helps in establishing a baseline understanding of which aspects of the experiment are geometry dependent and which are independent. The present study also investigates the relationship between the heating rate observed in the experiment and the measured speed of sound. The trends identified between the experimental geometry, heat rate and ultrasound wave speed measurement assist in providing a baseline understanding of the applicability of this technique to various industries, including the polymer industry and the oil industry.

  1. The Relationship Between Experimental Geometry Heat Rate and Ultrasound Wave Speed Measurement While Observing Phase Changes in Highly Attenuative Materials

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

    Moore, David G.; Stair, Sarah Louise; Jack, David A.

    Ultrasound techniques are capable of monitoring changes in the time-of-flight as a material is exposed to different thermal environments. The focus of the present study is to identify the phase of a material via ultrasound compression wave measurements in a through transmission experimental setup as the material is heated from a solid to a liquid and then allowed to re-solidify. The present work seeks to expand upon the authors’ previous research, which proved this through transmission phase monitoring technique was possible, by considering different experimental geometries. The relationship between geometry, the measured speed of sound, and the temperature profile ismore » presented. The use of different volumes helps in establishing a baseline understanding of which aspects of the experiment are geometry dependent and which are independent. The present study also investigates the relationship between the heating rate observed in the experiment and the measured speed of sound. Lastly, the trends identified between the experimental geometry, heat rate and ultrasound wave speed measurement assist in providing a baseline understanding of the applicability of this technique to various industries, including the polymer industry and the oil industry.« less

  2. The Relationship Between Experimental Geometry Heat Rate and Ultrasound Wave Speed Measurement While Observing Phase Changes in Highly Attenuative Materials

    DOE PAGES

    Moore, David G.; Stair, Sarah Louise; Jack, David A.

    2018-04-01

    Ultrasound techniques are capable of monitoring changes in the time-of-flight as a material is exposed to different thermal environments. The focus of the present study is to identify the phase of a material via ultrasound compression wave measurements in a through transmission experimental setup as the material is heated from a solid to a liquid and then allowed to re-solidify. The present work seeks to expand upon the authors’ previous research, which proved this through transmission phase monitoring technique was possible, by considering different experimental geometries. The relationship between geometry, the measured speed of sound, and the temperature profile ismore » presented. The use of different volumes helps in establishing a baseline understanding of which aspects of the experiment are geometry dependent and which are independent. The present study also investigates the relationship between the heating rate observed in the experiment and the measured speed of sound. Lastly, the trends identified between the experimental geometry, heat rate and ultrasound wave speed measurement assist in providing a baseline understanding of the applicability of this technique to various industries, including the polymer industry and the oil industry.« less

  3. Standardized 2D ultrasound versus 3D/4D ultrasound and image fusion for measurement of aortic aneurysm diameter in follow-up after EVAR.

    PubMed

    Pfister, Karin; Schierling, Wilma; Jung, Ernst Michael; Apfelbeck, Hanna; Hennersperger, Christoph; Kasprzak, Piotr M

    2016-01-01

    To compare standardised 2D ultrasound (US) to the novel ultrasonographic imaging techniques 3D/4D US and image fusion (combined real-time display of B mode and CT scan) for routine measurement of aortic diameter in follow-up after endovascular aortic aneurysm repair (EVAR). 300 measurements were performed on 20 patients after EVAR by one experienced sonographer (3rd degree of the German society of ultrasound (DEGUM)) with a high-end ultrasound machine and a convex probe (1-5 MHz). An internally standardized scanning protocol of the aortic aneurysm diameter in B mode used a so called leading-edge method. In summary, five different US methods (2D, 3D free-hand, magnetic field tracked 3D - Curefab™, 4D volume sweep, image fusion), each including contrast-enhanced ultrasound (CEUS), were used for measurement of the maximum aortic aneurysm diameter. Standardized 2D sonography was the defined reference standard for statistical analysis. CEUS was used for endoleak detection. Technical success was 100%. In augmented transverse imaging the mean aortic anteroposterior (AP) diameter was 4.0±1.3 cm for 2D US, 4.0±1.2 cm for 3D Curefab™, and 3.9±1.3 cm for 4D US and 4.0±1.2 for image fusion. The mean differences were below 1 mm (0.2-0.9 mm). Concerning estimation of aneurysm growth, agreement was found between 2D, 3D and 4D US in 19 of the 20 patients (95%). Definitive decision could always be made by image fusion. CEUS was combined with all methods and detected two out of the 20 patients (10%) with an endoleak type II. In one case, endoleak feeding arteries remained unclear with 2D CEUS but could be clearly localized by 3D CEUS and image fusion. Standardized 2D US allows adequate routine follow-up of maximum aortic aneurysm diameter after EVAR. Image Fusion enables a definitive statement about aneurysm growth without the need for new CT imaging by combining the postoperative CT scan with real-time B mode in a dual image display. 3D/4D CEUS and image fusion

  4. Plantar fasciitis (fasciosis) treatment outcome study: plantar fascia thickness measured by ultrasound and correlated with patient self-reported improvement.

    PubMed

    Fabrikant, Jerry M; Park, Tae Soon

    2011-06-01

    Ultrasound, well recognized as an effective diagnostic tool, reveals a thickening of the plantar fascia in patients with plantar fasciitis/fasciosis disease. The authors hypothesized that ultrasound would also reveal a decrease in the plantar fascia thickness for patients undergoing treatment for the disease, a hypothesis that, heretofore, had been only tested on a limited number of subjects. They conducted a more statistically significant study that found that clinical treatment with injection and biomechanical correction does indeed diminish plantar fascia thickness as shown on ultrasound. The study also revealed that patients experience the most heightened plantar fascia tenderness toward the end of the day, and improvement in their symptomatic complaints were associated with a reduction in plantar fascia thickness. As a result, the authors conclude that office-based ultrasound can help diagnose and confirm plantar fasciitis/fasciosis through the measurement of the plantar fascia thickness. Because of the advantages of ultrasound--that it is non-invasive with greater patient acceptance, cost effective and radiation-free--the imaging tool should be considered and implemented early in the diagnosis and treatment of plantar fasciitis/fasciosis. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. The Effects of Ultrasound on Biological Systems: Site

    NASA Astrophysics Data System (ADS)

    El-Karmi, Anan M.

    Earlier studies (Dinno et al., Ultrasound Med. Biol. 15:461 -470; 1989) demonstrated that ultrasound at therapeutic intensities causes large increases in total conductance (G_{rm t}) of frog skin. These changes were attributed to non-thermal mechanisms, primarily, cavitation. In this study, the site(s) and mechanism(s) of action of ultrasound for the increase in G_{rm t} were examined. The reversible changes in G_{rm t } and sodium current were monitored in real time as a function of ultrasound exposure. Amiloride, a sodium channel blocker, was used to differentiate between cellular (G_{rm c}) and paracellular (G_{rm s}) pathways in the presence and absence of ultrasound. No significant changes were detected in G_ {rm c}. However, changes in G _{rm s} were significant. These results demonstrate that most of the increase in G _{rm t} due to ultrasound is taking place in the paracellular pathways. Sodium channels were not significantly affected by ultrasound. Thus, the changes in G_{rm c} are not specific. The effects of ultrasound were examined in the presence of radical scavengers and antioxidants. The increase in G_{rm t} due to ultrasound was significantly minimized in the presence of cystamine, cysteamine, and sodium ascorbate. This demonstrates that free radicals and other reactive species generated by cavitation are causing the increase in G_ {rm t}, possibly by acting from inside the cells. Radical scavengers and antioxidants are providing protection from oxidative damage but are not involved in the recovery of G_{ rm t} towards steady state values after sonication. The role of Ca^{2+} in the effects of ultrasound was examined since many of the cellular reactions involved in tissue recovery are dependent on the intracellular availability of free Ca^{2+}. The percentage increase in G_{rm t} in the presence of Ca^{2+} was larger than in its absence (140% vs. 27%). The time constant for G_{rm t} to return to steady state was longer in calcium-free solutions (122

  6. Feasibility of dynamic cardiac ultrasound transmission via mobile phone for basic emergency teleconsultation.

    PubMed

    Lim, Tae Ho; Choi, Hyuk Joong; Kang, Bo Seung

    2010-01-01

    We assessed the feasibility of using a camcorder mobile phone for teleconsulting about cardiac echocardiography. The diagnostic performance of evaluating left ventricle (LV) systolic function was measured by three emergency medicine physicians. A total of 138 short echocardiography video sequences (from 70 subjects) was selected from previous emergency room ultrasound examinations. The measurement of LV ejection fraction based on the transmitted video displayed on a mobile phone was compared with the original video displayed on the LCD monitor of the ultrasound machine. The image quality was evaluated using the double stimulation impairment scale (DSIS). All observers showed high sensitivity. There was an improvement in specificity with the observer's increasing experience of cardiac ultrasound. Although the image quality of video on the mobile phone was lower than that of the original, a receiver operating characteristic (ROC) analysis indicated that there was no significant difference in diagnostic performance. Immediate basic teleconsulting of echocardiography movies is possible using current commercially-available mobile phone systems.

  7. Non-Invasive Measurement of Pulsatile Intracranial Pressures Using Ultrasound

    NASA Technical Reports Server (NTRS)

    Ueno, Toshiaki; Ballard, Richard E.; Shuer, Lawrence M.; Cantrell, John H.; Cantrell, John H.; Hargens, Alan R.

    1997-01-01

    Early detection of elevated intracranial pressure (ICP) will aid clinical decision-making for head trauma, brain tumor and other cerebrovascular diseases. Conventional methods, however, require surgical procedures which take time and are accompanied by increased risk of infection. Accordingly we have developed and refined a new ultrasound device to measure skull movements which are known to occur in conjunction with altered ICP. The principle of this device is based upon pulse phase locked loop (PPLL), which enables us to detect changes in distance on the order of microns between an ultrasound transducer on one side of the skull and the opposite inner surface of the cranium. The present study was designed to verify this measurement technique in cadavera. Transcranial distance was increased in steps of 10 mmHg from zero to 50 mmHg by saline infusion into the lateral ventricle of two cadavera. In separate experiments, pulsations of ICP with the amplitudes of zero to 2 mmHg were generated by rhythmic injections of saline using a syringe. When the ICP was stepwise increased from zero to 50 mmHg, transcranial distance increased in proportion with the ICP increase (y=12 x - 76, r=0.938), where y is changes in transcranial distance in microns and x is ICP in mmHg. In the data recorded while ICP pulsations were generated, fast Fourier transform analysis demonstrated that cranial pulsations were clearly associated with ICP pulsations. The results indicate that changes in transcranial distance is linearly correlated with those in ICP, and also that the PPLL device has sufficient sensitivity to detect transcranial pulsations which occur in association with the cardiac cycle. By analyzing the magnitude of cranial pulsations, we may be able to estimate the pressure-volume index in the cranium. As a result, estimates of intracranial compliance may be possible by using the PPLL device. Further studies are necessary in normal subjects and patients.

  8. Errors in the ultrasound diagnosis of the kidneys, ureters and urinary bladder

    PubMed Central

    Wieczorek, Andrzej Paweł; Tyloch, Janusz F.

    2013-01-01

    The article presents the most frequent errors made in the ultrasound diagnosis of the urinary system. They usually result from improper technique of ultrasound examination or its erroneous interpretation. Such errors are frequent effects of insufficient experience of the ultrasonographer, inadequate class of the scanner, insufficient knowledge of its operation as well as of wrong preparation of patients, their constitution, severe condition and the lack of cooperation during the examination. The reasons for misinterpretations of ultrasound images of the urinary system may lie in a large polymorphism of the kidney (defects and developmental variants) and may result from improper access to the organ as well as from the presence of artefacts. Errors may also result from the lack of knowledge concerning clinical and laboratory data. Moreover, mistakes in ultrasound diagnosis of the urinary system are frequently related to the lack of knowledge of the management algorithms and diagnostic possibilities of other imaging modalities. The paper lists errors in ultrasound diagnosis of the urinary system divided into: errors resulting from improper technique of examination, artefacts caused by incorrect preparation of patients for the examination or their constitution and errors resulting from misinterpretation of ultrasound images of the kidneys (such as their number, size, fluid spaces, pathological lesions and others), ureters and urinary bladder. Each physician performing kidney or bladder ultrasound examination should possess the knowledge of the most frequent errors and their causes which might help to avoid them. PMID:26674139

  9. Diffuse optical tomography using semiautomated coregistered ultrasound measurements

    NASA Astrophysics Data System (ADS)

    Mostafa, Atahar; Vavadi, Hamed; Uddin, K. M. Shihab; Zhu, Quing

    2017-12-01

    Diffuse optical tomography (DOT) has demonstrated huge potential in breast cancer diagnosis and treatment monitoring. DOT image reconstruction guided by ultrasound (US) improves the diffused light localization and lesion reconstruction accuracy. However, DOT reconstruction depends on tumor geometry provided by coregistered US. Experienced operators can manually measure these lesion parameters; however, training and measurement time are needed. The wide clinical use of this technique depends on its robustness and faster imaging reconstruction capability. This article introduces a semiautomated procedure that automatically extracts lesion information from US images and incorporates it into the optical reconstruction. An adaptive threshold-based image segmentation is used to obtain tumor boundaries. For some US images, posterior shadow can extend to the chest wall and make the detection of deeper lesion boundary difficult. This problem can be solved using a Hough transform. The proposed procedure was validated from data of 20 patients. Optical reconstruction results using the proposed procedure were compared with those reconstructed using extracted tumor information from an experienced user. Mean optical absorption obtained from manual measurement was 0.21±0.06 cm-1 for malignant and 0.12±0.06 cm-1 for benign cases, whereas for the proposed method it was 0.24±0.08 cm-1 and 0.12±0.05 cm-1, respectively.

  10. Can Ultrasound Accurately Assess Ischiofemoral Space Dimensions? A Validation Study.

    PubMed

    Finnoff, Jonathan T; Johnson, Adam C; Hollman, John H

    2017-04-01

    Ischiofemoral impingement is a potential cause of hip and buttock pain. It is evaluated commonly with magnetic resonance imaging (MRI). To our knowledge, no study previously has evaluated the ability of ultrasound to measure the ischiofemoral space (IFS) dimensions reliably. To determine whether ultrasound could accurately measure the IFS dimensions when compared with the gold standard imaging modality of MRI. A methods comparison study. Sports medicine center within a tertiary-care institution. A total of 5 male and 5 female asymptomatic adult subjects (age mean = 29.2 years, range = 23-35 years; body mass index mean = 23.5, range = 19.5-26.6) were recruited to participate in the study. Subjects were secured in a prone position on a MRI table with their hips in a neutral position. Their IFS dimensions were then acquired in a randomized order using diagnostic ultrasound and MRI. The main outcome measurements were the IFS dimensions acquired with ultrasound and MRI. The mean IFS dimensions measured with ultrasound was 29.5 mm (standard deviation [SD] 4.99 mm, standard error mean 1.12 mm), whereas those obtained with MRI were 28.25 mm (SD 5.91 mm, standard error mean 1.32 mm). The mean difference between the ultrasound and MRI measurements was 1.25 mm, which was not statistically significant (SD 3.71 mm, standard error mean 3.71 mm, 95% confidence interval -0.49 mm to 2.98 mm, t 19 = 1.506, P = .15). The Bland-Altman analysis indicated that the 95% limits of agreement between the 2 measurement was -6.0 to 8.5 mm, indicating that there was no systematic bias between the ultrasound and MRI measurements. Our findings suggest that the IFS measurements obtained with ultrasound are very similar to those obtained with MRI. Therefore, when evaluating individuals with suspected ischiofemoral impingement, one could consider using ultrasound to measure their IFS dimensions. III. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier

  11. Agreement between preoperative transvaginal ultrasound and intraoperative macroscopic examination for assessing myometrial infiltration in low-risk endometrioid carcinoma.

    PubMed

    Pineda, L; Alcázar, J L; Caparrós, M; Mínguez, J A; Idoate, M A; Quiceno, H; Solórzano, J L; Jurado, M

    2016-03-01

    To compare diagnostic performance of preoperative transvaginal ultrasound (TVS) and intraoperative macroscopic examination for determining myometrial infiltration in women with low-risk endometrial cancer, and to estimate the agreement between the two methods. This was a single-center observational study comprising women with preoperative diagnosis of well- or moderately differentiated endometrioid carcinoma of the endometrium. All women underwent preoperative TVS by a single examiner. According to the examiner's subjective impression, myometrial infiltration was stated as ≥ 50% or < 50%. Surgical staging was performed in all cases. Intraoperative macroscopic examination of the removed uterus was performed by pathologists who were unaware of the ultrasound findings, and myometrial infiltration was stated as ≥ 50% or < 50%. Definitive histological diagnosis of myometrial infiltration was made by frozen section analysis and was used as the gold standard. Sensitivity and specificity with 95% CIs were calculated for TVS and intraoperative macroscopic inspection and compared using McNemar's test. Agreement between TVS and intraoperative macroscopic inspection was estimated using Cohen's kappa index (κ) and percentage of agreement. Of 209 eligible women, 152 were ultimately included. Mean (± SD) age was 60.9 ± 10.2 years, with a range of 32-91 years. Definitive histological diagnosis revealed that myometrial infiltration was < 50% in 114 women and ≥ 50% in 38 women. Sensitivity and specificity of TVS for detecting deep myometrial infiltration were 81.6% and 89.5%, respectively, whereas the respective values for intraoperative macroscopic examination were 78.9% and 90.4% (McNemar's test, P > 0.05 when comparing TVS and intraoperative macroscopic examination). Agreement between methods was moderate with κ = 0.54 (95% CI, 0.39-0.69) and percentage of agreement of 82%. Although the agreement between preoperative TVS and

  12. Semiautomated thyroid volumetry using 3D CT: prospective comparison with measurements obtained using 2D ultrasound, 2D CT, and water displacement method of specimen.

    PubMed

    Lee, Sun Jin; Chong, Semin; Kang, Kyung Ho; Hur, Joonho; Hong, Byung-Woo; Kim, Hyun Jung; Kim, Soo Jin

    2014-11-01

    The objective of our study was to measure thyroid volumes using semiautomated 3D CT and to compare the 3D CT volumes with volumes measured using 2D ultrasound, 2D CT, and the water displacement method. In 47 patients, 2D ultrasound volumes and 2D CT volumes of the thyroid gland were estimated using the ellipsoid volume formula, and 3D CT volumes were calculated using semiautomated reconstructive techniques. All volume data were compared with thyroid specimen volumes obtained using the water displacement method and were statistically analyzed using the one-way ANOVA, the Pearson correlation coefficient (R), linear regression, and the concordance correlation coefficient (CCC). The processing time of semiautomated 3D CT thyroid volumetry was measured. The paired mean differences ± SD between the three imaging-determined volumes and the specimen volumes were 0.8 ± 3.1 mL for 2D ultrasound, 4.0 ± 4.7 mL for 2D CT, and 0.2 ± 2.5 mL for 3D CT. A significant difference in the mean thyroid volume was found between 2D CT and specimen volumes (p = 0.016) compared with the other pairs (p = 0.937 for 2D ultrasound mean volume vs specimen mean volume, and p = 0.999 for 3D CT mean volume vs specimen mean volume). Between specimen volume and 2D ultrasound volume, specimen volume and 2D CT volume, and specimen volume and 3D CT volume, R values were 0.885, 0.724, and 0.929, respectively, and CCC values were 0.876, 0.598, and 0.925, respectively. The mean processing time of semiautomated 3D CT thyroid volumetry was 7.0 minutes. Thyroid volumes measured using 2D ultrasound or semiautomated 3D CT are substantially close to thyroid specimen volumes measured using the water displacement method. Semiautomated 3D CT thyroid volumetry can provide a more reliable measure of thyroid volume than 2D ultrasound.

  13. Ultrasound measurement apparatus for liquids characterization

    NASA Astrophysics Data System (ADS)

    Vieira, R. C.; Costa-Felix, R. P. B.

    2018-03-01

    The present paper discloses the validation of an experimental ultrasound apparatus and method for liquids characterization. The research aims to stablish a simple, reliable, accurate and portable way to identify contaminants in hydrocarbon substances, such as adulteration in gasoline. The results depicted so far demonstrated a general uncertainty of speed of sound assessment less than 10 m s-1, and distance accuracy of less than 1%. Those figures are good enough for an in-site device to evaluate possible contamination of fuels or other liquids.

  14. Comparison of barium swallow and ultrasound in diagnosis of gastro-oesophageal reflux in children.

    PubMed Central

    Naik, D R; Bolia, A; Moore, D J

    1985-01-01

    Fifty one infants and older children with suspected gastro-oesophageal reflux entered a study comparing the diagnostic accuracy of a standard barium swallow examination with that of ultrasound scanning. All children were examined by both techniques. In 40 cases there was unequivocal agreement between the examinations. Of the remaining patients, four had definite reflux by ultrasonic criteria but showed no evidence of reflux on barium swallow examination, four had positive findings on ultrasound but showed only minimal reflux on barium swallow, and one showed minimal reflux on ultrasound but had a negative barium meal result. In two children the ultrasound study was inconclusive. Ultrasound has an important role in the diagnosis and follow up of patients under the age of 5 years with gastro-oesophageal reflux. Images FIG 1 FIG 2 PMID:3924317

  15. Ultrasound-guided pleural access.

    PubMed

    Shojaee, Samira; Argento, A Christine

    2014-12-01

    Ultrasonography of the thorax has become a more recognized tool in pulmonary medicine, thanks to continuing clinical research that has proven its many valuable roles in the day-to-day management of pulmonary and pleural diseases. Ultrasound examination is a cost-effective imaging modality that permits the pulmonologist to obtain information about the pathologies in the thorax without the risk of exposure to ionizing radiation, providing the examiner with real-time and immediate results. Its ease of use and training along with its portability to the patient's bedside and accurate examination of the pleural space has allowed for safer pleural procedures such as thoracentesis, chest tube placement, tunneled pleural catheter placement, and medical thoracoscopy. In this review, we summarize the technique of chest ultrasonography, compare ultrasound to other frequently used thoracic imaging modalities, and focus on its use in obtaining pleural access while performing invasive pleural procedures. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  16. Discriminant validity study of Achilles enthesis ultrasound.

    PubMed

    Expósito Molinero, María Rosa; de Miguel Mendieta, Eugenio

    2016-01-01

    We want to know if the ultrasound examination of the Achilles tendon in spondyloarthritis is different compared to other rheumatic diseases. We studied 97 patients divided into five groups: rheumatoid arthritis, spondyloarthritis, gout, chondrocalcinosis and osteoarthritis, exploring six elementary lesions in 194 Achilles entheses examined. In our study the total index ultrasonographic Achilles is higher in spondyloarthritis with significant differences. The worst elementary spondyloarthritis lesions for discriminations against other pathologies were calcification. This study aims to demonstrate the discriminant validity of Achilles enthesitis observed by ultrasound in spondyloarthritis compared with other rheumatic diseases that may also have ultrasound abnormalities such enthesis level. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  17. Droplets, Bubbles and Ultrasound Interactions.

    PubMed

    Shpak, Oleksandr; Verweij, Martin; de Jong, Nico; Versluis, Michel

    2016-01-01

    The interaction of droplets and bubbles with ultrasound has been studied extensively in the last 25 years. Microbubbles are broadly used in diagnostic and therapeutic medical applications, for instance, as ultrasound contrast agents. They have a similar size as red blood cells, and thus are able to circulate within blood vessels. Perfluorocarbon liquid droplets can be a potential new generation of microbubble agents as ultrasound can trigger their conversion into gas bubbles. Prior to activation, they are at least five times smaller in diameter than the resulting bubbles. Together with the violent nature of the phase-transition, the droplets can be used for local drug delivery, embolotherapy, HIFU enhancement and tumor imaging. Here we explain the basics of bubble dynamics, described by the Rayleigh-Plesset equation, bubble resonance frequency, damping and quality factor. We show the elegant calculation of the above characteristics for the case of small amplitude oscillations by linearizing the equations. The effect and importance of a bubble coating and effective surface tension are also discussed. We give the main characteristics of the power spectrum of bubble oscillations. Preceding bubble dynamics, ultrasound propagation is introduced. We explain the speed of sound, nonlinearity and attenuation terms. We examine bubble ultrasound scattering and how it depends on the wave-shape of the incident wave. Finally, we introduce droplet interaction with ultrasound. We elucidate the ultrasound-focusing concept within a droplets sphere, droplet shaking due to media compressibility and droplet phase-conversion dynamics.

  18. Temperature Dependence of Parametric Phenomenon in Airborne Ultrasound for Temperature Measurement

    NASA Astrophysics Data System (ADS)

    Kon, Akihiko; Wakatsuki, Naoto; Mizutani, Koichi

    2008-08-01

    The temperature dependence of parametric phenomenon in air was experimentally studied. It was confirmed from experimental data that the amplitude of upper sideband sound with a frequency of 36.175 kHz, which is caused by parametric phenomenon between high-power ultrasound with a frequency of 20.175 kHz and another normal sound with a frequency of 16.0 kHz, is proportional to -0.88×10-4×(T+273.15). This temperature dependence of the amplitude of upper sideband sound caused by the parametric phenomenon suggests a simple and effective method of temperature measurement.

  19. Inter- and intratester reliability values of ultrasound imaging measurements of diaphragm movement in the thoracic and thoracolumbar curves in adolescent idiopathic scoliosis.

    PubMed

    Noh, Dong Koog; Koh, Jae-Hyun; You, Joshua Sung-H

    2016-01-01

    The purpose of this study was to determine intertester and intratester reliability of ultrasound measurements of bilateral diaphragm excursions in the thoracic and thoracolumbar spinal curves of 31 females with adolescent idiopathic scoliosis (AIS) (mean age = 14.1 ± 1.8 years). Subjects were tested during tidal breathing using real-time ultrasound imaging with a 3.5 MHz curvilinear transducer. There were no significant differences in intratester and intertester reliability values in bilateral diaphragmatic excursions measured at the thoracolumbar spinal curve, whereas significant differences were observed in measurements taken at the thoracic spinal curve (p < 0.05). Overall, the intertester and intratester reliabilities of the thoracic and thoracolumbar curves in AIS ranged from 0.764 to 0.998. These findings suggest that ultrasound imaging is highly reliable between and within testers and is useful to precisely discriminate pathological diaphragm movement in idiopathic thoracic scoliosis and idiopathic thoracolumbar scoliosis.

  20. Measuring tongue shapes and positions with ultrasound imaging: a validation experiment using an articulatory model.

    PubMed

    Ménard, Lucie; Aubin, Jérôme; Thibeault, Mélanie; Richard, Gabrielle

    2012-01-01

    The goal of this paper is to assess the validity of various metrics developed to characterize tongue shapes and positions collected through ultrasound imaging in experimental setups where the probe is not constrained relative to the subject's head. Midsagittal contours were generated using an articulatory-acoustic model of the vocal tract. Sections of the tongue were extracted to simulate ultrasound imaging. Various transformations were applied to the tongue contours in order to simulate ultrasound probe displacements: vertical displacement, horizontal displacement, and rotation. The proposed data analysis method reshapes tongue contours into triangles and then extracts measures of angles, x and y coordinates of the highest point of the tongue, curvature degree, and curvature position. Parameters related to the absolute tongue position (tongue height and front/back position) are more sensitive to horizontal and vertical displacements of the probe, whereas parameters related to tongue curvature are less sensitive to such displacements. Because of their robustness to probe displacements, parameters related to tongue shape (especially curvature) are particularly well suited to cases where the transducer is not constrained relative to the head (studies with clinical populations or children). Copyright © 2011 S. Karger AG, Basel.

  1. The utility of ultrasound in patients with melanoma.

    PubMed

    Uren, Roger F; Sanki, Amira; Thompson, John F

    2007-11-01

    The highest quality gray-scale ultrasound images are obtained with high-frequency transducers; however, such high frequencies do not penetrate more than a few centimeters into body tissue. Fortunately, in patients with melanoma, the structures of interest are close to the skin surface, making them ideal targets for examination with high-resolution ultrasound. These include primary cutaneous melanomas, uveal melanomas and the regional lymph nodes draining the skin that lie in the axilla, groin, neck and other locations. Although ultrasound study of primary melanomas arising in the skin and eye has provided some insights, a major role for ultrasound has evolved recently, to provide early detection of metastatic melanoma in regional lymph nodes. Ultrasound is clearly superior to clinical palpation of the nodes during follow-up and, when combined with guided fine-needle biopsy, allows the earliest possible surgical intervention for regional nodal metastases. In the future the use of ultrasound contrast agents may improve the sensitivity of ultrasound in the detection of very small metastatic deposits.

  2. Biofilm thickness measurement using an ultrasound method in a liquid phase.

    PubMed

    Maurício, R; Dias, C J; Jubilado, N; Santana, F

    2013-10-01

    In this report, the development of an online, noninvasive, measurement method of the biofilm thickness in a liquid phase is presented. The method is based in the analysis of the ultrasound wave pulse-echo behavior in a liquid phase reproducing the real reactor conditions. It does not imply the removal of the biomass from the support or any kind of intervention in the support (pipes) to detect and perform the measurements (non-invasiveness). The developed method allows for its sensor to be easily and quickly mounted and unmounted in any location along a pipe or reactor wall. Finally, this method is an important innovation because it allows the thickness measurement of a biofilm, in liquid phase conditions that can be used in monitoring programs, to help in scheduling cleaning actions to remove the unwanted biofilm, in several application areas, namely in potable water supply pipes.

  3. Reliability of real-time ultrasound measurement of transversus abdominis thickness in healthy trained subjects.

    PubMed

    Gnat, Rafael; Saulicz, Edward; Miądowicz, Barbara

    2012-08-01

    To investigate intra- and inter-rater reliability of the ultrasound measurement of transversus abdominis (TrA) thickness and thickness change (difference between thickness at rest and during contraction) in asymptomatic, trained subjects. To define the number of repeated measurements that provide acceptable level of reliability. To investigate variability of the measurements over time of 5 days and the reliability of duplicate analysis of images. A single-group repeated-measures design was used to assess reliability. Healthy volunteers (n = 10) were subjected to 1-week training in voluntary activation of TrA. Real-time ultrasound imaging and subsequent measurement of the TrA thickness at rest and during voluntary contraction were repeated on Monday, Wednesday and Friday of the next week. Using a single repeated measurement, intraclass correlation coefficients (ICCs) for TrA thickness were: 0.86-0.95 (intra-rater), 0.86-0.92 (inter-rater); and for TrA thickness change: 0.34-0.56 (intra-rater), 0.47-0.61 (inter-rater). Using the mean of three repeated measurements respective values were: 0.97, 0.96-0.98; and 0.81-0.84, 0.80-0.90. No significant differences were found between mean values of TrA thickness as well as thickness change obtained on three consecutive measurement days. Duplicate analysis of the images was highly reliable with ICCs of 0.89-0.99. Two repeated measurements for TrA thickness and at least three measurements for TrA thickness change are needed to achieve acceptable levels of intra- and inter-rater reliability. In healthy trained volunteers TrA thickness and thickness change are relatively stable parameters over a 5-day period. Duplicate analysis of the same images by two blinded observers is reliable.

  4. Whole breast tissue characterization with ultrasound tomography

    NASA Astrophysics Data System (ADS)

    Duric, Neb; Littrup, Peter; Li, Cuiping; Roy, Olivier; Schmidt, Steve; Seamans, John; Wallen, Andrea; Bey-Knight, Lisa

    2015-03-01

    A number of clinical trials have shown that screening ultrasound, supplemental to mammography, detects additional cancers in women with dense breasts. However, labor intensity, operator dependence and high recall rates have limited adoption. This paper describes the use of ultrasound tomography for whole-breast tissue stiffness measurements as a first step toward addressing the issue of high recall rates. The validation of the technique using an anthropomorphic phantom is described. In-vivo applications are demonstrated on 13 breast masses, indicating that lesion stiffness correlates with lesion type as expected. Comparison of lesion stiffness measurements with standard elastography was available for 11 masses and showed a strong correlation between the 2 measures. It is concluded that ultrasound tomography can map out the 3 dimensional distribution of tissue stiffness over the whole breast. Such a capability is well suited for screening where additional characterization may improve the specificity of screening ultrasound, thereby lowering barriers to acceptance.

  5. Prenatal Exposure to Traffic-Related Air Pollution and Ultrasound Measures of Fetal Growth in the INMA Sabadell Cohort

    PubMed Central

    Aguilera, Inmaculada; Garcia-Esteban, Raquel; Iñiguez, Carmen; Nieuwenhuijsen, Mark J.; Rodríguez, Àgueda; Paez, Montserrat; Ballester, Ferran; Sunyer, Jordi

    2010-01-01

    Background Few studies have used longitudinal ultrasound measurements to assess the effect of traffic-related air pollution on fetal growth. Objective We examined the relationship between exposure to nitrogen dioxide (NO2) and aromatic hydrocarbons [benzene, toluene, ethylbenzene, m/p-xylene, and o-xylene (BTEX)] on fetal growth assessed by 1,692 ultrasound measurements among 562 pregnant women from the Sabadell cohort of the Spanish INMA (Environment and Childhood) study. Methods We used temporally adjusted land-use regression models to estimate exposures to NO2 and BTEX. We fitted mixed-effects models to estimate longitudinal growth curves for femur length (FL), head circumference (HC), abdominal circumference (AC), biparietal diameter (BPD), and estimated fetal weight (EFW). Unconditional and conditional SD scores were calculated at 12, 20, and 32 weeks of gestation. Sensitivity analyses were performed considering time–activity patterns during pregnancy. Results Exposure to BTEX from early pregnancy was negatively associated with growth in BPD during weeks 20–32. None of the other fetal growth parameters were associated with exposure to air pollution during pregnancy. When considering only women who spent < 2 hr/day in nonresidential outdoor locations, effect estimates were stronger and statistically significant for the association between NO2 and growth in HC during weeks 12–20 and growth in AC, BPD, and EFW during weeks 20–32. Conclusions Our results lend some support to an effect of exposure to traffic-related air pollutants from early pregnancy on fetal growth during mid-pregnancy. PMID:20103496

  6. The use of ultrasound in the diagnosis of abdominal wall hernias.

    PubMed

    Young, J; Gilbert, A I; Graham, M F

    2007-08-01

    The diagnosis of abdominal wall hernias is not always straightforward and may require additional investigative modalities. Real-time ultrasound is accurate, non-invasive, relatively inexpensive, and readily available. The value of ultrasound as an adjunctive tool in the diagnosis of abdominal wall hernias in both pre-operative and post-operative patients was studied. Retrospective analysis of 200 patients treated at the Hernia Institute of Florida was carried out. In these cases, ultrasound had been used to assist with case management. Patients without previous hernia surgery and those with early and late post-herniorrhaphy complaints were studied. Patients with obvious hernias were excluded. Indications for ultrasound examination included patients with abdominal pain without a palpable hernia, a palpable mass of questionable etiology, and patients with inordinate pain or excessive swelling during the early post-operative period. Patients were treated with surgery or conservative therapy depending on the results of the physical examination and ultrasound studies. Cases in which the ultrasound findings influenced the decision-making process by confirming clinical findings or altering the diagnosis and changing the treatment plan are discussed. Of the 200 patients, 144 complained of pain alone and on physical exam no hernia or mass was palpable. Of these 144 patients with pain alone, 21 had a hernia identified on the US examination and were referred for surgery. The 108 that had a negative ultrasound were treated conservatively with rest, heat, and anti-inflammatory drugs, most often with excellent results. Of the 56 remaining patients who had a mass, with or without pain, 22 had hernias identified by means of ultrasound examination. In the other 34, the etiology of the mass was not a hernia. Abdominal wall ultrasound is a valuable tool in the scheme of management of patients in whom the diagnosis of abdominal wall hernia is unclear. Therapeutic decisions can be

  7. Ultrasound

    MedlinePlus

    Ultrasound is a type of imaging. It uses high-frequency sound waves to look at organs and ... liver, and other organs. During pregnancy, doctors use ultrasound to view the fetus. Unlike x-rays, ultrasound ...

  8. Randomized, controlled trial of biofeedback with anal manometry, transanal ultrasound, or pelvic floor retraining with digital guidance alone in the treatment of mild to moderate fecal incontinence.

    PubMed

    Solomon, Michael J; Pager, Chet K; Rex, Jenny; Roberts, Rachael; Manning, Jane

    2003-06-01

    A prospective, three-armed, randomized, controlled trial was performed to assess whether pelvic floor exercises with biofeedback using anal manometry or transanal ultrasound are superior to pelvic floor exercises with feedback from digital examination alone in terms of continence, quality of life, physiologic sphincter strength, and compliance. Its secondary objectives were to assess whether there are any differences in these outcomes between biofeedback with transanal ultrasound vs. anal manometry and to correlate the physiologic measures with clinical outcome. One hundred twenty patients with mild to moderate fecal incontinence were randomized into one of three treatment groups: biofeedback with anal manometry, biofeedback with transanal ultrasound, or pelvic floor exercises with feedback from digital examination alone. Commencing one week after an initial 45-minute assessment session, patients attended monthly treatments for a total of five sessions. Each session lasted 30 minutes and involved sphincter exercises with biofeedback that involved instrumentation or digital examination alone, and patients were encouraged to perform identical exercises twice per day between outpatient visits. One hundred two patients (85 percent) completed the four-month treatment program. Across all treatment allocations, patients experienced modest but highly significant improvements in all nine outcome measures during treatment, with 70 percent of all patients perceiving improvement in symptom severity and 69 percent of patients reporting improved quality of life. With the possible exception of isotonic fatigue time, there were no significant differences between the three treatment groups in compliance, physiologic sphincter strength, and clinical or quality-of-life measures. Correlations between physiologic measures and clinical outcomes were much stronger with ultrasound-based measures than with manometry. Although patients in this study who completed pelvic floor exercises with

  9. Hunger Games: Interactive Ultrasound Imaging for Learning Gastrointestinal Physiology.

    PubMed

    Kafer, Ilana; Rennie, William; Noor, Ali; Pellerito, John S

    2017-02-01

    Ultrasound is playing an increasingly important role in medical student education. Although most uses of ultrasound have focused on learning purely anatomic relationships or augmentation of the physical examination, there is little documentation of the value of ultrasound as a learning tool regarding physiology alone or in association with anatomy. We devised an interactive learning session for first-year medical students using ultrasound to combine both anatomic and physiologic principles as an integration of gastrointestinal and vascular function. The incorporation of our activity, The Hunger Games, provides the foundation for a powerful integration tool for medical student education. © 2016 by the American Institute of Ultrasound in Medicine.

  10. Mechanics of ultrasound elastography

    PubMed Central

    Li, Guo-Yang

    2017-01-01

    Ultrasound elastography enables in vivo measurement of the mechanical properties of living soft tissues in a non-destructive and non-invasive manner and has attracted considerable interest for clinical use in recent years. Continuum mechanics plays an essential role in understanding and improving ultrasound-based elastography methods and is the main focus of this review. In particular, the mechanics theories involved in both static and dynamic elastography methods are surveyed. They may help understand the challenges in and opportunities for the practical applications of various ultrasound elastography methods to characterize the linear elastic, viscoelastic, anisotropic elastic and hyperelastic properties of both bulk and thin-walled soft materials, especially the in vivo characterization of biological soft tissues. PMID:28413350

  11. Comparison of the learning curves of digital examination and transabdominal sonography for the determination of fetal head position during labor.

    PubMed

    Rozenberg, P; Porcher, R; Salomon, L J; Boirot, F; Morin, C; Ville, Y

    2008-03-01

    To evaluate the learning curve of transabdominal sonography for the determination of fetal head position in labor and to compare it with that of digital vaginal examination. A student midwife who had never performed digital vaginal examination or ultrasound examination was recruited for this study. Instructions on how to perform digital vaginal examination and ultrasound examination were given before and after completing the first vaginal and ultrasound examinations, and repeated for each subsequent examination for as long as necessary. Digital and ultrasound diagnoses of the fetal head position were always performed first by the student midwife, and repeated by an experienced midwife or physician. The learning curve for identification of the fetal head position by either one of the two methods was analyzed using the cumulative sums (CUSUM) method for measurement errors. One hundred patients underwent digital vaginal examination and 99 had transabdominal sonography for the determination of fetal head position. An error rate of around 50% for vaginal examination was nearly constant during the first 50 examinations. It decreased subsequently, to stabilize at a low level from the 82(nd) patient. Errors of +/- 180 degrees were the most frequent. The learning curve for ultrasound imaging stabilized earlier than that of vaginal examination, after the 32(nd) patient. The most frequent errors with ultrasound examination were the inability to conclude on a diagnosis, particularly at the beginning of training, followed by errors of +/- 45 degrees. Based on our findings for the student tested, learning and accuracy of the determination of fetal head position in labor were easier and higher, respectively, with transabdominal sonography than with digital examination. This should encourage physicians to introduce clinical ultrasound examination into their practice. CUSUM charts provide a reliable representation of the learning curve, by accumulating evidence of performance

  12. Apoptosis Induction in Cancer Cells by Ultrasound Exposure

    NASA Astrophysics Data System (ADS)

    Watanabe, Akihiro; Kawai, Kazuaki; Sato, Toshio; Nishimura, Hiroyuki; Kawashima, Norimichi; Takeuchi, Shinichi

    2004-05-01

    The methods of suppressing cancer cell proliferation by ultrasound exposure were investigated to develop a new minimally invasive cancer treatment. A stainless-steel diaphragm with a bolt-clamped Langevin-type transducer (BLT) was attached to the bottom of a water tank in the ultrasound exposure system used in this study. Cancer cells of a mouse T lymphoma (EL-4) in a flask were exposed to ultrasound under various conditions of exposure time, ultrasound frequency, ultrasound waveform, and so forth. The number of cancer cells exposed to ultrasound decreased during the culturing process. In this study, it was proved by electrophoresis, enzyme activity measurement and morphological observation that cancer cell proliferation can be suppressed by apoptosis induction in cancer cells by ultrasound exposure.

  13. Agreement and reliability of pelvic floor measurements during rest and on maximum Valsalva maneuver using three-dimensional translabial ultrasound and virtual reality imaging.

    PubMed

    Speksnijder, L; Oom, D M J; Koning, A H J; Biesmeijer, C S; Steegers, E A P; Steensma, A B

    2016-08-01

    Imaging of the levator ani hiatus provides valuable information for the diagnosis and follow-up of patients with pelvic organ prolapse (POP). This study compared measurements of levator ani hiatal volume during rest and on maximum Valsalva, obtained using conventional three-dimensional (3D) translabial ultrasound and virtual reality imaging. Our objectives were to establish their agreement and reliability, and their relationship with prolapse symptoms and POP quantification (POP-Q) stage. One hundred women with an intact levator ani were selected from our tertiary clinic database. Information on clinical symptoms were obtained using standardized questionnaires. Ultrasound datasets were analyzed using a rendered volume with a slice thickness of 1.5 cm, at the level of minimal hiatal dimensions, during rest and on maximum Valsalva. The levator area (in cm(2) ) was measured and multiplied by 1.5 to obtain the levator ani hiatal volume (in cm(3) ) on conventional 3D ultrasound. Levator ani hiatal volume (in cm(3) ) was measured semi-automatically by virtual reality imaging using a segmentation algorithm. Twenty patients were chosen randomly to analyze intra- and interobserver agreement. The mean difference between levator hiatal volume measurements on 3D ultrasound and by virtual reality was 1.52 cm(3) (95% CI, 1.00-2.04 cm(3) ) at rest and 1.16 cm(3) (95% CI, 0.56-1.76 cm(3) ) during maximum Valsalva (P < 0.001). Both intra- and interobserver intraclass correlation coefficients were ≥ 0.96 for conventional 3D ultrasound and > 0.99 for virtual reality. Patients with prolapse symptoms or POP-Q Stage ≥ 2 had significantly larger hiatal measurements than those without symptoms or POP-Q Stage < 2. Levator ani hiatal volume at rest and on maximum Valsalva is significantly smaller when using virtual reality compared with conventional 3D ultrasound; however, this difference does not seem clinically important. Copyright © 2015 ISUOG. Published by

  14. Development of the Fetal Vermis: New Biometry Reference Data and Comparison of 3 Diagnostic Modalities-3D Ultrasound, 2D Ultrasound, and MR Imaging.

    PubMed

    Katorza, E; Bertucci, E; Perlman, S; Taschini, S; Ber, R; Gilboa, Y; Mazza, V; Achiron, R

    2016-07-01

    Normal biometry of the fetal posterior fossa rules out most major anomalies of the cerebellum and vermis. Our aim was to provide new reference data of the fetal vermis in 4 biometric parameters by using 3 imaging modalities, 2D ultrasound, 3D ultrasound, and MR imaging, and to assess the relation among these modalities. A retrospective study was conducted between June 2011 and June 2013. Three different imaging modalities were used to measure vermis biometry: 2D ultrasound, 3D ultrasound, and MR imaging. The vermian parameters evaluated were the maximum superoinferior diameter, maximum anteroposterior diameter, the perimeter, and the surface area. Statistical analysis was performed to calculate centiles for gestational age and to assess the agreement among the 3 imaging modalities. The number of fetuses in the study group was 193, 172, and 151 for 2D ultrasound, 3D ultrasound, and MR imaging, respectively. The mean and median gestational ages were 29.1 weeks, 29.5 weeks (range, 21-35 weeks); 28.2 weeks, 29.05 weeks (range, 21-35 weeks); and 32.1 weeks, 32.6 weeks (range, 27-35 weeks) for 2D ultrasound, 3D ultrasound, and MR imaging, respectively. In all 3 modalities, the biometric measurements of the vermis have shown a linear growth with gestational age. For all 4 biometric parameters, the lowest results were those measured by MR imaging, while the highest results were measured by 3D ultrasound. The inter- and intraobserver agreement was excellent for all measures and all imaging modalities. Limits of agreement were considered acceptable for clinical purposes for all parameters, with excellent or substantial agreement defined by the intraclass correlation coefficient. Imaging technique-specific reference data should be used for the assessment of the fetal vermis in pregnancy. © 2016 by American Journal of Neuroradiology.

  15. Developing an ultrasound correlation velocimetry system

    NASA Astrophysics Data System (ADS)

    Surup, Gerrit; White, Christopher; UNH Team

    2011-11-01

    The process of building an ultrasound correlation velocimetry (UCV) system by integrating a commercial medical ultrasound with a PC running commercial PIV software is described and preliminary validation measurements in pipe flow using UCV and optical particle image velocimetry (PIV) are reported. In principles of operation, UCV is similar to the technique of PIV, differing only in the image acquisition process. The benefits of UCV are that it does not require optical access to the flow field and can be used for measuring flows of opaque fluids. While the limitations of UVC are the inherently low frame rates (limited by the imaging capabilities of the commercial ultrasound system) and low spatial resolution, which limits the range of velocities and transient flow behavior that can be measured. The support of the NSF (CBET0846359, grant monitor Horst Henning Winter) is gratefully acknowledged.

  16. Ultrasound in differential diagnosis of periapical radiolucencies: A radiohistopathological study

    PubMed Central

    Khambete, Neha; Kumar, Rahul

    2015-01-01

    Objectives: To evaluate the efficacy of ultrasound in differential diagnosis of periapical radiolucencies. Materials and Methods: Ten patients aged between 19 years and 40 years with periapical lesions associated with anterior maxillary or mandibular teeth were selected and consented for the study. Pre-operative periapical radiographs were obtained. Measurements and provisional diagnoses of the apical areas were made by two specialist observers on two separate occasions. Preoperative ultrasound examinations with Doppler flowmetry were then performed and the images assessed by two specialist observers for the size, contents, vascular supply and a provisional diagnosis made as to whether the lesion was a cyst or granuloma. Endodontic surgery was performed including curettage of the apical tissues to enable histopathological investigation, which provided the gold standard diagnosis. All measurements and findings were compared and statistically analyzed. Results: Total 10 lesions were identified in 10 patients. On periapical radiographs, lesions were readily identified but observers were unable to differentiate granuloma from cyst using either modality. Where sufficient buccal cortical bone had been resorbed, ultrasound imaging was simple but underestimated the size of the lesions compared with periapical radiographs. In all cases, the ultrasound diagnosis agreed with the histopathological gold standard. Conclusion: Ultrasonography (USG) can provide accurate information about the nature of intraosseous lesions of the jaws before any surgical procedure. It is proposed that USG with Doppler flowmetry can provide an additional diagnostic tool without invasive surgery, where treatment option is nonsurgical. PMID:25657525

  17. Fast Track ultrasound protocol to detect acute complications after totally implantable venous access device placement.

    PubMed

    Wu, Chun-Yu; Lin, Feng-Sheng; Wang, Yi-Chia; Chou, Wei-Han; Lin, Wen-Ying; Sun, Wei-Zen; Lin, Chih-Peng

    2015-01-01

    The role of ultrasound examination in detection of postprocedure complications from totally implantable venous access devices (TIVAD) placement is still uncertain. In a cohort of 665 cancer outpatients, we assessed a quick ultrasound examination protocol in early detection of mechanical complications of catheterization. Immediately after TIVAD placement, an ultrasound examination and chest radiography were performed to detect hemothorax, pneumothorax, and catheter malposition. The two methods were compared. Of the 668 catheters inserted, 628 were placed into axillary veins and 40 into internal jugular veins. The ultrasound examination took 2.5 ± 1.1 min. No hemothorax was detected, and neither pneumothorax nor catheter malposition was evident among the 40 internal jugular vein cannulations. Ultrasound and chest radiography examinations of the 628 axillary vein cannulations detected five and four instances of pneumothorax, respectively. Ultrasound detected all six catheter malpositions into the internal jugular vein. However, ultrasound failed to detect two out of three malpositions in the contralateral brachiocephalic vein and one kinking inside the superior vena cava. Without revision surgery, the operating time was 34.1 ± 15.6 min. With revision surgery, the operating time was shorter when ultrasound detected catheter malposition than when chest radiography was used (96.8 ± 12.9 vs. 188.8 ± 10.3 min, p < 0.001). Postprocedure ultrasound examination is a quick and sensitive method to detect TIVAD-related pneumothorax. It also precisely detects catheter malposition to internal jugular vein thus reduces time needed for revision surgery while chest radiography remains necessary to confirm catheter final position.

  18. Ultrasound Imaging of Muscle Contraction of the Tibialis Anterior in Patients with Facioscapulohumeral Dystrophy.

    PubMed

    Gijsbertse, Kaj; Goselink, Rianne; Lassche, Saskia; Nillesen, Maartje; Sprengers, André; Verdonschot, Nico; van Alfen, Nens; de Korte, Chris

    2017-11-01

    A need exists for biomarkers to diagnose, quantify and longitudinally follow facioscapulohumeral muscular dystrophy (FSHD) and many other neuromuscular disorders. Furthermore, the pathophysiological mechanisms leading to muscle weakness in most neuromuscular disorders are not completely understood. Dynamic ultrasound imaging (B-mode image sequences) in combination with speckle tracking is an easy, applicable and patient-friendly imaging tool to visualize and quantify muscle deformation. This dynamic information provides insight in the pathophysiological mechanisms and may help to distinguish the various stages of diseased muscle in FSHD. In this proof-of-principle study, we applied a speckle tracking technique to 2-D ultrasound image sequences to quantify the deformation of the tibialis anterior muscle in patients with FSHD and in healthy controls. The resulting deformation patterns were compared with muscle ultrasound echo intensity analysis (a measure of fat infiltration and dystrophy) and clinical outcome measures. Of the four FSHD patients, two patients had severe peroneal weakness and two patients had mild peroneal weakness on clinical examination. We found a markedly varied muscle deformation pattern between these groups: patients with severe peroneal weakness showed a different motion pattern of the tibialis anterior, with overall less displacement of the central tendon region, while healthy patients showed a non-uniform displacement pattern, with the central aponeurosis showing the largest displacement. Hence, dynamic muscle ultrasound of the tibialis anterior muscle in patients with FSHD revealed a distinctively different tissue deformation pattern among persons with and without tibialis anterior weakness. These findings could clarify the understanding of the pathophysiology of muscle weakness in FSHD patients. In addition, the change in muscle deformation shows good correlation with clinical measures and quantitative muscle ultrasound measurements. In

  19. Ultrasound

    MedlinePlus Videos and Cool Tools

    Ultrasound is a useful procedure for monitoring the baby's development in the uterus. Ultrasound uses inaudible sound waves to produce a two- ... sound waves and appear dark or black. An ultrasound can supply vital information about a mother's pregnancy ...

  20. Therapeutic ultrasound for acute ankle sprains.

    PubMed

    van den Bekerom, Michel Pj; van der Windt, Daniëlle Awm; Ter Riet, Gerben; van der Heijden, Geert J; Bouter, Lex M

    2011-06-15

    Ultrasound is used in the treatment of a wide variety of musculoskeletal disorders, which include acute ankle sprains. This is an update of a Cochrane review first published in 1999, and previously updated in 2004. To evaluate the effects of ultrasound therapy in the treatment of acute ankle sprains. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (September 2010), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2010, Issue 3), MEDLINE (1966 to September 2010), EMBASE (1983 to September 2010), CINAHL (1982 to 2004), and PEDro - the Physiotherapy Evidence Database (accessed 01/06/09). We also searched the Cochrane Rehabilitation and Related Therapies Field database, reference lists of articles, and contacted colleagues.The WHO International Clinical Trials Registry Platform was searched for ongoing trials. Randomised or quasi-randomised trials were included if the following conditions were met: at least one study group was treated with therapeutic ultrasound; participants had acute lateral ankle sprains; and outcome measures included general improvement, pain, swelling, functional disability, or range of motion. Two authors independently performed study selection, and assessed the risk of bias and extracted data. Risk ratios and risk differences together with 95% confidence intervals were calculated for dichotomous outcomes and mean differences together with 95% confidence intervals for continuous outcome measures. Limited pooling of data was undertaken where there was clinical homogeneity in terms of participants, treatments, outcomes, and follow-up time points. Six trials were included, involving 606 participants. Five trials included comparisons of ultrasound therapy with sham ultrasound; and three trials included single comparisons of ultrasound with three other treatments. The assessment of risk of bias was hampered by poor reporting of trial methods and results. None of the five placebo

  1. Calibration and Evaluation of Ultrasound Thermography using Infrared Imaging

    PubMed Central

    Hsiao, Yi-Sing; Deng, Cheri X.

    2015-01-01

    Real-time monitoring of the spatiotemporal evolution of tissue temperature is important to ensure safe and effective treatment in thermal therapies including hyperthermia and thermal ablation. Ultrasound thermography has been proposed as a non-invasive technique for temperature measurement, and accurate calibration of the temperature-dependent ultrasound signal changes against temperature is required. Here we report a method that uses infrared (IR) thermography for calibration and validation of ultrasound thermography. Using phantoms and cardiac tissue specimens subjected to high-intensity focused ultrasound (HIFU) heating, we simultaneously acquired ultrasound and IR imaging data from the same surface plane of a sample. The commonly used echo time shift-based method was chosen to compute ultrasound thermometry. We first correlated the ultrasound echo time shifts with IR-measured temperatures for material-dependent calibration and found that the calibration coefficient was positive for fat-mimicking phantom (1.49 ± 0.27) but negative for tissue-mimicking phantom (− 0.59 ± 0.08) and cardiac tissue (− 0.69 ± 0.18 °C-mm/ns). We then obtained the estimation error of the ultrasound thermometry by comparing against the IR measured temperature and revealed that the error increased with decreased size of the heated region. Consistent with previous findings, the echo time shifts were no longer linearly dependent on temperature beyond 45 – 50 °C in cardiac tissues. Unlike previous studies where thermocouples or water-bath techniques were used to evaluate the performance of ultrasound thermography, our results show that high resolution IR thermography provides a useful tool that can be applied to evaluate and understand the limitations of ultrasound thermography methods. PMID:26547634

  2. On the reproducibility of expert-operated and robotic ultrasound acquisitions.

    PubMed

    Kojcev, Risto; Khakzar, Ashkan; Fuerst, Bernhard; Zettinig, Oliver; Fahkry, Carole; DeJong, Robert; Richmon, Jeremy; Taylor, Russell; Sinibaldi, Edoardo; Navab, Nassir

    2017-06-01

    We present the evaluation of the reproducibility of measurements performed using robotic ultrasound imaging in comparison with expert-operated sonography. Robotic imaging for interventional procedures may be a valuable contribution, but requires reproducibility for its acceptance in clinical routine. We study this by comparing repeated measurements based on robotic and expert-operated ultrasound imaging. Robotic ultrasound acquisition is performed in three steps under user guidance: First, the patient is observed using a 3D camera on the robot end effector, and the user selects the region of interest. This allows for automatic planning of the robot trajectory. Next, the robot executes a sweeping motion following the planned trajectory, during which the ultrasound images and tracking data are recorded. As the robot is compliant, deviations from the path are possible, for instance due to patient motion. Finally, the ultrasound slices are compounded to create a volume. Repeated acquisitions can be performed automatically by comparing the previous and current patient surface. After repeated image acquisitions, the measurements based on acquisitions performed by the robotic system and expert are compared. Within our case series, the expert measured the anterior-posterior, longitudinal, transversal lengths of both of the left and right thyroid lobes on each of the 4 healthy volunteers 3 times, providing 72 measurements. Subsequently, the same procedure was performed using the robotic system resulting in a cumulative total of 144 clinically relevant measurements. Our results clearly indicated that robotic ultrasound enables more repeatable measurements. A robotic ultrasound platform leads to more reproducible data, which is of crucial importance for planning and executing interventions.

  3. Noninvasive measurement of pulsatile intracranial pressure using ultrasound

    NASA Technical Reports Server (NTRS)

    Ueno, T.; Ballard, R. E.; Shuer, L. M.; Cantrell, J. H.; Yost, W. T.; Hargens, A. R.

    1998-01-01

    The present study was designed to validate our noninvasive ultrasonic technique (pulse phase locked loop: PPLL) for measuring intracranial pressure (ICP) waveforms. The technique is based upon detecting skull movements which are known to occur in conjunction with altered intracranial pressure. In bench model studies, PPLL output was highly correlated with changes in the distance between a transducer and a reflecting target (R2 = 0.977). In cadaver studies, transcranial distance was measured while pulsations of ICP (amplitudes of zero to 10 mmHg) were generated by rhythmic injections of saline. Frequency analyses (fast Fourier transformation) clearly demonstrate the correspondence between the PPLL output and ICP pulse cycles. Although theoretically there is a slight possibility that changes in the PPLL output are caused by changes in the ultrasonic velocity of brain tissue, the decreased amplitudes of the PPLL output as the external compression of the head was increased indicates that the PPLL output represents substantial skull movement associated with altered ICP. In conclusion, the ultrasound device has sufficient sensitivity to detect transcranial pulsations which occur in association with the cardiac cycle. Our technique makes it possible to analyze ICP waveforms noninvasively and will be helpful for understanding intracranial compliance and cerebrovascular circulation.

  4. Sonographic physical diagnosis 101: teaching senior medical students basic ultrasound scanning skills using a compact ultrasound system.

    PubMed

    Angtuaco, Teresita L; Hopkins, Robert H; DuBose, Terry J; Bursac, Zoran; Angtuaco, Michael J; Ferris, Ernest J

    2007-06-01

    This project was designed to test the feasibility of introducing ultrasound to senior medical students as a primary diagnostic tool in the evaluation of patients. Specifically, its aim was to determine if it is possible for medical students untrained in sonography to gain basic competence in performing abdominal ultrasound with limited didactic and hands-on instructions. Registered sonographers provided the students with hands-on instructions on the use of a compact ultrasound system. They were likewise shown how to evaluate specific organs and perform measurements. The results of the student measurements and those obtained by the sonographers were compared. There was close correlation between the results obtained by sonographers and students on both normal and abnormal findings. This supports the concept that medical students can be taught basic ultrasound skills with limited didactic and hands-on instructions with the potential of using these skills in the patient clinics as an adjunct to routine physical diagnosis.

  5. Classification of blood cells and tumor cells using label-free ultrasound and photoacoustics.

    PubMed

    Strohm, Eric M; Kolios, Michael C

    2015-08-01

    A label-free method that can identify cells in a blood sample using high frequency photoacoustic and ultrasound signals is demonstrated. When the wavelength of the ultrasound or photoacoustic wave is similar to the size of a single cell (frequencies of 100-500 MHz), unique periodic features occur within the ultrasound and photoacoustic power spectrum that depend on the cell size, structure, and morphology. These spectral features can be used to identify different cell types present in blood, such as red blood cells (RBCs), white blood cells (WBCs), and circulating tumor cells. Circulating melanoma cells are ideal for photoacoustic detection due to their endogenous optical absorption properties. Using a 532 nm pulsed laser and a 375 MHz transducer, the ultrasound and photoacoustic signals from RBCs, WBCs, and melanoma cells were individually measured in an acoustic microscope to examine how the signals change between cell types. A photoacoustic and ultrasound signal was detected from RBCs and melanoma cells; only an ultrasound signal was detected from WBCs. The different cell types were distinctly separated using the ultrasound and photoacoustic signal amplitude and power spectral periodicity. The size of each cell was also estimated from the spectral periodicity. For the first time, sound waves generated using pulse-echo ultrasound and photoacoustics have been used to identify and size single cells, with applications toward counting and identifying cells, including circulating melanoma cells. © 2015 International Society for Advancement of Cytometry.

  6. Results of vardenafil mediated power Doppler ultrasound, contrast enhanced ultrasound and systematic random biopsies to detect prostate cancer.

    PubMed

    Morelli, Girolamo; Pagni, Riccardo; Mariani, Chiara; Minervini, Riccardo; Morelli, Andrea; Gori, Francesco; Ferdeghini, Ezio Maria; Paterni, Marco; Mauro, Eva; Guidi, Elisa; Armillotta, Nicola; Canale, Domenico; Vitti, Paolo; Caramella, Davide; Minervini, Andrea

    2011-06-01

    We evaluated the ability of the phosphodiesterase-5 inhibitor vardenafil to increase prostate microcirculation during power Doppler ultrasound. We also evaluated the results of contrast and vardenafil enhanced targeted biopsies compared to those of standard 12-core random biopsies to detect cancer. Between May 2008 and January 2010, 150 consecutive patients with prostate specific antigen more than 4 ng/ml at first diagnosis with negative digital rectal examination and transrectal ultrasound, and no clinical history of prostatitis underwent contrast enhanced power Doppler ultrasound (bolus injection of 2.4 ml SonoVue® contrast agent), followed by vardenafil enhanced power Doppler ultrasound (1 hour after oral administration of vardenafil 20 mg). All patients underwent standard 12-core transrectal ultrasound guided random prostate biopsy plus 1 further sampling from each suspected hypervascular lesion detected by contrast and vardenafil enhanced power Doppler ultrasound. Prostate cancer was detected in 44 patients (29.3%). Contrast and vardenafil enhanced power Doppler ultrasound detected suspicious, contrast enhanced and vardenafil enhanced areas in 112 (74.6%) and 110 patients (73.3%), and was diagnostic for cancer in 32 (28.5%) and 42 (38%), respectively. Analysis of standard technique, and contrast and vardenafil enhanced power Doppler ultrasound findings by biopsy core showed significantly higher detection using vardenafil vs contrast enhanced power Doppler ultrasound and standard technique (41.2% vs 22.7% and 8.1%, p <0.005 and <0.001, respectively). The detection rate of standard plus contrast or vardenafil enhanced power Doppler ultrasound was 10% and 11.7% (p not significant). Vardenafil enhanced power Doppler ultrasound enables excellent visualization of the microvasculature associated with cancer and can improve the detection rate compared to contrast enhanced power Doppler ultrasound and the random technique. Copyright © 2011 American Urological

  7. Comparison of Central Corneal Thickness Measurements Obtained by RTVue OCT, Lenstar, Sirius Topography, and Ultrasound Pachymetry in Healthy Subjects.

    PubMed

    Şimşek, Ali; Bilak, Şemsettin; Güler, Mete; Çapkin, Musa; Bilgin, Burak; Reyhan, Ali Hakim

    2016-01-01

    To compare central corneal thickness (CCT) measurement results obtained by RTVue OCT, Lenstar, Sirius topography, and ultrasound pachymetry (UP) (OcuScan RxP Ophthalmic Ultrasound System, Alcon Laboratories) in healthy subjects. 256 eyes of 128 healthy subjects were included in the study. CCT measurements were obtained from the eyes for each subject using the UP, Lenstar, Sirius topography, and RTVue OCT instruments. Ultrasound pachymetry measurements were performed after the eyes were anesthetized with one drop of 0.5% proparacaine hydrochloride and were performed at the same day after 15 minutes after previous measurements. Of 128 participants, 84 were male and 44 were female with a mean age of 33.15 ± 12.95 years (ranging from 18 to 75 years). The mean CCTs for UP, Lenstar, Sirius topography, and RTVue OCT were 535.60 ± 35.15 (440,00-668,00); 532.63 ± 34.44 (449,00-650,00); 526.05 ± 36.45 (314,00-640,00); 525.89 ± 33.21 (437,00-646,00) µm, respectively. The mean CCT measurements were statistically different among the three groups (p = 0.002). CCT measurements obtained using RTVue-OCT were significantly thinner than those obtained using UP (p = 0.009). Sirius CCT measurements were also thinner than UP (p = 0.011). Mean CCT measurements between UP and Lenstar were similar (p = 0.769). Measurements with Lenstar (r = 0.849), Sirius topography (r = 0.883), and RTVue OCT (0.949) were highly correlated with UP measurements. RTVue OCT and Sirius topography significantly underestimated the CCT compared with UP. Although highly correlated, the measurement values with these devices are not directly interchangeable in clinical practice.

  8. Dependence of thresholds for pulmonary capillary hemorrhage on diagnostic ultrasound frequency.

    PubMed

    Miller, Douglas L; Dou, Chunyan; Raghavendran, Krishnan

    2015-06-01

    Pulmonary ultrasound examination has become routine for diagnosis in many clinical and point-of-care medical settings. However, the phenomenon of pulmonary capillary hemorrhage (PCH) induction during diagnostic ultrasound imaging presents a poorly understood risk factor. PCH was observed in anesthetized rats exposed to 1.5-, 4.5- and 12.0-MHz diagnostic ultrasound to investigate the frequency dependence of PCH thresholds. PCH was detected in the ultrasound images as growing comet tail artifacts and was assessed using photographs of the surface of excised lungs. Previous photographs acquired after exposure to 7.6-MHz diagnostic ultrasound were included for analysis. In addition, at each frequency we measured dosimetric parameters, including peak rarefactional pressure amplitude and spatial peak, pulse average intensity attenuated by rat chest wall samples. Peak rarefactional pressure amplitude thresholds determined at each frequency, based on the proportion of PCH in groups of five rats, were 1.03 ± 0.02, 1.28 ± 0.14, 1.18 ± 0.12 and 1.36 ± 0.15 MPa at 1.5, 4.5, 7.6 and 12.0 MHz, respectively. Although the PCH lesions decreased in size with increasing ultrasonic frequency, owing to the smaller beam widths and scan lengths, the peak rarefactional pressure amplitude thresholds remained approximately constant. This dependence was different from that of the mechanical index, which indicates a need for a specific dosimetric parameter for safety guidance in pulmonary ultrasound. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  9. Comparable ultrasound measurements of ten anatomical specimens of infant hip joints by the methods of Graf and Terjesen.

    PubMed

    Falliner, A; Hahne, H J; Hedderich, J; Brossmann, J; Hassenpflug, J

    2004-04-01

    To define which sonographic section planes relative to the acetabular inlet plane will produce analyzable images with the methods of Graf and Terjesen. Anatomical specimens of infant hip joints were investigated in a water bath using the methods of Graf and Terjesen. Acetabular position was varied in defined increments with respect to the ultrasound beam. The alpha angles and the femoral head coverage (FHC) were measured. To obtain images analyzable by the two methods, the ultrasound beam had to intersect with the acetabular inlet plane at defined angles. The acetabular notch had to be anteriorly rotated from the ultrasound beam plane by at least 20 degrees. Beam entry within a 50 degrees sector posterior to the perpendicular on the inlet plane resulted in analyzable images. The stepwise multiple linear regression analysis showed that alpha angles and FHC were much affected by the coronal-plane transducer tilt. The fact that caudal tilts of the transducer are associated with reduced alpha angles and FHC values should be kept in mind in clinical ultrasound investigations. It is recommended that the transducer should be put on the greater trochanter perpendicular to the transverse axis of the body.

  10. Ultrasound measurement of the brachial artery flow-mediated dilation without ECG gating.

    PubMed

    Gemignani, Vincenzo; Bianchini, Elisabetta; Faita, Francesco; Giannarelli, Chiara; Plantinga, Yvonne; Ghiadoni, Lorenzo; Demi, Marcello

    2008-03-01

    The methods commonly used for noninvasive ultrasound assessment of endothelium-dependent flow-mediated dilation (FMD) require an electrocardiogram (ECG) signal to synchronize the measurements with the cardiac cycle. In this article, we present a method for assessing FMD that does not require ECG gating. The approach is based on temporal filtering of the diameter-time curve, which is obtained by means of a B-mode image processing system. The method was tested on 22 healthy volunteers without cardiovascular risk factors. The measurements obtained with the proposed approach were compared with those obtained with ECG gating and with both systolic and end-diastolic measurements. Results showed good agreement between the methods and a higher precision of the new method due to the fact that it is based on a larger number of measurements. Further advantages were also found both in terms of reliability of the measure and simplification of the instrumentation. (E-mail: gemi@ifc.cnr.it).

  11. [Diagnostic ultrasound in pneumothorax].

    PubMed

    Maury, É; Pichereau, C; Bourcier, S; Galbois, A; Lejour, G; Baudel, J-L; Ait-Oufella, H; Guidet, B

    2016-10-01

    For a long time the lung has been regarded as inaccessible to ultrasound. However, recent clinical studies have shown that this organ can be examined by this technique, which appears, in some situations, to be superior to thoracic radiography. The examination does not require special equipment and is possible using a combination of simple qualitative signs: lung sliding, the presence of B lines and the demonstration of the lung point. The lung sliding corresponds to the artefact produced by the movement of the two pleural layers, one against the other. The B lines indicate the presence of an interstitial syndrome. The presence of lung sliding and/or B lines has a negative predictive value of 100% and formally excludes a pneumothorax in the area where the probe has been applied. The presence of the lung point is pathognomonic of pneumothorax but the sensitivity is no more than 60%. Ultrasound is therefore a rapid and simple means of excluding a pneumothorax (lung sliding or B lines) and of confirming a pneumothorax when the lung point is visible. The question that remains is whether ultrasound can totally replace radiography in the management of this disorder. Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  12. A cMUT probe for ultrasound-guided focused ultrasound targeted therapy.

    PubMed

    Gross, Dominique; Coutier, Caroline; Legros, Mathieu; Bouakaz, Ayache; Certon, Dominique

    2015-06-01

    Ultrasound-mediated targeted therapy represents a promising strategy in the arsenal of modern therapy. Capacitive micromachined ultrasonic transducer (cMUT) technology could overcome some difficulties encountered by traditional piezoelectric transducers. In this study, we report on the design, fabrication, and characterization of an ultrasound-guided focused ultrasound (USgFUS) cMUT probe dedicated to preclinical evaluation of targeted therapy (hyperthermia, thermosensitive liposomes activation, and sonoporation) at low frequency (1 MHz) with simultaneous ultrasonic imaging and guidance (15 to 20 MHz). The probe embeds two types of cMUT arrays to perform the modalities of targeted therapy and imaging respectively. The wafer-bonding process flow employed for the manufacturing of the cMUTs is reported. One of its main features is the possibility of implementing two different gap heights on the same wafer. All the design and characterization steps of the devices are described and discussed, starting from the array design up to the first in vitro measurements: optical (microscopy) and electrical (impedance) measurements, arrays' electroacoustic responses, focused pressure field mapping (maximum peak-to-peak pressure = 2.5 MPa), and the first B-scan image of a wire-target phantom.

  13. Brachial artery vasomotion and transducer pressure effect on measurements by active contour segmentation on ultrasound

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

    Cary, Theodore W.; Sultan, Laith R.; Sehgal, Chandra M., E-mail: sehgalc@uphs.upenn.edu

    Purpose: To use feed-forward active contours (snakes) to track and measure brachial artery vasomotion on ultrasound images recorded in both transverse and longitudinal views; and to compare the algorithm's performance in each view. Methods: Longitudinal and transverse view ultrasound image sequences of 45 brachial arteries were segmented by feed-forward active contour (FFAC). The segmented regions were used to measure vasomotion artery diameter, cross-sectional area, and distention both as peak-to-peak diameter and as area. ECG waveforms were also simultaneously extracted frame-by-frame by thresholding a running finite-difference image between consecutive images. The arterial and ECG waveforms were compared as they traced eachmore » phase of the cardiac cycle. Results: FFAC successfully segmented arteries in longitudinal and transverse views in all 45 cases. The automated analysis took significantly less time than manual tracing, but produced superior, well-behaved arterial waveforms. Automated arterial measurements also had lower interobserver variability as measured by correlation, difference in mean values, and coefficient of variation. Although FFAC successfully segmented both the longitudinal and transverse images, transverse measurements were less variable. The cross-sectional area computed from the longitudinal images was 27% lower than the area measured from transverse images, possibly due to the compression of the artery along the image depth by transducer pressure. Conclusions: FFAC is a robust and sensitive vasomotion segmentation algorithm in both transverse and longitudinal views. Transverse imaging may offer advantages over longitudinal imaging: transverse measurements are more consistent, possibly because the method is less sensitive to variations in transducer pressure during imaging.« less

  14. Brachial artery vasomotion and transducer pressure effect on measurements by active contour segmentation on ultrasound.

    PubMed

    Cary, Theodore W; Reamer, Courtney B; Sultan, Laith R; Mohler, Emile R; Sehgal, Chandra M

    2014-02-01

    To use feed-forward active contours (snakes) to track and measure brachial artery vasomotion on ultrasound images recorded in both transverse and longitudinal views; and to compare the algorithm's performance in each view. Longitudinal and transverse view ultrasound image sequences of 45 brachial arteries were segmented by feed-forward active contour (FFAC). The segmented regions were used to measure vasomotion artery diameter, cross-sectional area, and distention both as peak-to-peak diameter and as area. ECG waveforms were also simultaneously extracted frame-by-frame by thresholding a running finite-difference image between consecutive images. The arterial and ECG waveforms were compared as they traced each phase of the cardiac cycle. FFAC successfully segmented arteries in longitudinal and transverse views in all 45 cases. The automated analysis took significantly less time than manual tracing, but produced superior, well-behaved arterial waveforms. Automated arterial measurements also had lower interobserver variability as measured by correlation, difference in mean values, and coefficient of variation. Although FFAC successfully segmented both the longitudinal and transverse images, transverse measurements were less variable. The cross-sectional area computed from the longitudinal images was 27% lower than the area measured from transverse images, possibly due to the compression of the artery along the image depth by transducer pressure. FFAC is a robust and sensitive vasomotion segmentation algorithm in both transverse and longitudinal views. Transverse imaging may offer advantages over longitudinal imaging: transverse measurements are more consistent, possibly because the method is less sensitive to variations in transducer pressure during imaging.

  15. Brachial artery vasomotion and transducer pressure effect on measurements by active contour segmentation on ultrasound

    PubMed Central

    Cary, Theodore W.; Reamer, Courtney B.; Sultan, Laith R.; Mohler, Emile R.; Sehgal, Chandra M.

    2014-01-01

    Purpose: To use feed-forward active contours (snakes) to track and measure brachial artery vasomotion on ultrasound images recorded in both transverse and longitudinal views; and to compare the algorithm's performance in each view. Methods: Longitudinal and transverse view ultrasound image sequences of 45 brachial arteries were segmented by feed-forward active contour (FFAC). The segmented regions were used to measure vasomotion artery diameter, cross-sectional area, and distention both as peak-to-peak diameter and as area. ECG waveforms were also simultaneously extracted frame-by-frame by thresholding a running finite-difference image between consecutive images. The arterial and ECG waveforms were compared as they traced each phase of the cardiac cycle. Results: FFAC successfully segmented arteries in longitudinal and transverse views in all 45 cases. The automated analysis took significantly less time than manual tracing, but produced superior, well-behaved arterial waveforms. Automated arterial measurements also had lower interobserver variability as measured by correlation, difference in mean values, and coefficient of variation. Although FFAC successfully segmented both the longitudinal and transverse images, transverse measurements were less variable. The cross-sectional area computed from the longitudinal images was 27% lower than the area measured from transverse images, possibly due to the compression of the artery along the image depth by transducer pressure. Conclusions: FFAC is a robust and sensitive vasomotion segmentation algorithm in both transverse and longitudinal views. Transverse imaging may offer advantages over longitudinal imaging: transverse measurements are more consistent, possibly because the method is less sensitive to variations in transducer pressure during imaging. PMID:24506648

  16. The World Health Organization Fetal Growth Charts: A Multinational Longitudinal Study of Ultrasound Biometric Measurements and Estimated Fetal Weight.

    PubMed

    Kiserud, Torvid; Piaggio, Gilda; Carroli, Guillermo; Widmer, Mariana; Carvalho, José; Neerup Jensen, Lisa; Giordano, Daniel; Cecatti, José Guilherme; Abdel Aleem, Hany; Talegawkar, Sameera A; Benachi, Alexandra; Diemert, Anke; Tshefu Kitoto, Antoinette; Thinkhamrop, Jadsada; Lumbiganon, Pisake; Tabor, Ann; Kriplani, Alka; Gonzalez Perez, Rogelio; Hecher, Kurt; Hanson, Mark A; Gülmezoglu, A Metin; Platt, Lawrence D

    2017-01-01

    Perinatal mortality and morbidity continue to be major global health challenges strongly associated with prematurity and reduced fetal growth, an issue of further interest given the mounting evidence that fetal growth in general is linked to degrees of risk of common noncommunicable diseases in adulthood. Against this background, WHO made it a high priority to provide the present fetal growth charts for estimated fetal weight (EFW) and common ultrasound biometric measurements intended for worldwide use. We conducted a multinational prospective observational longitudinal study of fetal growth in low-risk singleton pregnancies of women of high or middle socioeconomic status and without known environmental constraints on fetal growth. Centers in ten countries (Argentina, Brazil, Democratic Republic of the Congo, Denmark, Egypt, France, Germany, India, Norway, and Thailand) recruited participants who had reliable information on last menstrual period and gestational age confirmed by crown-rump length measured at 8-13 wk of gestation. Participants had anthropometric and nutritional assessments and seven scheduled ultrasound examinations during pregnancy. Fifty-two participants withdrew consent, and 1,387 participated in the study. At study entry, median maternal age was 28 y (interquartile range [IQR] 25-31), median height was 162 cm (IQR 157-168), median weight was 61 kg (IQR 55-68), 58% of the women were nulliparous, and median daily caloric intake was 1,840 cal (IQR 1,487-2,222). The median pregnancy duration was 39 wk (IQR 38-40) although there were significant differences between countries, the largest difference being 12 d (95% CI 8-16). The median birthweight was 3,300 g (IQR 2,980-3,615). There were differences in birthweight between countries, e.g., India had significantly smaller neonates than the other countries, even after adjusting for gestational age. Thirty-one women had a miscarriage, and three fetuses had intrauterine death. The 8,203 sets of ultrasound

  17. The World Health Organization Fetal Growth Charts: A Multinational Longitudinal Study of Ultrasound Biometric Measurements and Estimated Fetal Weight

    PubMed Central

    Carroli, Guillermo; Widmer, Mariana; Neerup Jensen, Lisa; Giordano, Daniel; Abdel Aleem, Hany; Talegawkar, Sameera A.; Benachi, Alexandra; Diemert, Anke; Tshefu Kitoto, Antoinette; Thinkhamrop, Jadsada; Lumbiganon, Pisake; Tabor, Ann; Kriplani, Alka; Gonzalez Perez, Rogelio; Hecher, Kurt; Hanson, Mark A.; Gülmezoglu, A. Metin; Platt, Lawrence D.

    2017-01-01

    Background Perinatal mortality and morbidity continue to be major global health challenges strongly associated with prematurity and reduced fetal growth, an issue of further interest given the mounting evidence that fetal growth in general is linked to degrees of risk of common noncommunicable diseases in adulthood. Against this background, WHO made it a high priority to provide the present fetal growth charts for estimated fetal weight (EFW) and common ultrasound biometric measurements intended for worldwide use. Methods and Findings We conducted a multinational prospective observational longitudinal study of fetal growth in low-risk singleton pregnancies of women of high or middle socioeconomic status and without known environmental constraints on fetal growth. Centers in ten countries (Argentina, Brazil, Democratic Republic of the Congo, Denmark, Egypt, France, Germany, India, Norway, and Thailand) recruited participants who had reliable information on last menstrual period and gestational age confirmed by crown–rump length measured at 8–13 wk of gestation. Participants had anthropometric and nutritional assessments and seven scheduled ultrasound examinations during pregnancy. Fifty-two participants withdrew consent, and 1,387 participated in the study. At study entry, median maternal age was 28 y (interquartile range [IQR] 25–31), median height was 162 cm (IQR 157–168), median weight was 61 kg (IQR 55–68), 58% of the women were nulliparous, and median daily caloric intake was 1,840 cal (IQR 1,487–2,222). The median pregnancy duration was 39 wk (IQR 38–40) although there were significant differences between countries, the largest difference being 12 d (95% CI 8–16). The median birthweight was 3,300 g (IQR 2,980–3,615). There were differences in birthweight between countries, e.g., India had significantly smaller neonates than the other countries, even after adjusting for gestational age. Thirty-one women had a miscarriage, and three fetuses had

  18. Use of ultrasound in the evaluation of trophoblastic disease and its response to therapy. [Comparison with HCG radioimmunoassay

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

    Requard, C.K.; Mettler, F.A. Jr.

    1980-05-01

    Thirty-nine patients with trophoblastic disease were studied to determine the usefulness of ultrasound in identifying risk patterns and response to therapy. Serial measurements of serum human chorionic gonadotropin-beta subunit (HCG-BSU) were compared with ultrasonographic uterine and theca lutein cyst volumes. In 16 patients ultrasound demonstrated theca lutein cysts, many of which were not palpable on physical examination. Although there was a significant decrease in uterine volume and a change in the sonographic pattern following evacuation, volume slowly returned to normal over a period of several months. Persistent trophoblastic disease was more accurately detected by HCG-BSU measurements than by ultrasound. Persistentmore » disease developed in 44% of those patients who had theca lutein cysts and in 22% of those without cysts. Patients with theca lutein cysts did not consistently have higher HCG-BSU levels than patients without cysts, and it is concluded that ultrasound is the best method for detecting these cysts.« less

  19. Signal processing in ultrasound. [for diagnostic medicine

    NASA Technical Reports Server (NTRS)

    Le Croissette, D. H.; Gammell, P. M.

    1978-01-01

    Signal is the term used to denote the characteristic in the time or frequency domain of the probing energy of the system. Processing of this signal in diagnostic ultrasound occurs as the signal travels through the ultrasonic and electrical sections of the apparatus. The paper discusses current signal processing methods, postreception processing, display devices, real-time imaging, and quantitative measurements in noninvasive cardiology. The possibility of using deconvolution in a single transducer system is examined, and some future developments using digital techniques are outlined.

  20. Diagnostic ultrasound estimates of muscle mass and muscle quality discriminate between women with and without sarcopenia

    PubMed Central

    Ismail, Catheeja; Zabal, Johannah; Hernandez, Haniel J.; Woletz, Paula; Manning, Heather; Teixeira, Carla; DiPietro, Loretta; Blackman, Marc R.; Harris-Love, Michael O.

    2015-01-01

    Introduction: Age-related changes in muscle mass and muscle tissue composition contribute to diminished strength in older adults. The objectives of this study are to examine if an assessment method using mobile diagnostic ultrasound augments well-known determinants of lean body mass (LBM) to aid sarcopenia staging, and if a sonographic measure of muscle quality is associated with muscle performance. Methods: Twenty community-dwelling female subjects participated in the study (age = 43.4 ± 20.9 years; BMI: 23.8, interquartile range: 8.5). Dual energy X-ray absorptiometry (DXA) and diagnostic ultrasound morphometry were used to estimate LBM. Muscle tissue quality was estimated via the echogenicity using grayscale histogram analysis. Peak force was measured with grip dynamometry and scaled for body size. Bivariate and multiple regression analyses were used to determine the association of the predictor variables with appendicular lean mass (aLM/ht2), and examine the relationship between scaled peak force values and muscle echogenicity. The sarcopenia LBM cut point value of 6.75 kg/m2 determined participant assignment into the Normal LBM and Low LBM subgroups. Results: The selected LBM predictor variables were body mass index (BMI), ultrasound morphometry, and age. Although BMI exhibited a significant positive relationship with aLM/ht2 (adj. R2 = 0.61, p < 0.001), the strength of association improved with the addition of ultrasound morphometry and age as predictor variables (adj. R2 = 0.85, p < 0.001). Scaled peak force was associated with age and echogenicity (adj. R2 = 0.53, p < 0.001), but not LBM. The Low LBM subgroup of women (n = 10) had higher scaled peak force, lower BMI, and lower echogenicity values in comparison to the Normal LBM subgroup (n = 10; p < 0.05). Conclusions: Diagnostic ultrasound morphometry values are associated with LBM, and improve the BMI predictive model for aLM/ht2 in women. In addition, ultrasound proxy measures of muscle quality are more

  1. Diagnostic ultrasound estimates of muscle mass and muscle quality discriminate between women with and without sarcopenia.

    PubMed

    Ismail, Catheeja; Zabal, Johannah; Hernandez, Haniel J; Woletz, Paula; Manning, Heather; Teixeira, Carla; DiPietro, Loretta; Blackman, Marc R; Harris-Love, Michael O

    2015-01-01

    Age-related changes in muscle mass and muscle tissue composition contribute to diminished strength in older adults. The objectives of this study are to examine if an assessment method using mobile diagnostic ultrasound augments well-known determinants of lean body mass (LBM) to aid sarcopenia staging, and if a sonographic measure of muscle quality is associated with muscle performance. Twenty community-dwelling female subjects participated in the study (age = 43.4 ± 20.9 years; BMI: 23.8, interquartile range: 8.5). Dual energy X-ray absorptiometry (DXA) and diagnostic ultrasound morphometry were used to estimate LBM. Muscle tissue quality was estimated via the echogenicity using grayscale histogram analysis. Peak force was measured with grip dynamometry and scaled for body size. Bivariate and multiple regression analyses were used to determine the association of the predictor variables with appendicular lean mass (aLM/ht(2)), and examine the relationship between scaled peak force values and muscle echogenicity. The sarcopenia LBM cut point value of 6.75 kg/m(2) determined participant assignment into the Normal LBM and Low LBM subgroups. The selected LBM predictor variables were body mass index (BMI), ultrasound morphometry, and age. Although BMI exhibited a significant positive relationship with aLM/ht(2) (adj. R (2) = 0.61, p < 0.001), the strength of association improved with the addition of ultrasound morphometry and age as predictor variables (adj. R (2) = 0.85, p < 0.001). Scaled peak force was associated with age and echogenicity (adj. R (2) = 0.53, p < 0.001), but not LBM. The Low LBM subgroup of women (n = 10) had higher scaled peak force, lower BMI, and lower echogenicity values in comparison to the Normal LBM subgroup (n = 10; p < 0.05). Diagnostic ultrasound morphometry values are associated with LBM, and improve the BMI predictive model for aLM/ht(2) in women. In addition, ultrasound proxy measures of muscle quality are more strongly associated with

  2. Relationships among dual-energy X-ray absorptiometry (DXA), bioelectrical impedance (BIA), and ultrasound measurements of body composition of swine

    USDA-ARS?s Scientific Manuscript database

    In three separate studies (156 pigs total), DXA, BIA, and ultrasound were compared as methods for measuring live body composition of pigs at 60 and 100-110 kg BWt. DXA measured total body fat and lean content, BIA measurements of resistance (Rs) and reactance (Xc) were used to calculate total body l...

  3. Ultrasound assessment of spleen size in collegiate athletes.

    PubMed

    Hosey, R G; Mattacola, C G; Kriss, V; Armsey, T; Quarles, J D; Jagger, J

    2006-03-01

    To determine normal spleen dimensions in a healthy collegiate athletic population. 631 Division I collegiate athletes from one university participated in the study. During pre-participation examinations, demographic data collected were collected from volunteer athletes including sex, race, measurement of height and weight, and age. Subjects also completed a medical history form to determine any history of mononucleosis infection, platelet disorder, sickle cell disease (or trait), thalassaemia, or recent viral symptoms. Subjects then underwent a limited abdominal ultrasound examination, where splenic length and width were recorded. Mean (SD) splenic length was 10.65 (1.55) cm and width, 5.16 (1.21) cm. Men had larger spleens than women (p<0.001). White subjects had larger spleens than African-American subjects (p<0.001). A previous history of infectious mononucleosis or the presence of recent cold symptoms had no significant affect on spleen size. In more than 7% of athletes, baseline spleen size met current criteria for splenomegaly. There is a wide range of normal spleen size among collegiate athletes. Average spleen size was larger in men and white athletes than in women and black athletes. A single ultrasound examination for determination of splenomegaly is of limited value in this population.

  4. Reproducibility of abdominal fat assessment by ultrasound and computed tomography.

    PubMed

    Mauad, Fernando Marum; Chagas-Neto, Francisco Abaeté; Benedeti, Augusto César Garcia Saab; Nogueira-Barbosa, Marcello Henrique; Muglia, Valdair Francisco; Carneiro, Antonio Adilton Oliveira; Muller, Enrico Mattana; Elias Junior, Jorge

    2017-01-01

    To test the accuracy and reproducibility of ultrasound and computed tomography (CT) for the quantification of abdominal fat in correlation with the anthropometric, clinical, and biochemical assessments. Using ultrasound and CT, we determined the thickness of subcutaneous and intra-abdominal fat in 101 subjects-of whom 39 (38.6%) were men and 62 (61.4%) were women-with a mean age of 66.3 years (60-80 years). The ultrasound data were correlated with the anthropometric, clinical, and biochemical parameters, as well as with the areas measured by abdominal CT. Intra-abdominal thickness was the variable for which the correlation with the areas of abdominal fat was strongest (i.e., the correlation coefficient was highest). We also tested the reproducibility of ultrasound and CT for the assessment of abdominal fat and found that CT measurements of abdominal fat showed greater reproducibility, having higher intraobserver and interobserver reliability than had the ultrasound measurements. There was a significant correlation between ultrasound and CT, with a correlation coefficient of 0.71. In the assessment of abdominal fat, the intraobserver and interobserver reliability were greater for CT than for ultrasound, although both methods showed high accuracy and good reproducibility.

  5. Adding New Tools to the Black Bag—Introduction of Ultrasound into the Physical Diagnosis Course

    PubMed Central

    Amponsah, David; Yang, James; Mendez, Jennifer; Bridge, Patrick; Hays, Gregory; Baliga, Sudhir; Crist, Karen; Brennan, Simone; Jackson, Matt; Dulchavsky, Scott

    2010-01-01

    INTRODUCTION Ultrasound, a versatile diagnostic modality that permits real-time visualization at the patient’s bedside, can be used as an adjunct in teaching physical diagnosis (PD). Aims: (1) to study the feasibility of incorporating ultrasound into PD courses and (2) determine whether learners can demonstrate image recognition and acquisition skills. PROGRAM DESCRIPTION Three hundred seven second-year medical students were introduced to cardiovascular and abdominal ultrasound scanning after training in the physical examination. This consisted of a demonstration of the ultrasound examination, followed by practice on standardized patients (SPs). Pre-post tests were administered to evaluate students’ knowledge and understanding of ultrasound. Students performed an ultrasound examination during the PD final examination. PROGRAM EVALUATION Pre-post test data revealed significant improvements in image recognition. On the final exam, the highest scores (98.4%) were obtained for the internal jugular vein and lowest scores (74.6%) on the Focused Assessment with Sonography for Trauma images. Eighty-nine percent of students’ surveyed felt ultrasound was a valuable tool for physicians. DISCUSSION An introductory ultrasound course is effective in improving medical students' acquisition and recognition of basic cardiovascular and abdominal ultrasound images. This innovative program demonstrates the feasibility of incorporating portable ultrasound as a learning tool during medical school. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1451-5) contains supplementary material, which is available to authorized users. PMID:20697974

  6. Ultrasound determination of rotator cuff tear repairability

    PubMed Central

    Tse, Andrew K; Lam, Patrick H; Walton, Judie R; Hackett, Lisa

    2015-01-01

    Background Rotator cuff repair aims to reattach the torn tendon to the greater tuberosity footprint with suture anchors. The present study aimed to assess the diagnostic accuracy of ultrasound in predicting rotator cuff tear repairability and to assess which sonographic and pre-operative features are strongest in predicting repairability. Methods The study was a retrospective analysis of measurements made prospectively in a cohort of 373 patients who had ultrasounds of their shoulder and underwent rotator cuff repair. Measurements of rotator cuff tear size and muscle atrophy were made pre-operatively by ultrasound to enable prediction of rotator cuff repairability. Tears were classified following ultrasound as repairable or irreparable, and were correlated with intra-operative repairability. Results Ultrasound assessment of rotator cuff tear repairability has a sensitivity of 86% (p < 0.0001) and a specificity of 67% (p < 0.0001). The strongest predictors of rotator cuff repairability were tear size (p < 0.001) and age (p = 0.004). Sonographic assessments of tear size ≥4 cm2 or anteroposterior tear length ≥25 mm indicated an irreparable rotator cuff tear. Conclusions Ultrasound assessment is accurate in predicting rotator cuff tear repairability. Tear size or anteroposterior tear length and age were the best predictors of repairability. PMID:27582996

  7. Monitoring high-intensity focused ultrasound (HIFU) therapy using radio frequency ultrasound backscatter to quantify heating

    NASA Astrophysics Data System (ADS)

    Kaczkowski, Peter J.; Anand, Ajay

    2005-09-01

    The spatial distribution and temporal history of tissue temperature is an essential indicator of thermal therapy progress, and treatment safety and efficacy. Magnetic resonance methods provide the gold standard noninvasive measurement of temperature but are costly and cumbersome compared to the therapy itself. We have been developing the use of ultrasound backscattering for real-time temperature estimation; ultrasonic methods have been limited to relatively low temperature rise, primarily due to lack of sensitivity at protein denaturation temperatures (50-70°C). Through validation experiments on gel phantoms and ex vivo tissue we show that temperature rise can be accurately mapped throughout the therapeutic temperature range using a new BioHeat Transfer Equation (BHTE) model-constrained inverse approach. Speckle-free temperature and thermal dose maps are generated using the ultrasound calibrated model over the imaged region throughout therapy delivery and post-treatment cooling periods. Results of turkey breast tissue experiments are presented for static HIFU exposures, in which the ultrasound calibrated BHTE temperature maps are shown to be very accurate (within a degree) using independent thermocouple measurements. This new temperature monitoring method may speed clinical adoption of ultrasound-guided HIFU therapy. [Work supported by Army MRMC.

  8. Critical Care Ultrasound: A Review for Practicing Nephrologists.

    PubMed

    Wilson, Jennifer G; Breyer, Kristine E W

    2016-05-01

    The use of point-of-care ultrasound in the intensive care unit, both for diagnostic and procedural purposes, has rapidly proliferated, and evidence supporting its use is growing. Conceptually, critical care ultrasound (CCUS) should be considered an extension of the physical examination and should not be considered a replacement for formal echocardiography or radiology-performed ultrasound. Several CCUS applications are of particular relevance to nephrologists, including focused renal ultrasound in patients at high risk for urinary tract obstruction, real-time ultrasound guidance and verification during the placement of central venous catheters, and ultrasound-augmented assessment of shock and volume status. Each of these applications has the capacity to improve outcomes in patients with acute kidney injury. Although robust evidence regarding long-term outcomes is lacking, existing data demonstrate that CCUS has the potential to improve diagnostic accuracy, expedite appropriate management, and increase safety for critically ill patients across a spectrum of pathologies. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  9. Reliability tests and guidelines for B-mode ultrasound assessment of central adiposity.

    PubMed

    Stoner, Lee; Chinn, Victoria; Cornwall, Jon; Meikle, Grant; Page, Rachel; Lambrick, Danielle; Faulkner, James

    2015-11-01

    Ultrasound represents a validated and relatively inexpensive diagnostic device for assessing central adiposity; however, widespread adoption has been impeded by the lack of reliable standard operating procedures. To examine the reliability of, and describe guidelines for, ultrasound-derived recording of intra-abdominal fat thickness (IAT) and maximal preperitoneal fat thickness (PFT). Ultrasound scans were obtained from 20 adults (50% female, 26 ± 7 years, 24·5 kg/m(2) ) on three different mornings. IAT was assessed 2 cm above the umbilicus (transverse plane) measuring from linea alba to: (i) anterior aorta, (ii) posterior aorta and (iii) anterior aspect of the vertebral column. PFT was measured from linea alba to visceral peritoneum in (i) sagittal and (ii) transverse planes, immediately over and inferior to the xiphi-sternum, respectively. For IAT, the criterion intraclass correlation coefficient (ICC) of 0·75 was exceeded for measurements to anterior aorta (0·95), posterior aorta (0·94) and vertebra (0·96). The reliability coefficient expressed as a percentage of the mean (RC%) was lowest (better) for measurement to vertebrae (9·8%). For PFT, mean thickness was comparable for sagittal (1·74 cm) and transverse (1·76 cm) planes; ICC values were also comparable for both planes (0·98 vs. 0·98, respectively), as were RC% (7·5% vs. 7·1%, respectively). IAT assessments to the vertebra were marginally more reliable than those to other structures. While PFT assessments were equally reliable for both measurements planes, precise probe placement was easier for the sagittal plane. Based on these findings, guidelines for the reliable measurement of central adiposity using ultrasound are presented. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

  10. Ultrasound Imaging Velocimetry: a review

    NASA Astrophysics Data System (ADS)

    Poelma, Christian

    2017-01-01

    Whole-field velocity measurement techniques based on ultrasound imaging (a.k.a. `ultrasound imaging velocimetry' or `echo-PIV') have received significant attention from the fluid mechanics community in the last decade, in particular because of their ability to obtain velocity fields in flows that elude characterisation by conventional optical methods. In this review, an overview is given of the history, typical components and challenges of these techniques. The basic principles of ultrasound image formation are summarised, as well as various techniques to estimate flow velocities; the emphasis is on correlation-based techniques. Examples are given for a wide range of applications, including in vivo cardiovascular flow measurements, the characterisation of sediment transport and the characterisation of complex non-Newtonian fluids. To conclude, future opportunities are identified. These encompass not just optimisation of the accuracy and dynamic range, but also extension to other application areas.

  11. Standard B-Mode Ultrasound Measures Local Carotid Artery Characteristics as Reliably as Radiofrequency Phase Tracking in Symptomatic Carotid Artery Patients.

    PubMed

    Steinbuch, Jeire; Hoeks, Arnold P G; Hermeling, Evelien; Truijman, Martine T B; Schreuder, Floris H B M; Mess, Werner H

    2016-02-01

    Local arterial stiffness can be assessed with high accuracy and precision by measuring arterial distension on the basis of phase tracking of radiofrequency ultrasound signals acquired at a high frame rate. However, in clinical practice, B-mode ultrasound registrations are made at a low frame rate (20-50 Hz). We compared the accuracy and intra-subject precision of edge tracking and phase tracking distension in symptomatic carotid artery patients. B-mode ultrasound recordings (40 mm, 37 fps) and radiofrequency recordings (31 lines covering 29 mm, 300 fps) were acquired from the left common carotid artery of 30 patients (aged 45-88 y) with recent cerebrovascular events. To extract the distension, semi-automatic echo edge and phase tracking algorithms were applied to B-mode and radiofrequency recordings, respectively. Both methods exhibited a similar intra-subject precision for distension (standard deviation = 44 μm and 47 μm, p = 0.66) and mean distension (difference: -6 ± 69 μm, p = 0.67). Intra-subject distension inhomogeneity tends to be larger for edge tracking (difference: 15 ± 35 μm, p = 0.04). Standard B-mode scanners are suitable for measuring local artery characteristics in symptomatic carotid artery patients with good precision and accuracy. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  12. Ultrasound of the coracoclavicular ligaments in the acute phase of an acromioclavicular disjonction: Comparison of radiographic, ultrasound and MRI findings.

    PubMed

    Faruch Bilfeld, Marie; Lapègue, Franck; Chiavassa Gandois, Hélène; Bayol, Marie Aurélie; Bonnevialle, Nicolas; Sans, Nicolas

    2017-02-01

    Acromioclavicular joint injuries are typically diagnosed by clinical and radiographic assessment with the Rockwood classification, which is crucial for treatment planning. The purpose of this study was to describe how the ultrasound findings of acromioclavicular joint injury compare with radiography and MRI findings. Forty-seven patients with suspected unilateral acromioclavicular joint injury after acute trauma were enrolled in this prospective study. All patients underwent digital radiography, ultrasound and 3T MRI. A modified Rockwood classification was used to evaluate the coracoclavicular ligaments. The classifications of acromioclavicular joint injuries diagnosed with radiography, ultrasound and MRI were compared. MRI was used as the gold standard. The agreement between the ultrasound and MRI findings was very good, with a correlation coefficient of 0.83 (95 % CI: 0.72-0.90; p < 0.0001). Ultrasound detected coracoclavicular ligament injuries with a sensitivity of 88.9 %, specificity of 90.0 %, positive predictive value of 92.3 % and negative predictive value of 85.7 %. The agreement between the ultrasound and radiography findings was poor, with a correlation coefficient of 0.69 (95 % CI: 0.51-0.82; p < 0.0001). Ultrasound is an effective examination for the diagnostic work-up of lesions of the coracoclavicular ligaments in the acute phase of an acromioclavicular injury. • Ultrasound is appropriate for acute acromioclavicular trauma due to its accessibility. • Ultrasound contributes to the diagnostic work-up of acute lesions of the coracoclavicular ligaments. • Ultrasound is appropriate in patients likely to benefit from surgical treatment. • Ultrasound could be a supplement to standard radiography in acute acromioclavicular trauma.

  13. Studies on the foundation and development of diagnostic ultrasound

    PubMed Central

    Wagai, Toshio

    2007-01-01

    In recent years, various types of diagnostic imaging methods, such as CT, MRI, PET and Ultrasound, have been developed rapidly and become indispensable as clinical diagnostic tools. Among these imaging modalities, CT, MRI and PET all apply electromagnetic waves like radiation rays. In contrast, an ultrasound imaging method uses a completely different mechanical pressure wave: “sound”. Ultrasound has various features, including inaudible sound at very high frequencies, which allows its use in medical diagnoses. That is, ultrasound techniques can be applied in transmission, reflection and Doppler methods. Moreover, the sharp directivity of an ultrasound beam can also improve image resolution. Another big advantage of diagnostic ultrasound is that it does not harm the human body or cause any pain to patients. Given these various advantages, diagnostic ultrasound has recently been widely used in diagnosing cancer and cardiovascular disease and scanning fetuses (Fig. 1) as well as routine clinical examinations in hospitals. In this paper, I outline my almost 50-year history of diagnostic ultrasound research, particularly that performed at the early stage from 1950–56. PMID:24367150

  14. Effect of Transducer Orientation on Errors in Ultrasound Image-Based Measurements of Human Medial Gastrocnemius Muscle Fascicle Length and Pennation

    PubMed Central

    Gandevia, Simon C.; Herbert, Robert D.

    2016-01-01

    Ultrasound imaging is often used to measure muscle fascicle lengths and pennation angles in human muscles in vivo. Theoretically the most accurate measurements are made when the transducer is oriented so that the image plane aligns with muscle fascicles and, for measurements of pennation, when the image plane also intersects the aponeuroses perpendicularly. However this orientation is difficult to achieve and usually there is some degree of misalignment. Here, we used simulated ultrasound images based on three-dimensional models of the human medial gastrocnemius, derived from magnetic resonance and diffusion tensor images, to describe the relationship between transducer orientation and measurement errors. With the transducer oriented perpendicular to the surface of the leg, the error in measurement of fascicle lengths was about 0.4 mm per degree of misalignment of the ultrasound image with the muscle fascicles. If the transducer is then tipped by 20°, the error increases to 1.1 mm per degree of misalignment. For a given degree of misalignment of muscle fascicles with the image plane, the smallest absolute error in fascicle length measurements occurs when the transducer is held perpendicular to the surface of the leg. Misalignment of the transducer with the fascicles may cause fascicle length measurements to be underestimated or overestimated. Contrary to widely held beliefs, it is shown that pennation angles are always overestimated if the image is not perpendicular to the aponeurosis, even when the image is perfectly aligned with the fascicles. An analytical explanation is provided for this finding. PMID:27294280

  15. Effect of Transducer Orientation on Errors in Ultrasound Image-Based Measurements of Human Medial Gastrocnemius Muscle Fascicle Length and Pennation.

    PubMed

    Bolsterlee, Bart; Gandevia, Simon C; Herbert, Robert D

    2016-01-01

    Ultrasound imaging is often used to measure muscle fascicle lengths and pennation angles in human muscles in vivo. Theoretically the most accurate measurements are made when the transducer is oriented so that the image plane aligns with muscle fascicles and, for measurements of pennation, when the image plane also intersects the aponeuroses perpendicularly. However this orientation is difficult to achieve and usually there is some degree of misalignment. Here, we used simulated ultrasound images based on three-dimensional models of the human medial gastrocnemius, derived from magnetic resonance and diffusion tensor images, to describe the relationship between transducer orientation and measurement errors. With the transducer oriented perpendicular to the surface of the leg, the error in measurement of fascicle lengths was about 0.4 mm per degree of misalignment of the ultrasound image with the muscle fascicles. If the transducer is then tipped by 20°, the error increases to 1.1 mm per degree of misalignment. For a given degree of misalignment of muscle fascicles with the image plane, the smallest absolute error in fascicle length measurements occurs when the transducer is held perpendicular to the surface of the leg. Misalignment of the transducer with the fascicles may cause fascicle length measurements to be underestimated or overestimated. Contrary to widely held beliefs, it is shown that pennation angles are always overestimated if the image is not perpendicular to the aponeurosis, even when the image is perfectly aligned with the fascicles. An analytical explanation is provided for this finding.

  16. Usefulness of emergency ultrasound in nontraumatic cardiac arrest.

    PubMed

    Volpicelli, Giovanni

    2011-02-01

    Treatment of nontraumatic cardiac arrest in the hospital setting depends on the recognition of heart rhythm and differential diagnosis of the underlying condition while maintaining a constant oxygenated blood flow by ventilation and chest compression. Diagnostic process relies only on patient's history, physical findings, and active electrocardiography. Ultrasound is not currently scheduled in the resuscitation guidelines. Nevertheless, the use of real-time ultrasonography during resuscitation has the potential to improve diagnostic accuracy and allows the physician a greater confidence in deciding aggressive life-saving therapeutic procedures. This article reviews the current opinions and literature about the use of emergency ultrasound during resuscitation of nontraumatic cardiac arrest. Cardiac and lung ultrasound have a great potential in identifying the reversible mechanical causes of pulseless electrical activity or asystole. Brief examination of the heart can even detect a real cardiac standstill regardless of electrical activity displayed on the monitor, which is a crucial prognostic indicator. Moreover, ultrasound can be useful to verify and monitor the tracheal tube placement. Limitation to the use of ultrasound is the need to minimize the no-flow intervals during mechanical cardiopulmonary resuscitation. However, real-time ultrasound can be successfully applied during brief pausing of chest compression and first pulse-check. Finally, lung sonographic examination targeted to the detection of signs of pulmonary congestion has the potential to allow hemodynamic noninvasive monitoring before and after mechanical cardiopulmonary maneuvers. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. [Renal length measured by ultrasound in adult mexican population].

    PubMed

    Oyuela-Carrasco, J; Rodríguez-Castellanos, F; Kimura, E; Delgado-Hernández, R; Herrera-Félix, J P

    2009-01-01

    Renal length estimation by ultrasound is an important parameter in clinical evaluation of kidney disease and healthy donors. Changes in renal volume may be a sign of kidney disease. Correct interpretation of renal length requires the knowledge of normal limits, these have not been described for Latin American population. To describe normal renal length (RL) by ultrasonography in a group of Mexican adults. Ultrasound measure of RL in 153 healthy Mexican adults stratified by age. Describe the association of RL to several anthropometric variables. A total of 77 males and 76 females were scanner. The average age for the group was 44.12 +/- 15.44 years. The mean weight, body mass index (BMI) and height were 68.87 +/- 11.69 Kg, 26.77 +/- 3.82 kg/m2 and 160 +/- 8.62 cm respectively. Dividing the population by gender, showed a height of 166 +/- 6.15 cm for males and 154.7 +/- 5.97 cm for females (p =0.000). Left renal length (LRL) in the whole group was 105.8 +/- 7.56 mm and right renal length (RRL) was 104.3 +/- 6.45 mm (p = 0.000.) The LRL for males was 107.16 +/- 6.97 mm and for females was 104.6 +/- 7.96 mm. The average RRL for males was 105.74 +/- 5.74 mm and for females 102.99 +/- 6.85 mm (p = 0.008.) We noted that RL decreased with age and the rate of decline accelerates alter 60 years of age. Both lengths correlated significantly and positively with weight, BMI and height. The RL was significantly larger in males than in females in both kidneys (p = 0.036) in this Mexican population. Renal length declines after 60 years of age and specially after 70 years.

  18. Ultrasound follow-up of infantile hypertrophic pyloric stenosis (IHPS) during conservative therapy: ultrasound findings as criteria for diagnosis and cure.

    PubMed

    Miura, Sachiko; Haku, Eijitsu; Hirai, Toshiko; Marugami, Nagaaki; Itoh, Takahiro; Tanaka, Takehiro; Kichikawa, Kimihiko; Ohishi, Hajime

    2008-06-01

    During conservative therapy of infantile hypertrophic pyloric stenosis (IHPS) with atropine sulfate, there are many patients who do not achieve normal values of pyloric wall thickness and canal length even though they are clinically cured (vomiting has ceased); an objective criterion for cure has not yet been established. The aim of this study was to examine whether the appearance of pyloric wall stratification can be used as a criterion for cure. Twenty infants with IHPS who were treated conservatively were enrolled. Two of them ultimately required surgery. Ultrasound examinations were done serially and the pyloric wall thickness and canal length were measured. The echogenicity of the pyloric wall and the presence of wall stratification were noted. On admission, all infants satisfied the ultrasound criteria for IHPS and had a heterogeneous pyloric wall without stratification. With conservative therapy, symptoms disappeared, the pyloric wall thickness and the canal length gradually decreased, the echogenicity gradually became homogeneous and hypoechoic, and wall stratification appeared (in most cases before the pyloric wall thickness and the canal length had normalized). The absence of wall stratification suggests that cellular interstitial changes, such as edema or inflammation, are present in the pyloric wall in the acute stage. Pyloric wall stratification was absent during the acute stage, but it appeared after initiation of treatment but before the pyloric wall thickness and the canal length had normalized. The presence of pyloric wall stratification can be used as a criterion for cure; the absence of wall stratification can be added to ultrasound diagnostic criteria for IHPS.

  19. Comparison of Central Corneal Thickness Measured by Standard Ultrasound Pachymetry, Corneal Topography, Tono-Pachymetry and Anterior Segment Optical Coherence Tomography.

    PubMed

    González-Pérez, Javier; Queiruga Piñeiro, Juan; Sánchez García, Ángelx; González Méijome, José Manuel

    2018-04-10

    To compare central corneal thickness (CCT) measured by standard ultrasound pachymetry (USP), and three non-contact devices in healthy eyes. A cross-sectional study of CCT measurement in 52 eyes of 52 healthy volunteers was done by a single examiner at Ocular Surface and Contact Lens Laboratory. Three consecutive measurements were done by standard USP, non-contact tono-pachymeter, Pentacam corneal topographer, and Anterior Segment Optical Coherence Tomography (AS-OCT). The mean values were used for assessment. The results were compared using multivariate ANOVA, linear regression, and Pearson correlation. Agreement among the devices was analyzed using mean differences and Bland-Altman analysis with 95% limits of agreement (LoA). Finally, reliability was analyzed using intraclass correlation coefficient (ICC). Mean CCT by ultrasound pachymeter, tono-pachymeter, corneal topographer and AS-OCT were 558.9 ± 31.2 µm, 525.8 ± 43.1 µm, 550.4 ± 30.5 µm, and 545.9 ± 30.5 µm respectively. There was a significant positive correlation between AS-OCT and USP (Pearson correlation = 0.957, p < 0.001), corneal topography and USP (Pearson correlation = 0.965, p < 0.001), and corneal topography and AS-OCT (Pearson correlation = 0.965, p < 0.001). There was a lower correlation between CT-1P tono-pachymeter and the other three modalities. Intraclass correlation coefficients show an excellent reliability between pairs except for CT-1P against the other three instruments that were found moderate. CT-1P tono-pachymeter underestimates CCT measurements compared to Scheimpflug system, AS-OCT device, and USP. Mean CCT among USP, Pentacam and AS-OCT were comparable and had significant linear correlations. In clinical practice, these three modalities could be interchangeable in healthy patients.

  20. Core review: physician-performed ultrasound: the time has come for routine use in acute care medicine.

    PubMed

    Royse, Colin F; Canty, David J; Faris, John; Haji, Darsim L; Veltman, Michael; Royse, Alistair

    2012-11-01

    The use of ultrasound in the acute care specialties of anesthesiology, intensive care, emergency medicine, and surgery has evolved from discrete, office-based echocardiographic examinations to the real-time or point-of-care clinical assessment and interventions. "Goal-focused" transthoracic echocardiography is a limited scope (as compared with comprehensive examination) echocardiographic examination, performed by the treating clinician in acute care medical practice, and is aimed at addressing specific clinical concerns. In the future, the practice of surface ultrasound will be integrated into the everyday clinical practice as ultrasound-assisted examination and ultrasound-guided procedures. This evolution should start at the medical student level and be reinforced throughout specialist training. The key to making ultrasound available to every physician is through education programs designed to facilitate uptake, rather than to prevent access to this technology and education by specialist craft groups. There is evidence that diagnosis is improved with ultrasound examination, yet data showing change in management and improvement in patient outcome are few and an important area for future research.

  1. Calibration and Evaluation of Ultrasound Thermography Using Infrared Imaging.

    PubMed

    Hsiao, Yi-Sing; Deng, Cheri X

    2016-02-01

    Real-time monitoring of the spatiotemporal evolution of tissue temperature is important to ensure safe and effective treatment in thermal therapies including hyperthermia and thermal ablation. Ultrasound thermography has been proposed as a non-invasive technique for temperature measurement, and accurate calibration of the temperature-dependent ultrasound signal changes against temperature is required. Here we report a method that uses infrared thermography for calibration and validation of ultrasound thermography. Using phantoms and cardiac tissue specimens subjected to high-intensity focused ultrasound heating, we simultaneously acquired ultrasound and infrared imaging data from the same surface plane of a sample. The commonly used echo time shift-based method was chosen to compute ultrasound thermometry. We first correlated the ultrasound echo time shifts with infrared-measured temperatures for material-dependent calibration and found that the calibration coefficient was positive for fat-mimicking phantom (1.49 ± 0.27) but negative for tissue-mimicking phantom (-0.59 ± 0.08) and cardiac tissue (-0.69 ± 0.18°C-mm/ns). We then obtained the estimation error of the ultrasound thermometry by comparing against the infrared-measured temperature and revealed that the error increased with decreased size of the heated region. Consistent with previous findings, the echo time shifts were no longer linearly dependent on temperature beyond 45°C-50°C in cardiac tissues. Unlike previous studies in which thermocouples or water bath techniques were used to evaluate the performance of ultrasound thermography, our results indicate that high-resolution infrared thermography is a useful tool that can be applied to evaluate and understand the limitations of ultrasound thermography methods. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  2. Nondestructive evaluation of hydrogel mechanical properties using ultrasound

    PubMed Central

    Walker, Jason M.; Myers, Ashley M.; Schluchter, Mark D.; Goldberg, Victor M.; Caplan, Arnold I.; Berilla, Jim A.; Mansour, Joseph M.; Welter, Jean F.

    2012-01-01

    The feasibility of using ultrasound technology as a noninvasive, nondestructive method for evaluating the mechanical properties of engineered weight-bearing tissues was evaluated. A fixture was designed to accurately and reproducibly position the ultrasound transducer normal to the test sample surface. Agarose hydrogels were used as phantoms for cartilage to explore the feasibility of establishing correlations between ultrasound measurements and commonly used mechanical tissue assessments. The hydrogels were fabricated in 1–10% concentrations with a 2–10 mm thickness. For each concentration and thickness, six samples were created, for a total of 216 gel samples. Speed of sound was determined from the time difference between peak reflections and the known height of each sample. Modulus was computed from the speed of sound using elastic and poroelastic models. All ultrasonic measurements were made using a 15 MHz ultrasound transducer. The elastic modulus was also determined for each sample from a mechanical unconfined compression test. Analytical comparison and statistical analysis of ultrasound and mechanical testing data was carried out. A correlation between estimates of compressive modulus from ultrasonic and mechanical measurements was found, but the correlation depended on the model used to estimate the modulus from ultrasonic measurements. A stronger correlation with mechanical measurements was found using the poroelastic rather than the elastic model. Results from this preliminary testing will be used to guide further studies of native and engineered cartilage. PMID:21773854

  3. Sensitivity and specificity of diagnostic ultrasound in the diagnosis of phrenic neuropathy.

    PubMed

    Boon, Andrea J; Sekiguchi, Hiroshi; Harper, Caitlin J; Strommen, Jeffrey A; Ghahfarokhi, Leili S; Watson, James C; Sorenson, Eric J

    2014-09-30

    To determine the sensitivity and specificity of B-mode ultrasound in the diagnosis of neuromuscular diaphragmatic dysfunction, including phrenic neuropathy. A prospective study of patients with dyspnea referred to the EMG laboratory over a 2-year time frame for evaluation of neuromuscular respiratory failure who were recruited consecutively and examined with ultrasound for possible diaphragm dysfunction. Sonographic outcome measures were absolute thickness of the diaphragm and degree of increased thickness with maximal inspiration. The comparison standard for diagnosis of diaphragm dysfunction was the final clinical diagnosis of clinicians blinded to the diaphragm ultrasound results, but taking into account other diagnostic workup, including chest radiographs, fluoroscopy, phrenic nerve conduction studies, diaphragm EMG, and/or pulmonary function tests. Of 82 patients recruited over a 2-year period, 66 were enrolled in the study. Sixteen patients were excluded because of inconclusive or insufficient reference testing. One hemidiaphragm could not be adequately visualized; therefore, hemidiaphragm assessment was conducted in a total of 131 hemidiaphragms in 66 patients. Of the 82 abnormal hemidiaphragms, 76 had abnormal sonographic findings (atrophy or decreased contractility). Of the 49 normal hemidiaphragms, none had a false-positive ultrasound. Diaphragmatic ultrasound was 93% sensitive and 100% specific for the diagnosis of neuromuscular diaphragmatic dysfunction. B-mode ultrasound imaging of the diaphragm is a highly sensitive and specific tool for diagnosis of neuromuscular diaphragm dysfunction. This study provides Class II evidence that diaphragmatic ultrasound performed by well-trained individuals accurately identifies patients with neuromuscular diaphragmatic respiratory failure (sensitivity 93%; specificity 100%). © 2014 American Academy of Neurology.

  4. Three-dimensional simulation of ultrasound propagation through trabecular bone structures measured by synchrotron microtomography.

    PubMed

    Bossy, Emmanuel; Padilla, Frédéric; Peyrin, Françoise; Laugier, Pascal

    2005-12-07

    Three-dimensional numerical simulations of ultrasound transmission were performed through 31 trabecular bone samples measured by synchrotron microtomography. The synchrotron microtomography provided high resolution 3D mappings of bone structures, which were used as the input geometry in the simulation software developed in our laboratory. While absorption (i.e. the absorption of ultrasound through dissipative mechanisms) was not taken into account in the algorithm, the simulations reproduced major phenomena observed in real through-transmission experiments in trabecular bone. The simulated attenuation (i.e. the decrease of the transmitted ultrasonic energy) varies linearly with frequency in the MHz frequency range. Both the speed of sound (SOS) and the slope of the normalized frequency-dependent attenuation (nBUA) increase with the bone volume fraction. Twenty-five out of the thirty-one samples exhibited negative velocity dispersion. One sample was rotated to align the main orientation of the trabecular structure with the direction of ultrasonic propagation, leading to the observation of a fast and a slow wave. Coupling numerical simulation with real bone architecture therefore provides a powerful tool to investigate the physics of ultrasound propagation in trabecular structures. As an illustration, comparison between results obtained on bone modelled either as a fluid or a solid structure suggested the major role of mode conversion of the incident acoustic wave to shear waves in bone to explain the large contribution of scattering to the overall attenuation.

  5. Reproducibility of abdominal fat assessment by ultrasound and computed tomography

    PubMed Central

    Mauad, Fernando Marum; Chagas-Neto, Francisco Abaeté; Benedeti, Augusto César Garcia Saab; Nogueira-Barbosa, Marcello Henrique; Muglia, Valdair Francisco; Carneiro, Antonio Adilton Oliveira; Muller, Enrico Mattana; Elias Junior, Jorge

    2017-01-01

    Objective: To test the accuracy and reproducibility of ultrasound and computed tomography (CT) for the quantification of abdominal fat in correlation with the anthropometric, clinical, and biochemical assessments. Materials and Methods: Using ultrasound and CT, we determined the thickness of subcutaneous and intra-abdominal fat in 101 subjects-of whom 39 (38.6%) were men and 62 (61.4%) were women-with a mean age of 66.3 years (60-80 years). The ultrasound data were correlated with the anthropometric, clinical, and biochemical parameters, as well as with the areas measured by abdominal CT. Results: Intra-abdominal thickness was the variable for which the correlation with the areas of abdominal fat was strongest (i.e., the correlation coefficient was highest). We also tested the reproducibility of ultrasound and CT for the assessment of abdominal fat and found that CT measurements of abdominal fat showed greater reproducibility, having higher intraobserver and interobserver reliability than had the ultrasound measurements. There was a significant correlation between ultrasound and CT, with a correlation coefficient of 0.71. Conclusion: In the assessment of abdominal fat, the intraobserver and interobserver reliability were greater for CT than for ultrasound, although both methods showed high accuracy and good reproducibility. PMID:28670024

  6. Non-Contact Optical Ultrasound Concept for Biomedical Imaging

    DTIC Science & Technology

    2016-11-03

    Non -Contact Optical Ultrasound Concept for Biomedical Imaging Robert Haupt1, Charles Wynn1, Jonathan Fincke2, Shawn Zhang2, Brian Anthony2...results. Lastly, we present imaging capabilities using a non -contact laser ultrasound proof-of-concept system. Two and three dimensional time... non -contact, standoff optical ultrasound has the potential to provide a fixed reference measurement capability that minimizes operator variability as

  7. Influence of power density on the setting behaviour of light-cured glass-ionomer cements monitored by ultrasound measurements.

    PubMed

    Tonegawa, Motoka; Yasuda, Genta; Chikako, Takubo; Tamura, Yukie; Yoshida, Takeshi; Kurokawa, Hiroyasu; Miyazaki, Masashi

    2009-07-01

    To monitor the influence of the power density of the curing unit on the setting behaviour of light-cured glass-ionomer cements (LCGICs) using ultrasound measurements. The ultrasound equipment comprised a pulser-receiver, transducers and an oscilloscope. The LCGICs used were Fuji II LC, Fuji II LC EM and Fuji Filling LC. The cements were mixed according to the manufacturer's instructions and then inserted into a transparent mould. The specimens were placed on the sample stage and cured with power densities of 0 (no irradiation), 200 or 600 mW/cm(2). The transit time through the cement disk was divided by the specimen thickness and then the longitudinal ultrasound velocity (V) within the material was obtained. Analysis of variance and Tukey's Honestly Significantly Different test were used to compare the V values between the set cements. When the LCGICs were light-irradiated, each curve displayed an initial plateau at approximately 1500 m/s and then rapidly increased to a second plateau at approximately 2600 m/s. The rate of increase of V was retarded when the cements were light-irradiated with a power density of 200 mW/cm(2) than with a power density of 600 mW/cm(2). Although sonic echoes were detected from the beginning of the measurements, the rates of increase of the sonic velocity were relatively slow when the cement was not light-irradiated. The ultrasound device monitored the setting processes of LCGICs accurately based on the longitudinal V. The polymerization behaviour of LCGICs was shown to be affected by the power density of the curing unit.

  8. Value of mammography and breast ultrasound in male patients with nipple discharge.

    PubMed

    Muñoz Carrasco, Rafaela; Álvarez Benito, Marina; Rivin del Campo, Eleonor

    2013-03-01

    To assess the contribution of mammography and ultrasound in men with nipple discharge. All men with nipple discharge who underwent mammography and/or ultrasound between 1993 and 2011 in our hospital were retrospectively evaluated. Radiological findings were classified according to BI-RADS lexicon. The final diagnosis was made based on histopathological results or clinical-radiological follow-up. The diagnostic performance of physical examination, mammography and ultrasound was calculated and compared. 26 men with 21 mammograms and 19 ultrasounds were reviewed. The final diagnoses were: 6 carcinomas (23.1%), 10 gynaecomastias, 2 pseudogynaecomastias and 8 normal breast tissues. Mammograms and ultrasounds performed on all five patients with infiltrating carcinoma showed a mass (categories 4 and 5). In all these patients except one, a breast mass was also noted and the physical examination was positive or suspected malignancy. In the patient with carcinoma in situ, the only conspicuous clinical sign was bloody nipple discharge and the mammography showed calcifications (category 4) that were not visible on ultrasound. Radiological findings of all patients without malignancy were classified as categories 1 and 2. The diagnostic performance of physical examination was lower than mammography and ultrasound (P>0.05). Mammography was more sensitive than ultrasound (100% vs. 83.3%). Both techniques showed the same specificity (100%). Men with nipple discharge have a high incidence of breast carcinoma. Nipple discharge may be the only clinical sign of carcinoma in situ. Mammography and ultrasound are useful in the evaluation of men with nipple discharge, diagnosing carcinoma in initial stages, avoiding unnecessary biopsies. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Ultrasound modulated optical tomography: Young's modulus of the insonified region from measurement of natural frequency of vibration.

    PubMed

    Chandran, R Sriram; Roy, Debasish; Kanhirodan, Rajan; Vasu, Ram Mohan; Devi, C Usha

    2011-11-07

    We demonstrate a method to recover the Young's modulus (E) of a tissue-mimicking phantom from measurements of ultrasound modulated optical tomography (UMOT). The object is insonified by a dual-beam, confocal ultrasound transducer (US) oscillating at frequencies f₀ and f₀ + Δf and the variation of modulation depth (M) in the autocorrelation of light traversed through the focal region of the US transducer against Δf is measured. From the dominant peaks observed in the above variation, the natural frequencies of the insonified region associated with the vibration along the US transducer axis are deduced. A consequence of the above resonance is that the speckle fluctuation at the resonance frequency has a higher signal-to-noise to ratio (SNR). From these natural frequencies and the associated eigenspectrum of the oscillating object, Young's modulus (E) of the material in the focal region is recovered. The working of this method is confirmed by recovering E in the case of three tissue-mimicking phantoms of different elastic modulus values.

  10. Use of positive reinforcement conditioning to monitor pregnancy in an unanesthetized snow leopard (Uncia uncia) via transabdominal ultrasound.

    PubMed

    Broder, Jacqueline M; Macfadden, Annabell J; Cosens, Lindsay M; Rosenstein, Diana S; Harrison, Tara M

    2008-01-01

    Closely monitoring snow leopard (Uncia uncia) fetal developments via transabdominal ultrasound, with minimal stress to the animal, was the goal of this project. The staff at Potter Park Zoo has used the principles of habituation, desensitization, and positive reinforcement to train a female snow leopard (U. uncia). Ultrasound examinations were preformed on an unanesthetized feline at 63 and 84 days. The animal remained calm and compliant throughout both procedures. Fetuses were observed and measured on both occasions. The absence of anesthesia eliminated components of psychologic and physiologic stress associated with sedation. This was the first recorded instance of transabdominal ultrasound being carried out on an unanesthetized snow leopard. It documents the feasibility of detecting pregnancy and monitoring fetal development via ultrasound. Zoo Biol 27:78-85, 2008. (c) 2007 Wiley-Liss, Inc.

  11. Radiographer-performed abdominal and pelvic ultrasound: its value in a urology out-patient clinic.

    PubMed

    Nargund, V H; Lomas, K; Sapherson, D A; Flannigan, G M; Stewart, P A

    1994-04-01

    To assess the efficacy of radiographer-performed ultrasound examination as a routine investigative procedure in a urological out-patient clinic. A total of 151 patients attending a District General Hospital Urological Out-patient Department underwent an ultrasound examination in the clinic. Diagnosis by ultrasound was achieved in 93% of patients. The remaining patients underwent further investigations. Two (1%) patients with normal scans had small bladder tumours. Subsequent intravenous urography in these individuals showed normal upper tracts. Abdominal and pelvic ultrasound examination performed in the urological out-patient clinic on unprepared patients was the only investigation necessary for evaluation of common problems such as non-specific urinary symptoms, recurrent urinary tract infections and bladder outlet obstruction.

  12. Point-of-care ultrasound education for non-physician clinicians in a resource-limited emergency department.

    PubMed

    Stolz, Lori A; Muruganandan, Krithika M; Bisanzo, Mark C; Sebikali, Mugisha J; Dreifuss, Bradley A; Hammerstedt, Heather S; Nelson, Sara W; Nayabale, Irene; Adhikari, Srikar; Shah, Sachita P

    2015-08-01

    To describe the outcomes and curriculum components of an educational programme to train non-physician clinicians working in a rural, Ugandan emergency department in the use of POC ultrasound. The use of point-of-care ultrasound was taught to emergency care providers through lectures, bedsides teaching and hands-on practical sessions. Lectures were tailored to care providers' knowledge base and available therapeutic means. Every ultrasound examination performed by these providers was recorded over 4.5 years. Findings of these examinations were categorised as positive, negative, indeterminate or procedural. Other radiologic studies ordered over this same time period were also recorded. A total of 22,639 patients were evaluated in the emergency department by emergency care providers, and 2185 point-of-care ultrasound examinations were performed on 1886 patients. Most commonly used were the focused assessment with sonography in trauma examination (53.3%) and echocardiography (16.4%). Point-of-care ultrasound studies were performed more frequently than radiology department-performed studies. Positive findings were documented in 46% of all examinations. We describe a novel curriculum for point-of-care ultrasound education of non-physician emergency practitioners in a resource-limited setting. These non-physician clinicians integrated ultrasound into clinical practice and utilised this imaging modality more frequently than traditional radiology department imaging with a large proportion of positive findings. © 2015 John Wiley & Sons Ltd.

  13. Biliary lithotripsy can be enhanced with proper ultrasound probe position.

    PubMed

    Affronti, J; Flournoy, T; Akers, S; Baillie, J

    1992-04-01

    We have demonstrated in our in vitro system that an extracorporeal lithotripter utilizing a movable ultrasound probe can fragment gallstones more effectively when the ultrasound probe is not partially blocking shock waves. Using a pressure transducer we measured the pressures in the focal volume of a Wolf Piezolith 2300 lithotripter with the ultrasound probe fully extended and fully retracted. We also chose 12 pairs of twin gallstones, each taken from the same gallbladder. One stone from each pair was subjected to shock waves while the ultrasound probe was fully extended and the other treated while the probe was fully retracted. Shock wave pressures (which are converted to a measurable voltage output by our transducer) were clearly lower when the ultrasound probe was extended (5.45 volts; SEM = 0.10 volts) as compared to when the ultrasound scanner was retracted (6.7 volts: SEM = 0.08 volts). Significantly more shock waves were required to completely fragment stones when the ultrasound scanner was extended than when it was retracted (p = 0.01 using the nonparametric Wilcoxon's signed rank test). These results show that, in the lithotripter tested, an extended in-line ultrasound scanner can partially block shock waves. Retraction of an extendible ultrasound probe may enhance stone fragmentation when operating at the highest shock wave intensity.

  14. Focusing of ferroelectret air-coupled ultrasound transducers

    NASA Astrophysics Data System (ADS)

    Gaal, Mate; Bartusch, Jürgen; Dohse, Elmar; Schadow, Florian; Köppe, Enrico

    2016-02-01

    Air-coupled ultrasound has been applied increasingly as a non-destructive testing method for lightweight construction in recent years. It is particularly appropriate for composite materials being used in automotive and aviation industry. Air-coupled ultrasound transducers mostly consist of piezoelectric materials and matching layers. However, their fabrication is challenging and their signal-to-noise ratio often not sufficient for many testing requirements. To enhance the efficiency, air-coupled ultrasound transducers made of cellular polypropylene have been developed. Because of its small density and sound velocity, this piezoelectric ferroelectret matches the small acoustic impedance of air much better than matching layers applied in conventional transducers. In our contribution, we present two different methods of spherical focusing of ferroelectret transducers for the further enhancement of their performance in NDT applications. Measurements on carbon-fiber-reinforced polymer (CFRP) samples and on metal adhesive joints performed with commercially available focused air-coupled ultrasound transducers are compared to measurements executed with self-developed focused ferroelectret transducers.

  15. Two-Dimensional and Three-Dimensional Ultrasound of Artificial Skin.

    PubMed

    Wortsman, Ximena; Navarrete, Nelson

    2017-01-01

    Wound healing may be a difficult problem, and variable types of artificial skin prototypes have been developed for supporting this process. Using ultrasound, we studied 4 cellulose-derived artificial skin prototypes and assessed their two-dimensional and three-dimensional morphology. These prototypes were identified on ultrasound both on in vitro and in vivo studies. They allowed the sonographic observation of deeper layers on different types of surfaces of the body with good definition on the in vivo examinations performed on healthy skin and cutaneous ulcers. The ultrasound detection of these artificial biomaterials may potentially support the noninvasive monitoring of wound healing. © 2016 by the American Institute of Ultrasound in Medicine.

  16. Measurement of ultrasound power using a calorimeter

    NASA Astrophysics Data System (ADS)

    Morgado, G.; Miqueleti, S.; Costa-Felix, R. P. B.

    2018-03-01

    This paper presents a comparison between the ultrasound power of a 1 MHz therapy equipment on the water using a calorimeter and a radiation force balance. For a range of 5 to 10 W, the results presented a normalized error less than 1, disclosing compatibility of the results from the developed system and the radiation force balance. The calorimetric method might be used as a faster and cheaper means for the verification of the ultrasonic power emitted by an equipment for physiotherapeutic treatment.

  17. Quality management of nuchal translucency ultrasound measurement in Australia.

    PubMed

    Nisbet, Debbie; Robertson, Ann; Mannil, Blessy; Pincham, Vanessa; Mclennan, Andrew

    2018-02-22

    Nuchal translucency measurement has an established role in first trimester screening. Accurate measurement requires that technical guidelines are followed. Performance can be monitored by auditing the distribution of measurements obtained in a series of cases. The primary aim is to develop an accessible, theory-based educational program for individuals whose distribution of measurements at audit falls outside an acceptable range, and assess operator performance following this intervention. Operators whose nuchal translucency measurement distributions fall outside a normal range (38-65% above the median) were expected to undergo a teleconference tutorial. Accessible from anywhere in Australia, the one hour tutorials were run by a senior sonographer (to explain technical ultrasound aspects) and the audit program manager (to explain the audit process). In 2011, 83 operators attended the teleconference tutorials. Compared to a random comparison group of operators meeting standard in 2011, teleconference tutorial attendees were significantly more likely to: (i) operate in rural or regional, rather than metropolitan, centres (P = 0.001); (ii) be less experienced (P < 0.0005); and (iii) have lower annual scan numbers (P = 0.0012). Improvement in nuchal translucency measurement quality was seen after one audit cycle and was maintained over subsequent years. The mean percentage of the study cohort reaching standard over the five-year audit was 77.8% which was not statistically different from the average for the comparison cohort of all other audited operators (79.3%; P = 0.61). Teleconference tutorials are a convenient, accessible and effective way to obtain immediate and sustained improvement in operator performance. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  18. Detection and measurement of fetal anatomies from ultrasound images using a constrained probabilistic boosting tree.

    PubMed

    Carneiro, Gustavo; Georgescu, Bogdan; Good, Sara; Comaniciu, Dorin

    2008-09-01

    We propose a novel method for the automatic detection and measurement of fetal anatomical structures in ultrasound images. This problem offers a myriad of challenges, including: difficulty of modeling the appearance variations of the visual object of interest, robustness to speckle noise and signal dropout, and large search space of the detection procedure. Previous solutions typically rely on the explicit encoding of prior knowledge and formulation of the problem as a perceptual grouping task solved through clustering or variational approaches. These methods are constrained by the validity of the underlying assumptions and usually are not enough to capture the complex appearances of fetal anatomies. We propose a novel system for fast automatic detection and measurement of fetal anatomies that directly exploits a large database of expert annotated fetal anatomical structures in ultrasound images. Our method learns automatically to distinguish between the appearance of the object of interest and background by training a constrained probabilistic boosting tree classifier. This system is able to produce the automatic segmentation of several fetal anatomies using the same basic detection algorithm. We show results on fully automatic measurement of biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), humerus length (HL), and crown rump length (CRL). Notice that our approach is the first in the literature to deal with the HL and CRL measurements. Extensive experiments (with clinical validation) show that our system is, on average, close to the accuracy of experts in terms of segmentation and obstetric measurements. Finally, this system runs under half second on a standard dual-core PC computer.

  19. Diagnostic ultrasound imaging for lateral epicondylalgia: a case-control study.

    PubMed

    Heales, Luke James; Broadhurst, Nathan; Mellor, Rebecca; Hodges, Paul William; Vicenzino, Bill

    2014-11-01

    Lateral epicondylalgia (LE) is clinically diagnosed as pain over the lateral elbow that is provoked by gripping. Usually, LE responds well to conservative intervention; however, those who fail such treatment require further evaluation, including musculoskeletal ultrasound. Previous studies of musculoskeletal ultrasound have methodological flaws, such as lack of assessor blinding and failure to control for participant age, sex, and arm dominance. The purpose of this study was to assess the diagnostic use of blinded ultrasound imaging in people with clinically diagnosed LE compared with that in a control group matched for age, sex, and arm dominance. Participants (30 with LE and 30 controls) underwent clinical examination as the criterion standard test. Unilateral LE was defined as pain over the lateral epicondyle, which was provoked by palpation, resisted wrist and finger extension, and gripping. Controls without symptoms were matched for age, sex, and arm dominance. Ultrasound investigations were performed by two sonographers using a standardized protocol. Grayscale images were assessed for signs of tendon pathology and rated on a four-point ordinal scale. Power Doppler was used to assess neovascularity and rated on a five-point ordinal scale. The combination of grayscale and power Doppler imaging revealed an overall sensitivity of 90% and specificity of 47%. The positive and negative likelihood ratios for combined grayscale and power Doppler imaging were 1.69 and 0.21, respectively. Although ultrasound imaging helps confirm the absence of LE, when findings are negative for tendinopathic changes, the high prevalence of tendinopathic changes in pain-free controls challenges the specificity of the measure. The validity of ultrasound imaging to confirm tendon pathology in clinically diagnosed LE requires further study with strong methodology.

  20. Evaluation of chest ultrasound integrated teaching of respiratory system physiology to medical students.

    PubMed

    Paganini, Matteo; Bondì, Michela; Rubini, Alessandro

    2017-12-01

    Ultrasound imaging is a widely used diagnostic technique, whose integration in medical education is constantly growing. The aim of this study was to evaluate chest ultrasound usefulness in teaching respiratory system physiology, students' perception of chest ultrasound integration into a traditional lecture in human physiology, and short-term concept retention. A lecture about respiratory physiology was integrated with ultrasound and delivered to third-year medical students. It included basic concepts of ultrasound imaging and the physiology of four anatomic sectors of the body of a male volunteer, shown with a portable ultrasound device (pleural sliding, diaphragmatic movement, inferior vena cava diameter variations, cardiac movements). Students' perceptions of the integrated lecture were assessed, and attendance recorded. After 4 mo, four multiple-choice questions about respiratory physiology were administered during the normal human physiology examinations, and the results of students who attended the lesson and those of who did not were compared. One hundred thirty-four students attended the lecture. Most of them showed encouragement for the study of the subject and considered the ultrasound integrated lecture more interesting than a traditional one and pertinent to the syllabus. Exposed students achieved a better score at the examination and committed less errors than did nonexposed students. The chest ultrasound integrated lecture was appreciated by students. A possible association between the exposure to the lecture and short-term concept retention is shown by better performances of the exposed cohort at the examination. A systematic introduction of ultrasound into physiology traditional teaching will be promoted by the Ultrasound-Based Medical Education movement. Copyright © 2017 the American Physiological Society.

  1. Color Doppler ultrasound evaluation of testicular blood flow in stallions.

    PubMed

    Pozor, M A; McDonnell, S M

    2004-04-01

    The objectives of this study were to evaluate the potential use of color Doppler ultrasound to characterize blood flow to the stallion testis, and to establish reference values for Doppler measures of blood flow in the testicular artery of the stallion. Both testes from each of 52 horses were examined using a pulsed-wave color Doppler ultrasound with a sector array 5/7.5 MHz transducer with a 1mm gate setting. Peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI), and pulsatility index (PI) of the testicular artery were measured in each of two locations, the convoluted aspect (spermatic cord) and the marginal aspect of the artery (on the epididymal edge of testis). We found that: (1) all measures were obtainable; (2) except for EDV, the majority of the measures were higher at the cord location than at the marginal aspect of the artery (P < 0.05); and (3) measures for left and right testes were similar (P > 0.10). Resulting measures from 41 of these stallions (82 testes) that appeared free of testicular pathology provide useful reference values for clinical evaluation. Evaluation of 11 cases with testicular pathology suggested further investigation of possible effects of these various conditions on testicular blood flow and testicular function.

  2. [Ultrasound diagnosis of aneurysm of the vein of Galen in children].

    PubMed

    Gazikalović, S; Kosutić, J; Komar, P; Vukomanović, V; Mogić, M

    2001-01-01

    Aneurysm of the vein of Galen is rare and complex vascular disorder that develops during embriogenesis and provokes significant haemodynamic changes. Boys are more frequently involved. During the foetal period Ballantyne syndrome may develop, and postnatal clinical presentation vary with ages. Serious haemodynamic changes are followed by congestive heart failure and, if not treated, with lethal exitus. Fast and correct diagnosis is very important. Ultrasound examination of central nervous system supported with Duplex-Doppler and Colour-Doppler examination of the head and heart enables the diagnosis. This text comments ultrasound presentation of the malformation and ultrasound diagnostic possibilities.

  3. Uncertainty evaluation of dead zone of diagnostic ultrasound equipment

    NASA Astrophysics Data System (ADS)

    Souza, R. M.; Alvarenga, A. V.; Braz, D. S.; Petrella, L. I.; Costa-Felix, R. P. B.

    2016-07-01

    This paper presents a model for evaluating measurement uncertainty of a feature used in the assessment of ultrasound images: dead zone. The dead zone was measured by two technicians of the INMETRO's Laboratory of Ultrasound using a phantom and following the standard IEC/TS 61390. The uncertainty model was proposed based on the Guide to the Expression of Uncertainty in Measurement. For the tested equipment, results indicate a dead zone of 1.01 mm, and based on the proposed model, the expanded uncertainty was 0.17 mm. The proposed uncertainty model contributes as a novel way for metrological evaluation of diagnostic imaging by ultrasound.

  4. Multiparametric Quantitative Ultrasound Imaging in Assessment of Chronic Kidney Disease.

    PubMed

    Gao, Jing; Perlman, Alan; Kalache, Safa; Berman, Nathaniel; Seshan, Surya; Salvatore, Steven; Smith, Lindsey; Wehrli, Natasha; Waldron, Levi; Kodali, Hanish; Chevalier, James

    2017-11-01

    To evaluate the value of multiparametric quantitative ultrasound imaging in assessing chronic kidney disease (CKD) using kidney biopsy pathologic findings as reference standards. We prospectively measured multiparametric quantitative ultrasound markers with grayscale, spectral Doppler, and acoustic radiation force impulse imaging in 25 patients with CKD before kidney biopsy and 10 healthy volunteers. Based on all pathologic (glomerulosclerosis, interstitial fibrosis/tubular atrophy, arteriosclerosis, and edema) scores, the patients with CKD were classified into mild (no grade 3 and <2 of grade 2) and moderate to severe (at least 2 of grade 2 or 1 of grade 3) CKD groups. Multiparametric quantitative ultrasound parameters included kidney length, cortical thickness, pixel intensity, parenchymal shear wave velocity, intrarenal artery peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index. We tested the difference in quantitative ultrasound parameters among mild CKD, moderate to severe CKD, and healthy controls using analysis of variance, analyzed correlations of quantitative ultrasound parameters with pathologic scores and the estimated glomerular filtration rate (GFR) using Pearson correlation coefficients, and examined the diagnostic performance of quantitative ultrasound parameters in determining moderate CKD and an estimated GFR of less than 60 mL/min/1.73 m 2 using receiver operating characteristic curve analysis. There were significant differences in cortical thickness, pixel intensity, PSV, and EDV among the 3 groups (all P < .01). Among quantitative ultrasound parameters, the top areas under the receiver operating characteristic curves for PSV and EDV were 0.88 and 0.97, respectively, for determining pathologic moderate to severe CKD, and 0.76 and 0.86 for estimated GFR of less than 60 mL/min/1.73 m 2 . Moderate to good correlations were found for PSV, EDV, and pixel intensity with pathologic scores and estimated GFR. The

  5. [Two- and three-dimensional power Doppler ultrasound in the follow-up of placenta accreta treated conservatively].

    PubMed

    Roulot, A; Barranger, E; Morel, O; Soyer, P; Héquet, D

    2015-02-01

    To determinate the potential of 2D and 3D-ultrasound in the follow-up of patients with placenta accreta treated conservatively. Seven patients with placenta accreta treated conservatively during June 2007 and September 2009 were included. The follow-up consisted in clinical examination and 2D/3D-ultrasound once a month. Criteria studied included clinical outcome, echogenicity at 2D-ultrasound, vascularisation at colour Doppler, Mean Grey at 3D-ultrasound and vascularisation, flow and perfusion index. Seven women with invasive placenta (3 placentas accreta and 2 percreta) were studied. The mean follow-up was 228 days [75-369]. Mean delay for complete elimination of residual placenta was 280 days [120-365]. The two main results were: presence of an increased anechogenicpart in residual placenta before complete resorption for all patients; a systematic and concomitant stop of genital haemorrhage and vascularisation at colour Doppler. High degrees of variability in parameters measured at 3D-ultrasound were observed between patients so that correlations with clinical outcome were found. Long and regular follow-up is essential after conservative management but the role of 3D-ultrasound compared to 2D-ultrasound was not demonstrated in this study. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  6. Ultrasound functional imaging in an ex vivo beating porcine heart platform

    NASA Astrophysics Data System (ADS)

    Petterson, Niels J.; Fixsen, Louis S.; Rutten, Marcel C. M.; Pijls, Nico H. J.; van de Vosse, Frans N.; Lopata, Richard G. P.

    2017-12-01

    In recent years, novel ultrasound functional imaging (UFI) techniques have been introduced to assess cardiac function by measuring, e.g. cardiac output (CO) and/or myocardial strain. Verification and reproducibility assessment in a realistic setting remain major issues. Simulations and phantoms are often unrealistic, whereas in vivo measurements often lack crucial hemodynamic parameters or ground truth data, or suffer from the large physiological and clinical variation between patients when attempting clinical validation. Controlled validation in certain pathologies is cumbersome and often requires the use of lab animals. In this study, an isolated beating pig heart setup was adapted and used for performance assessment of UFI techniques such as volume assessment and ultrasound strain imaging. The potential of performing verification and reproducibility studies was demonstrated. For proof-of-principle, validation of UFI in pathological hearts was examined. Ex vivo porcine hearts (n  =  6, slaughterhouse waste) were resuscitated and attached to a mock circulatory system. Radio frequency ultrasound data of the left ventricle were acquired in five short axis views and one long axis view. Based on these slices, the CO was measured, where verification was performed using flow sensor measurements in the aorta. Strain imaging was performed providing radial, circumferential and longitudinal strain to assess reproducibility and inter-subject variability under steady conditions. Finally, strains in healthy hearts were compared to a heart with an implanted left ventricular assist device, simulating a failing, supported heart. Good agreement between ultrasound and flow sensor based CO measurements was found. Strains were highly reproducible (intraclass correlation coefficients  >0.8). Differences were found due to biological variation and condition of the hearts. Strain magnitude and patterns in the assisted heart were available for different pump action, revealing

  7. Airborne ultrasound applied to anthropometry--physical and technical principles.

    PubMed

    Lindström, K; Mauritzson, L; Benoni, G; Willner, S

    1983-01-01

    Airborne ultrasound has been utilized for remote measurement of distance, direction, size, form, volume and velocity. General anthropometrical measurements are performed with a newly constructed real-time linear array scanner. To make full use of the method, we expect a rapid development of high-frequency ultrasound transducers for use in air.

  8. Ultrasound in the evaluation of enthesitis: status and perspectives.

    PubMed

    Gandjbakhch, Frédérique; Terslev, Lene; Joshua, Fredrick; Wakefield, Richard J; Naredo, Esperanza; D'Agostino, Maria Antonietta

    2011-01-01

    An increasing number of studies have applied ultrasound to the evaluation of entheses in spondyloarthritis patients. However, no clear agreement exists on the definition of enthesitis, on the number and choice of entheses to examine and on ultrasound technique, which may all affect the results of the examination. The objectives of this study were to first determine the level of homogeneity in the ultrasound definitions for the principal lesions of enthesitis in the published literature and second, to evaluate the metric properties of ultrasound for detecting enthesitis according to the OMERACT filter. Search was performed in PUBMED and EMBASE. Both grey-scale and Doppler definitions of enthesitis, including describing features of enthesitis, were collected and metrological qualities of studies were assessed. After selection, 48 articles were analyzed. The definition of ultrasound enthesitis and elementary features varied among authors. Grey-scale enthesitis was characterized by increasing thickness (94% of studies), hypoechogenicity (83%), enthesophytes (69%), erosions (67%), calcifications (52%), associated bursitis (46%) and cortical irregularities (29%). Only 46% of studies reported the use of Doppler. High discrepancies were observed on frequency, type of probe and Doppler mode used. Face and content validity were the most frequently evaluated criteria (43%) followed by reliability (29%) and responsiveness (19%). Ultrasound has evidence to support face, content validity and reliability for the evaluation of enthesitis, though there is a lack of well-reported methodology in most of the studies. Consensus on elementary lesions and standardization of exam is needed to determine the ultrasound definition of enthesitis in grey-scale and in Doppler for future applications.

  9. A comparison between the patella and the calcaneus using ultrasound velocity and attenuation as predictors of bone mineral density

    NASA Astrophysics Data System (ADS)

    Han, S. M.; Davis, J.

    1997-10-01

    The bone mineral density (BMD), ultrasound velocity (UV) and attenuation were examined in sixteen matched sets of human patellae and calcanei. For the sixteen calcanei, BMD was strongly correlated with all ultrasound parameters. Calcaneal UV appeared to be inferior to attenuation in the ability to predict BMD. For the sixteen patellae, the average UV was found to be greater in the superior/inferior direction than in the anterior/posterior and medial/lateral directions. It was found that patella BMD was significantly correlated with each of three directional ultrasound velocities. The relationship between BMD and ultrasound attenuation parameters was not significant in the patella. A comparative study of the two different bone sets demonstrated that the BMDs of the patella and calcaneus were significantly correlated with each other. Ultrasound velocity of calcaneus, measured in the medial/lateral direction, was not significantly associated with any of three directional ultrasound velocities in the patella. Similarly, ultrasound attenuation parameters of calcaneus were not significantly correlated with those of patella. The present study also demonstrated evidence that when predicting BMDs at their respective sites using ultrasound, the calcaneus appeared to be superior to the patella.

  10. Comparison of breast density measurements made using ultrasound tomography and mammography

    NASA Astrophysics Data System (ADS)

    Sak, Mark; Duric, Neb; Littrup, Peter; Bey-Knight, Lisa; Krycia, Mark; Sherman, Mark E.; Boyd, Norman; Gierach, Gretchen L.

    2015-03-01

    Women with elevated mammographic percent density, defined as the ratio of fibroglandular tissue area to total breast area on a mammogram are at an increased risk of developing breast cancer. Ultrasound tomography (UST) is an imaging modality that can create tomographic sound speed images of a patient's breast, which can then be used to measure breast density. These sound speed images are useful because physical tissue density is directly proportional to sound speed. The work presented here updates previous results that compared mammographic breast density measurements with UST breast density measurements within an ongoing study. The current analysis has been expanded to include 158 women with negative digital mammographic screens who then underwent a breast UST scan. Breast density was measured for both imaging modalities and preliminary analysis demonstrated strong and positive correlations (Spearman correlation coefficient rs = 0.703). Additional mammographic and UST related imaging characteristics were also analyzed and used to compare the behavior of both imaging modalities. Results suggest that UST can be used among women with negative mammographic screens as a quantitative marker of breast density that may avert shortcomings of mammography.

  11. Ultrasound-enhanced localized chemotherapy of drug-sensitive and multidrug resistant tumors

    NASA Astrophysics Data System (ADS)

    Rapoport, Natalya Y.; Gao, Zhonggao; Kamaev, Pavel; Christensen, Douglas A.

    2006-05-01

    A new modality of targeted tumor chemotherapy is based on the drug encapsulation in polymeric nanoparticles followed by a localized release at the tumor site triggered by focused ultrasound. Effect of 1 MHz and 3 MHz unfocused ultrasound applied locally to the tumor on the Doxorubicin (DOX) biodistribution and tumor growth rates was measured for ovarian carcinoma tumors in nu/nu mice. The bioeffects of ultrasound were investigated on the systemic and cellular levels. Growth rates of A2780 ovarian carcinoma tumors were substantially reduced by combining micellar drug delivery with tumor irradiation. Ultrasound effect was not thermal as manifested by intratumoral temperature measurements during sonication. Biodistribution studies showed that ultrasound did not enhance micelle extravasation. Main mechanisms of the ultrasound-enhanced chemotherapy included (i) passive targeting of drug-loaded micelles to the tumor interstitium; (ii) ultrasound-triggered localized drug release from micelles in the tumor volume; (iii) enhanced micelle and drug diffusion through the tumor interstitium; and (iv) ultrasound-triggered cell membrane damage resulting in the enhanced micelle and drug uptake by tumor cells.

  12. Reliability of pelvic floor measurements on three- and four-dimensional ultrasound during and after first pregnancy: implications for training.

    PubMed

    van Veelen, G A; Schweitzer, K J; van der Vaart, C H

    2013-11-01

    To evaluate the reliability of measurements of the levator hiatus and levator-urethra gap (LUG) using three/four-dimensional (3D/4D) transperineal ultrasound in women during their first pregnancy and 6 months postpartum, and to assess the learning process for these measurements. An inexperienced observer was taught to perform measurements of the levator hiatus and LUG by an experienced observer. After training, 3D/4D ultrasound volume datasets of 40 women in the first trimester were analyzed by these two observers. Another training session then took place and both observers repeated the analyses of the same volume datasets. Finally, analyses of 40 volume datasets of the women 6 months postpartum were performed by both observers. Intra- and interobserver reliability were determined by intraclass correlation coefficients (ICC) with 95% CIs. For levator hiatal measurements, in the women during their first pregnancy the interobserver reliability was substantial to almost perfect after both the first and second training session (ICC, 0.62-0.83 and 0.71-0.89, respectively, for anteroposterior diameter, transverse diameter and area at rest, on contraction and on Valsalva) and the intraobserver reliability was substantial to almost perfect for both observers. For these measurements performed once the women had delivered, interobserver reliability was moderate to almost perfect. For LUG measurements performed during pregnancy, interobserver reliability was slight to moderate after the first training session (ICC, 0.14-0.54), but improved after the second training session (ICC, 0.38-0.71), and intraobserver reliability was moderate to substantial for the experienced observer and slight to moderate for the inexperienced observer. For these measurements performed when the women had delivered, interobserver reliability was fair to moderate. The levator hiatus and LUG can be measured reliably using 3D/4D ultrasound in primigravid and primiparous women. The technique to measure

  13. [Ultrasound-guided peripheral catheterization].

    PubMed

    Salleras-Duran, Laia; Fuentes-Pumarola, Concepció

    2016-01-01

    Peripheral catheterization is a technique that can be difficult in some patients. Some studies have recently described the use of ultrasound to guide the venous catheterization. To describe the success rate, time required, complications of ultrasound-guided peripheral venous catheterization. and patients and professionals satisfaction The search was performed in databases (Medline-PubMed, Cochrane Library, CINAHL and Cuiden Plus) for studies published about ultrasound-guided peripheral venous catheterization performed on patients that provided results on the success of the technique, complications, time used, patient satisfaction and the type of professional who performed the technique. A total of 21 studies were included. Most of them get a higher success rate 80% in the catheterization ecoguide and time it is not higher than the traditional technique. The Technical complications analyzed were arterial puncture rates and lower nerve 10%. In all studies measuring and comparing patient satisfaction in the art ecoguide is greater. Various professional groups perform the technique. The use of ultrasound for peripheral pipes has a high success rate, complications are rare and the time used is similar to that of the traditional technique. The technique of inserting catheters through ultrasound may be learned by any professional group performing venipuncture. Finally, it gets underscores the high patient satisfaction with the use of this technique. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  14. [Evidence of lacrimal plugs via high resolution ultrasound].

    PubMed

    Tost, Frank H W; Darman, Jacques

    2003-07-01

    The practical value of high-frequency ultrasound (transducer frequency of 20 MHz) for studying lacrimal plugs positioned into canaliculi was proved. Twelve patients with twenty intracanalicular plugs and two punctum plugs were examined via high-frequency B-scan ultrasonography using 20 MHz transducer (model I3 Sacramento, USA). Detection and localisation of the intracanalicular plugs was made by a 20 MHz sector scanner. The ultrasound examinations were performed 1 - 24 month after the placement of lacrimal plugs. After patient's head positioning, the high-frequency ultrasound investigation was done via immersion fluid (2 % methylcellulose). All patients with dry eye treated by lacrimal plug implant showed echographic structure in the lacrimal canaliculus. In transversal echograms it was possible to image both canaliculi together when the lids were half-closed. Contrary to the normal state, it was not necessary to inject viscous fluid into the canaliculus. High-resolution ultrasound was able to differentiate the normal canaliculus from the findings after plug placement. The echograms can vary from one plug type to another. Highly reflective structures were found after the placement of silicone intracanalicular plugs, e. g. HERRICK-Plug. In contrast, the ultrasonic image taken through acrylic polymer intracanalicular plugs showed homogeneous small reflective inner structure, e. g. SMART-Plug. However, smooth and flat acoustic interface between acrylic polymer plug and the lacrimal canaliculus produced strong echoes. 20 MHz ultrasound seems to be well suited for the detection and localisation of intracanalicular plugs. By use of 20 MHz ultrasound scans it is possible to get high-quality images of the intracanalicular plug and around lacrimal canaliculus. Compared with UBM, the depth of penetration is much higher with negligible resolution. On the whole, we believe that 20 MHz ultrasound can become a useful tool for evaluating the placement of intracanalicular plugs

  15. Usefulness of automatic measurement of contrast flow intensity: an innovative tool in contrast-enhanced ultrasound imaging of atherosclerotic carotid plaque neovascularization. A pilot study.

    PubMed

    Lisowska, A; Knapp, M; Tycinska, A; Sawicki, R; Kralisz, P; Lisowski, P; Sobkowicz, B; Musial, W I

    2014-02-01

    Contrast-enhanced ultrasound imaging of the carotid arteries (CECU) permits direct, real-time visualization of neovascularization in atherosclerotic plaques and is a confirmed predictor of unstable atheromatous lesions. The aim of the study was the assessment of a new, automatically measured index of intensity in quantitative estimation of the contrast flow through the carotid plaque (till now assessed only visually). Forty-four patients (mean age 70.4±11.4) with ultrasound diagnosed significant stenosis of internal carotid artery (ICA), after cerebrovascular or cardiovascular events, qualified for carotid artery stenting (CAS) were examined. The carotid ultrasound examinations with contrast agent Sonovue were performed. Visually in 22 patients (50%) contrast flow through the atherosclerotic plaques was found. In 17 patients (38.6%) massive, calcified atherosclerotic plaques were present. Patients with preserved contrast flow through the plaque more frequently had a history of cerebral stroke (P=0.04). Massive calcifications of atherosclerotic plaques correlated with a previous MI (P=0.03) and the degree of advancement of coronary artery disease (P=0.04), but not with a previous cerebral stroke. Contrast flow through the atherosclerotic plaque positively correlated with values of the index of intensity (r=0.69, P<0.00001). In patients with preserved contrast flow the mean value of the index of intensity was 22.24±3.55 dB as compared with 12.37±7.67 dB - a value present in patients without preserved contrast flow. No significant relation for the degree of calcifications and the value of the index of intensity was found. The assessment of the index of intensity is a novel, simple and automatic method to estimate the degree of contrast flow through the carotid plaque. The values of the index of intensity correlate with the contrast flow through the atherosclerotic plaque, but not with its calcification.

  16. Measurement of glenohumeral joint translation using real-time ultrasound imaging: A physiotherapist and sonographer intra-rater and inter-rater reliability study.

    PubMed

    Rathi, Sangeeta; Taylor, Nicholas F; Gee, Jamie; Green, Rodney A

    2016-12-01

    Ultrasonography is an economical and non-invasive method for measuring real-time joint movements. Although physiotherapists are increasingly using ultrasound imaging for rotator cuff disorders, there is a lack of evidence on their reliability in using ultrasonography to measure glenohumeral translation. The aim of this study was to evaluate the reliability of a physiotherapist in measuring anterior and posterior glenohumeral joint translation with ultrasound. Study design: within day reliability. Anterior and posterior glenohumeral translations were measured at rest, in response to passive accessory motion testing force, and with isometric internal and external rotation in 12 young healthy adults. All the measurements were made in real time by a physiotherapist and an experienced sonographer in two positions (neutral and abducted) and in two views (anterior and posterior). Intra-rater and inter-rater reliability were expressed using intraclass correlation coefficients (ICC) and measurement error (mm). Intra-rater reliability was good for both raters (ICC P : 0.86-0.98; ICC S : 0.85-0.96). The inter-rater reliability between the physiotherapist and sonographer was moderate to good for posterior measurements (ICC 0.50-0.75) and poor to moderate for anterior measurements (ICC 0.31-0.53). For both intra-rater and inter-rater measurements, posterior translation was more reliable than the anterior translation with smaller measurement errors (posterior: 0.1-0.2 mm, anterior: 0.2-0.3 mm). A physiotherapist with minimal training was reliable in measuring glenohumeral joint translations. The ultrasound method was reliable for repeated measurement of both anterior and posterior glenohumeral translations with posterior measurements being more reliable than anterior. This method is recommended for future research to investigate the stabilising role of rotator cuff muscles. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Localization of focused-ultrasound beams in a tissue phantom, using remote thermocouple arrays.

    PubMed

    Hariharan, Prasanna; Dibaji, Seyed Ahmad Reza; Banerjee, Rupak K; Nagaraja, Srinidhi; Myers, Matthew R

    2014-12-01

    In focused-ultrasound procedures such as vessel cauterization or clot lysis, targeting accuracy is critical. To investigate the targeting accuracy of the focused-ultrasound systems, tissue phantoms embedded with thermocouples can be employed. This paper describes a method that utilizes an array of thermocouples to localize the focused ultrasound beam. All of the thermocouples are located away from the beam, so that thermocouple artifacts and sensor interference are minimized. Beam propagation and temperature rise in the phantom are simulated numerically, and an optimization routine calculates the beam location that produces the best agreement between the numerical temperature values and those measured with thermocouples. The accuracy of the method was examined as a function of the array characteristics, including the number of thermocouples in the array and their orientation. For exposures with a 3.3-MHz source, the remote-thermocouple technique was able to predict the focal position to within 0.06 mm. Once the focal location is determined using the localization method, temperatures at desired locations (including the focus) can be estimated from remote thermocouple measurements by curve fitting an analytical solution to the heat equation. Temperature increases in the focal plane were predicted to within 5% agreement with measured values using this method.

  18. Noninvasive measurement of regional pulse wave velocity in human ascending aorta with ultrasound imaging: an in-vivo feasibility study.

    PubMed

    Huang, Chengwu; Guo, Dong; Lan, Feng; Zhang, Hongjia; Luo, Jianwen

    2016-10-01

    Accurate and noninvasive techniques for measurement of local/regional pulse wave velocity (PWV), instead of global PWV, is desired for quantifying localized arterial stiffness and improving cardiovascular disease assessment. This study aimed at investigating the feasibility of regional PWV measurement in human ascending aorta in vivo using an ultrasound-based technique. Proximal ascending aortas of 76 healthy patients (23-71 years) were scanned with transthoracic echocardiography in parasternal long-axis view, and ultrasound radiofrequency data were acquired in a high temporal resolution (∼404 Hz). The PWV was derived from the determination of arrival times and identification of travel distances. Both PWVs in early systolic phase (PWVsf; pulse wave velocity measured using the systolic foot as characteristic time point) and late systolic phase (PWVdn; pulse wave velocity measured using the dicrotic notch as characteristic time point) were obtained. The PWVsf and PWVdn were 4.58 ± 1.38 and 6.51 ± 1.90 m/s, respectively, and both were correlated with age (r = 0.30, P = 0.02 and r = 0.71, P < 0.0001). The measurements were reproducible, and PWVdn showed significant correlation with aortic diameter (r = 0.53, P < 0.0001), relative distension (r = -0.44, P = 0.0002), and local PWV derived from Bramwell-Hill equation (r = 35, P = 0.004). The PWV difference (PWVdn - PWVsf) reflected aortic stiffness change within cardiac cycle from early systole to late systole and was also correlated with age (r = 0.50, P < 0.0001). The feasibility of ascending aortic PWV measurement using ultrasound imaging was illustrated in vivo, suggesting the potential of the technique in characterization of regional aortic stiffness and assessment of aortic diseases.

  19. Petroleum Jelly: A Novel Medium for Ocular Ultrasound.

    PubMed

    Engelbert, Patrick R; Palma, James K

    2015-08-01

    Ocular ultrasound is a useful emergency department imaging modality for evaluation of many conditions, such as retinal detachment, vitreous detachment, vitreous hemorrhage, and elevated intracranial pressure. Obtaining satisfactory ocular ultrasound images requires the use of a medium that eliminates the air interface between the patient's eye and the transducer. Ultrasound gel is most commonly used; however, the use of a transparent dressing applied to the closed eye prior to the application of gel has also been described as a suitable technique. Ocular ultrasound is performed with the high-frequency linear array transducer using a medium to eliminate the air interface between the eye and the transducer. Although ultrasound gel is most frequently used, it can cause minor eye irritation. Placing a transparent dressing over a closed eye prior to application of gel can eliminate the eye irritation. However, our experience in training >500 students in ocular ultrasound has shown that air is frequently introduced underneath the dressing, which leads to poor-quality images. This article introduces petroleum jelly as a medium for ocular ultrasound. By applying a layer of petroleum jelly over the closed eye and allowing it to warm via body heat for 30 to 45 s, this medium can both minimize patient discomfort and provide easily obtainable, high-quality ocular ultrasound images. This article introduces petroleum jelly as a safe, comfortable, and effective medium for ocular ultrasound examination. Published by Elsevier Inc.

  20. Ultrasound - Breast

    MedlinePlus

    ... the patient. Because ultrasound images are captured in real-time, they can show the structure and movement of ... perform an ultrasound-guided biopsy . Because ultrasound provides real-time images, it is often used to guide biopsy ...

  1. Obstetric Ultrasound

    PubMed Central

    Nicholson, Stuart F.; Nimrod, Carl A.

    1988-01-01

    This article addresses the current indications for an obstetric ultrasound and describes the findings that it is reasonable to expect when reading an ultrasound report. The authors discuss several common obstetrical problems focussing the attention on the usefulness of the imaging information. Finally, they provide a glimpse into the future direction of obstetric ultrasound by discussing vaginal scanning, Doppler assessment of fetal blood flow, and routine ultrasound in pregnancy. PMID:21253229

  2. Quantitative evaluation of the fetal cerebellar vermis using the median view on three-dimensional ultrasound.

    PubMed

    Zhao, Dan; Liu, Wei; Cai, Ailu; Li, Jingyu; Chen, Lizhu; Wang, Bing

    2013-02-01

    The purpose of this study was to investigate the effectiveness for quantitative evaluation of cerebellar vermis using three-dimensional (3D) ultrasound and to establish a nomogram for Chinese fetal vermis measurements during gestation. Sonographic examinations were performed in normal fetuses and in cases suspected of the diagnosis of vermian rotation. 3D median planes were obtained with both OMNIVIEW and tomographic ultrasound imaging. Measurements of the cerebellar vermis were highly correlated between two-dimensional and 3D median planes. The diameter of the cerebellar vermis follows growth approximately predicted by the quadratic regression equation. The normal vermis was almost parallel to the brain stem, with the average angle degree to be <2° in normal fetuses. The average angle degree of the 9 cases of vermian rotation was >5°. Three-dimensional median planes are obtained more easily than two-dimensional ones, and allow accurate measurements of the cerebellar vermis. The 3D approach may enable rapid assessment of fetal cerebral anatomy in standard examination. Measurements of cerebellar vermis may provide a quantitative index for prenatal diagnosis of posterior fossa malformations. © 2012 John Wiley & Sons, Ltd.

  3. Prognostic value of three-dimensional ultrasound for fetal hydronephrosis

    PubMed Central

    WANG, JUNMEI; YING, WEIWEN; TANG, DAXING; YANG, LIMING; LIU, DONGSHENG; LIU, YUANHUI; PAN, JIAOE; XIE, XING

    2015-01-01

    The present study evaluated the prognostic value of three-dimensional ultrasound for fetal hydronephrosis. Pregnant females with fetal hydronephrosis were enrolled and a novel three-dimensional ultrasound indicator, renal parenchymal volume/kidney volume, was introduced to predict the postnatal prognosis of fetal hydronephrosis in comparison with commonly used ultrasound indicators. All ultrasound indicators of fetal hydronephrosis could predict whether postnatal surgery was required for fetal hydronephrosis; however, the predictive performance of renal parenchymal volume/kidney volume measurements as an individual indicator was the highest. In conclusion, ultrasound is important in predicting whether postnatal surgery is required for fetal hydronephrosis, and the three-dimensional ultrasound indicator renal parenchymal volume/kidney volume has a high predictive performance. Furthermore, the majority of cases of fetal hydronephrosis spontaneously regress subsequent to birth, and the regression time is closely associated with ultrasound indicators. PMID:25667626

  4. Ultrasound-based measurement of liquid-layer thickness: A novel time-domain approach

    NASA Astrophysics Data System (ADS)

    Praher, Bernhard; Steinbichler, Georg

    2017-01-01

    Measuring the thickness of a thin liquid layer between two solid materials is important when the adequate separation of metallic parts by a lubricant film (e.g., in bearings or mechanical seals) is to be assessed. The challenge in using ultrasound-based systems for such measurements is that the signal from the liquid layer is a superposition of multiple reflections. We have developed an algorithm for reconstructing this superimposed signal in the time domain. By comparing simulated and measured signals, the time-of-flight of the ultrasonic pulse in a layer can be estimated. With the longitudinal sound velocity known, the layer thickness can then be calculated. In laboratory measurements, we validate successfully (maximum relative error 4.9%) our algorithm for layer thicknesses ranging from 30 μm to 200 μm. Furthermore, we tested our method in the high-temperature environment of polymer processing by measuring the clearance between screw and barrel in the plasticisation unit of an injection moulding machine. The results of such measurements can indicate (i) the wear status of the tribo-mechanical screw-barrel system and (ii) unsuitable process conditions.

  5. Prenatal Diagnosis of Abnormal Invasive Placenta by Ultrasound: Measurement of Highest Peak Systolic Velocity of Subplacental Blood Flow.

    PubMed

    Zhang, Junling; Li, Hezhou; Wang, Fang; Qin, Hongyan; Qin, Qiaohong

    2018-05-07

    The aim of the study described here was to identify an efficient criterion for the prenatal diagnosis of abnormal invasive placenta. We evaluated 129 women with anterior placenta previa who underwent trans-abdominal ultrasound evaluation in the third trimester. Spectral Doppler ultrasonography was performed to assess the subplacental blood flow of the anterior lower uterine segment by measuring the highest peak systolic velocity and resistive index. These patients were prospectively followed until delivery and evaluated for abnormal placental invasion. The peak systolic velocity and resistive index of patients with and without abnormal placental invasion were then compared. Postpartum examination revealed that 55 of the patients had an abnormal invasive placenta, whereas the remaining 74 did not. Patients with abnormal placental invasion had a higher peak systolic velocity of the subplacental blood flow in the lower segment of the anterior aspect of the uterus (area under receiver operating characteristic curve: 0.91; 95% confidence interval: 0.87-0.96) than did those without abnormal placental invasion. Our preliminary investigations suggest that a peak systolic velocity of 41 cm/s can be considered a cutoff point to diagnose abnormal invasive placenta, with both good sensitivity (87%) and good specificity (78%), and the higher the peak systolic velocity, the greater is the chance of abnormal placental invasion. Resistive index had no statistical significance (area under receiver operating characteristic curve, 0.56; 95% confidence interval: 0.46-0.66) in the diagnosis of abnormal invasive placenta. In conclusion, measurement of the highest peak systolic velocity of subplacental blood flow in the anterior lower uterine segment can serve as an additional marker of anterior abnormal invasive placenta. Copyright © 2018 World Federation for Ultrasound in Medicine and Biology. Published by Elsevier Inc. All rights reserved.

  6. [The development of obstetric ultrasound in Switzerland].

    PubMed

    Zimmermann, Roland

    2005-04-01

    Ultrasound has conquered obstetrics during the last 40 years. Today it is an integral part of antenatal care. Its broad use as a screening method has pushed critics who found open doors at health authorities facing short resources. In Switzerland in early 1996, routine ultrasound as a health technology was temporarily excluded from reimbursement by the health insurances. Under the pressure of the public, the health authorities had to reintroduce reimbursement within a few months. However, reimbursement was linked with several conditions: the ultrasound examination has to be performed by physicians with adequate training and experience; routine ultrasound needs a strict informed consent, and its benefit has to be evidenced. This decision has had a positive impact on quality. After 7 years, Switzerland has a good training program; guidelines for prenatal ultrasound already exist in their second edition, and spot checks of performance showed that quality in Switzerland meets international standards. Ultrasound mainly has a positive cost-effectiveness ratio due to the detection of fetal malformations with consecutive termination of pregnancy. Since termination of pregnancy is ethically questionable, the discussion with respect to reimbursement will most probably go on. In this light, a comprehensive informed consent of the pregnant women is essential.

  7. FAST at MACH 20: clinical ultrasound aboard the International Space Station.

    PubMed

    Sargsyan, Ashot E; Hamilton, Douglas R; Jones, Jeffrey A; Melton, Shannon; Whitson, Peggy A; Kirkpatrick, Andrew W; Martin, David; Dulchavsky, Scott A

    2005-01-01

    Focused assessment with sonography for trauma (FAST) examination has been proved accurate for diagnosing trauma when performed by nonradiologist physicians. Recent reports have suggested that nonphysicians also may be able to perform the FAST examination reliably. A multipurpose ultrasound system is installed on the International Space Station as a component of the Human Research Facility. Nonphysician crew members aboard the International Space Station receive modest training in hardware operation, sonographic techniques, and remotely guided scanning. This report documents the first FAST examination conducted in space, as part of the sustained effort to maintain the highest possible level of available medical care during long-duration space flight. An International Space Station crew member with minimal sonography training was remotely guided through a FAST examination by an ultrasound imaging expert from Mission Control Center using private real-time two-way audio and a private space-to-ground video downlink (7.5 frames/second). There was a 2-second satellite delay for both video and audio. To facilitate the real-time telemedical ultrasound examination, identical reference cards showing topologic reference points and hardware controls were available to both the crew member and the ground-based expert. A FAST examination, including four standard abdominal windows, was completed in approximately 5.5 minutes. Following commands from the Mission Control Center-based expert, the crew member acquired all target images without difficulty. The anatomic content and fidelity of the ultrasound video were excellent and would allow clinical decision making. It is possible to conduct a remotely guided FAST examination with excellent clinical results and speed, even with a significantly reduced video frame rate and a 2-second communication latency. A wider application of trauma ultrasound applications for remote medicine on earth appears to be possible and warranted.

  8. Evaluation of established and new reference lines for the standardization of transperineal ultrasound.

    PubMed

    Hennemann, J; Kennes, L N; Maass, N; Najjari, L

    2014-11-01

    To examine the performance of a new reference line for the assessment of pelvic organ descent by transperineal ultrasound. We compared our newly proposed reference line, between two hyperechoic contours of the symphysis pubis (Line 3), with the horizontal reference line proposed by Dietz and Wilson (Line 1) and the central pubic line proposed by Schaer et al. (Line 2). Ultrasound volumes of 94 women obtained in routine clinical practice were analyzed. The perpendicular distance from the reference lines to the internal sphincter and the most dependent part of the bladder base was measured for volumes obtained at rest, on pelvic floor muscle contraction, on Valsalva maneuver and during coughing. Measurements were repeated 4 months later by the same examiner. Rates of assessment were calculated, and intrarater reliability was evaluated using Bland-Altman plots and intraclass correlation coefficients. Line 2 had to be excluded from reliability analysis because of an assessment rate of only 12%, whereas Lines 1 and 3 could be assessed in 100% of volumes. The intrarater repeatability of Lines 1 and 3 was shown to be very similar. In this comparison of three potential reference lines for the assessment of pelvic organ descent by transperineal ultrasound, the central pubic line was shown to be inferior owing to poor visibility in our volumes. Inter-rater reliability analysis and validation studies are required to confirm our results. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

  9. [Is ultrasound equal to X-ray in pediatric fracture diagnosis?].

    PubMed

    Moritz, J D; Hoffmann, B; Meuser, S H; Sehr, D H; Caliebe, A; Heller, M

    2010-08-01

    Ultrasound is currently not established for the diagnosis of fractures. The aim of this study was to compare ultrasound and X-ray beyond their use solely for the identification of fractures, i. e., for the detection of fracture type and dislocation for pediatric fracture diagnosis. Limb bones of dead young pigs served as a model for pediatric bones. The fractured bones were examined with ultrasound, X-ray, and CT, which served as the gold standard. 162 of 248 bones were fractured. 130 fractures were identified using ultrasound, and 148 using X-ray. There were some advantages of X-ray over ultrasound in the detection of fracture type (80 correct results using X-ray, 66 correct results using ultrasound). Ultrasound, however, was superior to X-ray for dislocation identification (41 correct results using X-ray, 51 correct results using ultrasound). Both findings were not statistically significant after adjustment for multiple testing. Ultrasound not only has comparable sensitivity to that of X-ray for the identification of limb fractures but is also equally effective for the diagnosis of fracture type and dislocation. Thus, ultrasound can be used as an adequate alternative method to X-ray for pediatric fracture diagnosis. Georg Thieme Verlag KG Stuttgart, New York.

  10. Development of a Body Condition Scoring Index for Female African Elephants Validated by Ultrasound Measurements of Subcutaneous Fat

    PubMed Central

    Morfeld, Kari A.; Lehnhardt, John; Alligood, Christina; Bolling, Jeff; Brown, Janine L.

    2014-01-01

    Obesity-related health and reproductive problems may be contributing to non-sustainability of zoo African elephant (Loxodonta africana) populations. However, a major constraint in screening for obesity in elephants is lack of a practical method to accurately assess body fat. Body condition scoring (BCS) is the assessment of subcutaneous fat stores based on visual evaluation and provides an immediate appraisal of the degree of obesity of an individual. The objective of this study was to develop a visual BCS index for female African elephants and validate it using ultrasound measures of subcutaneous fat. To develop the index, standardized photographs were collected from zoo (n = 50) and free-ranging (n = 57) female African elephants for identifying key body regions and skeletal features, which were then used to visually determine body fat deposition patterns. This information was used to develop a visual BCS method consisting of a list of body regions and the physical criteria for assigning an overall score on a 5-point scale, with 1 representing the lowest and 5 representing the highest levels of body fat. Results showed that as BCS increased, ultrasound measures of subcutaneous fat thickness also increased (P<0.01), indicating the scores closely coincide with physical measures of fat reserves. The BCS index proved to be reliable and repeatable based on high intra- and inter-assessor agreement across three assessors. In comparing photographs of wild vs. captive African elephants, the median BCS in the free-ranging individuals (BCS = 3, range 1–5) was lower (P<0.001) than that of the zoo population (BCS = 4, range 2–5). In sum, we have developed the first validated BCS index for African elephants. This tool can be used to examine which factors impact body condition in zoo and free-ranging elephants, providing valuable information on how it affects health and reproductive potential of individual elephants. PMID:24718304

  11. Development of a body condition scoring index for female African elephants validated by ultrasound measurements of subcutaneous fat.

    PubMed

    Morfeld, Kari A; Lehnhardt, John; Alligood, Christina; Bolling, Jeff; Brown, Janine L

    2014-01-01

    Obesity-related health and reproductive problems may be contributing to non-sustainability of zoo African elephant (Loxodonta africana) populations. However, a major constraint in screening for obesity in elephants is lack of a practical method to accurately assess body fat. Body condition scoring (BCS) is the assessment of subcutaneous fat stores based on visual evaluation and provides an immediate appraisal of the degree of obesity of an individual. The objective of this study was to develop a visual BCS index for female African elephants and validate it using ultrasound measures of subcutaneous fat. To develop the index, standardized photographs were collected from zoo (n = 50) and free-ranging (n = 57) female African elephants for identifying key body regions and skeletal features, which were then used to visually determine body fat deposition patterns. This information was used to develop a visual BCS method consisting of a list of body regions and the physical criteria for assigning an overall score on a 5-point scale, with 1 representing the lowest and 5 representing the highest levels of body fat. Results showed that as BCS increased, ultrasound measures of subcutaneous fat thickness also increased (P<0.01), indicating the scores closely coincide with physical measures of fat reserves. The BCS index proved to be reliable and repeatable based on high intra- and inter-assessor agreement across three assessors. In comparing photographs of wild vs. captive African elephants, the median BCS in the free-ranging individuals (BCS = 3, range 1-5) was lower (P<0.001) than that of the zoo population (BCS = 4, range 2-5). In sum, we have developed the first validated BCS index for African elephants. This tool can be used to examine which factors impact body condition in zoo and free-ranging elephants, providing valuable information on how it affects health and reproductive potential of individual elephants.

  12. Measurement of compartment elasticity using pressure related ultrasound: a method to identify patients with potential compartment syndrome.

    PubMed

    Sellei, R M; Hingmann, S J; Kobbe, P; Weber, C; Grice, J E; Zimmerman, F; Jeromin, S; Gansslen, A; Hildebrand, F; Pape, H C

    2015-01-01

    PURPOSE OF THE STUDY Decision-making in treatment of an acute compartment syndrome is based on clinical assessment, supported by invasive monitoring. Thus, evolving compartment syndrome may require repeated pressure measurements. In suspected cases of potential compartment syndromes clinical assessment alone seems to be unreliable. The objective of this study was to investigate the feasibility of a non-invasive application estimating whole compartmental elasticity by ultrasound, which may improve accuracy of diagnostics. MATERIAL AND METHODS In an in-vitro model, using an artificial container simulating dimensions of the human anterior tibial compartment, intracompartmental pressures (p) were raised subsequently up to 80 mm Hg by infusion of saline solution. The compartmental depth (mm) in the cross-section view was measured before and after manual probe compression (100 mm Hg) upon the surface resulting in a linear compartmental displacement (Δd). This was repeated at rising compartmental pressures. The resulting displacements were related to the corresponding intra-compartmental pressures simulated in our model. A hypothesized relationship between pressures related compartmental displacement and the elasticity at elevated compartment pressures was investigated. RESULTS With rising compartmental pressures, a non-linear, reciprocal proportional relation between the displacement (mm) and the intra-compartmental pressure (mm Hg) occurred. The Pearson's coefficient showed a high correlation (r2 = -0.960). The intraobserver reliability value kappa resulted in a statistically high reliability (κ = 0.840). The inter-observer value indicated a fair reliability (κ = 0.640). CONCLUSIONS Our model reveals that a strong correlation between compartmental strain displacements assessed by ultrasound and the intra-compartmental pressure changes occurs. Further studies are required to prove whether this assessment is transferable to human muscle tissue. Determining the complete

  13. Experimental and clinical trial of measuring urinary velocity with the pitot tube and a transrectal ultrasound guided video urodynamic system.

    PubMed

    Tsujimoto, Yukio; Nose, Yorihito; Ohba, Kenkichi

    2003-01-01

    The pitot tube is a common device to measure flow velocity. If the pitot tube is used as an urodynamic catheter, urinary velocity and urethral pressure may be measured simultaneously. However, to our knowledge, urodynamic studies with the pitot tube have not been reported. We experimentally and clinically evaluated the feasibility of the pitot tube to measure urinary velocity with a transrectal ultrasound guided video urodynamic system. We carried out a basal experiment measuring flow velocity in model urethras of 4.5-8.0 mm in inner diameter with a 12-Fr pitot tube. In a clinical trial, 79 patients underwent transrectal ultrasound guided video urodynamic studies with the 12-Fr pitot tube. Urinary velocity was calculated from dynamic pressure (Pd) with the pitot tube formula and the correcting equation according to the results of the basal experiment. Velocity measured by the pitot tube was proportional to the average velocity in model urethras and the coefficients were determined by diameters of model urethras. We obtained a formula to calculate urinary velocity from the basal experiment. The urinary velocity could be obtained in 32 of 79 patients. Qmax was 8.1 +/- 4.3 mL/s (mean +/- SD; range, 18.4-1.3 mL/s), urethral diameter was 7.3 +/- 3.0 mm (mean +/- SD; range, 18.7-4.3 mm) and urinary velocity was 69.4 +/- 43.6 (mean +/- SD; range, 181.3-0 cm/s) at maximum flow rate. The correlation coefficient of Qmax measured by a flowmeter versus Qdv flow rate calculated with urethral diameter and velocity was 0.41 without significant difference. The use of the pitot tube as an urodynamic catheter to a transrectal ultrasound-guided video urodynamic system can measure urethral pressure, diameter and urinary velocity simultaneously. However, a thinner pitot tube and further clinical trials are needed to obtain more accurate results.

  14. Quantitative ultrasound method for assessing stress-strain properties and the cross-sectional area of Achilles tendon

    NASA Astrophysics Data System (ADS)

    Du, Yi-Chun; Chen, Yung-Fu; Li, Chien-Ming; Lin, Chia-Hung; Yang, Chia-En; Wu, Jian-Xing; Chen, Tainsong

    2013-12-01

    The Achilles tendon is one of the most commonly observed tendons injured with a variety of causes, such as trauma, overuse and degeneration, in the human body. Rupture and tendinosis are relatively common for this strong tendon. Stress-strain properties and shape change are important biomechanical properties of the tendon to assess surgical repair or healing progress. Currently, there are rather limited non-invasive methods available for precisely quantifying the in vivo biomechanical properties of the tendons. The aim of this study was to apply quantitative ultrasound (QUS) methods, including ultrasonic attenuation and speed of sound (SOS), to investigate porcine tendons in different stress-strain conditions. In order to find a reliable method to evaluate the change of tendon shape, ultrasound measurement was also utilized for measuring tendon thickness and compared with the change in tendon cross-sectional area under different stress. A total of 15 porcine tendons of hind trotters were examined. The test results show that the attenuation and broadband ultrasound attenuation decreased and the SOS increased by a smaller magnitude as the uniaxial loading of the stress-strain upon tendons increased. Furthermore, the tendon thickness measured with the ultrasound method was significantly correlated with tendon cross-sectional area (Pearson coefficient = 0.86). These results also indicate that attenuation of QUS and ultrasonic thickness measurement are reliable and potential parameters for assessing biomechanical properties of tendons. Further investigations are needed to warrant the application of the proposed method in a clinical setting.

  15. The role of abdominal ultrasound in the diagnosis of typhoid fever: an observational study.

    PubMed

    Younis, Saeed Nadhim

    2014-01-01

    To study the usefulness of abdominal ultrasound in the diagnosis of typhoid fever and to determine the common ultrasound findings early in the course of the disease. Abdominal ultrasound examination was performed within the first week of initiation of symptoms in 350 cases with clinical diagnosis of typhoid fever. Subsequent ultrasound follow-up examination was done 15 days later (beginning of the third week). All the patients proved to have positive Widal test and Sallmonella culture. The study was performed in Erbil-Iraq from the period January 1993 to October 2010. The following ultrasound findings were reported: hepatomegaly (31.4%), prominent intrahepatic bile ducts (64.85%), splenomegaly (100%), mesenteric lymphadenopathy (42.85%), bowel wall thickening (35.71%), acalculous cholecystitis (16.28%), perforations (1.14%), and ascites in (3.4%). The current study showed that the findings are typical enough to justify initiation of treatment for typhoid fever when serology is equivocal and culture is negative, and is fairly safe to say that normal ultrasound examination early in the course of febrile illness rules out typhoid fever. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Contrast-enhanced ultrasound measurement of pancreatic blood flow dynamics predicts type 1 diabetes progression in preclinical models.

    PubMed

    St Clair, Joshua R; Ramirez, David; Passman, Samantha; Benninger, Richard K P

    2018-05-01

    In type 1 diabetes (T1D), immune-cell infiltration into the islets of Langerhans (insulitis) and β-cell decline occurs many years before diabetes clinically presents. Non-invasively detecting insulitis and β-cell decline would allow the diagnosis of eventual diabetes, and provide a means to monitor therapeutic intervention. However, there is a lack of validated clinical approaches for specifically and non-invasively imaging disease progression leading to T1D. Islets have a denser microvasculature that reorganizes during diabetes. Here we apply contrast-enhanced ultrasound measurements of pancreatic blood-flow dynamics to non-invasively and predictively assess disease progression in T1D pre-clinical models. STZ-treated mice, NOD mice, and adoptive-transfer mice demonstrate altered islet blood-flow dynamics prior to diabetes onset, consistent with islet microvasculature reorganization. These assessments predict both time to diabetes onset and future responders to antiCD4-mediated disease prevention. Thus contrast-enhanced ultrasound measurements of pancreas blood-flow dynamics may provide a clinically deployable predictive marker for disease progression in pre-symptomatic T1D and therapeutic reversal.

  17. High Intensity Focused Ultrasound: A Novel Model of Mild Traumatic Brain Injury

    DTIC Science & Technology

    2013-11-07

    RE, Melo B, Christensen B, Ngo L-A, Monette G, Bradbury C. 2008. Measuring premorbid IQ in traumatic brain injury: An examination of the validity of...High Intensity Focused Ultrasound: A Novel Model of Mild Traumatic Brain Injury by Brendan J. Finton Thesis...Mild Traumatic Brain Injury" is appropriately acknowledged and, beyond brief excerpts, is with the permission of the copyright owner. Brendan J

  18. How to set up a low cost tele-ultrasound capable videoconferencing system with wide applicability

    PubMed Central

    2012-01-01

    Background Worldwide ultrasound equipment accessibility is at an all-time high, as technology improves and costs decrease. Ensuring that patients benefit from more accurate resuscitation and diagnoses from a user-dependent technology, such as ultrasound, requires accurate examination, typically entailing significant training. Remote tele-mentored ultrasound (RTUS) examination is, however, a technique pioneered in space medicine that has increased applicability on earth. We, thus, sought to create and demonstrate a cost-minimal approach and system with potentially global applicability. Methods The cost-minimal RTUS system was constructed by utilizing a standard off-the-shelf laptop computer that connected to the internet through an internal wireless receiver and/or was tethered through a smartphone. A number of portable hand-held ultrasound devices were digitally streamed into the laptop utilizing a video converter. Both the ultrasound video and the output of a head-mounted video camera were transmitted over freely available Voice Over Internet Protocol (VOIP) software to remote experts who could receive and communicate using any mobile device (computer, tablet, or smartphone) that could access secure VOIP transmissions from the internet. Results The RTUS system allowed real-time mentored tele-ultrasound to be conducted from a variety of settings that were inside buildings, outside on mountainsides, and even within aircraft in flight all unified by the simple capability of receiving and transmitting VOIP transmissions. . Numerous types of ultrasound examinations were conducted such as abdominal and thoracic examinations with a variety of users mentored who had previous skills ranging from none to expert. Internet connectivity was rarely a limiting factor, with competing logistical and scheduling demands of the participants predominating. Conclusions RTUS examinations can educate and guide point of care clinical providers to enhance their use of ultrasound. The scope

  19. Diagnosis of Complex Pulley Ruptures Using Ultrasound in Cadaver Models.

    PubMed

    Schöffl, Isabelle; Hugel, Arnica; Schöffl, Volker; Rascher, Wolfgang; Jüngert, Jörg

    2017-03-01

    Pulley ruptures are common in climbing athletes. The purposes of this study were to determine the specific positioning of each pulley with regards to the joint, and to evaluate the ultrasound diagnostics of various pulley rupture combinations. For this, 34 cadaver fingers were analyzed via ultrasound, the results of which were compared to anatomic measurements. Different pulley ruptures were then simulated and evaluated using ultrasound in standardized dynamic forced flexion. Visualization of the A2 and A4 pulleys was achieved 100% of the time, while the A3 pulley was visible in 74% of cases. Similarly, injuries to the A2 and A4 pulleys were readily observable, while A3 pulley injuries were more challenging to identify (sensitivity of 0.2 for singular A3 pulley, 0.5 for A2/A4 pulley and 0.33 for A3/A4 pulley ruptures). Receiver operating characteristic analysis was used to evaluate the optimal tendon-bone distance for pulley rupture diagnosis, a threshold which was determined to be 1.9 mm for A2 pulley ruptures and 1.85 for A4 pulley ruptures. This study was the first to carry out a cadaver ultrasound examination of a wide variety of pulley ruptures. Ultrasound is a highly accurate tool for visualizing the A2 and A4 pulleys in a cadaver model. This method of pathology diagnosis was determined to be suitable for injuries to the A2 and A4 pulleys, but inadequate for A3 pulley injuries. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  20. Characterization of fetal growth by repeated ultrasound measurements in the wild guinea pig (Cavia aperea).

    PubMed

    Schumann, K; Guenther, A; Göritz, F; Jewgenow, K

    2014-08-01

    Fetal growth during pregnancy has previously been studied in the domesticated guinea pig (Cavia aperea f. porcellus) after dissecting pregnant females, but there are no studies describing the fetal growth in their wild progenitor, the wild guinea pig (C aperea). In this study, 50 pregnancies of wild guinea pig sows were investigated using modern ultrasound technique. The two most common fetal growth parameters (biparietal diameter [BPD] and crown-rump-length [CRL]) and uterine position were measured. Data revealed similar fetal growth patterns in the wild guinea pig and domesticated guinea pig in the investigated gestation period, although they differ in reproductive milestones such as gestation length (average duration of pregnancy 68 days), average birth weight, and litter mass. In this study, pregnancy lasted on average 60.2 days with a variance of less than a day (0.96 days). The measured fetal growth parameters are strongly correlated with each (R = 0.91; P < 0.001) other and with gestational age (BPD regression equation y = 0.04x - 0.29; P < 0.001 and CRL regression equation y = 0.17x - 2.21; P < 0.01). Furthermore, fetuses in the most frequent uterine positions did not differ in their growth parameters and were not influenced by the mother ID. Our results imply that ultrasound measurement of a single fetal growth parameter is sufficient to reliably estimate gestational age in the wild guinea pig. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. 3D ultrasound imaging in image-guided intervention.

    PubMed

    Fenster, Aaron; Bax, Jeff; Neshat, Hamid; Cool, Derek; Kakani, Nirmal; Romagnoli, Cesare

    2014-01-01

    Ultrasound imaging is used extensively in diagnosis and image-guidance for interventions of human diseases. However, conventional 2D ultrasound suffers from limitations since it can only provide 2D images of 3-dimensional structures in the body. Thus, measurement of organ size is variable, and guidance of interventions is limited, as the physician is required to mentally reconstruct the 3-dimensional anatomy using 2D views. Over the past 20 years, a number of 3-dimensional ultrasound imaging approaches have been developed. We have developed an approach that is based on a mechanical mechanism to move any conventional ultrasound transducer while 2D images are collected rapidly and reconstructed into a 3D image. In this presentation, 3D ultrasound imaging approaches will be described for use in image-guided interventions.

  2. Comparison of central corneal thickness measurement using ultrasonic pachymetry, rotating Scheimpflug camera, and scanning-slit topography.

    PubMed

    Sedaghat, Mohammad Reza; Daneshvar, Ramin; Kargozar, Abbas; Derakhshan, Akbar; Daraei, Mona

    2010-12-01

    To evaluate and compare central corneal thickness measurements using rotating Scheimpflug camera, scanning-slit topography, and ultrasound pachymetry in virgin, healthy corneas. Prospective, observational, cross-sectional study. Central corneal thickness in 157 healthy eyes of 157 patients without ocular abnormalities other than refractive errors was measured, in a sequential order, once with rotating Scheimpflug camera and scanning-slit topography and 3 times with ultrasound pachymetry as the last part of examination. All measurements were performed by a single experienced examiner. The results from scanning-slit topography are given with and without correction for "acoustic correction factor" of 0.92. The average measurements of central corneal thickness by rotating Scheimpflug imaging, scanning-slit pachymetry, and ultrasound were 537.15 ± 32.98 μm, 542.06 ± 39.04 μm, and 544.07 ± 34.75 μm, respectively. The mean differences between modalities were 6.92 μm between rotating Scheimpflug and ultrasound (P < .0001), 2.01 μm between corrected scanning-slit and ultrasound (P = .204), and 4.91 μm between corrected scanning-slit and rotating Scheimpflug imaging (P = .001). According to Bland-Altman analysis, highest agreement was between ultrasonic and rotating Scheimpflug pachymetry. In the assessment of normal corneas, rotating Scheimpflug topography measures central corneal thickness values with higher agreement to ultrasound pachymetry. Copyright © 2010 Elsevier Inc. All rights reserved.

  3. Comparison of postoperative refractive outcomes: IOLMaster® versus immersion ultrasound.

    PubMed

    Whang, Woong-Joo; Jung, Byung-Ju; Oh, Tae-Hoon; Byun, Yong-Soo; Joo, Choun-Ki

    2012-01-01

    To compare the postoperative refractive outcomes between IOLMaster biometry (Carl Zeiss Meditec, Inc., Dublin, CA) and immersion ultrasound biometry for axial length measurements. Refractive outcomes in 354 eyes were compared using the IOLMaster and the immersion ultrasound biometry. Predicted refraction was determined using manual keratometry and the SRK-T formula with personalized A-constant. The axial lengths measured using the IOLMaster and immersion ultrasound were 24.49 ± 2.11 and 24.46 ± 2.11 mm, respectively, and the difference was significant (P < .05). The mean errors were 0.000 ± 0.578 D with the IOLMaster, and 0.000 ± 0.599 D with the immersion ultrasound, but the difference was not significant. The mean absolute error was smaller with the IOLMaster than with immersion ultrasound (0.463 ± 0.341 vs 0.479 ± 0.359 D), but the difference was not significant. IOLMaster biometry yields highly accurate results in cataract surgery. However, if the IOLMaster is unavailable, immersion ultrasound biometry with personalized intraocular lens constants is an acceptable alternative. Copyright 2012, SLACK Incorporated.

  4. Automatic segmentation of vessels in in-vivo ultrasound scans

    NASA Astrophysics Data System (ADS)

    Tamimi-Sarnikowski, Philip; Brink-Kjær, Andreas; Moshavegh, Ramin; Arendt Jensen, Jørgen

    2017-03-01

    Ultrasound has become highly popular to monitor atherosclerosis, by scanning the carotid artery. The screening involves measuring the thickness of the vessel wall and diameter of the lumen. An automatic segmentation of the vessel lumen, can enable the determination of lumen diameter. This paper presents a fully automatic segmentation algorithm, for robustly segmenting the vessel lumen in longitudinal B-mode ultrasound images. The automatic segmentation is performed using a combination of B-mode and power Doppler images. The proposed algorithm includes a series of preprocessing steps, and performs a vessel segmentation by use of the marker-controlled watershed transform. The ultrasound images used in the study were acquired using the bk3000 ultrasound scanner (BK Ultrasound, Herlev, Denmark) with two transducers "8L2 Linear" and "10L2w Wide Linear" (BK Ultrasound, Herlev, Denmark). The algorithm was evaluated empirically and applied to a dataset of in-vivo 1770 images recorded from 8 healthy subjects. The segmentation results were compared to manual delineation performed by two experienced users. The results showed a sensitivity and specificity of 90.41+/-11.2 % and 97.93+/-5.7% (mean+/-standard deviation), respectively. The amount of overlap of segmentation and manual segmentation, was measured by the Dice similarity coefficient, which was 91.25+/-11.6%. The empirical results demonstrated the feasibility of segmenting the vessel lumen in ultrasound scans using a fully automatic algorithm.

  5. Noncontact ultrasound imaging applied to cortical bone phantoms

    PubMed Central

    Bulman, J. B.; Ganezer, K. S.; Halcrow, P. W.; Neeson, Ian

    2012-01-01

    1%–2%. Transmittance images of cortical bone phantoms showed differences in the nominal overall BMD values of the phantoms that were large enough to be distinguished by a visual examination. A list of possible sources of errors in quantitative NCU was also included in this study. Conclusions: The results of this paper suggest that NCU might find additional applications in medical imaging, beyond its original and only previous usage in assessing third degree burns. The fact that the authors’ phantom measurements using conventional, gel coupled ultrasound are in agreement with those obtained with NCU demonstrates that in spite of large additional levels of attenuation of up to 150 dB and new error sources, NCU could have comparable levels of accuracy to those of conventional quantitative ultrasound, while providing the medical and patient comfort-related advantages of not involving direct contact. PMID:22755697

  6. Ultrasound as a monitoring tool for cystic echinococcosis in sheep.

    PubMed

    Dore, F; Varcasia, A; Pipia, A P; Sanna, G; Pinna Parpaglia, M L; Corda, A; Romig, T; Scala, A

    2014-06-16

    An ultrasound-based survey for cystic echinococcosis (CE) in sheep was carried out in Sardinia in 2012. The study was done on three farms (A, B, C) which had been pre-selected for different CE prevalence levels (A: >80%, B: 50-80%, C: <50%). In total, 129 sheep were examined on the farms using portable ultrasound equipment (A: n=51, B: n=30, C: n=48). Within a period of 20 days after ultrasound examination, all sheep were slaughtered and underwent a parasitological post-mortem examination for cysts in the liver and lungs. With post-mortem as gold standard, ultrasonography gave a test sensitivity of 88.7% and a specificity of 75.9%, while the positive and negative predictive values were 81.8% and 84.6%, respectively. When only sheep with fertile cysts were considered, the sensitivity of the test increased to 100%. We conclude that the ultrasound examination of the liver in sheep - using state-of-the-art technology - is a sensitive and specific diagnostic tool, which is cost-effective, highly appropriate for field use and requires only moderate time (no shaving required). The method can also be applied to other livestock species and will be useful tool in epidemiological studies, monitoring schemes and vaccination/control trials. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. [The effect of focused ultrasound on the physicochemical properties of Sarcoma 180 cell membrane].

    PubMed

    Li, Tao; Hao, Qiao; Wang, Xiaobing; Liu, Quanhong

    2009-10-01

    This study was amied to detect the changes in the cell membrane of Sarcoma 180 (S180) cells induced by focused ultrasound and to probe the underlying mechanism. The viability of tumor cells was examined at various intensities and different treatment times by ultrasound at the frequency of 2.2MHz. Flow cytometry and fluorescence microscopy were used to detect the loading of fluorescein isothiocyanate dextran (FD500) which signifies the change of membrane permeability. The results showed that after the cells were treated by ultrasound, especially when irradiated for 60s, the number of fluorescent cell, which represented the transient change of membrane permeabilization with cell survival, increased significantly. Then the damage of cell membrane was evaluated by the measurement of lactate dehydrogenase (LDH) release which became more severe as the radiation time was increasing. The generation of lipid peroxidation was estimated using the Thibabituric Acid (TBA) method after irradiation. The results reveal that the instant cell damage effects induced by ultrasound may be related to the improved membrane lipid peroxidation levels post-treatment. The physicochemical properties of S180 cell membrane were changed by focused ultrasound. The findings also imply an exposure time-dependent pattern and suggest that the lipid peroxidation produced by acoustic cavitation may play important roles in these actions.

  8. Motion Detection in Ultrasound Image-Sequences Using Tensor Voting

    NASA Astrophysics Data System (ADS)

    Inba, Masafumi; Yanagida, Hirotaka; Tamura, Yasutaka

    2008-05-01

    Motion detection in ultrasound image sequences using tensor voting is described. We have been developing an ultrasound imaging system adopting a combination of coded excitation and synthetic aperture focusing techniques. In our method, frame rate of the system at distance of 150 mm reaches 5000 frame/s. Sparse array and short duration coded ultrasound signals are used for high-speed data acquisition. However, many artifacts appear in the reconstructed image sequences because of the incompleteness of the transmitted code. To reduce the artifacts, we have examined the application of tensor voting to the imaging method which adopts both coded excitation and synthetic aperture techniques. In this study, the basis of applying tensor voting and the motion detection method to ultrasound images is derived. It was confirmed that velocity detection and feature enhancement are possible using tensor voting in the time and space of simulated ultrasound three-dimensional image sequences.

  9. Assistive technology for ultrasound-guided central venous catheter placement.

    PubMed

    Ikhsan, Mohammad; Tan, Kok Kiong; Putra, Andi Sudjana

    2018-01-01

    This study evaluated the existing technology used to improve the safety and ease of ultrasound-guided central venous catheterization. Electronic database searches were conducted in Scopus, IEEE, Google Patents, and relevant conference databases (SPIE, MICCAI, and IEEE conferences) for related articles on assistive technology for ultrasound-guided central venous catheterization. A total of 89 articles were examined and pointed to several fields that are currently the focus of improvements to ultrasound-guided procedures. These include improving needle visualization, needle guides and localization technology, image processing algorithms to enhance and segment important features within the ultrasound image, robotic assistance using probe-mounted manipulators, and improving procedure ergonomics through in situ projections of important information. Probe-mounted robotic manipulators provide a promising avenue for assistive technology developed for freehand ultrasound-guided percutaneous procedures. However, there is currently a lack of clinical trials to validate the effectiveness of these devices.

  10. Meta-analysis of Pentacam vs. ultrasound pachymetry in central corneal thickness measurement in normal, post-LASIK or PRK, and keratoconic or keratoconus-suspect eyes.

    PubMed

    Wu, Wenjing; Wang, Yan; Xu, Lulu

    2014-01-01

    The aim of this meta-analysis is to evaluate the central corneal thickness (CCT) measurement differences between Pentacam (Oculus Inc., Germany) and Ultrasound Pachymetry (USP) in normal (unoperated eyes , myopic and astigmatic eyes without corneal disease or topographic irregularity), after laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK), and keratoconic or keratoconus suspected eyes. We assess whether Pentacam and USP have similar CCT differences in normal, thinner corneas after LASIK or PRK procedures, and kerotoconic or keratoconus suspected eyes. Data sources, including PubMed, Medline, EMBASE, and Cochrane Central Registry of Controlled Trials on the Cochrane Library, were searched to find the relevant studies. Primary outcome measures were CCT measurement between Pentacam and USP. Three groups of eyes were analyzed: normal; LASIK or PRK eyes; and keratoconus suspected or keratoconic eyes. Nineteen studies describing 1,908 eyes were enrolled in the normal group. Pentacam results were 1.47 μm ,95 % confidence interval (CI) -2.32 to 5.27, higher than USP without statistically significant difference (P = 0.45). Nine studies with total 539 eyes were included in the corneas after LASIK or PRK. The mean difference in the CCT measurement with Pentacam and ultrasound pachymetry was 1.03 μm, with the 95 % CI -3.36 to 5.42, there was no statistically difference (P = 0.64). Four studies with a total of 185 eyes were included in the keratoconic eyes or keratoconus-suspect group, however,the mean difference was -6.33 μm (95 % CI -9.17 to-3.49), which was statistically different between Pentacam and ultrasound pachymetry in the CCT measurement (P < 0.0001). Pentacam offers similar CCT results to ultrasound pachymetry in normal eyes, thinner corneas after LASIK or PRK procedures. However, in keratoconic or keratoconus-suspect eyes, Pentacam slightly underestimates the central corneal thickness than does ultrasound pachymetry

  11. The potential of ultrasound in cardiac pacing and rhythm modulation.

    PubMed

    Kohut, Andrew R; Vecchio, Christopher; Adam, Dan; Lewin, Peter A

    2016-09-01

    This review examines the potential for ultrasound to induce or otherwise influence cardiac pacing and rhythm modulation. Of particular interest is the possibility of developing new, truly non-invasive, nonpharmacological, acute and chronic, ultrasound-based arrhythmia treatments. Such approaches would not depend upon implanted or indwelling devices of any kind and would use ultrasound at diagnostic exposure levels (so as not to harm the heart or surrounding tissues). It is known that ultrasound can cause cardiomyocyte depolarization and a variety of underlying mechanisms have been proposed. Expert commentary: Questions still remain regarding the effect of exposure parameters and work will also be necessary to identify the optimal target regions within the heart if ultrasound energy is to be used to induce safe and reliable pacing in a clinical setting.

  12. Intra- and interobserver reliability of quantitative ultrasound measurement of the plantar fascia.

    PubMed

    Rathleff, Michael Skovdal; Moelgaard, Carsten; Lykkegaard Olesen, Jens

    2011-01-01

    To determine intra- and interobserver reliability and measurement precision of sonographic assessment of plantar fascia thickness when using one, the mean of two, or the mean of three measurements. Two experienced observers scanned 20 healthy subjects twice with 60 minutes between test and retest. A GE LOGIQe ultrasound scanner was used in the study. The built-in software in the scanner was used to measure the thickness of the plantar fascia (PF). Reliability was calculated using intraclass correlation coefficient (ICC) and limits of agreement (LOA). Intraobserver reliability (ICC) using one measurement was 0.50 for one observer and 0.52 for the other, and using the mean of three measurements intraobserver reliability increased up to 0.77 and 0.67, respectively. Interobserver reliability (ICC) when using one measurement was 0.62 and increased to 0.82 when using the average of three measurements. LOA showed that when using the average of three measurements, LOA decreased to 0.6 mm, corresponding to 17.5% of the mean thickness of the PF. The results showed that reliability increases when using the mean of three measurements compared with one. Limits of agreement based on intratester reliability shows that changes in thickness that are larger than 0.6 mm can be considered actual changes in thickness and not a result of measurement error. Copyright © 2011 Wiley Periodicals, Inc.

  13. Use of Ultrasound Elastography in the Assessment of the Musculoskeletal System.

    PubMed

    Paluch, Łukasz; Nawrocka-Laskus, Ewa; Wieczorek, Janusz; Mruk, Bartosz; Frel, Małgorzata; Walecki, Jerzy

    2016-01-01

    This article presents possible applications of ultrasound elastography in musculoskeletal imaging based on the available literature, as well as the possibility of extending indications for the use of elastography in the future. Ultrasound elastography (EUS) is a new method that shows structural changes in tissues following application of physical stress. Elastography techniques have been widely used to assess muscles and tendons in vitro since the early parts of the twentieth century. Only recently with the advent of new technology and creation of highly specialized ultrasound devices, has elastography gained widespread use in numerous applications. The authors performed a search of the Medline/PubMed databases for original research and reviewed publications on the application of ultrasound elastography for musculoskeletal imaging. All publications demonstrate possible uses of ultrasound elastography in examinations of the musculoskeletal system. The most widely studied areas include the muscles, tendons and rheumatic diseases. There are also reports on the employment in vessel imaging. The main limitation of elastography as a technique is above all the variability of applied pressure during imaging, which is operator-dependent. It would therefore be reasonable to provide clear guidelines on the technique applied, as well as clear indications for performing the test. It is important to develop methods for creating artifact-free, closed-loop, compression-decompression cycles. The main advantages include cost-effectiveness, short duration of the study, non-invasive nature of the procedure, as well as a potentially broader clinical availability. There are no clear guidelines with regard to indications as well as examination techniques. Ultrasound elastography is a new and still poorly researched method. We conclude, however, that it can be widely used in the examinations of musculoskeletal system. Therefore, it is necessary to conduct large, multi-center studies to

  14. Development of ultrasound focusing discrete array for air-coupled ultrasound generation

    NASA Astrophysics Data System (ADS)

    Korobov, Alexander I.; Izosimova, Maria Y.; Toschov, Sergey A.

    2010-01-01

    The technique and results of synthesis of ultrasound focusing discrete arrays for air-coupled ultrasound generation are presented. One of the arrays is an antenna 22 cm in diameter. It consists of 60 transmitters of Murata Company. The resonant frequency of each transmitter is 40 kHz, diameter is 16 mm. The transmitters were placed in first four Fresnel zones. Each of the zones was emitting with anti-phases. Position data and pressure field in focus were calculated using Rayleigh integral. Parameters of made array were measured using method of air-coupled vibrometry with laser scanning vibrometer. Measured parameters (operating frequency is 40 ± 1 kHz, focal distance is 308 mm, size of focal spot is 16.3 mm, and pressure in focus is about 150 dB) are in good agreement with calculated data. The examples of use of designed arrays for noncontact non-destructive diagnostics of some structural materials are reported. Work supported by RFBR.

  15. Handheld ultrasound versus physical examination in patients referred for transthoracic echocardiography for a suspected cardiac condition.

    PubMed

    Mehta, Manish; Jacobson, Timothy; Peters, Dawn; Le, Elizabeth; Chadderdon, Scott; Allen, Allison J; Caughey, Aaron B; Kaul, Sanjiv

    2014-10-01

    The purpose of this study was to test the hypothesis that handheld ultrasound (HHU) provides a more accurate diagnosis than physical examination in patients with suspected cardiovascular abnormalities and that its use thus reduces additional testing and overall costs. Despite the limitations of physical examination and the demonstrated superiority of HHU for detecting cardiac abnormalities, it is not routinely used for the bedside diagnosis of cardiac conditions. Patients referred for a standard echocardiogram for common indications (cardiac function, murmur, stroke, arrhythmias, and miscellaneous) underwent physical examination and HHU by different cardiologists, who filled out a form that also included suggestions for additional testing, if necessary, based on their findings. Of 250 patients, 142 had an abnormal finding on standard echocardiogram. Of these, HHU correctly identified 117 patients (82%), and physical examination correctly identified 67 (47%, p < 0.0001). HHU was superior to physical examination (p < 0.0001) for both normal and abnormal cardiac function. It was also superior to physical examination in correctly identifying the presence of substantial valve disease (71% vs. 31%, p = 0.0003) and in identifying miscellaneous findings (47% vs. 3%, p < 0.0001). Of 108 patients without any abnormalities on standard echocardiography, further testing was suggested for 89 (82%) undergoing physical examination versus only 60 (56%) undergoing HHU (p < 0.0001). Cost modeling showed that HHU had an average cost of $644.43 versus an average cost of $707.44 for physical examination. This yielded a savings of $63.01 per patient when HHU was used versus physical examination. When used by cardiologists, HHU provides a more accurate diagnosis than physical examination for the majority of common cardiovascular abnormalities. The finding of no significant abnormality on HHU is also likely to result in less downstream testing and thus potentially reduce the overall cost

  16. I Vivo Quantitative Ultrasound Imaging and Scatter Assessments.

    NASA Astrophysics Data System (ADS)

    Lu, Zheng Feng

    There is evidence that "instrument independent" measurements of ultrasonic scattering properties would provide useful diagnostic information that is not available with conventional ultrasound imaging. This dissertation is a continuing effort to test the above hypothesis and to incorporate quantitative ultrasound methods into clinical examinations for early detection of diffuse liver disease. A well-established reference phantom method was employed to construct quantitative ultrasound images of tissue in vivo. The method was verified by extensive phantom tests. A new method was developed to measure the effective attenuation coefficient of the body wall. The method relates the slope of the difference between the echo signal power spectrum from a uniform region distal to the body wall and the echo signal power spectrum from a reference phantom to the body wall attenuation. The accuracy obtained from phantom tests suggests further studies with animal experiments. Clinically, thirty-five healthy subjects and sixteen patients with diffuse liver disease were studied by these quantitative ultrasound methods. The average attenuation coefficient in normals agreed with previous investigators' results; in vivo backscatter coefficients agreed with the results from normals measured by O'Donnell. Strong discriminating power (p < 0.001) was found for both attenuation and backscatter coefficients between fatty livers and normals; a significant difference (p < 0.01) was observed in the backscatter coefficient but not in the attenuation coefficient between cirrhotic livers and normals. An in vivo animal model of steroid hepatopathy was used to investigate the system sensitivity in detecting early changes in canine liver resulting from corticosteroid administration. The average attenuation coefficient slope increased from 0.7 dB/cm/MHz in controls to 0.82 dB/cm/MHz (at 6 MHz) in treated animals on day 14 into the treatment, and the backscatter coefficient was 26times 10^{ -4}cm^{-1}sr

  17. Downstream Imaging Utilization After Emergency Department Ultrasound Interpreted by Radiologists Versus Nonradiologists: A Medicare Claims-Based Study.

    PubMed

    Allen, Bibb; Carrol, L Van; Hughes, Danny R; Hemingway, Jennifer; Duszak, Richard; Rosenkrantz, Andrew B

    2017-04-01

    To study differences in imaging utilization downstream to initial emergency department (ED) ultrasound examinations interpreted by radiologists versus nonradiologists. Using 5% Medicare Research Identifiable Files from 2009 to 2014, we identified episodes where the place of service was "emergency room hospital" and the patient also underwent an ultrasound examination. We determined whether the initial ultrasound was interpreted by a radiologist or nonradiologist and then summed all additional imaging events occurring within 7, 14, and 30 days of each initial ED ultrasound. For each year and each study window, we calculated the mean number of downstream imaging procedures by specialty group. Of 200,357 ED ultrasound events, 163,569 (81.6%) were interpreted by radiologists and 36,788 (18.4%) by nonradiologists. Across all study years, ED patients undergoing ultrasound examinations interpreted by nonradiologists underwent 1.08, 1.22, and 1.34 additional diagnostic imaging studies at 7, 14, and 30 days, respectively (P < .01) compared with when the initial ultrasound examination was interpreted by a radiologist. From 2010 to 2014, the volume of downstream imaging for both radiologists and nonradiologists significantly decreased, with each year resulting in 0.08 fewer imaging examinations (P < .001) 14 days after the ED ultrasound event. Despite that decline, differences in downstream imaging between radiologists and nonradiologists persisted over time. Downstream imaging after an initial ED ultrasound is significantly reduced when the ultrasound examination is interpreted by a radiologist rather than a nonradiologist. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  18. Immediate postpartum ultrasound evaluation for suspected retained placental tissue in patients undergoing manual removal of placenta.

    PubMed

    Weissbach, T; Haikin-Herzberger, E; Bacci-Hugger, K; Shechter-Maor, G; Fejgin, M; Biron-Shental, T

    2015-09-01

    Approximately 1% of term deliveries are complicated by retained products of conception. Untreated, this condition may cause bleeding, infection and intrauterine adhesions. This study assessed whether performing routine bedside uterine ultrasound immediately after manual removal of the placenta reduced the occurrence of undiagnosed, retained products of conception and its associated complications. A retrospective study was conducted using the records of patients who delivered and underwent manual removal of placenta at a single obstetrics center over a 6-year period. The outcomes of patients who were assessed using immediate bedside ultrasound were compared to a similar group who were treated based on clinical evaluation alone. All patients underwent ultrasound examination prior to discharge. Outcome variables included the rate of additional interventions (medical or surgical), abnormal pre-discharge uterine ultrasound findings, postpartum hemorrhage rate, puerperal fever and length of hospital stay. A total of 399 charts were reviewed. Immediate post-procedural ultrasound was performed in 235 patients. The remaining 164 women did not undergo immediate post-procedural ultrasound. All patients underwent an ultrasound examination prior to discharge. Among the patients who had an immediate post-procedural ultrasound, 12 (5.1%) received immediate re-intervention (2 methergine, 6 curettage and 4 manual uterine revision) vs. no intervention in the second group (p<0.001). No statistically significant difference was found between the group of patients who had immediate post-procedural ultrasound and those who did not, in the rates of postpartum hemorrhage (3.1% vs. 0.7%, p=0.13), abnormal ultrasound findings prior to discharge (14.9% vs. 14.8%, p=0.96) or additional late intervention (7.2% vs. 7.9%, p=0.79), respectively. Our findings suggest that immediate, bedside uterine ultrasound examination after manual removal of placenta might not change patient outcomes

  19. In Vivo Validation of Volume Flow Measurements of Pulsatile Flow Using a Clinical Ultrasound System and Matrix Array Transducer.

    PubMed

    Hudson, John M; Williams, Ross; Milot, Laurent; Wei, Qifeng; Jago, James; Burns, Peter N

    2017-03-01

    The goal of this study was to evaluate the accuracy of a non-invasive C-plane Doppler estimation of pulsatile blood flow in the lower abdominal vessels of a porcine model. Doppler ultrasound measurements from a matrix array transducer system were compared with invasive volume flow measurements made on the same vessels with a surgically implanted ultrasonic transit-time flow probe. For volume flow rates ranging from 60 to 750 mL/min, agreement was very good, with a Pearson correlation coefficient of 0.97 (p < 0.0001) and a mean bias of -4.2%. The combination of 2-D matrix array technology and fast processing gives this Doppler method clinical potential, as many of the user- and system-dependent parameters of previous methods, including explicit vessel angle and diameter measurements, are eliminated. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  20. Use of high-resolution ultrasound to measure changes in plantar fascia thickness resulting from tissue creep in runners and walkers.

    PubMed

    Welk, Aaron B; Haun, Daniel W; Clark, Thomas B; Kettner, Norman W

    2015-01-01

    This study sought to use high-resolution ultrasound to measure changes in plantar fascia thickness as a result of tissue creep generated by walking and running. Independent samples of participants were obtained. Thirty-six walkers and 25 runners walked on a treadmill for 10 minutes or ran for 30 minutes, respectively. Standardized measures of the thickness of the plantar fascia were obtained in both groups using high-resolution ultrasound. The mean thickness of the plantar fascia was measured immediately before and after participation. The mean plantar fascia thickness was decreased by 0.06 ± 0.33 mm SD after running and 0.03 ± 0.22 mm SD after walking. The difference between groups was not significant. Although the parameters of this study did not produce significant changes in the plantar fascia thickness, a slightly higher change in the mean thickness of the plantar fascia in the running group deserves further investigation. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.