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Sample records for intraductal ultrasonography combined

  1. Can intraductal ultrasonography (IDUS) predicting the longitudinal extension of intraductal papillary mucinous tumor (IPMT) of the pancreas?

    International Nuclear Information System (INIS)

    Cho, Young Deok; Jang, Jae Young; Cheon, Young Koog; Moon, Jung Ho; Kim, Yun Soo; Lee, Moon Sung; Hur, Kyung Yul; Shim, Chan Sup

    2002-01-01

    The treatment of the choice of IPMT is a partial pancreatic resection with complete excision of this potentially malignant lesion, thus preserving sufficient pancreatic tissue to ensure endocrine and exocrine functions. This strategy, however, requires a reliable preoperative assessment of the highly variable extension of IPMT. We performed this study to determine the role of intraductal ultrasonography (IDUS) in predicting extension of IPMT and selecting the resection methods of pancreas. From January 1997 to August 2001, there were 12 consequent patients, including 5 men and 7 women, with a median age of 54 years (range, 37-66) who underwent a resection of IPMT. A preoperative assessment of IPMT by IDUS was performed in all patients. According to the preoperative localization of IPMT by IDUS, various type of limited pancreatic resections were planned. The frozen sectional histologic examination of pancreatic cut surface was performed in all patient. In the case of cut surface tumor positive, a modification of the planned resection was done.

  2. Usefulness of breast MRI for diagnosing an extensive intraductal component of breast cancer: comparison with mammography and ultrasonography

    International Nuclear Information System (INIS)

    Kim, Tae Hee; Kang, Doo Kyung; Jung, Yong Sik; Yim, Hyun Ee

    2006-01-01

    An extensive intraductal component of breast cancer is a principal risk factor for local recurrence, and this is difficult to diagnose with performing only mammography. We investigated the usefulness of breast MRI for evaluating an extensive intraductal component of breast cancer, and we compared this modality with mammography and ultrasonography (US). From March 2003 to July 2004, 90 patients underwent breast MRI among all the patients who were suffering with breast cancer and for whom and EIC was ultimately revealed to be present or not. A total 83 patients with stage I and II breast cancer were finally included in this study. EIC positivity was defined according to the imaging data as follows: 1) microcalcifications beyond the tumor shadow or malignant microcalcifications without a tumor mass on mammography, 2) tubular hypoechoic structures adjacent to the tumor or architectural distortion with calcifications beyond the tumor on US, and 3) linear or ductal enhancement, segmental or regional clumped enhancement, and spotty nodular or reticular enhancement adjacent to the tumor on MRI. EIC was present in 41 patients and this finding was negative in 42 patients. The results were then compared those results from mammography and US. The sensitivities of detecting EIC by mammography, US and MRI were 48.6%, 67.5% and 80.5%, respectively, and the corresponding specificities were 92.3%, 73.2% and 69.0%, respectively. In the cases that were suspected to be EIC positive on more than two imaging modality, the positive predictive value (PPV) was 78.1%. In cases that were suspected of being EIC positive on just one imaging modality, the negative predictive value (NPV) was 75.0%. Breast MRI provides good information about an EIC of breast cancer and it is a more sensitive study than mammography and US, yet the specificity for the detection of EIC is highest on mammography. A combined evaluation by mammography, US and MRI is the most accurate way to diagnose an EIC of breast

  3. Vascular patterns in nodules of intraductal papillary mucinous neoplasms depicted under contrast-enhanced ultrasonography are helpful for evaluating malignant potential

    International Nuclear Information System (INIS)

    Kurihara, Naoko; Kawamoto, Hirofumi; Kobayashi, Yoshiyuki; Okamoto, Yuko; Yamamoto, Naoki; Tsutsumi, Koichiro; Fujii, Masakuni; Kato, Hironari; Yamamoto, Kazuhide

    2012-01-01

    Objectives: The purpose of this study is to evaluate the feasibility of contrast-enhanced ultrasonography (CE-US) to differentiate between benign and malignant intraductal papillary mucinous neoplasms (IPMN). Patients and methods: Contrast-enhanced ultrasonography with a contrast agent was performed on 22 consecutive patients with IPMN suspected of being malignant. This revealed 10 carcinomas, 1 borderline lesion and 11 adenomas. All patients underwent surgery, and the histological diagnosis was confirmed by examination of resected specimens. CE-US was performed using a contrast agent. The detection rates of mural nodules were compared between CE-US and contrast-enhanced computed tomography (CE-CT), and the imaging of mural nodules depicted under CE-US was analyzed. Results: Seventeen of 22 resected specimens (77.3%) had mural nodules. There was no significant difference in the detection rate between CE-US (n = 15; 88.2%) and CE-CT (n = 12; 70.6%). In 12 (80.0%) of these patients, CE-US revealed small vessels in the mural nodule. The spotty or linear-shaped pattern was detected in 4 patients and the branch-shaped pattern in 8. The branch-shaped pattern lesion was associated with carcinoma. These mural nodules were 10 mm or more in height. In the perfusion image phase, cystic walls and mural nodules were also enhanced in all cases. Conclusion: The vessel shapes of the mural nodules depicted under CE-US were associated with size and pathological findings. These results suggested that CE-US with a contrast agent is a powerful modality with which to evaluate the malignant potential of IPMN.

  4. Ultrasonographic Diagnosis of Intraductal Papilloma

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    Seong, Ki Ho; Cho, Dae Hyoun; Hwang, Mi Soo

    1996-01-01

    To demonstrate the ultrasonographic findings in the diagnosis of intraductal papilloma by comparing it with mammography and ductography. The findings of mammography (n = 22), ultrasonography (n= 15), and ductography (n = 5) were analyzed in 25 women with intraductal papilloma. The mammographic findings were asymmetric focal increase in density (n = 4 : 18%), mass without calcification (n = 6 : 27%), mass with calcification (n = 2 : 9%), and calcification only (n = 1 : 5%). Nine studies (41%) showed no abnormal findings. The ultrasonographic findings were ductal dilatation with a mass (n = 7 : 47%), mass only (n = 5 : 33%),and intra cystic mass (n = 3 : 20%). There is no case of normal findings on ultrasonography. Three ductograms (60%)showed a filling defect within duct : the other two studies were normal. Ultrasonography offers very useful findings in early detecting the intraductal papilloma in conjunction with mammography and ductography

  5. Differential diagnosis between intraductal papillary mucinous neoplasm with an associated invasive carcinoma and pancreatic ductal adenocarcinoma on ultrasonography: the utility of echo intensity and contrast enhancement

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    Saito, Masato [Dept. of Radiology, Sapporo Teishinkai Hospital, Sapporo (Japan); Hirokawa, Naoki; Usami, Yoko; Someya, Masanori; Sakata, Kohichi [Dept. of Radiology, Sapporo Medical University School of Medicine, Sapporo (Japan)

    2017-07-15

    The aim of this study was to investigate the utility of echo intensity and contrast enhancement in the differential diagnosis between intraductal papillary mucinous neoplasm with an associated invasive carcinoma (IPMN-IC) and pancreatic ductal adenocarcinoma (PDAC) on ultrasonography. This study included eight and 37 patients who had pathologically confirmed IPMN-IC and PDAC, respectively, and were enrolled for a comparative analysis of the sonographic features of the tumors. In the quantitative echo intensity evaluation, the two groups were compared with respect to the difference between the tumor intensity and the pancreatic intensity (TI-PI) and between the tumor intensity and the vascular intensity (TI-VI). In the quantitative contrast enhancement evaluation, the increase in echo intensity (ΔTI) and increase in echo intensity per unit of time (slope) were compared between the groups. The echo intensity and contrast enhancement were also compared between the two groups in patients with T3-T4 disease. In addition, the correlations of the histological type, tumor size, stromal type, and T factor with echogenicity and contrast enhancement were analyzed. IPMN-IC had significantly greater echo intensity and contrast enhancement than PDAC (TI-PI, P=0.004; TI-VI, P=0.001; ΔTI, P=0.012; slope, P=0.002). In T3-T4 disease, IPMN-IC also showed greater echo intensity and faster enhancement than PDAC. Echo intensity and contrast enhancement were correlated with histological type (TI-PI, P=0.003; TI-VI, P<0.001; ΔTI, P=0.007; slope, P<0.001). IPMN-IC and PDAC can be differentiated by the quantitative evaluation of echo intensity and contrast enhancement.

  6. Pancreatic cancer screening employing noncontrast magnetic resonance imaging combined with ultrasonography

    International Nuclear Information System (INIS)

    Kuroki-Suzuki, Seiko; Nagashima, Chieko; Machida, Minoru; Muramatsu, Yukio; Moriyama, Noriyuki; Kuroki, Yoshifumi; Nasu, Katsuhiro

    2011-01-01

    We have conducted an initial evaluation on the potential of combining noncontrast magnetic resonance imaging (MRI) and ultrasonography (US) to screen for pancreatic cancer. An independent ethics committee approved this study. A total of 2511 patients who underwent US were enrolled. Among them, noncontrast MRI was performed in patients in whom the entire pancreas was difficult to depict or in those with US-suspected pancreatic lesions. In total, using 1.5-T MRI, T1- and T2-weighted imaging, magnetic resonance cholangiopancreatography, and diffusion-weighted imaging, we acquired a variety of images. The efficacy of US and MRI in screening for pancreatic lesions, including pancreatic cancer, was evaluated. Of 2511 patients, 184 underwent MRI, and the pancreas was demonstrated in all of them. Among the 2511, five pancreatic cancers were detected by MRI combined with US (detection rate 0.20%). Of the five pancreatic cancers, three were detected by US (detection rate 0.12%) and two by MRI. Four of the five pancreatic cancers were resectable. By combining noncontrast MRI with US, pancreatic cancer can be detected with high accuracy. Other pancreatic lesions that require follow-up, including intraductal papillary mucinous neoplasms, can also be detected. Thus, pancreatic cancer screening with a combination of US and MRI is suggested. (author)

  7. Efficacy of percutaneous intraductal radiofrequency ablation combined with biliary stenting in treatment of malignant biliary obstruction

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    ZHANG Kai

    2015-05-01

    Full Text Available ObjectiveTo investigate the safety and feasibility of percutaneous intraductal radiofrequency ablation (palliative therapy in the treatment of malignant obstructive jaundice. MethodsThis study included 20 patients with unresectable malignant obstructive jaundice, who were treated in the First Affiliated Hospital of Zhengzhou University from January 2013 to March 2014. Nine of them (test group underwent percutaneous intraductal radiofrequency ablation plus metallic biliary stent placement. The other 11 similar cases (control group underwent metallic biliary stent placement alone after successful percutaneous transhepatic cholangiography. Operative complications and remission of jaundice were observed, and the stent patency after at 3 and 6 months after operation was evaluated and compared between the two groups. ResultsAll patients were followed completely by outpatient or telephone. The stent patency rate at 3 months after operation was 9/9 in the test group and 8/11 in the control group (χ2=2.888, P=0.218, and the stent patency rates at 6 months were 7/8 and 3/11, respectively (χ2=6.739, P=0.02. During follow-up, one case in the test group died of gastrointestinal bleeding at 113 d after operation; one case in the control group died of liver failure at 57 d after operation and one case died of disseminated intravascular coagulation at 142 d. ConclusionPercutaneous intraductal radiofrequency ablation is safe and feasible in the treatment of malignant biliary obstruction, and the preliminary efficacy in prolonging the patency of self-expanding metallic stent is satisfactory. However, this therapy needs to be further verified via large-sample randomized controlled studies.

  8. The role of multi-detector-row computed tomograph in the diagnosis of intraductal papillary-mucinous tumors of the pancreas in comparison to endoscopic retrograde pancreatography, endoscopic ultrasonography, magnetic resonance cholangiopancreatography

    International Nuclear Information System (INIS)

    Arikawa, Shunji; Uchida, Masafumi; Shinagawa, Masaharu

    2007-01-01

    Thirty patients with intraductal papillary-mucinous tumor (IPMT) of the pancreas underwent multidetector-row CT (MD-CT) in addition to endoscopic retrograde pancreatography (ERP), and, in 27 cases magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography (EUS). The usefulness of MD-CT was investigated by comparing various imaging methods of the communication from the main pancreatic duct (MPD) to patulous/bulging papilla in addition to the indices for benign or malignant disease, the degree of dilation of the MPD, localization and size of cystic lesions, and presence or absence of neoplastic lesions, such as thickened walls and septa, intramural nodule, solid mass. With MD-CT, dilation of the MPD and localization and size of cystic lesions were accurately assessed, even in patients with obstruction of the main pancreatic duct in whom ERP was difficult to perform regardless of the presence or absence of massive amount of mucus. MD-CT with reconstructive imaging, such as multiplanar reformation (MPR) imaging and curred planar reformation (CPR) imaging, allowed us to assess communication with the MPD and patulous/bulging papilla easier than MRCP. In our study, MD-CT was useful in the evaluation of thickened walls and septa that are predictive factors of malignancy in IPMT. (author)

  9. Combination of Juvenile Papillomatosis, Juvenile Fibroadenoma and Intraductal Carcinoma of the Breast in a 15-Year-old Girl.

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    Sedloev, Theophil; Bassarova, Assia; Angelov, Kostadin; Vasileva, Mariela; Asenov, Yavor

    2015-09-01

    The association of juvenile papillomatosis with carcinoma is proven, but very rare, as there exist several reported cases. A 15-year-old girl with no family history of breast cancer presented with two masses in the left breast. The excisional biopsy on both lumps revealed juvenile fibroadenoma and juvenile papillomatosis epithelial proliferation multiple cystic expanded channels. In some of these channels, cytological features of intraductal carcinoma were observed. We performed a full immunohistochemical examination of the juvenile papillomatosis. The patient refused any further surgical or adjuvant treatment. There are no signs of recurrence in the 15 year follow-up. This case is a diagnostic and therapeutic challenge, taking into account the patient's age and the controversial treatment recommendations. Good collaboration between surgeons and pathologists is essential for an accurate diagnostic process and aims to avoid under- or overtreatment. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  10. BREAST INTRADUCTAL PAPILLOMA

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    Shantanu Kumar Sahu; Prashant Kumar Singh; Birinder Pal Singh; Smriti Bhushan; Kush Aeron; Mohanish Sinha; Praveendra Kumar Sachan

    2012-01-01

    Introduction Intraductal papilloma of the breast is characterized by a proliferation of epithelial and myoepithelial cells overlying fibrovascular stalks creating an arborescent structure within the lumen of duct. Case report We present a 36 years female patient with history of bleeding from the nipple of right breast since last 3months. Examination of right nipple revealed bleeding and mammography show a right ductal papilloma. We performed microdochectomy of the involved duct with excision ...

  11. Clinical value analysis of routine ultrasound combined with endoscopic ultrasonography in judging ulcerative colitis

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    Jing-Mei Tuo

    2016-01-01

    Full Text Available Objective: To study the clinical value of routine ultrasound combined with endoscopic ultrasonography in judging ulcerative colitis. Methods: A total of 60 cases of patients with ulcerative colitis were collected as observation group of research and 60 cases of healthy volunteers were collected as control group of research. Intestinal wall thickness was detected by white light endoscopy, abdominal intestinal ultrasound and endoscopic ultrasonography; TNF-α, IL-1β, IL-4 and IL-10 contents were detected by Elisa kit; Th1, Th2, Th17 and Treg ratios were detected by flow cytometry. Results: (1 intestinal wall thickness: intestinal wall thickness of both active UC patients and quiescent UC patients was significantly higher than that of control group, intestinal wall thickness of active UC patients was significantly higher than that of quiescent UC patients and the higher the degree of activity, the higher the intestinal wall thickness; (2 inflammatory mediators: TNF-α and IL-1β contents in intestinal mucosa of active UC patients were higher than those of quiescent UC patients and positively correlated with intestinal wall thickness; IL-4 and IL-10 contents were lower than those of quiescent UC patients and negatively correlated with intestinal wall thickness; (3 T cell contents: Th1 and Th17 cell contents in intestinal mucosa of active UC patients were higher than those of quiescent UC patients and positively correlated with intestinal wall thickness; Th2 and Treg cell contents in intestinal mucosa of active UC patients were lower than those of quiescent UC patients and negatively correlated with intestinal wall thickness. Conclusion: Routine ultrasound combined with endoscopic ultrasonography can accurately determine the severity of ulcerative colitis; measured intestinal wall thickness is closely correlated with the degree of inflammation and abnormal immune response.

  12. Use of Combination Thermal Therapy and Radiation in Breast-Conserving Treatment of Extensive Intraductal Breast Cancer

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    1997-07-01

    dose reirradiation in combination with hyperthermia: a palliative treatment for patients with breast cancer recurring in previously irradiated areas...Additional monitoring: 5.61 The P.I. or a physician designated by the P.I. will be in attendance during every treatment. 5.62 The treatment nurse will...device will obtain blood pressure every 5 minutes. 5.64 General anesthesia cannot be used, but light sedation (e.g. Ativan, Percocet, etc.) can be

  13. Survey of the Role of Combined Screening Method with Ultrasonography in the Diagnosis of Breast Cancer

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    F. Gharekhanloo

    2011-01-01

    Full Text Available Introduction & Objective: The breast cancer is the most common malignancy in women and in recent years it is seen in younger ages. Because of dense breast tissue in these ages, the mammography sensitivity for breast cancer detection is reduced, so high quality ultrasonography (US as a combined screening method is effective. The aim of this study is the evaluation of the mammographic finding with the positive finding of ultrasonogarphy.Materials & Methods: In this cross-sectional study 300 cases were referred to the Mehr Medical Imaging Center for breast US and sonography of breast and axilla was performed. Mammography before or after US was also performed by another radiologist. All suspicious patients were referred for biopsy or surgery.Results: Mean age of patients was 46 y/o with the range of 32-76 y/o. Pathologic specimens approved malignancy in 21 patients and abscess in 1 patient. The most frequent symptom was palpable breast mass with mean diameter of 29 mm. Mean diameter of lymph nodes was 17.3 mm. Positive mammographic findings were seen in 85.7%and negative findings or only an asymmetric density in 14.3%.Conclusion: According to dense breast tissue especially in young women sensitivity of single screening by mammography is reduced in breast cancer detection, so combined screening with sonography and mammography especially in younger women improves the detection rate of breast carcinoma. (Sci J Hamadan Univ Med Sci 2011;17(4:57-60

  14. Diagnosis of thromboembolic disease: combined ventilation perfusion lung scan and compression ultrasonography

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    Dadparvar, S.; Woods, K.; Magno, R.M.; Sabatino, J. C.; Patil, S.; Dou, Y.

    2002-01-01

    The clinical management of pulmonary embolism and deep venous thrombosis of the legs are similar and require prolonged anticoagulation therapy. The standard diagnostic approach in patients suspected of pulmonary embolism is ventilation-perfusion (V/Q) lung scan and compression ultrasonography to detect deep venous thrombosis. This retrospective study analyzed the role of V Q lung scan and compression ultrasonography in detection of thromboembolic disease. One hundred-twenty consecutive patients (65 female, 55 male) age range 18-95 (mean age 60.7) suspected for pulmonary embolism underwent concomitant V/Q lung scan and compression ultrasonography of the lower extremities. The clinical and radiographic correlation was performed. Of patients with non-diagnostic (low or intermediate probability ) lung scans, 15.4 % (14/91) received anticoagulation therapy for pulmonary embolism. This patients had either high pre-clinical suspicion for PE or underwent pulmonary arterio gram. However, there was an additional 7 % (7/91) increase in the number of patients who received anticoagulation therapy based on the results of ultrasound with confidence interval (3 %-16 %). We conclude that V/Q lung scan is a more sensitive examination for thromboembolic disease, and has a high negative predictive value. Ultrasonography of lower extremities demonstrated higher specificity and positive value. Among patients with non-diagnostic lung scan, the detection rate of thromboembolic disease is improved with addition of ultrasound

  15. The combined use of senometry and ultrasonography for breast cancer surgical planning

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    Ștefan Voiculescu

    2017-11-01

    Full Text Available Ultrasound exerts an important role in breast cancer diagnosis protocol, but the use of eco-senometry can also improve therapeutic options, surgical planning and technique. We describe various measurement formulas and techniques that are applied in order to acquire important information regarding the breast and its lesions. Senometry and ultrasonography have been proven to be very effective, reaching up to reliability levels as high as 0.997 and accuracy levels as high as 99.6%. Senometry and ultrasonography have clearly demonstrated their value in breast cancer diagnosis and treatment. These methods are reliable, inexpensive and can be easily performed by the surgeon. More advances in the domain are expected in the future.

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

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

    2017-01-31

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

  17. The value of ultrasonography combined with compression technique in differentiation between benign and malignant breast masses

    International Nuclear Information System (INIS)

    Yoon, Seong Kuk; Lee, Ki Nam; Nam, Kyung Jin; Jung, Won Jung

    2001-01-01

    To determine whether the compression technique is a valuable additional method for differentiating between benign and malignant breast masses. The ultrasonographic findings of 95 benign and 53 malignant masses, all pathologically proven, were prospectively analyzed with regard to five diagnostic criteria: shape (regular/irregular), retrotumoral acoustic phenomena (posterior enhancement/posterior attenuation), internal echo pattern (homogeneous/inhomogeneous), compression effect on shape (distortion/no change), and compression effect on internal echo pattern (more homogeneous/no change). The number of cases of benign and malignant masses, respectively, was as follows: regular/irregular shape: 84/11, 9/44; posterior acoustic enhancement/posterior attenuation: 82/13, 16/37; homogeneous/inhomogeneous internal echo pattern: 78/17, 14/39; distortion/no change in shape: 76/19, 5/48; and more homogeneous/no change in internal echo pattern: 71/24, 3/50. For all diagnostic criteria for the differentiation of benign and malignant masses, the differences were statistically significant (p<.05). Ultrasonography is helpful for differentiating between benign and malignant breast masses. The compression technique is a valuable additional diagnostic method

  18. The Values of Combined and Sub-Stratified Imaging Scores with Ultrasonography and Mammography in Breast Cancer Subtypes.

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    Tsun-Hou Chang

    Full Text Available The Breast Imaging Reporting and Data System (BI-RADS of Mammography (MG and Ultrasonography (US were equivalent to the "5-point score" and applied for combined and sub-stratified imaging assessments. This study evaluated the value of combined and sub-stratified imaging assessments with MG and US over breast cancer subtypes (BCS.Medical records of 5,037 cases having imaging-guided core biopsy, performed from 2009 to 2012, were retrospectively reviewed. This study selected 1,995 cases (1,457 benign and 538 invasive cancer having both MG and US before biopsy. These cases were categorized with the "5-point score" for their MG and US, and applied for combined and sub-stratified imaging assessments. Invasive cancers were classified on the basis of BCS, and correlated with combined and sub-stratified imaging assessments.These selected cases were evaluated by the "5-point score." MG, US, and combined and sub-stratified imaging assessments all revealed statistically significant (P < 0.001 incidence of malignancy. The sensitivity was increased in the combined imaging score (99.8%, and the specificity was increased in the sub-stratified combined score (75.4%. In the sub-stratified combined imaging assessment, all BCS can be classified with higher scores (abnormality hierarchy, and luminal B subtype showed the most salient result (hierarchy: higher, 95%; lower, 5%.Combined and sub-stratified imaging assessments can increase sensitivity and specificity of breast cancer diagnosis, respectively, and Luminal B subtype shows the best identification by sub-stratified combined imaging scoring.

  19. Relative and combined performance of mammography and ultrasonography for breast cancer screening in the general population. A pilot study in Tochigi prefecture, Japan

    International Nuclear Information System (INIS)

    Honjo, Satoshi; Ando, Jiro; Tsukioka, Takeo

    2007-01-01

    Breast cancer screening by mammography is thought to be effective in reducing breast cancer mortality while ultrasonography is not accepted as a population screening modality, although the latter has been suggested to be useful in detection of cancer in the dense breast, relatively more typical for a younger woman. Mammography with medio-lateral oblique view was offered on trial in 1999-2000 for 3453 female residents in Tochigi prefecture who also underwent clinical breast examination and ultrasonography. The municipalities that provided cancer screening were informed of the final diagnosis for women with positive findings in the screening trial by doctors who performed the diagnostic evaluation. Linkage was also made between the list of participants in the trial and registrations at Tochigi Cancer Registry for breast cancer cases diagnosed during 1999-2001. Thirteen cases with breast cancer were identified during a 2-year follow-up period: 10 were diagnosed subsequent to positive finding in the trial; two were negative in the trial and diagnosed 23 and 24 months after, respectively; and one had a positive finding at the trial but was undiagnosed at first and then diagnosed 18 months after the trial. Among the 11 cases judged as positive in the trial, four were judged only by mammography while three were judged only by ultrasonography. Those mammography alone-detected cases were relatively young, at 36, 40, 47 and 54 years of age, respectively, while the ultrasonography alone-detected cases were aged 50, 55 and 68, respectively. Combined screening with mammography and ultrasonography may be feasible. A larger study is required to evaluate relative performance of mammography and ultrasonography in detail by characteristics of examinees and their breasts. (author)

  20. Combination of cyst fluid CEA and CA 125 is an accurate diagnostic tool for differentiating mucinous cystic neoplasms from intraductal papillary mucinous neoplasms.

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    Nagashio, Yoshikuni; Hijioka, Susumu; Mizuno, Nobumasa; Hara, Kazuo; Imaoka, Hiroshi; Bhatia, Vikram; Niwa, Yasumasa; Tajika, Masahiro; Tanaka, Tsutomu; Ishihara, Makoto; Shimizu, Yasuhiro; Hosoda, Waki; Yatabe, Yasushi; Yamao, Kenji

    2014-01-01

    Despite advances in imaging techniques, diagnosis and management of pancreatic cystic lesions still remains challenging. The objective of this study was to determine the utility of cyst fluid analysis (CEA, CA 19-9, CA 125, amylase, and cytology) in categorizing pancreatic cystic lesions, and in differentiating malignant from benign cystic lesions. A retrospective analysis of 68 patients with histologically and clinically confirmed cystic lesions was performed. Cyst fluid was obtained by surgical resection (n = 45) or endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) (n = 23). Cyst fluid tumor markers and amylase were measured and compared between the cyst types. Receiver operating characteristic (ROC) curve analysis of the tumor markers demonstrated that cyst fluid CEA provided the greatest area under ROC curve (AUC) (0.884) for differentiating mucinous versus non-mucinous cystic lesions. When a CEA cutoff value was set at 67.3 ng/ml, the sensitivity, specificity and accuracy for diagnosing mucinous cysts were 89.2%, 77.8%, and 84.4%, respectively. The combination of cyst fluid CEA content >67.3 ng/ml and cyst fluid CA 125 content >10.0 U/ml segregated 77.8% (14/18) of mucinous cystic neoplasms (MCNs) from other cyst subtypes. On the other hand, no fluid marker was useful for differentiating malignant versus benign cystic lesions. Although cytology (accuracy 83.3%) more accurately diagnosed malignant cysts than CEA (accuracy 65.6%), it lacked sensitivity (35.3%). Our results demonstrate that cyst fluid CEA can be a helpful marker in differentiating mucinous from non-mucinous, but not malignant from benign cystic lesions. A combined CEA and CA 125 approach may help segregate MCNs from IPMNs. Copyright © 2014 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  1. The diagnostic value of transrectal ultrasonography combined with prostate specific antigen density in prostate cancer

    International Nuclear Information System (INIS)

    Shen Weidong; Zha Yueqin; Wang Ajun; Hou Jianquan; Ouyang Jun

    2008-01-01

    Objective: To discuss the value of transrectal ultrasound (TRUS) and prostate specific antigen density (PSAD) and prostate specific antigen density of transition zone (PSATZ) for diagnosing prostate cancer. Methods: Chose cases of prostate cancer(PCa) and benign prostate hyperplasia(BPH), each was 19, all the eases were authenticated by pathology. Then compared the characteristic of prostate cancer with prostate specific antigen (PSA) and homologous PSAD, PSATZ. Results: Fourteen cases were discovered by ultrasound among the 19 PCa, the others were only diagnosed as BPH.Among the 14 cases, diffuse pathological changing was found in 1 patient, nodular changing in 13 patients (16 nodules were found). Among the 16 nodules, there were 13 hypoechoic nodules (75%) and 3 hyper echoic or compound echoic nodules (25%), and there were 13 nodules in outer zone and 3 nodules in transition zone.The PSA of PCa and BPH was 8.61-98.65 ng/ml [(48.79±25.34)ng/ml] and 0.58-28.36 ng/ml [(9.73±8.19)ng/ml]. There were no significant differences between the volume of prostate and prostate transition zone (P>0.05), but there were significant differences between the PSAD and PSATZ (P<0.01). That the PCa group was higher than that in the BPH group. Conclusion: It is higher sensitive but bess specific in diagonosis PCa by means of transrectal ultrasound. If it is combined with PSAD and PSATZ, the diagnostic rate of PCa is highly raised. (authors)

  2. MRI features of intraductal papilloma of the breast: sheep in wolf's clothing?

    International Nuclear Information System (INIS)

    Kurz, Kathinka D; Roy, Sumit; Saleh, Andreas; Diallo-Danebrock, Raihana; Skaane, Per

    2011-01-01

    Background: Intraductal papillomas often present as small, smooth masses, dilated ducts or microcalcifications at mammography and as smooth, hypoechoic masses at sonography. At magnetic resonance imaging (MRI), intraductal papillomas often present as small smooth masses, however, often with strong enhancement with type 2 or 3 time intensity curves. The result of the MR analysis is therefore not infrequently inconclusive in order to characterize the mass as benign or malignant. Purpose: To characterize the appearance of intraductal papillomas of the breast at MRI, and determine whether the application of diagnostic rules described in literature could contribute to correctly classifying the lesions as benign. Material and Methods: Twenty patients with histologically proven intraductal papillomas were included. Two radiologists independently reviewed the MR images of the breast. The BI-RADS nomenclature was used to describe morphology and contrast-enhancement kinetics. Interobserver agreement in the interpretation of the MR images by the two investigators was performed. Kappa coefficient was calculated as index for the level of agreement. Subsequently, three sets of diagnostic rules, including the Goettinger score described by Fischer and the interpretation flowcharts according to Kinkel and to Tozaki were applied to characterize whether a biopsy should be recommended or not. Results: All papillomas presented as masses on dynamic contrast-enhanced MRI. Only five papillomas showed a round, oval, or lobulated shape combined with smooth margins and continuous rise of the time intensity curve. Using the Goettinger score, biopsy would be recommended in 16 patients. Based on the interpretation flowcharts of Kinkel and of Tozaki, an additional 13 and 10 papillomas, respectively, were correctly classified as benign. Dilated ducts were visible in 10 patients. The interobserver agreement was good or excellent for all included variables. Conclusion: Including systematic analysis

  3. MRI features of intraductal papilloma of the breast: sheep in wolf's clothing?

    Energy Technology Data Exchange (ETDEWEB)

    Kurz, Kathinka D; Roy, Sumit (Dept. of Radiology, Stavanger Univ. Hospital, Stavanger (Norway)), e-mail: kurk@sus.no; Saleh, Andreas (Inst. of Diagnostic Radiology, Duesseldorf Univ. Hospital, Duesseldorf (Germany)); Diallo-Danebrock, Raihana (Inst. of Pathology, Duesseldorf Univ. Hospital, Duesseldorf (Germany)); Skaane, Per (Dept. of Radiology, Ullevaal Univ. Hospital, Univ. of Oslo, Oslo (Norway))

    2011-04-15

    Background: Intraductal papillomas often present as small, smooth masses, dilated ducts or microcalcifications at mammography and as smooth, hypoechoic masses at sonography. At magnetic resonance imaging (MRI), intraductal papillomas often present as small smooth masses, however, often with strong enhancement with type 2 or 3 time intensity curves. The result of the MR analysis is therefore not infrequently inconclusive in order to characterize the mass as benign or malignant. Purpose: To characterize the appearance of intraductal papillomas of the breast at MRI, and determine whether the application of diagnostic rules described in literature could contribute to correctly classifying the lesions as benign. Material and Methods: Twenty patients with histologically proven intraductal papillomas were included. Two radiologists independently reviewed the MR images of the breast. The BI-RADS nomenclature was used to describe morphology and contrast-enhancement kinetics. Interobserver agreement in the interpretation of the MR images by the two investigators was performed. Kappa coefficient was calculated as index for the level of agreement. Subsequently, three sets of diagnostic rules, including the Goettinger score described by Fischer and the interpretation flowcharts according to Kinkel and to Tozaki were applied to characterize whether a biopsy should be recommended or not. Results: All papillomas presented as masses on dynamic contrast-enhanced MRI. Only five papillomas showed a round, oval, or lobulated shape combined with smooth margins and continuous rise of the time intensity curve. Using the Goettinger score, biopsy would be recommended in 16 patients. Based on the interpretation flowcharts of Kinkel and of Tozaki, an additional 13 and 10 papillomas, respectively, were correctly classified as benign. Dilated ducts were visible in 10 patients. The interobserver agreement was good or excellent for all included variables. Conclusion: Including systematic analysis

  4. Intraductal biliopancreatic imaging: European Society of Gastrointestinal Endoscopy (ESGE) technology review.

    Science.gov (United States)

    Tringali, Andrea; Lemmers, Arnaud; Meves, Volker; Terheggen, Grischa; Pohl, Jürgen; Manfredi, Guido; Häfner, Michael; Costamagna, Guido; Devière, Jacques; Neuhaus, Horst; Caillol, Fabrice; Giovannini, Marc; Hassan, Cesare; Dumonceau, Jean-Marc

    2015-08-01

    This technology review expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) on the available techniques for intraductal biliopancreatic imaging. The three cholangioscopy techniques are described: the "dual-operator" and " single-operator" mother-baby approaches using dedicated instruments, and the "direct" technique using currently available ultrathin gastroscopes. The mother-baby method is standardized and reproducible, while direct cholangioscopy is technically demanding and its safety requires further evaluation. As well as direct visualization of the bile ducts, cholangioscopy has the further advantage of allowing targeted biopsy. Image quality is still suboptimal for single-operator cholangioscopy, while the other techniques have achieved adequately detailed imaging. The costs of mother-baby cholangioscopy are high and its application in clinical practice should be restricted to selected cases (i.e. indeterminate biliary strictures/intraluminal lesions, difficult biliary stones) and to the setting of tertiary care centers. Peroral pancreatoscopy may find an indication in situations where other imaging modalities (mainly EUS) are inconclusive (i.e. delineation of main duct intraductal papillary mucinous neoplasia extension, sampling of indeterminate main pancreatic duct strictures). Intraductal ultrasonography (IDUS) has a poorer performance than EUS in the staging of pancreatic malignancies and can increase the risk of pancreatitis. A promising indication for IDUS could be the evaluation of indeterminate biliary strictures and ampullary tumors. Probe-based confocal laser endomicroscopy (pCLE) of the bile ducts is a difficult and expensive technique. Appropriate training needs to be established, since interpretation of images is challenging. pCLE can be an important diagnostic tool in the setting of indeterminate biliary strictures. © Georg Thieme Verlag KG Stuttgart · New York.

  5. [Pancreatic ultrasonography].

    Science.gov (United States)

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

    2015-04-01

    Despite the recent technological advances in imaging, abdominal ultrasonography continues to be the first diagnostic test indicated in patients with a suspicion of pancreatic disease, due to its safety, accessibility and low cost. It is an essential technique in the study of inflammatory processes, since it not only assesses changes in pancreatic parenchyma, but also gives an indication of the origin (bile or alcoholic). It is also essential in the detection and tracing of possible complications as well as being used as a guide in diagnostic and therapeutic punctures. It is also the first technique used in the study of pancreatic tumors, detecting them with a sensitivity of around 70% and a specificity of 90%. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  6. Percutaneous intraductal radiofrequency ablation in the management of unresectable Bismuth types III and IV hilar cholangiocarcinoma.

    Science.gov (United States)

    Wang, Yu; Cui, Wei; Fan, Wenzhe; Zhang, Yingqiang; Yao, Wang; Huang, Kunbo; Li, Jiaping

    2016-08-16

    To assess the feasibility and safety of percutaneous intraductal radiofrequency ablation (RFA) for unresectable Bismuth types III and IV hilar cholangiocarcinoma. Percutaneous intraductal RFA combined with metal stent placement was successful in all patients without any technical problems; the technical success rate was 100%. Chemotherapy was administered to two patients. After treatment, serum direct bilirubin levels were notably decreased. Six patients died during the follow-up period. Median stent patency from the time of the first RFA and survival from the time of diagnosis were 100 days (95% confidence interval (CI), 85-115 days) and 5.3 months (95% CI, 2.5-8.1 months), respectively. No acute pancreatitis, bile duct bleeding and perforation, bile leakage, or other severe complications occurred. Four cases of procedure-related cholangitis, three cases of postoperative abdominal pain, and five cases of asymptomatic transient increase in serum amylase were observed. One patient who presented with stent blockage 252 days' post-procedure underwent repeat ablation. Between September 2013 and May 2015, nine patients with unresectable Bismuth types III and IV hilar cholangiocarcinoma who were treated with percutaneous intraductal RFA combined with metal stent placement after the percutaneous transhepatic cholangial drainage were included in the retrospective analysis. Procedure-related complications, stent patency, and survival after treatment were investigated. Percutaneous intraductal RFA combined with metal stent placement is a technically safe and feasible therapeutic option for the palliative treatment of unresectable Bismuth types III and IV hilar cholangiocarcinoma. Its long-term efficacy and safety is promising, but needs further study via randomized and prospective trials that include a greater number of patients.

  7. Diagnostic performance of combined single photon emission computed tomographic scintimammography and ultrasonography based on computer-aided diagnosis for breast cancer

    International Nuclear Information System (INIS)

    Hwang, Kyung Hoon; Choi, Duck Joo; Choe, Won Sick; Lee, Jun Gu; Kim, Jong Hyo; Lee, Hyung Ji; Om, Kyong Sik; Lee, Byeong Il

    2007-01-01

    We investigated whether the diagnostic performance of SPECT scintimammography (SMM) can be improved by adding computer-aided diagnosis (CAD) of ultrasonography (US). We reviewed breast SPECT SMM images and corresponding US images from 40 patients with breast masses (21 malignant and 19 benign tumors.) The quantitative data of SPECT SMM were obtained as the uptake ratio of lesion to contralateral normal breast. The morphologic features of the breast lesions on US were extracted and quantitated using the automated CAD software program. The diagnostic performance of SPECT SMM and CAD of US alone was determined using receiver operating characteristic (ROC) curve analysis. The best discriminating parameter (D-value) combining SPECT SMM and the CAD of US was created. The sensitivity, specificity and accuracy of combined two diagnostic modalities were compared to those of a single one. Both SPECT SMM and CAD of US showed a relatively good diagnostic performance (area under curve=0.846 and 0.831, respectively). Combining the results of SPECT SMM and CAD of US resulted in improved diagnostic performance (area under curve=0.860), but there was no statistical difference in sensitivity, specificity and accuracy between the combined method and a single modality. It seems that combining the results of SPECT SMM and CAD of breast US do not significantly improve the diagnostic performance for diagnosis of breast cancer, compared with that of SPECT SMM alone. However, SPECT SMM and CAD of US may complement each other in differential diagnosis of breast cancer

  8. Ultrasonography of Neonatal Cholestasis

    Energy Technology Data Exchange (ETDEWEB)

    Cheon, Jung Eun [Seoul National University Hospital, Seoul (Korea, Republic of)

    2012-06-15

    Ultrasonography (US) is as an important tool for differentiation of obstructive and non-obstructive causes of jaundice in infants and children. Beyond two weeks of age, extrahepatic biliary atresia and neonatal hepatitis are the two most common causes of persistent neonatal jaundice: differentiation of extrahepatic biliary atresia, which requires early surgical intervention, is very important. Meticulous analysis should focus on size and configuration of the gallbladder and anatomical changes of the portahepatis. In order to narrow the differential diagnosis, combined approaches using hepatic scintigraphy, MR cholangiography, and, at times, percutaneous liver biopsy are necessary. US is useful for demonstrating choledochal cyst, bile plug syndrome, and spontaneous perforation of the extrahepatic bile duct

  9. The mammographic spectrum of intraductal carcinoma

    International Nuclear Information System (INIS)

    Ikeda, D.M.; Andersson, I.

    1988-01-01

    To analyze the atypical radiographic spectrum of ductal carcinoma in situ (DCIS), the authors retrospectively reviewed the mammograms of 190 women who had biopsy-proved DCIS at Malmo General Hospital between January 1976 and March 1988. Of these, 117 (61.6%) showed clustered microcalcifications as the major abnormality, a finding often associated with DCIS. The remaining 73 women (38.4%) had either negative mammograms (30 women) or radiographic findings not usually associated with DCIS (43 women), including circumscribed masses (15 women) and focal conglomerates of prominent ducts and nodules (12 cases). Since treatment of DCIS may cure the disease, the radiologist should learn to recognize the more unusual mammographic manifestations of intraductal carcinoma

  10. Diagnostic accuracy of circulating thyrotropin receptor messenger RNA combined with neck ultrasonography in patients with Bethesda III-V thyroid cytology.

    Science.gov (United States)

    Aliyev, Altay; Patel, Jinesh; Brainard, Jennifer; Gupta, Manjula; Nasr, Christian; Hatipoglu, Betul; Siperstein, Allan; Berber, Eren

    2016-01-01

    The aim of this study was to analyze the usefulness of thyrotropin receptor messenger RNA (TSHR-mRNA) combined with neck ultrasonography (US) in the management of thyroid nodules with Bethesda III-V cytology. Cytology slides of patients with a preoperative fine needle aspiration (FNA) and TSHR-mRNA who underwent thyroidectomy between 2002 and 2011 were recategorized based on the Bethesda classification. Results of thyroid FNA, TSHR-mRNA, and US were compared with the final pathology. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. There were 12 patients with Bethesda III, 112 with Bethesda IV, and 58 with Bethesda V cytology. The sensitivity of TSHR-mRNA in predicting cancer was 33%, 65%, and 79 %, and specificity was 67%, 66%, and 71%, for Bethesda III, IV, and V categories, respectively. For the same categories, the PPV of TSHR-mRNA was 25%, 33%, and 79%, respectively; whereas the NPV was 75%, 88%, and 71%, respectively. The addition of neck US to TSHR-mRNA increased the NPV to 100% for Bethesda III, and 86%, for Bethesda IV, and 82% for Bethesda V disease. This study documents the potential usefulness of TSHR-mRNA for thyroid nodules with Bethesda III-V FNA categories. TSHR-mRNA may be used to exclude Bethesda IV disease. A large sample analysis is needed to determine its accuracy for Bethesda category III nodules. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

    Min, Ji Hye; Lee, Min Woo; Cha, Dong Ik [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of); Jeon, Yong Hwan [Department of Radiology, Kangwon National University College of Medicine, Chuncheon 200-722 (Korea, Republic of); Shin, Sung Wook; Cho, Sung Ki; Rhim, Hyunchul; Lim, Hyo K. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of)

    2013-07-01

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

  12. Ultrasonography in gastroenterology.

    Science.gov (United States)

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

    2015-06-01

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

  13. Intraductal delivery of adenoviruses targets pancreatic tumors in transgenic Ela-myc mice and orthotopic xenografts.

    Science.gov (United States)

    José, Anabel; Sobrevals, Luciano; Miguel Camacho-Sánchez, Juan; Huch, Meritxell; Andreu, Núria; Ayuso, Eduard; Navarro, Pilar; Alemany, Ramon; Fillat, Cristina

    2013-01-01

    Gene-based anticancer therapies delivered by adenoviruses are limited by the poor viral distribution into the tumor. In the current work we have explored the feasibility of targeting pancreatic tumors through a loco-regional route. We have taken advantage of the ductal network in the pancreas to retrogradelly inject adenoviruses through the common bile duct in two different mouse models of pancreatic carcinogenesis: The transgenic Ela-myc mice that develop mixed neoplasms displaying both acinar-like and duct-like neoplastic cells affecting the whole pancreas; and mice bearing PANC-1 and BxPC-3 orthotopic xenografts that constitute a model of localized human neoplastic tumors. We studied tumor targeting and the anticancer effects of newly thymidine kinase-engineered adenoviruses both in vitro and in vivo, and conducted comparative studies between intraductal or intravenous administration. Our data indicate that the intraductal delivery of adenovirus efficiently targets pancreatic tumors in the two mouse models. The in vivo application of AduPARTKT plus ganciclovir (GCV) treatment induced tumor regression in Ela-myc mice. Moreover, the intraductal injection of ICOVIR15-TKT oncolytic adenoviruses significantly improved mean survival of mice bearing PANC-1 and BxPC-3 pancreatic xenografts from 30 to 52 days and from 20 to 68 days respectively (p less than 0.0001) when combined with GCV. Of notice, both AduPARTKT and ICOVIR15-TKT antitumoral responses were stronger by ductal viral application than intravenously, in line with the 38-fold increase in pancreas transduction observed upon ductal administration. In summary our data show that cytotoxic adenoviruses retrogradelly injected to the pancreas can be a feasible approach to treat localized pancreatic tumors.

  14. Ultrasonography versus intravenous urography

    International Nuclear Information System (INIS)

    Aslaksen, A.

    1991-01-01

    The present study was performed to compare the clinical value of urography and ultrasonography in a non-selected group of patients referred for urography to a university hospital. The conslusions and clinical implications of the study are as follows: Intravenous urography remains the cornerstone imaging examination in the evaluation of ureteral calculi. Ultrasonography is a valuable adjunct in cases of non- visualization of the kidneys, in distal obstruction and known contrast media allergy. When women with recurrent urinary tract infection are referred for imaging of the urinary tract, ultrasonography should be used. Ultrasonography should replace urography for screening of non-acute hydronephrosis like in female genital cancer and benign prostate hyperplasia. There is good correlation between urography and ultrasonography in assessing the degree of hydronephrosis. However, more researh on the relationship between hydronephrosis and obstruction is necessary. Ultrasonography should be used as the only imaging method of the upper urinary tract in patients with microscopic hematuria. In patients less than 50 years with macroscopic hematuria, ultrasonography should be used as the only imaging of the upper urinary tract, and an examination of the urinary bladder should be included. In patients over 50 years, urography supplied with ultrasonography should be used, but more research is necessary on the subject of imaging method and age. 158 refs

  15. Multiple intraductal papillomas of breast clinically masquerading as malignancy

    Directory of Open Access Journals (Sweden)

    Singh Pallavi

    2010-01-01

    Full Text Available Background: Intraductal papilloma is characterized by proliferation of epithelial and myoepithelial cells overlying fibro-vascular stalks creating an arborescent structure within the lumen of duct. Some times multiple papillomas with florid proliferation of epithelium may be confused with malignancy. A case of multiple intraductal papillomas of breast with ulceration of overlying skin and large lump leading to clinical diagnosis of malignancy is documented here. Case Report: A 45-year-old female presented with ulcerated mass of six months duration in the left breast. On examination, a firm, immobile lump of 8× 10 cm in size involving nipple with excoriation of surrounding skin and serosanguinous discharge from nipple was present. There was no axillary lymphadenopathy. No family history of carcinoma breast was present. Fine needle aspiration smears showed benign cellular changes with apocrine metaplasia. Biopsy from an area adjacent to nipple showed intraductal papilloma. Simple mastectomy showed lobulated dirty white mass with well circumscribed nodules below the nipple and areola. On histology with immunohistochemistry a diagnosis of multiple intraductal papillomas was made. Patient is on regular follow-up and doing well. Conclusion: The case highlights the problem in differentiating marked papillomatosis from a malignant lesion of breast and importance of biopsy with immunohistochemistry in such cases for proper management.

  16. Cystic lesion of pancreas - Intraductal papillary mucinous neoplasm

    Directory of Open Access Journals (Sweden)

    Rajiv Baijal

    2013-01-01

    Full Text Available Intraductal papillary mucinous neoplasm (IPMN of the pancreas is an intraductal mucin-producing epithelial neoplasm that arises from the main and/or branched pancreatic duct. It usually presents as cystic lesion of pancreas. There are well known differential diagnosis of cystic pancreatic lesion. Pancreatic cystic neoplasms are detected at an increasing frequency due to an increased use of abdominal imaging. The diagnosis and treatment of intraductal papillary mucinous tumors (IPMN of the pancreas has evolved over the past decade. IPMN represents a spectrum of disease, ranging from benign to malignant lesions, making the early detection and characterization of these lesions important. Definitive management is surgical resection for appropriate candidates, as benign lesions harbor malignant potential. IPMN has a prognosis, which is different from adenocarcinoma of the pancreas. We report a case of a 58-year-old male with intraductal papillary neoplasm involving main duct and side branches presenting to us with clinical symptoms of chronic pancreatitis with obstructive jaundice and cholangitis treated surgically.

  17. Effects of pancreatic intraductal injection of a radioisotope in dogs

    International Nuclear Information System (INIS)

    Devonec, M.; Faure, J.L.; Blanc-Brunat, N.; Dubernard, J.M.; Traeger, J.

    1980-01-01

    The effects on exocrine and endocrine pancreatic functions of local irradiation by the intraductal injection of Rhenium 186 were investigated as an alternative to neoprene for exocrine secretion suppression. The results indicate that Rhenium 186 irradiation suppressed exocrine secretion of the pancreas while conserving the endocrine function. Although some edema and fibrosis were observed, the effects were not excessive

  18. Diagnostic nerve ultrasonography

    International Nuclear Information System (INIS)

    Baeumer, T.; Grimm, A.; Schelle, T.

    2017-01-01

    For the diagnostics of nerve lesions an imaging method is necessary to visualize peripheral nerves and their surrounding structures for an etiological classification. Clinical neurological and electrophysiological investigations provide functional information about nerve lesions. The information provided by a standard magnetic resonance imaging (MRI) examination is inadequate for peripheral nerve diagnostics; however, MRI neurography is suitable but on the other hand a resource and time-consuming method. Using ultrasonography for peripheral nerve diagnostics. With ultrasonography reliable diagnostics of entrapment neuropathies and traumatic nerve lesions are possible. The use of ultrasonography for neuropathies shows that a differentiation between different forms is possible. Nerve ultrasonography is an established diagnostic tool. In addition to the clinical examination and clinical electrophysiology, structural information can be obtained, which results in a clear improvement in the diagnostics. Ultrasonography has become an integral part of the diagnostic work-up of peripheral nerve lesions in neurophysiological departments. Nerve ultrasonography is recommended for the diagnostic work-up of peripheral nerve lesions in addition to clinical and electrophysiological investigations. It should be used in the clinical work-up of entrapment neuropathies, traumatic nerve lesions and spacy-occupying lesions of nerves. (orig.) [de

  19. Intraductal fibroadenoma under the nipple in an 11-year-old female.

    Science.gov (United States)

    Hayano, Fumiko; Yamada, Sohsuke; Nakano, Shigeo; Watanabe, Teruo; Sasaguri, Yasuyuki; Koga, Sunao

    2014-02-10

    Recently, Chung et al. have reported the detailed clinicopathological features of an extremely rare case sharing similar histopathological characteristics with fibroadenomas, phyllodes tumours, intraductal papillomas or ductal adenomas, given the name of intraductal fibroadenomatosis, as an unusual variant of intracanalicular fibroadenoma. Herein we demonstrated a very unusual case of intraductal fibroadenoma of the breast with admixture of components of intracanalicular type fibroadenoma or benign phyllodes tumour and a smaller amount of intraductal papilloma, occupying the one duct and some adjacent ductules, presenting as a well-demarcated nodule.

  20. Intraductal papillary neoplasm of the bile duct: a case report.

    Science.gov (United States)

    Peeters, Karen; Delvaux, Peter; Huysentruyt, Frederik

    2017-08-01

    Intraductal papillary neoplasm of the bile duct (IPNB) is a rare variant of bile duct tumors, characterized by papillary growth within the bile duct lumen and is regarded as a biliary counterpart of intraductal papillary mucinous neoplasm (IPMN) of the pancreas. IPNBs are mainly found in patients from Far Eastern areas, where hepatolithiasis and clonorchiasis are endemic. The Western experience, however, remains limited. In this article, we report a 56-year-old man, referred to our hospital because of deranged liver function tests. Further imaging modalities showed a cystic lesion of 9 cm diameter, arising from the left hepatic duct. Inlying was a heterogeneous, lobulated mass. The patient underwent a left hemihepatectomy and adjuvant chemotherapy. Despite recent advanced technologies, diagnosis of IPNB is still challenging, especially in western countries due to its rarity. Early identification and resection of lesions, even in asymptomatic or minimally symptomatic patients, are however important prognostic factors.

  1. Computed tomography of hepatocellular carcinoma. Comparison with scintigraphy and ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Kaneko, Kuniyuki; Nakata, Hajime; Honda, Hiroshi [University of Occupational and Environmental Health, Kitakyushu, Fukuoka (Japan)

    1983-09-01

    The detectability of hepatocellular carcinoma by computed tomography (CT) was evaluated on 76 cases. The detectability by plain CT was 93% with only slight improvement following a drip infusion of contrast medium. A comparison of scintigraphy, ultrasonography, and CT was also done on 63 cases. From the standpoint of the overall detectability of the tumor, CT was as good as ultrasonography or scintigraphy. Several cases were positive only on either CT or ultrasonography but no case was positive on scintigraphy alone. We believe that the combination of CT and ultrasonography is the most reliable as the screening method.

  2. Interrogation of the rat mammary gland using intraductal impedance spectroscopy

    International Nuclear Information System (INIS)

    Young, E F; Quinn, D A; Davies, R J

    2010-01-01

    Extant technologies for the detection of breast cancer exploit changes in the morphology of the mammary ductal epithelial network and can involve ionizing radiation. Intraductal surveillance of mammary epithelium has the potential to allow for earlier detection based on changes in function of the epithelium. This study investigated the feasibility of using intraductal impedance spectroscopy (IIS) to assess changes in resistance in the mammary epithelium in a small group of female rats in resting, pregnant and ultimately lactating states. In resting rats, intraductal surveillance was able to detect only a single resistive capacitance (RC). In pregnant animals, a second RC became evident in the frequency range between 1 and 190 Hz. The real resistance of this low frequency RC increased when measurements were made after the animals had begun lactating. Equivalent circuit modeling revealed this increase to be a 1.7-fold change from pregnancy to lactation. A model of tight junction closure in the context of ductal expansion is proposed. These results suggest that physiologic measurements can be made in rodent mammary epithelium using this technique allowing for assessment of function in normal and disease states

  3. Ultrasonography in trauma

    DEFF Research Database (Denmark)

    Weile, Jesper; Nielsen, Klaus; Primdahl, Stine C

    2017-01-01

    BACKGROUND: The Focused Assessment with Sonography in Trauma (FAST) protocol is considered beneficial in emergent evaluation of trauma patients with blunt or penetrating injury and has become integrated into the Advanced Trauma Life Support (ATLS) protocol. No guidelines exist as to the use...... of ultrasonography in trauma in Denmark. We aimed to determine the current use of ultrasonography for assessing trauma patients in Denmark. METHODS: We conducted a nation-wide cross-sectional investigation of ultrasonography usage in trauma care. The first phase consisted of an Internet-based investigation....... Twenty-one (95.5%) of the guidelines included and recommended FAST as part of trauma assessment. The recommended person to perform the examination was the radiologist in n = 11 (50.0%), the surgeon in n = 6 (27.3%), the anesthesiologist in n = 1 (4.5%), and unspecified in n = 3 (13.6%) facilities. FAST...

  4. Ultrasonography of polycystic kidney

    International Nuclear Information System (INIS)

    Oh, Seung Chul; Cho, Seung Gi; Lee, Kwan Seh; Kim, Kun Sang

    1980-01-01

    Polycystic disease is defined as a heritable disorder with diffuse involvement of both kidneys. The term 'Polycystic disease' comprises at least two separate, genetically different disease-one with an onset typically in childhood (infantile polycystic disease) and the other with an onset typically in adulthood (adult polycystic disease). Adult polycystic kidney disease is the most common form of cystic kidney disease in humans. Ultrasonography is a very useful noninvasive diagnostic modality in the patient with clinically suspected renal diseases as well as screening test. 14 cases of ultrasonography in patient with polycystic kidney were reviewed. All cases show unilateral or bilateral enlarged kidneys. 7 cases reveal kidneys and liver replaced by multiple cysts of varing size. Screening ultrasonography for a familial tree is reported

  5. Ultrasonography of jaundice

    International Nuclear Information System (INIS)

    Cho, Byung Jae; Bae, Sang Hoon; Lee, Seung Ro; Kim, Chu Wan

    1980-01-01

    The importance of ultrasonography in the evaluation of jaundice is stressed with an analysis of 47 cases of jaundice. 31 cases proved to be obstructive and 16 non-obstructive jaundice. Obstructive jaundice could be differentiated from non-obstructive jaundice in all but 2 cases, (96%). The site of obstruction in 31 cases of obstructive jaundice could be predicted correctly in 23 cases of 31, (90%), and cause of obstruction with an accuracy of 35% as well. One can certainly recommend ultrasonography as an initial procedure of choice in jaundice patients

  6. Ultrasonography in abdominal emergencies

    International Nuclear Information System (INIS)

    Risi, D.; Alessi, G.; Meli, C.; Marzano, M.; Fiori, E.; Caterino, S.

    1989-01-01

    From February 1986 to March 1988 113 abdominal US exams were performed in emergency situation to evaluate the accuracy of this methodology: 13 were blunt traumas, 18 post-operative complications. A real-time scanner with a linear probe of 5 MHz was employed. The results were confirmed by surgical and/or clinical and instrumental evaluation. In 81% of the examinations, ultrasonography allowed a diagnosis to be made. Gallbladder and biliary pathologies were the most common findings. The results (sensibility 96%, specificity 88%, accuracy 95%) confirm the affidability of ultrasonography in abdominal emergencies, as shown in literature

  7. Efficacy of a combined protocol for re-insemination of open cows after early pregnancy diagnosis using ultrasonography and its effect on fertility

    Directory of Open Access Journals (Sweden)

    A.O. Gaja

    2013-04-01

    Full Text Available The objective of the present field study was to establish the beneficial effects of re-insemination of non-pregnant cows using ultrasonography 20 to 23 days after the artificial insemination. A total of 245 Japanese Black cows were artificially inseminated and early pregnancy diagnosis (EPD was performed on 92 cows 20 days after insemination, using ultrasonography. The remaining 153 cows were considered as negative controls in which routine rectal palpation was performed for pregnancy diagnosis 45-50 days post-insemination. EPD revealed that eleven of the 92 cows (12% were infertile due to ovarian abnormalities and were thus excluded from the rest of the study. Forty-eight (59% of the remaining 81 cows were diagnosed as pregnant, while the other 33 (41% were diagnosed as non-pregnant. Of these non-pregnant cows, 17 of them received a dose of an analogue of the gonadotropin-releasing hormone (GnRH analogue and were then timed-inseminated, while the other 16 were observed for estrus signs, and 13 of them (81% were artificially inseminated. Rates of conception were 35% and 38% in the GnRH and the artificially inseminated groups, respectively (P>0.05. Total pregnancy rate for the EPD group increased significantly (74% (P<0.01 when compared to the control cows (54% within the same period. In conclusion, our field study demonstrated that re-insemination of non-pregnant cows following EPD is highly efficacious not only in improving the rate of fertility via reducing inter-insemination and inter-calving intervals, but also aids in the early detection of ovarian disorders.

  8. Optically neuronavigated ultrasonography in an intraoperative magnetic resonance imaging environment.

    Science.gov (United States)

    Katisko, Jani P A; Koivukangas, John P

    2007-04-01

    To develop a clinically useful method that shows the corresponding planes of intraoperative two-dimensional ultrasonography and intraoperative magnetic resonance imaging (MRI) scans determined with an optical neuronavigator from an intraoperative three-dimensional MRI scan data set, and to determine the qualitative and the quantitative spatial correspondence between the ultrasonography and MRI scans. An ultrasound probe was interlinked with an ergonomic and MRI scan-compatible ultrasonography probe tracker to the optical neuronavigator used in a low-field intraoperative MRI scan environment for brain surgery. Spatial correspondence measurements were performed using a custom-made ultrasonography/MRI scan phantom. In this work, instruments to combine intraoperatively collected ultrasonography and MRI scan data with an optical localization method in a magnetic environment were developed. The ultrasonography transducer tracker played an important role. Furthermore, a phantom for ultrasonography and MRI scanning was produced. This is the first report, to our knowledge, regarding the possibility of combining the two most important intraoperative imaging modalities used in neurosurgery, ultrasonography and MRI scanning, to guide brain tumor surgery. The method was feasible and, as shown in an illustrative surgical case, has direct clinical impact on image-guided brain surgery. The spatial deviation between the ultrasonography and the MRI scans was, on average, 1.90 +/- 1.30 mm at depths of 0 to 120 mm from the ultrasonography probe. The overall result of this work is a unique method to guide the neurosurgical operation with neuronavigated ultrasonography imaging in an intraoperative MRI scanning environment. The relevance of the method is emphasized in minimally invasive neurosurgery.

  9. Ultrasonography of the scrotum in adults

    Energy Technology Data Exchange (ETDEWEB)

    Kuhn, Anna L.; Scotegagna, Eduardo; Nowitaki, Kristina M.; Kim, Young M. [Dept. of UMass Memorial Medical Center, University of Massachusetts Medical Center, Worcester (United States)

    2016-07-15

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

  10. Ultrasonography X gamma radiography

    International Nuclear Information System (INIS)

    Mello Campos, A.M. de

    1989-01-01

    The accumulated experience in the last ten years of substitution to essays by gamma radiography to essay by ultrasonography, starting of the systematic comparison and tabulation of the results obtained by both essays applied in welding joints, in field, in steel pipelines of the SABESP. (V.R.B.)

  11. Surgeon-performed ultrasonography

    DEFF Research Database (Denmark)

    Todsen, Tobias

    2017-01-01

    Surgeons are increasingly using ultrasonography (US) in their clinical management of patients. However, US is a very user-dependent imaging modality and proper skills of the US operator are needed to ensure quality in patient care. This thesis explores the validity evidence for assessment...

  12. Ultrasonography of the Kidney

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  13. Intraductal papillary mucinous neoplasm of the pancreas. Personal series and synthetic review

    Directory of Open Access Journals (Sweden)

    F. Gallucci

    2012-12-01

    Full Text Available Intraductal papillary mucinous neoplasms (IPMNs are rare pancreatic tumors, accounting for less than 1-2% of all neoplasms of the pancreas. The main characteristic of IPMNs is their favorable prognosis, as these pre-malignant or malignant lesions are usually slow-growing tumors and radical surgery is frequently possible. According to the localization of the lesions, three different tumor types have been identified: the main-duct IPMN, the branch-duct IPMN and the mixed-type IPMN (involving both the main pancreatic duct and the side branches. IMPNs do not present pathognomonic signs or symptoms. The obstruction of the main pancreatic duct system may cause abdominal pain and acute pancreatitis (single or recurrent episodes. The tumor may be incidentally discovered in asymptomatic patients, particularly in those with branch-duct IPMNs. In clinical practice, any non-inflammatory cystic lesion of the pancreas should be considered as possible IPMN. Computed tomography, magnetic resonance imaging with cholangiopancreatography and endoscopic ultrasonography can localize an IPMN and assess its morphology and size. The choice between non-operative and surgical management depends on the risk of malignancy and on the definitive distinction between benign and malignant IPMNs. Main-duct IPMNs have a high risk of malignant degeneration, especially in older patients. The clinical and radiological features, as well as treatment and outcome, of eight patients with IPMN (five with main-duct, two with branch-duct and one with mixed-type observed by the authors over the last ten years are presented.

  14. Incidental intraductal papillomas (breast diagnosed on needle core biopsy do not need to be excised.

    Science.gov (United States)

    Jaffer, Shabnam; Bleiweiss, Ira J; Nagi, Chandandeep

    2013-01-01

    Most authors recommend excision of intraductal papillomas diagnosed on core needle biopsy. This leads to the question of whether or not excision is necessary for incidental intraductal papillomas on core needle biopsy as opposed to those corresponding to imaging findings. Using the pathology computerized data base we retrospectively identified 46 incidental intraductal papillomas diagnosed on core needle biopsy from 1/2000 to 12/2008. Clinical, radiologic, and pathologic information was gathered and correlated. All core needle biopsies were reviewed to confirm the diagnosis of incidental intraductal papillomas, and excision specimens reviewed when available. Of the 46 patients, follow-up information was available in only 38. The age of the patients ranged from 39 to 82 years (mean = 48 years). Most incidental intraductal papillomas were diagnosed by mammotome core needle biopsy (36 cases). A total of 33 cases were performed for calcifications with the following indications: clustered = 21, new = 4, pleomorphic = 3, increasing = 3, indeterminant = 2. The correlating diagnoses included the following: fibrocystic changes with calcium phosphate = 18 or calcium oxalate = 10, fibroadenoma with calcifications = 5. The three masses were: two cases of cystic papillary apocrine metaplasia (I Ultrasound and 1 MRI) and 1 fibroadenoma (Ultrasound). In all cases, the intraductal papillomas were ≤0.2 cm, were not associated with calcifications, and were incidental to them or the underlying mass. A total of 14 patients underwent excision, whereas the remaining 24 have remained radiologically stable for over 12 months. The excision specimen findings were: fibrocystic changes = 8 and intraductal papilloma = 6. With the exception of one case, all the intraductal papilloma remained incidental to imaging findings. In this solitary case, the calcifications were described as pleomorphic and corresponded to fibrocystic changes calcifications on core needle

  15. Ultrasonography in Obstertrics

    International Nuclear Information System (INIS)

    Lee, Hyon U.

    1982-01-01

    The usefulness of pulse-echo ultrasonography of the practices of obstetrics has been great. It is more reliable than many biochemical and biophysical technics that have been developed in recent years to try to improve pregnancy outcome. When carefully performed and accurately interpreted, it can supply most vital information about the status of the fetus without any known risks to both mother and the fetus itself. The main obstertricalindications of ultrasonography coule be summarized as follows. 1. Diagnosis of early pregnancy. 2. Fetal growth and its maturity. 3. Complications of pregnancy and abnormal pregnancy. a) Vaginal bleeding in early intrauterinepregnancy. b) Multiple pregnancy. c) Ectopic pregnancy d) Hydatidiform mole e) Pelvic mass complicated with pregnancy f) Fetal anomaly 4. Fetal presenation and attitude 5. Placentography

  16. Molecular pathology of intraductal papillary mucinous neoplasms of the pancreas.

    Science.gov (United States)

    Paini, Marina; Crippa, Stefano; Partelli, Stefano; Scopelliti, Filippo; Tamburrino, Domenico; Baldoni, Andrea; Falconi, Massimo

    2014-08-07

    Since the first description of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas in the eighties, their identification has dramatically increased in the last decades, hand to hand with the improvements in diagnostic imaging and sampling techniques for the study of pancreatic diseases. However, the heterogeneity of IPMNs and their malignant potential make difficult the management of these lesions. The objective of this review is to identify the molecular characteristics of IPMNs in order to recognize potential markers for the discrimination of more aggressive IPMNs requiring surgical resection from benign IPMNs that could be observed. We briefly summarize recent research findings on the genetics and epigenetics of intraductal papillary mucinous neoplasms, identifying some genes, molecular mechanisms and cellular signaling pathways correlated to the pathogenesis of IPMNs and their progression to malignancy. The knowledge of molecular biology of IPMNs has impressively developed over the last few years. A great amount of genes functioning as oncogenes or tumor suppressor genes have been identified, in pancreatic juice or in blood or in the samples from the pancreatic resections, but further researches are required to use these informations for clinical intent, in order to better define the natural history of these diseases and to improve their management.

  17. Diagnosis of fibroadenoma and breast cancer: ultrasonography vs. X-ray mammography

    Energy Technology Data Exchange (ETDEWEB)

    Song, Jong Gi; Im, Jung gi; Choi, Byung Ihn; Kim, Choo Wan [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1993-12-15

    To evaluate the clinical value of ultrasonography in the diagnosis of fibroadenoma and carcinoma as compared with mammography, we performed a blind retrospective analysis of 85 sonograms and 40 mammograms of 85 breasts that were proved pathologically to have diseases. The lesions included 30 ductal carcinomas, 29 fibroadenomas, 14mammary dysplasias, 2 medullary carcinomas, 1 intraductal papillary carcinoma, and 9 cases of other pathology. The sonograms were reviewed in regards to the border, shape and internal echo pattern of the lesion and the shadows from the margin of the lesion. The mammograms were reviewed in regards to the parenchymal pattern, shape, margin,and calcification of the lesion. The accuracy, sensitivity, and specificity of mammography and ultrasonography in the diagnosis of fibroadenoma were 77%/92%, 40%/93%, and 100%/92%, respectively. The accuracy, sensitivity, and specificity of mammography and ultrasonography in the diagnosis of carcinoma were 85%/85%, 76%/82%, and 91%/86%,respectively. Ultrasonography is more accurate and more sensitive than mammography in the diagnosis offibroadenoma, but not in the diagnosis of carcinoma

  18. Diagnosis of fibroadenoma and breast cancer: ultrasonography vs. X-ray mammography

    International Nuclear Information System (INIS)

    Song, Jong Gi; Im, Jung gi; Choi, Byung Ihn; Kim, Choo Wan

    1993-01-01

    To evaluate the clinical value of ultrasonography in the diagnosis of fibroadenoma and carcinoma as compared with mammography, we performed a blind retrospective analysis of 85 sonograms and 40 mammograms of 85 breasts that were proved pathologically to have diseases. The lesions included 30 ductal carcinomas, 29 fibroadenomas, 14mammary dysplasias, 2 medullary carcinomas, 1 intraductal papillary carcinoma, and 9 cases of other pathology. The sonograms were reviewed in regards to the border, shape and internal echo pattern of the lesion and the shadows from the margin of the lesion. The mammograms were reviewed in regards to the parenchymal pattern, shape, margin,and calcification of the lesion. The accuracy, sensitivity, and specificity of mammography and ultrasonography in the diagnosis of fibroadenoma were 77%/92%, 40%/93%, and 100%/92%, respectively. The accuracy, sensitivity, and specificity of mammography and ultrasonography in the diagnosis of carcinoma were 85%/85%, 76%/82%, and 91%/86%,respectively. Ultrasonography is more accurate and more sensitive than mammography in the diagnosis offibroadenoma, but not in the diagnosis of carcinoma

  19. Simultaneous liver mucinous cystic and intraductal papillary mucinous neoplasms of the bile duct: a case report.

    Science.gov (United States)

    Budzynska, Agnieszka; Hartleb, Marek; Nowakowska-Dulawa, Ewa; Krol, Robert; Remiszewski, Piotr; Mazurkiewicz, Michal

    2014-04-14

    Cystic hepatic neoplasms are rare tumors, and are classified into two separate entities: mucinous cystic neoplasms (MCNs) and intraductal papillary mucinous neoplasms of the bile duct (IPMN-B). We report the case of a 56-year-old woman who presented with abdominal pain and jaundice due to the presence of a large hepatic multilocular cystic tumor associated with an intraductal tumor. Partial hepatectomy with resection of extrahepatic bile ducts demonstrated an intrahepatic MCN and an intraductal IPMN-B. This is the first report of the simultaneous occurrence of these two histologically distinct entities in the liver.

  20. Gd-EOB-DTPA-enhanced magnetic resonance imaging for bile duct intraductal papillary mucinous neoplasms

    OpenAIRE

    Ying, Shi-Hong; Teng, Xiao-Dong; Wang, Zhao-Ming; Wang, Qi-Dong; Zhao, Yi-Lei; Chen, Feng; Xiao, Wen-Bo

    2015-01-01

    AIM: To investigate gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) of intraductal papillary mucinous neoplasms of the bile duct (IPMN-B).

  1. Ultrasonography of ovarian hyperandrogenemia

    Science.gov (United States)

    Kuzmina, Svetlana A.; Zharkin, Nikolay A.

    2001-05-01

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

  2. Intraductal location of the sclerosing adenosis of the breast.

    Science.gov (United States)

    Unal, Bulent; Gur, A Serhat; Bhargava, Rohit; Edington, Howard; Ahrendt, Gretchen; Soran, Atilla

    2009-01-01

    Sclerosing adenosis is a benign breast disease with non-specific images on ultrasound or mammogram. It can mimic infiltrating carcinoma when the above mentioned imaging techniques are used. Herein we present a patient with breast cancer who received neoadjuvant chemotherapy and subsequently underwent mastectomy. Ductoscopy was performed to the mastectomised breast specimen as per the ductoscopy research protocol. Ductoscopy revealed several nodular lesions in the duct with no additional demonstrable intraductal pathology. The lesions were reported as sclerosing adenosis by pathologist. As to our knowledge, this is the first case in literature that demonstrates the use of ductoscopy in diagnosing the sclerosing adenosis in the breast tissue. Ductoscopy and development of ductoscopy guided biopsy techniques may be used as an early diagnostic method for the ductal breast lesions (Fig. 2, Ref. 10). Full Text (Free, PDF) www.bmj.sk.

  3. Predictors of malignancy in intraductal papillary mucinous neoplasm of the pancreas: analysis of 310 pancreatic resection patients at multiple high-volume centers.

    Science.gov (United States)

    Shimizu, Yasuhiro; Yamaue, Hiroki; Maguchi, Hiroyuki; Yamao, Kenji; Hirono, Seiko; Osanai, Manabu; Hijioka, Susumu; Hosoda, Waki; Nakamura, Yasushi; Shinohara, Toshiya; Yanagisawa, Akio

    2013-07-01

    The present study was a retrospective investigation of predictors of malignancy in intraductal papillary mucinous neoplasm (IPMN) of the pancreas. The subjects were 310 patients who underwent pancreatic resection at 3 high-volume centers. Preoperative laboratory and imaging findings were analyzed in logistic regression analyses. Endoscopic ultrasonography measurements were essential for the size of mural nodules, and a central review was conducted for pathological diagnosis. Pathological diagnosis was benign IPMN in 150 cases and malignant in 160 (noninvasive carcinoma, n = 100; invasive, n = 60). In multivariate analysis, size of mural nodules, diameter of main pancreatic duct, and cyst size of branch pancreatic duct were independent predictors of malignancy, and areas under the receiver operating characteristic curve for these 3 factors were 0.798, 0.643, and 0.601, respectively. With 7 mm taken as the cutoff value for the size of mural nodules, the diagnosis of malignant IPMN had sensitivity of 74.3% and specificity of 72.7%. Carcinoma without nodules was present in 15 patients (15/160 [9.4%]). The size of mural nodules measured with endoscopic ultrasonography showed high predictive ability. However, about 10% of carcinoma patients did not have nodules, and the handling of the diagnosis in such cases is a problem for the future.

  4. Musculoskeletal ultrasonography in children

    International Nuclear Information System (INIS)

    Teo, E.-L.H.; Strouse, P.J.; Chhem, R.K.

    2002-01-01

    With the development of high-resolution ultrasound transducers, the role of ultrasonography (US) in evaluating the musculoskeletal system has increased. It is now possible to obtain detailed images of bones and soft-tissue structures that were previously unattainable. The advantages of US, when compared with other imaging modalities, are many. It is less expensive than magnetic resonance imaging (MRI) and computed tomography (CT). It does not expose the patient to ionizing radiation, so US examinations can be repeated without harm to the patient. Furthermore, US is performed in real-time, making it possible to assess the musculoskeletal system dynamically, in multiple planes and with contralateral comparison. In experienced hands, US is a quick, noninvasive and cost-effective way to assess the musculoskeletal system in children. It is used to evaluate soft-tissue masses, joint swelling, infections, lesions involving the chest and abdominal walls, bones, muscles and clubfoot deformity and to locate any foreign bodies. (author)

  5. Accuracy of determining preoperative cancer extent measured by automated breast ultrasonography.

    Science.gov (United States)

    Tozaki, Mitsuhiro; Fukuma, Eisuke

    2010-12-01

    The aim of this study was to determine the accuracy of measuring preoperative cancer extent using automated breast ultrasonography (US). This retrospective study consisted of 40 patients with histopathologically confirmed breast cancer. All of the patients underwent automated breast US (ABVS; Siemens Medical Solutions, Mountain View, CA, USA) on the day before the surgery. The sizes of the lesions on US were measured on coronal multiplanar reconstruction images using the ABVS workstation. Histopathological measurement of tumor size included not only the invasive foci but also any in situ component and was used as the gold standard. The discrepancy of the tumor extent between automated breast US and the histological examination was calculated. Automated breast US enabled visualization of the breast carcinomas in all patients. The mean size of the lesions on US was 12 mm (range 4-62 mm). The histopathological diagnosis was ductal carcinoma in situ (DCIS) in seven patients and invasive ductal carcinoma in 33 patients (18 without an intraductal component, 15 with an intraductal component). Lesions ranged in diameter from 4 to 65 mm (mean 16 mm). The accuracy of determination of the tumor extent with a deviation in length of <2 cm was 98% (39/40). Automated breast US is thought to be useful for evaluating tumor extent preoperatively.

  6. Combination of Salivary Gland Ultrasonography and Virtual Touch Quantification for Diagnosis of Sjögren’s Syndrome: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Shaoqi Chen

    2016-01-01

    Full Text Available A total of 136 subjects (51 SS patients, 35 sicca syndrome patients without SS, and 50 healthy volunteers were enrolled in this study. The mean SWV value for salivary glands of SS patients was statistically higher than that of controls (2.81 ± 0.66 m/s versus 1.85 ± 0.28 m/s for parotid glands and 2.29 ± 0.34 m/s versus 1.82 ± 0.25 m/s for submandibular glands, resp.. Combining SWV values of parotid and submandibular glands gives a sensitivity of 88.2% (95% CI: 76.1–95.6% and specificity of 96.0% (95% CI: 86.3–99.5% at the cutoff point of 2.19 m/s, with an AUROC of 0.954 (95% CI: 0.893–0.986. In addition, combining SGUS score and SWV value yields a sensitivity of 98.0% (95% CI: 89.6–100%, specificity of 90.0% (95% CI: 78.2–96.7%, and AUROC of 0.962 (95% CI: 0.904–0.990. Classification tree considering the sequential use of SGUS score and SWV value achieved 92.1% accuracy for diagnosis of SS. Similarly, the ROC curve of combined SGUS scores and SWV values yields an AUROC of 0.954 (95% CI: 0.885–0.987, sensitivity of 97.1% (95% CI: 85.1–99.9%, and specificity of 92.2% (95% CI: 81.1–97.8% for separating sicca syndrome patients (without SS from SS patients. Combining SGUS and VTQ provides a promising tool for diagnosis of SS.

  7. Surgeon-performed ultrasonography.

    Science.gov (United States)

    Todsen, Tobias

    2017-11-01

    Surgeons are increasingly using ultrasonography (US) in their clinical management of patients. However, US is a very user-dependent imaging modality and proper skills of the US operator are needed to ensure quality in patient care. This thesis explores the validity evidence for assessment of competence in abdominal and head & neck ultrasonography using the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale. With the use of Messick's unitary framework of validity, five sources of validity evidence were explored: test content, response processes, inter-nal structure, relations to other variables, and consequences. Research paper I examined validity evidence for the use of the OSAUS scale to assess physicians' abdominal point-of-care US competence in an experimental setting using patient cases with and without pathological conditions. The RESULTS provided validity evidence of the internal structure of the OSAUS scale and a deci-sion study predicted that four cases and two raters or five cases and one rater could ensure sufficient reliability in future test setups. The relation to other variables was supported by a signifi-cant difference in scores between US experience levels, and by a strong correlation between the OSAUS score and diagnostic accuracy. Research paper II explored the transfer of learning from formal point-of-care US training to performance on patients in a randomized controlled study. The RESULTS supported validity evi-dence regarding OSAUS scores' relation to other variables by demonstrating a significant discrimination in the progress of training-a more refined validity evidence than the relation to difference experience levels. The RESULTS showed that physicians could transfer the skills learned on an ultrasonography course to improved US performance and diagnostic accuracy on patients. However, the RESULTS also indicated that following an initial course, additional training is needed for physicians to achieve competence in US

  8. Comparison of intraductal spread on dynamic contrast-enhanced MRI with clinicopathologic features in breast cancer

    International Nuclear Information System (INIS)

    Komatsu, Shuhei; Lee, Chol-Joo; Hosokawa, Yohei; Ichikawa, Daisuke; Hamashima, Takashi; Shirono, Koichi; Okabe, Harumi; Kurioka, Hideaki; Oka, Takahiro

    2004-01-01

    Contrast-enhanced magnetic resonance imaging (CE-MRI) has emerged as a new diagnostic technology in various breast cancer treatments. However, little is known about the correlation between intraductal spread on CE-MRI and clinicopathologic features. This study was designed to evaluate these correlations for the surgical planning of breast cancer. Twenty-six breast cancer lesions (in 26 female patients) treated by breast conserving surgery between March 2001 and March 2003 were evaluated retrospectively. CE-MRI was performed with a 1.5 T unit using a dedicated bilateral breast coil. In detecting intraductal spread of breast cancer, the sensitivity, specificity and accuracy of CE-MRI were 82.4%, 60.0% and 77.3%, respectively. On mammography (MMG), these were 21.1%, 100.0% and 42.3%, respectively. Therefore, CE-MRI has a higher sensitivity and accuracy, although with a lower specificity than MMG. Compared with breast cancer lesions without intraductal spread on CE-MRI, lesions with intraductal spread on CE-MRI were found more frequently in larger-sized tumors (P=0.0088). Preoperative evaluation for intraductal spread by CE-MRI should be more useful than by MMG for breast cancer. When making the surgical decision regarding excision range, particular attention should be paid to this consideration for patients with larger-sized cancer tumors. (author)

  9. Imaging diagnosis of intraductal papillary mucinous tumor of the pancreas

    International Nuclear Information System (INIS)

    Zhang Huimao; Lai Ying; Yang Shuqin; Yang Haishan; Murakami, K.

    2005-01-01

    Objective: To explore the diagnostic value of intraductal papillary mucinous tumor (IPMT) of the pancreas, and to assess its clinical and characteristic radiological features. Methods: Thirty-six cases with IPMT who underwent CT and MRI with plain and contrast enhancement before operation were reviewed. The clinical presentation and characteristic imaging findings of main duct type (8 cases) and branch duct type (28 cases) were retrospectively reviewed. Results: Typical imaging findings of main duct type were segmental or diffuse dilation of MPD (diameter was over 9 mm) with enhanced mural nodules after contrast medium administration. MR cholangiopancreatography (MRCP) showed dilation of MPD with flat/nodule filling defects in 4 cases and MPD dilatation in the head side in 2 cases. Branch duct type was more frequently located in the head or uncinate. Typical imaging findings of branch duct type were unilocular or multilocular cystic tumors with septa, mural nodules, and MPD dilatation. MRCP showed septa in 24 cases, filling defects in 15 cases, and MPD dilatation in 8 cases. Communication between the cystic lesion and the MPD was demonstrated in 19 cases by MRCP. Conclusion: It is extremely important to accurately make the diagnosis of IPMT for planning the surgical strategy. MRCP is a noninvasive and useful method in detecting and making definite diagnosis of IPMT. (authors)

  10. Transthoracic Ultrasonography for Clinicians

    Directory of Open Access Journals (Sweden)

    Morné Johan Vorster

    2015-04-01

    Full Text Available Transthoracic ultrasonography (US has become an essential tool for respiratory, emergency, and critical care physicians. It can be performed with basic equipment and by personnel with minimum training as a modality for the evaluation of a wide range of thoracic pathologies. Its advantages include immediate application at the point of care, low cost, and lack of radiation. The main indications for transthoracic US are the qualitative and quantitative assessment of pleural effusions, pleural thickening, diaphragmatic pathology, as well as chest wall and pleural tumors. Transthoracic US is also useful in visualizing pulmonary pathologies that abut the pleura, such as pneumonic consolidation and interstitial syndromes, including pulmonary edema. Transthoracic US is more sensitive than the traditional chest radiograph in the detection of pneumothoraces, and it is useful in diagnosing skeletal abnormalities such as rib fractures. It is the ideal tool to guide transthoracic procedures, including thoracocentesis and pleural biopsy. Moreover, transthoracic US-guided procedures can be performed by a single clinician with no sedation and minimal monitoring. Transthoracic US-guided fine needle aspiration and/or cutting needle biopsy of extrathoracic lymph nodes and lesions arising from the chest wall, pleura, peripheral lung, and mediastinum are safe to perform and have a high yield in the of hands of experienced clinicians. Transthoracic US can also potentially guide the aspiration and biopsy of diffuse pulmonary infiltrates, consolidations, and lung abscesses. Moreover, transthoracic US may be used in the detection of pulmonary embolism

  11. Advances in diagnostic ultrasonography.

    Science.gov (United States)

    Reef, V B

    1991-08-01

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

  12. Utility of 18F-fluoro-deoxyglucose emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in combination with ultrasonography for axillary staging in primary breast cancer

    International Nuclear Information System (INIS)

    Ueda, Shigeto; Ishida, Jiro; Abe, Yoshiyuki; Mochizuki, Hidetaka; Tsuda, Hitoshi; Asakawa, Hideki; Omata, Jiro; Fukatsu, Kazuhiko; Kondo, Nobuo; Kondo, Tadaharu; Hama, Yukihiro; Tamura, Katsumi

    2008-01-01

    Accurate evaluation of axillary lymph node (ALN) involvement is mandatory before treatment of primary breast cancer. The aim of this study is to compare preoperative diagnostic accuracy between positron emission tomography/computed tomography with 18 F-fluorodeoxyglucose ( 18 F-FDG PET/CT) and axillary ultrasonography (AUS) for detecting ALN metastasis in patients having operable breast cancer, and to assess the clinical management of axillary 18 F-FDG PET/CT for therapeutic indication of sentinel node biopsy (SNB) and preoperative systemic chemotherapy (PSC). One hundred eighty-three patients with primary operable breast cancer were recruited. All patients underwent 18 F-FDG PET/CT and AUS followed by SNB and/or ALN dissection (ALND). Using 18 F-FDG PET/CT, we studied both a visual assessment of 18 F-FDG uptake and standardized uptake value (SUV) for axillary staging. In a visual assessment of 18 F-FDG PET/CT, the diagnostic accuracy of ALN metastasis was 83% with 58% in sensitivity and 95% in specificity, and when cut-off point of SUV was set at 1.8, sensitivity, specificity, and accuracy were 36, 100, and 79%, respectively. On the other hand, the diagnostic accuracy of AUS was 85% with 54% in sensitivity and 99% in specificity. By the combination of 18 F-FDG PET/CT and AUS to the axilla, the sensitivity, specificity, and accuracy were 64, 94, and 85%, respectively. If either 18 F-FDG PET uptake or AUS was positive in allixa, the probability of axillary metastasis was high; 50% (6 of 12) in 18 F-FDG PET uptake only, 80% (4 of 5) in AUS positive only, and 100% (28 of 28) in dual positive. By the combination of AUS and 18 F-FDG PET/CT, candidates of SNB were more appropriately selected. The axillary 18 F-FDG uptake was correlated with the maximum size and nuclear grade of metastatic foci (p = 0.006 and p = 0.03). The diagnostic accuracy of 18 F-FDG PET/CT was shown to be nearly equal to ultrasound, and considering their limited sensitivities, the high radiation

  13. Utility of 18F-fluoro-deoxyglucose emission tomography/computed tomography fusion imaging (18F-FDG PET/CT in combination with ultrasonography for axillary staging in primary breast cancer

    Directory of Open Access Journals (Sweden)

    Tamura Katsumi

    2008-06-01

    Full Text Available Abstract Background Accurate evaluation of axillary lymph node (ALN involvement is mandatory before treatment of primary breast cancer. The aim of this study is to compare preoperative diagnostic accuracy between positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (18F-FDG PET/CT and axillary ultrasonography (AUS for detecting ALN metastasis in patients having operable breast cancer, and to assess the clinical management of axillary 18F-FDG PET/CT for therapeutic indication of sentinel node biopsy (SNB and preoperative systemic chemotherapy (PSC. Methods One hundred eighty-three patients with primary operable breast cancer were recruited. All patients underwent 18F-FDG PET/CT and AUS followed by SNB and/or ALN dissection (ALND. Using 18F-FDG PET/CT, we studied both a visual assessment of 18F-FDG uptake and standardized uptake value (SUV for axillary staging. Results In a visual assessment of 18F-FDG PET/CT, the diagnostic accuracy of ALN metastasis was 83% with 58% in sensitivity and 95% in specificity, and when cut-off point of SUV was set at 1.8, sensitivity, specificity, and accuracy were 36, 100, and 79%, respectively. On the other hand, the diagnostic accuracy of AUS was 85% with 54% in sensitivity and 99% in specificity. By the combination of 18F-FDG PET/CT and AUS to the axilla, the sensitivity, specificity, and accuracy were 64, 94, and 85%, respectively. If either 18F-FDG PET uptake or AUS was positive in allixa, the probability of axillary metastasis was high; 50% (6 of 12 in 18F-FDG PET uptake only, 80% (4 of 5 in AUS positive only, and 100% (28 of 28 in dual positive. By the combination of AUS and 18F-FDG PET/CT, candidates of SNB were more appropriately selected. The axillary 18F-FDG uptake was correlated with the maximum size and nuclear grade of metastatic foci (p = 0.006 and p = 0.03. Conclusion The diagnostic accuracy of 18F-FDG PET/CT was shown to be nearly equal to ultrasound, and considering their

  14. Transvaginal ultrasonography of rectal endometriosis

    DEFF Research Database (Denmark)

    Egekvist, Anne Gisselmann; Seyer-Hansen, Mikkel; Forman, Axel

    Objectives: The aim of this present study was to evaluate the interobserver variation of transvaginal ultrasonographic measurements of endometriosis infiltrating the rectosigmoid wall. Methods: Transvaginal ultrasonography was performed independently by two observers. Observer 1 had several years...... of experience in ultrasonography while observer 2 was a medical student with no prior experience in ultrasonography or endometriosis. In 24 patient length, width and depth of endometriosis infiltrating the rectosigmoid bowel was measured. The differences between the observers were analysed by Bland and Altman...... for a relatively short period gives comparable scanning results between the two observers. It seems that transvaginal ultrasound could be used as a diagnostic tool for rectal endometriosis in most departments. However, the irregular morphology of the lesions makes the measurements very complex, and a strict...

  15. Oncocytic Type Intraductal Papillary Mucinous Neoplasm of the Pancreas with Unusually Low Mucin Production Mimicking Intraductal Tubulopapillary Neoplasm: A Report of a Case Diagnosed by a Preoperative Endoscopic Biopsy

    Science.gov (United States)

    Yoshida, Yukinari; Endo, Takao; Tanaka, Eiichi; Kikuchi, Takefumi; Akino, Kimishige; Mita, Hiroaki; Adachi, Yasuyo; Nakamura, Masahiro; Adachi, Yasushi; Ishii, Yoshifumi; Matsumoto, Joe; Hirano, Satoshi; Nitta, Takeo; Mitsuhashi, Tomoko; Kato, Yasuo

    2017-01-01

    We herein report the case of a 78-year-old woman with an intraductal tumor with scant mucin production in a moderately dilated main pancreatic duct that resembled an intraductal tubulopapillary neoplasm (ITPN) on imaging. An endoscopic transpapillary forceps biopsy enabled an accurate preoperative diagnosis of the tumor as an oncocytic type intraductal papillary mucinous neoplasm (IPMN) of the pancreas microscopically showing papillary growth consisting of oncocytic cells with a typical mucin expression profile, although with few intraepithelial lumina containing mucin. This is the first case of an oncocytic type IPMN mimicking an ITPN that was able to be diagnosed preoperatively. PMID:29021473

  16. Ultrasonography of the equine shoulder

    International Nuclear Information System (INIS)

    Dik, K.J.

    1996-01-01

    Six horses with shoulder injuries were presented in this report with emphasis on the use of ultrasonography vs. radiography in diagnosis. The two imaging modalities represented valuable and complementary diagnostic procedures. Two horses had fracture fragments of the lateral humeral tuberosity, the accurate ultrasonographic findings encouraging clearer radiographic identification by oblique projections. In one horseultrasonography enabled more accurate localization of calcification within the supraspinatus muscle. In the remaining three cases ultrasonography visualized distension of the bicipital bursa due to aseptic bursitis, bursal hemorrhage, or associated with injury of the biceps brachii muscle and the underlying intermediate humeral tubercle, the bony involvement more clearly demonstrated radiographically

  17. Molecular genetics of intraductal papillary-mucinous neoplasms of the pancreas.

    Science.gov (United States)

    Furukawa, Toru

    2007-01-01

    Intraductal papillary-mucinous neoplasms of the pancreas show characteristic clinicopathological and molecular pathobiological features which are distinct from those of conventional ductal adenocarcinomas. Alterations of KRAS, AKT/PKB, CDKN2A, TP53, SMAD4, STK11/LKB1, and DUSP6, and other molecular alterations, including global expression studies as well as their clinical implications, are discussed.

  18. Intraductal membranous fat necrosis in a fibroadenoma of breast: a case report.

    Science.gov (United States)

    Coyne, John D

    2014-09-01

    Membranous fat necrosis is an unusual type of fat necrosis occurring in the breast and normally involves the parenchyma. This report describes an apparently unique intraductal focus in a fibroadenoma following prior needling. Displacement of fatty tissue in the form of membranous fat necrosis within ducts could be added to the list of histological features following core biopsy. © The Author(s) 2013.

  19. The use of film imaging techniques in the diagnosis of mammary intraductal papilloma (report of 23 cases)

    International Nuclear Information System (INIS)

    Wei Shaohua; Liu Genshou

    2001-01-01

    Objective: To summarize the value of the film imaging techniques in the diagnosis of mammary intraductal papilloma. Methods: Retrospectively analysis 23 in patients with mammary intraductal papilloma which was confirmed by diagnosis with multiple function ultrasound instrument, mammography and breast duct imaging techniques. Results: The diagnosis sensitivities of multiple function ultrasound instrument and breast duct imaging techniques were 66.7% and 70.6% respectively (P > 0.05). Both of them had a definite value in diagnosis of mammary intraductal papilloma. Conclusion: Film imaging techniques are valuable to locate lesions, but is not useful for making pathological diagnosis

  20. Multimodal treatment in difficult sialolithiasis: Role of extracorporeal shock-wave lithotripsy and intraductal pneumatic lithotripsy.

    Science.gov (United States)

    Koch, Michael; Schapher, Mirco; Mantsopoulos, Konstantinos; von Scotti, Felix; Goncalves, Miguel; Iro, Heinrich

    2017-12-15

    To assess results after treatment of difficult/complex sialolithiasis with extracorporeal shock-wave lithotripsy (ESWL) and intraductal pneumatic lithotripsy (IPL). Retrospective study in a tertiary referral center. Altogether, 63 stones were diagnosed in 38 patients with difficult/complex sialolithiasis. Forty-nine stones were treated with fragmentation using both ESWL and IPL. Stones accessible with the sialendoscope were treated primarily with IPL in multiple sialolithiasis. Seventy-one ESWL procedures and 57 IPL were performed in our patients. Forty-nine stones were treated by 67 ESWL procedures and 52 IPL. ESWL converted sialoliths from sialendoscopically untreatable into sialendoscopically treatable cases in 94.7%; the treatment then was completed by a total of 52 IPL procedures. ESWL was performed before IPL (81.6%), in combination with IPL (7.9%) and after (10.5%). Complete fragmentation was achieved in 97.9%. Four stones each were treated with ESWL and IPL alone in multiple sialolithiasis. Altogether, 53 stones were treated by 57 IPL procedures. Complete fragmentation was achieved in 98.1% of the 53 stones. ESWL and IPL were the dominant treatment modalities in 84.1% of all 63 stones treated. Of all 38 patients, 92.1% became stone-free and all became symptom-free. All the glands were preserved. Multiple stones were treated in 34.2% of the patients; of these, 92.3% became stone-free. These results show that patients with difficult and complex sialolithiasis can be treated with high success rates of > 90% using a multimodal, minimally invasive, and gland-preserving treatment approach. ESWL and IPL played a key role in this multimodal treatment regime in > 80% of stones. 4. Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  1. Imaging features of intraductal papillary neoplasm of the bile duct

    International Nuclear Information System (INIS)

    Liu Yubao; Li Meng; Zhong Xiaomei; Liu Zaiyi; Liang Changhong

    2014-01-01

    Objective: To investigate the CT and MRI features of intraductal papillary neoplasm of the bile duct (IPNB). Methods: Thirty eight patients with IPNB finally diagnosed by puncture biopsy or surgery were enrolled in this study. All the CT or MRI data were investigated retrospectively. Twenty one patients underwent CT examinations, 17 patients underwent MRI examinations. The features of IPNB including the distribution features of the nodules or masses, CT and MRI features of cholangiectasis, mucus were analyzed. The accuracy differences of CT and MRI for the preoperatively diagnosing mucus and tumor growing along mucous were compared by nonparametric test. Results: The lesions (including 5 patients with solitary lesions and 19 patients with multiple lesions) were located in intrahepatic bile duct in 24 patients, 3 patients occurred simultaneously in intrahepatic and portal bile duct, 2 lesions occurred in portal bile duct, 8 lesions occurred in common bile duct, the lesions of 1 patient occurred simultaneously in common bile duct, cystic duct and gallbladder. Seventeen and 11 patients appeared nodules locating in dilated bile duct on CT and MRI, respectively. Four and 5 patients appeared cystic lesions with multiple nodules of the liver on CT and MRI, respectively. Higher contrast enhancement on CT and MRI in arterial phase than that in portal vein and equilibrium phase were observed in 18 and 12 patients, respectively. Excluding the patients undergoing puncture, CT was better than MRI in evaluating whether the mucus was present, with the accuracies of 30.0% (6/20) and 6.3% (1/16) for CT and MRI, respectively (Z=2.58, P<0.05). CT was worse than MRI in preoperatively evaluating the features of tumor growing along mucous, with the accuracies of 77.8% (14/18) and 92.6% (13/14) for CT and MRI, respectively (Z=4.23, P<0.01). Conclusion: IPNB had the features of growing along mucous of the bile duct, nodule or mass in dilated bile duct and other features, CT and MRI are

  2. Low-grade salivary duct carcinoma or low-grade intraductal carcinoma? Review of the literature.

    Science.gov (United States)

    Kuo, Ying-Ju; Weinreb, Ilan; Perez-Ordonez, Bayardo

    2013-07-01

    Low-grade salivary duct carcinoma (LG-SDC) is a rare neoplasm characterized by predominant intraductal growth, luminal ductal phenotype, bland microscopic features, and favorable clinical behavior with an appearance reminiscent of florid to atypical ductal hyperplasia to low grade intraductal breast carcinoma. LG-SDC is composed of multiple cysts, cribriform architecture with "Roman Bridges", "pseudocribriform" proliferations with floppy fenestrations or irregular slits, micropapillae with epithelial tufts, fibrovascular cores, and solid areas. Most of the tumor cells are small to medium sized with pale eosinophilic cytoplasm, and round to oval nuclei, which may contain finely dispersed or dark condensed chromatin. Foci of intermediate to high grade atypia, and invasive carcinoma or micro-invasion have been reported in up to 23 % of cases. The neoplastic cells have a ductal phenotype with coexpression of keratins and S100 protein and are surrounded by a layer of myoepithelial cells in non-invasive cases. The main differential diagnosis of LG-SDC includes cystadenoma, cystadenocarcinoma, sclerosing polycystic adenosis, salivary duct carcinoma in situ/high-grade intraductal carcinoma, and papillary-cystic variant of acinic cell carcinoma. There is no published data supporting the continuous classification of LG-SDC as a variant of cystadenocarcinoma. Given that most LG-SDC are non-invasive neoplasms; the terms "cribriform cystadenocarcinoma" and LG-SDC should be replaced by "low-grade intraductal carcinoma" (LG-IDC) of salivary gland or "low-grade intraductal carcinoma with areas of invasive carcinoma" in those cases with evidence of invasive carcinoma.

  3. Cholescintigraphy and ultrasonography in patients suspected of having acute cholecystitis

    DEFF Research Database (Denmark)

    Lauritsen, K B; Sommer, W; Hahn, L

    1988-01-01

    The diagnostic power of combined cholescintigraphy and ultrasonography was tested in 67 patients suspected of having acute cholecystitis; of these, 42 (63%) had acute cholecystitis. The predictive value of a positive scintigraphy (PVpos) was 95% and that of a negative (PVneg) was 91% (n = 67......). The PVpos and PVneg of ultrasonography were 89% and 75%, respectively (n = 54), and these values did not achieve statistical significance when compared with those for scintigraphy. Inconclusive tests were 10% and 11%, respectively, but in no patient were both scintigraphy and ultrasonography inconclusive...... that in patients suspected of having acute cholecystitis cholescintigraphy should be the first diagnostic procedure performed. If the scintigraphy is positive, additional ultrasonographic detection of gallstones makes the diagnosis almost certain. If one diagnostic modality is inconclusive, the other makes a fair...

  4. Ultrasonography of the Rotator Cuff

    International Nuclear Information System (INIS)

    Yoon, Yong Cheol

    2006-01-01

    The ultrasonography (US) is an important modality in evaluating shoulder disease. It is accurate in diagnosing the various shoulder diseases including tendinosis, calcific tendinitis, and subacromial bursitis as well as rotator cuff tears. This article presents a pictorial review of US anatomy of the shoulder, the technical aspects of shoulder US, major types of shoulder pathology, and interventional procedure under US guidance

  5. Ultrasonography of the Rotator Cuff

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Yong Cheol [Samsung Medica Center, Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)

    2006-09-15

    The ultrasonography (US) is an important modality in evaluating shoulder disease. It is accurate in diagnosing the various shoulder diseases including tendinosis, calcific tendinitis, and subacromial bursitis as well as rotator cuff tears. This article presents a pictorial review of US anatomy of the shoulder, the technical aspects of shoulder US, major types of shoulder pathology, and interventional procedure under US guidance

  6. Unexpected metastasis of intraductal papillary mucinous neoplasm of the bile duct into thoracic cavity with direct extension: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eung Tae; Heo, Jeong Nam; Park, Choong Ki [Hanyang Univ. Guri Hospital, Guri (Korea, Republic of); Choi, Yo Won; Jeon, Seok Chol [Hanyang Univ. Seoul Hospital, Seoul (Korea, Republic of)

    2012-08-15

    Intraductal papillary mucinous neoplasm (IPMN) is known to arise from intraductal proliferation of mucinous cells with findings of marked dilatation of the biliary or pancreatic duct. There are reports of the metastasis and extension of pancreatic IPMN. However, cases of biliary IPMN with direct metastasis, or metastasis to distant locations, are rare. We present a case of metastasis of biliary IPMN with unexpected direct extension into the thoracic cavity, and we attempt to account for the mechanism of this extension.

  7. Unexpected metastasis of intraductal papillary mucinous neoplasm of the bile duct into thoracic cavity with direct extension: Case report

    International Nuclear Information System (INIS)

    Kim, Eung Tae; Heo, Jeong Nam; Park, Choong Ki; Choi, Yo Won; Jeon, Seok Chol

    2012-01-01

    Intraductal papillary mucinous neoplasm (IPMN) is known to arise from intraductal proliferation of mucinous cells with findings of marked dilatation of the biliary or pancreatic duct. There are reports of the metastasis and extension of pancreatic IPMN. However, cases of biliary IPMN with direct metastasis, or metastasis to distant locations, are rare. We present a case of metastasis of biliary IPMN with unexpected direct extension into the thoracic cavity, and we attempt to account for the mechanism of this extension

  8. Diagnostic nerve ultrasonography; Diagnostische Nervensonographie

    Energy Technology Data Exchange (ETDEWEB)

    Baeumer, T. [Universitaet zu Luebeck CBBM, Haus 66, Institut fuer Neurogenetik, Luebeck (Germany); Grimm, A. [Universitaetsklinikum Tuebingen, Klinik und Poliklinik fuer Neurologie, Tuebingen (Germany); Schelle, T. [Staedtisches Klinikum Dessau, Neurologische Klinik, Dessau (Germany)

    2017-03-15

    For the diagnostics of nerve lesions an imaging method is necessary to visualize peripheral nerves and their surrounding structures for an etiological classification. Clinical neurological and electrophysiological investigations provide functional information about nerve lesions. The information provided by a standard magnetic resonance imaging (MRI) examination is inadequate for peripheral nerve diagnostics; however, MRI neurography is suitable but on the other hand a resource and time-consuming method. Using ultrasonography for peripheral nerve diagnostics. With ultrasonography reliable diagnostics of entrapment neuropathies and traumatic nerve lesions are possible. The use of ultrasonography for neuropathies shows that a differentiation between different forms is possible. Nerve ultrasonography is an established diagnostic tool. In addition to the clinical examination and clinical electrophysiology, structural information can be obtained, which results in a clear improvement in the diagnostics. Ultrasonography has become an integral part of the diagnostic work-up of peripheral nerve lesions in neurophysiological departments. Nerve ultrasonography is recommended for the diagnostic work-up of peripheral nerve lesions in addition to clinical and electrophysiological investigations. It should be used in the clinical work-up of entrapment neuropathies, traumatic nerve lesions and spacy-occupying lesions of nerves. (orig.) [German] Fuer die Diagnostik von Nervenlaesionen ist ein bildgebendes Verfahren zur Darstellung des peripheren Nervs und seiner ihn umgebenden Strukturen fuer eine aetiologische Einordnung erforderlich. Mit der klinisch-neurologischen Untersuchung und Elektrophysiologie ist eine funktionelle Aussage ueber die Nervenlaesion moeglich. In der Standard-MRT-Untersuchung wird der periphere Nerv nur unzureichend gut dargestellt. Die MRT-Neurographie ist ein sehr gutes, aber auch zeit- und ressourcenintensives Verfahren. Nutzung des Ultraschalls fuer die

  9. Differential diagnosis of benign and malignant intraductal papillary mucinous tumors of the pancreas: MR cholangiopancreatography and MR angiography

    International Nuclear Information System (INIS)

    Choi, Byung Se; Kim, Tae Kyoung; Kim, Ah Young; Kim, Kyoung Won; Park, Sung Won; Kim, Pyo Nyun; Ha, Kyun Kwon; Lee, Moon Gyu; Kim, Song Cheol

    2003-01-01

    To compare the usefulness of magnetic resonance cholangiopancreatography (MRCP) and MR angiography (MRA) in differentiating malignant from benign intraductal papillary mucinous tumors of the pancreas (IPMTs), and to determine the findings which suggest malignancy. During a 6-year period, 46 patients with IPMT underwent MRCP. Morphologically, tumor type was classified as main duct, branch duct, or combined. The diameter of the main pancreatic duct (MPD), the extent of the dilated MPD, and the location and size of the cystic lesion, septum, and communicating channel were assessed. For all types of IPMTs, enhanced mural nodules and portal vein narrowing were evaluated at MRA. Combined-type IPMTs were more frequently malignant (78%) than benign (42%) (p<0.05). Compared with benign lesions, malignant lesions were larger, and the caliber of the communicating channel was also larger (p < 0.05). Their dilated MPD was more extensive and of greater diameter (p<0.05), and the presence of mural nodules was more frequent (p<0.001). Combined MRCP and MRA might be useful for the differential diagnosis of malignant and benign IPMTs of the pancreas

  10. Ultrasonography of the canine pancreas

    Directory of Open Access Journals (Sweden)

    Michelle L Avante

    2018-01-01

    Full Text Available This study describes the ultrasonographic techniques currently used in the evaluation of the canine pancreas. Ultrasonography was the first method to enable direct visualization of the pancreas in humans and it has been subsequently applied to animals. Currently, it is the method of choice for pancreatic evaluation and is essential as a diagnostic tool in the detection of abnormalities, especially tumors. Innovative equipment technology has led to the emergence of techniques complementary to B-mode ultrasound; such as Doppler, elastography, and contrast-enhanced ultrasonography, which have enabled more accurate diagnosis. Doppler provides information on vascular architecture and the hemodynamic aspect of blood vessels in multiple organs. ARFI elastography provides detailed images of the alterations detected by conventional examination (qualitative method and assists in differentiating between benign and malignant processes (quantitative method. Microbubble contrast agents determine parameters related to homogeneous and heterogeneous filling of organs with microbubbles, mainly nodular areas, thus defining high and low intensity patterns.

  11. Ultrasonography findings of gastric carcinoma

    International Nuclear Information System (INIS)

    Chung, Chong Ku; Choi, Ji Bai; Ko, Young Tae; Lim, Jae Hoon; Kim, Soon Young

    1985-01-01

    Stomach carcinoma is more common disease in Korea than western countries. The reported ultrasonographic findings of gastric carcinoma were thickening of gastric wall and 'pseudokidney' sign. The author analyzed ultrasonographic findings of 101 cases with gastric carcinoma who were performed ultrasonography and gastroscopy at Kyung Hee University Hospital from October 1982 to October 1985. The results were as followings; 1. Types of gastric carcinoma were consisted with infiltrative type 68 cases, infiltrative type with ulceration 16 cases, polypoid type with ulceration 1 case, infiltrative adn polypoid type 4 cases, limits plastica type 3 cases, ulcerative type 1 case and polypoid type 1 case. 2. Extent of the lesions were in body and antrum 45 cases, entire stomach 18 cases, antrum 18 cases, body 12 cases, body and fundus 6 cases. 3. Ultrasonography was useful in demonstrating the extent of the tumor and the presence of materials elsewhere in abdomen

  12. Ultrasonography findings of gastric carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Chong Ku; Choi, Ji Bai; Ko, Young Tae; Lim, Jae Hoon; Kim, Soon Young [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1985-12-15

    Stomach carcinoma is more common disease in Korea than western countries. The reported ultrasonographic findings of gastric carcinoma were thickening of gastric wall and 'pseudokidney' sign. The author analyzed ultrasonographic findings of 101 cases with gastric carcinoma who were performed ultrasonography and gastroscopy at Kyung Hee University Hospital from October 1982 to October 1985. The results were as followings; 1. Types of gastric carcinoma were consisted with infiltrative type 68 cases, infiltrative type with ulceration 16 cases, polypoid type with ulceration 1 case, infiltrative adn polypoid type 4 cases, limits plastica type 3 cases, ulcerative type 1 case and polypoid type 1 case. 2. Extent of the lesions were in body and antrum 45 cases, entire stomach 18 cases, antrum 18 cases, body 12 cases, body and fundus 6 cases. 3. Ultrasonography was useful in demonstrating the extent of the tumor and the presence of materials elsewhere in abdomen.

  13. Contrast-enhanced endoscopic ultrasonography

    DEFF Research Database (Denmark)

    Reddy, Nischita K; Ioncica, Ana Maria; Saftoiu, Adrian

    2011-01-01

    Contrast agents are increasingly being used to characterize the vasculature in an organ of interest, to better delineate benign from malignant pathology and to aid in staging and directing therapeutic procedures. We review the mechanisms of action of first, second and third generation contrast...... agents and their use in various endoscopic procedures in the gastrointestinal tract. Various applications of contrast-enhanced endoscopic ultrasonography include differentiating benign from malignant mediastinal lymphadenopathy, assessment of depth of invasion of esophageal, gastric and gall bladder...

  14. Abdominal ultrasonography, 2nd Ed

    International Nuclear Information System (INIS)

    Goldberg, B.B.

    1984-01-01

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

  15. Thyroid ultrasonography: Pitfalls and techniques

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seon hyeong; Kim, Eun Kyung; Kim, Soo Jin; Kwak, Jin Young [Dept. of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-04-15

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

  16. Intraductal papillary-mucinous neoplasia of the pancreas: Histopathology and molecular biology

    OpenAIRE

    Verbeke, Caroline S

    2010-01-01

    Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas is a clinically and morphologically distinctive precursor lesion of pancreatic cancer, characterized by gradual progression through a sequence of neoplastic changes. Based on the nature of the constituting neoplastic epithelium, degree of dysplasia and location within the pancreatic duct system, IPMNs are divided in several types which differ in their biological properties and clinical outcome. Molecular analysis and recent animal...

  17. Therapeutic effect of intraductal irrigation of the salivary gland: A technical report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chena [Dept. of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul (Korea, Republic of); Kim, Jo Eun; Huh, Kyoung Hoe; Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2017-06-15

    Obstructive and inflammatory disease often occurs in the major salivary glands, and no predictive treatment has yet been developed for this condition. The aim of this report was to introduce an intraductal irrigation procedure and to illustrate its application to practical patient cases. Two patients complaining of pain and swelling in the parotid gland during meals who underwent sialography were diagnosed as having sialodochitis with sialadenitis. Intraductal irrigation was then performed on the parotid gland on the side of the complaint. The irrigation procedure was conducted in the same manner as the sialography procedure, except that saline was used as the filling solution. Symptom severity was evaluated with a numerical rating scale (NRS) at the initial visit and a month after the irrigation. The initial NRS value of patient 1 was 10. The value decreased to 6 and then to 0 after 2 irrigation procedures. The NRS value of patient 2 regarding the symptoms involving the left parotid gland decreased from 4-5 to 1 after 4 irrigation procedures performed at 1-month intervals. Intraductal irrigation of the salivary gland may be a simple, safe, and effective treatment option for patients with obstructive and inflammatory disease of the salivary gland that is capable of resolving their symptoms.

  18. Therapeutic effect of intraductal irrigation of the salivary gland: A technical report.

    Science.gov (United States)

    Lee, Chena; Kim, Jo-Eun; Huh, Kyoung-Hoe; Yi, Won-Jin; Heo, Min-Suk; Lee, Sam-Sun; Choi, Soon-Chul

    2017-06-01

    Obstructive and inflammatory disease often occurs in the major salivary glands, and no predictive treatment has yet been developed for this condition. The aim of this report was to introduce an intraductal irrigation procedure and to illustrate its application to practical patient cases. Two patients complaining of pain and swelling in the parotid gland during meals who underwent sialography were diagnosed as having sialodochitis with sialadenitis. Intraductal irrigation was then performed on the parotid gland on the side of the complaint. The irrigation procedure was conducted in the same manner as the sialography procedure, except that saline was used as the filling solution. Symptom severity was evaluated with a numerical rating scale (NRS) at the initial visit and a month after the irrigation. The initial NRS value of patient 1 was 10. The value decreased to 6 and then to 0 after 2 irrigation procedures. The NRS value of patient 2 regarding the symptoms involving the left parotid gland decreased from 4-5 to 1 after 4 irrigation procedures performed at 1-month intervals. Intraductal irrigation of the salivary gland may be a simple, safe, and effective treatment option for patients with obstructive and inflammatory disease of the salivary gland that is capable of resolving their symptoms.

  19. Diagnostic performance of CT and MRI in distinguishing intraductal papillary neoplasm of the bile duct from cholangiocarcinoma with intraductal papillary growth

    International Nuclear Information System (INIS)

    Liu, Yubao; Zhong, Xiaomei; Yan, Lifen; Zheng, Junhui; Liu, Zaiyi; Liang, Changhong

    2015-01-01

    We aimed to evaluate the diagnostic performance of CT and MRI for distinguishing intraductal papillary neoplasm of the bile duct (IPNB) from cholangiocarcinoma (CC) with intraductal papillary growth (IPG). Forty-two patients with either IPNB or CC with IPG proven by histopathology were independently reviewed in retrospect. Strict criteria for diagnosis of IPNB included presence of the designated imaging features as follows: local dilatation of the bile duct, nodule within the dilated bile duct, growing along the interior wall of bile duct. Any lesion that was not consistent with the criteria was classified as CC with IPG. Sensitivity, specificity, positive and negative predictive values for characterization of IPNB were calculated, and k test was used to assess the level of agreement. Two imaging reviewers correctly identified 21 of 26 (80.8 %) and 22 of 26 (84.6 %) IPNB cases, respectively. Alternatively, they correctly identified 14 of 16 (87.5 %) and 15 of 16 (93.8 %) CC with IPG, respectively. Agreement between the two reviewers was perfect (k = 0.81) for the diagnosis of IPNB and differentiation from CC with IPG. By using our designated diagnostic criteria of CT and MRI, IPNB can be accurately identified and possible to be distinguished from CC with IPG. (orig.)

  20. Diagnostic performance of CT and MRI in distinguishing intraductal papillary neoplasm of the bile duct from cholangiocarcinoma with intraductal papillary growth

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yubao; Zhong, Xiaomei; Yan, Lifen; Zheng, Junhui; Liu, Zaiyi; Liang, Changhong [Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, Guangzhou (China)

    2015-07-15

    We aimed to evaluate the diagnostic performance of CT and MRI for distinguishing intraductal papillary neoplasm of the bile duct (IPNB) from cholangiocarcinoma (CC) with intraductal papillary growth (IPG). Forty-two patients with either IPNB or CC with IPG proven by histopathology were independently reviewed in retrospect. Strict criteria for diagnosis of IPNB included presence of the designated imaging features as follows: local dilatation of the bile duct, nodule within the dilated bile duct, growing along the interior wall of bile duct. Any lesion that was not consistent with the criteria was classified as CC with IPG. Sensitivity, specificity, positive and negative predictive values for characterization of IPNB were calculated, and k test was used to assess the level of agreement. Two imaging reviewers correctly identified 21 of 26 (80.8 %) and 22 of 26 (84.6 %) IPNB cases, respectively. Alternatively, they correctly identified 14 of 16 (87.5 %) and 15 of 16 (93.8 %) CC with IPG, respectively. Agreement between the two reviewers was perfect (k = 0.81) for the diagnosis of IPNB and differentiation from CC with IPG. By using our designated diagnostic criteria of CT and MRI, IPNB can be accurately identified and possible to be distinguished from CC with IPG. (orig.)

  1. Infusion tomography and ultrasonography of the gallbladder in the diagnosis of acute cholecystitis

    International Nuclear Information System (INIS)

    Karp, W.; Owman, T.; Herlin, P.; Holmin, T.

    1979-01-01

    Sixty-three patients with the clinical suspicion of acute cholecystitis were examined with infusion tomography of the gallbladder. Ultrasonography was performed in 51 of these cases. The technique and diagnostic principles of both methods are discussed. The diagnostic value of the two methods when used in combination is stressed. Thus in a case of gangrenous cholecystitis when opacification of the gallbladder wall may not appear at infusion tomography, ultrasonography may demonstrate signs of gallbladder disease. Infusion tomography, on the other hand, may be of great value if ultrasonography is not informative. (orig.) 891 AJ/orig. 892 BRE [de

  2. CT and MR imaging of multilocular acinar cell cystadenoma: comparison with branch duct intraductal papillary mucinous neoplasia (IPMNs)

    Energy Technology Data Exchange (ETDEWEB)

    Delavaud, Christophe; Assignies, Gaspard d' ; Vilgrain, Valerie; Vullierme, Marie-Pierre [Hopital Beaujon, Service de Radiologie, Clichy (France); Cros, Jerome [Hopital Beaujon, Service d' Anatomopathologie, Clichy (France); Ruszniewski, Philippe; Hammel, Pascal; Levy, Philippe [Hopital Beaujon, Service de Pancreato-Gastro-Enterologie, Clichy (France); Couvelard, Anne [Hopital Bichat, Service d' Anatomopathologie, Paris (France); Sauvanet, Alain; Dokmak, Safi [Hopital Beaujon, Service de Chirurgie Hepato-Pancreato-Biliaire, Clichy (France)

    2014-09-15

    To describe CT and MR imaging findings of acinar cell cystadenoma (ACC) of the pancreas and to compare them with those of branch duct intraductal papillary mucinous neoplasia (BD-IPMN) to identify distinctive elements. Five patients with ACC and the 20 consecutive patients with histologically proven BD-IPMN were retrospectively included. Clinical and biological information was collected and histological data reviewed. CT and MR findings were analysed blinded to pathological diagnosis in order to identify imaging diagnostic criteria of ACC. Patients with ACC were symptomatic in all but one case and were younger than those with BD-IPMN (p = 0.006). Four radiological criteria allowed for differentiating ACC from IPMN: five or more cysts, clustered peripheral small cysts, presence of cyst calcifications and absence of communication with the main pancreatic duct (p < 0.05). Presence of at least two or three of these imaging criteria had a strong diagnostic value for ACC with a sensitivity of 100 % and 80 % and a specificity of 85 % and 100 %, respectively. Preoperative differential diagnosis between ACC and BD-IPMN can be achieved using a combination of four CT and/or MR imaging criteria. Recognition of ACC patients could change patient management and lead to more conservative treatment. (orig.)

  3. International guidelines for contrast-enhanced ultrasonography

    DEFF Research Database (Denmark)

    Nolsøe, Christian Pállson; Lorentzen, Torben

    2016-01-01

    The intent of this review is to discuss and comment on common clinical scenarios in which contrast-enhanced ultrasonography (CEUS) may play a decisive role and to illustrate important points with typical cases. With the advent of CEUS, the scope of indications for ultrasonography has been dramati...

  4. Features of the Diagnosis of Intraductal Breast Diseases in Adolescent Girls Through the Example of Clinical Cases. The Algorithm of Examination And Treatment of Pathologies in Adolescence

    Directory of Open Access Journals (Sweden)

    M. L. Travina

    2016-01-01

    Full Text Available Intraductal breast diseases are characterized by a high risk of transformation in breast cancer. Difficulties of diagnosing intraductal lesions are associated with the only symptom — the appearance of pathologic discharge from the breast nipple. In adolescent girls, taking into account the immaturity of the nipple and it flatness, there are difficulties with removing it correctly. On physical examination, as well as with the high density of the surrounding tissue and areola, the control over the presence of pathologic discharge from the mammary ducts is difficult. The intraductal pathology requires ultrasound examination, mammography, and only after a full examination — ductographic research. The article presents its own clinical observations of the intraductal pathology in adolescent girls aged 14 and 15 years. The algorithms of examination and patient surveillance with intraductal pathology are described.

  5. Contrast-enhanced endoscopic ultrasonography

    DEFF Research Database (Denmark)

    Reddy, Nischita K; Ioncică, Ana Maria; Săftoiu, Adrian

    2011-01-01

    Contrast agents are increasingly being used to characterize the vasculature in an organ of interest, to better delineate benign from malignant pathology and to aid in staging and directing therapeutic procedures. We review the mechanisms of action of first, second and third generation contrast...... agents and their use in various endoscopic procedures in the gastrointestinal tract. Various applications of contrast-enhanced endoscopic ultrasonography include differentiating benign from malignant mediastinal lymphadenopathy, assessment of depth of invasion of esophageal, gastric and gall bladder...... cancers and visualization of the portal venous system and esophageal varices. In addition, contrast agents can be used to differentiate pancreatic lesions. The use of color Doppler further increases the ability to diagnose and differentiate various pancreatic malignancies. The sensitivity of power Doppler...

  6. Localization of intraductal mass through the ostium of the duct using wire guided ductography technique

    International Nuclear Information System (INIS)

    Aslam, M.

    2014-01-01

    To localize intraductal mass (Papilloma) before surgery Materials Guide wire 10-15 cm length of 2/3-0 Prolene/Surgipro Plastic 26G to 20G I/V cannulas Kopans breast lesion localization hook wire Disposable syringe heaving 2ml non-ionic contrast High intensity light and magnified glass. Methods: Prepare patient in sitting or lying position adjust high intensity light clean the nipple with antiseptic lotion. Elicit the discharge with gentle periareolar pressure or ask the patient to bring the discharge. If the opening with discharge is not clearly visualize use magnified glass or loop. Slowly inserted the wire into the duct orifice, it should pass freely into the duct. Introduce the 26G I/V plastic cannula coaxially over the guide wire and remove the guide wire. Gently inject 0.2-0.4 ml contrast, remove and the syringe and apply stopper. The cannula stopper assembly is secured to the breast with tape. Magnified craniocaudal view of the breast is taken, the 26G cannula removed and bigger length 22/20G cannula gradually passed over the guide wire according to distance of lesion from the ostium. Intraductal mass location is verified the hook wire is replaced with guide wire, the position of hook confirmed by mammographic film. The wire is cut 2cms from the nipple and pt. send to operation theater Results:Hook localization has been successfully carried out in six patients. Conclusion:This is a new method of localization of intraductal mass it enables the surgeon to do microductectomy with minimal cosmetic effects to the breast. (author)

  7. Transrectal ultrasonography of anorectal disease: advantages and disadvantages

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Min Ju [Dept. of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2015-01-15

    Transrectal ultrasonography (TRUS) has been widely accepted as a popular imaging modality for Epub ahead of print evaluating the lower rectum, anal sphincters, and pelvic floor in patients with various anorectal diseases. It provides excellent visualization of the layers of the rectal wall and of the anatomy of the anal canal. TRUS is an accurate tool for the staging of primary rectal cancer, especially for early stages. Although magnetic resonance imaging is a modality complementary to TRUS with advantages for evaluating the mesorectum, external sphincter, and deep pelvic inflammation, three-dimensional ultrasonography improves the detection and characterization of perianal fistulas and therefore plays a crucial role in optimal treatment planning. The operator should be familiar with the anatomy of the rectum and pelvic structures relevant to the preoperative evaluation of rectal cancer and other anal canal diseases, and should have technical proficiency in the use of TRUS combined with an awareness of its limitations compared to magnetic resonance imaging.

  8. [Value of MR imaging in the diagnosis of intraductal papillary neoplasm of the bile duct].

    Science.gov (United States)

    Song, Fengxiang; Zhou, Jun; Shi, Yuxin; Zeng, Mengsu; Zhou, Kangrong; Ding, Yuqin; Cao, Yingli; Zhou, Jianjun

    2015-01-01

    To analyze the value of MR imaging in diagnosis of intraductal papillary neoplasm of the bile duct (IPN-B). Fourteen patients with intraductal papillary neoplasms of the bile duct confirmed by surgical pathology were included in this study. The patients underwent MR routine plain scanning and enhancement scanning (including T1WI, T2WI with fat suppression, FALSH T1WI, and three-phase enhancement scanning), diffusion weighted imaging(DWI) and magnetic resonance cholangiopancreatography (MRCP) before operation. The imaging data were reviewed and analyzed retrospectively in comparison with the surgical and pathological results. In these patients, 7 cases had tumors located in the left lobe, 2 cases had tumors in both the left and right lobes, 2 cases in the hepatic hilum, 2 cases in the common bile duct, and 1 case in both the right lobe and the common bile duct. Solitary or multiple intraductal masses could be found in 12 cases, with 11 cases appeared as papillary masses and one case as flat mass. In the other two cases the tumor was not visible (one case had too many stones, and in another case the tumor was too small). The tumors in the 12 cases showed hypointensity on T1WI and hyperintensity on T2WI. On the dynamic contrast-enhanced MRI, 11 cases showed mild and one showed moderate enhancement in arterial phase, and all the cases showed mildly and gradually delayed enhancement. On DWI, the lesion areas showed high signal intensity in all the cases, and the ADC value of the tumor area (1.697×10(-3)mm(2)/s) was significantly lower than that of the normal bile (3.973×10(-3)mm(2)/s) (t = -10.94, P invisible tumors ). In the 3 cases with aneurysmal bile dilatation, the multiple directions of MRCP images helped to find the communication between the aneurysmal dilatation and the bile duct. All the cases showed significant proximal bile duct dilatation (the extent of dilatation >100%), and 9 cases also showed distal bile duct dilatation. Bile duct stones were noted in 6

  9. Intraductal carcinoma of the prostate: a distinct histopathological entity with important prognostic implications.

    Science.gov (United States)

    Henry, P C; Evans, A J

    2009-07-01

    Intraductal carcinoma of the prostate (IDCP) has been described as a lesion associated with poor prognostic features in prostate cancer. Its recognition and reporting in prostate specimens, particularly in needle biopsies, is critical as it carries significant implications for patient management. Recent histological definitions have been proposed to assist in the recognition of IDCP and to help distinguish it from lesions with similar appearance, but different clinical behaviour. In this review, a historical overview of the description of IDCP will be presented followed by a summary of the current histological diagnostic criteria and the recommendations for management and reporting of IDCP.

  10. Intraductal papillary-mucinous neoplasia of the pancreas: Histopathology and molecular biology.

    Science.gov (United States)

    Verbeke, Caroline S

    2010-10-27

    Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas is a clinically and morphologically distinctive precursor lesion of pancreatic cancer, characterized by gradual progression through a sequence of neoplastic changes. Based on the nature of the constituting neoplastic epithelium, degree of dysplasia and location within the pancreatic duct system, IPMNs are divided in several types which differ in their biological properties and clinical outcome. Molecular analysis and recent animal studies suggest that IPMNs develop in the context of a field-defect and reveal their possible relationship with other neoplastic precursor lesions of pancreatic cancer.

  11. Percutaneous Intraductal Radiofrequency Ablation is a Safe Treatment for Malignant Biliary Obstruction: Feasibility and Early Results

    Energy Technology Data Exchange (ETDEWEB)

    Mizandari, Malkhaz [Tbilisi State Medical University, Department of Radiology (Georgia); Pai, Madhava, E-mail: madhava.pai@imperial.ac.uk; Xi Feng [Imperial College, London, Hammersmith Hospital Campus, Department of Surgery (United Kingdom); Valek, Vlastimil; Tomas, Andrasina [University Hospital Brno Bohunice, Department of Radiology (Czech Republic); Quaretti, Pietro [IRCCS Policlinico San Matteo, Department of Radiology (Italy); Golfieri, Rita; Mosconi, Cristina [University of Bologna, Department of Radiology, Policlinico S. Orsola-Malpighi (Italy); Ao Guokun [The 309 Hospital of Chinese PLA, Department of Radiology (China); Kyriakides, Charis [Imperial College, London, Hammersmith Hospital Campus, Department of Surgery (United Kingdom); Dickinson, Robert [Imperial College London, Department of Bioengineering (United Kingdom); Nicholls, Joanna; Habib, Nagy, E-mail: nagy.habib@imperial.ac.uk [Imperial College, London, Hammersmith Hospital Campus, Department of Surgery (United Kingdom)

    2013-06-15

    Purpose. Previous clinical studies have shown the safety and efficacy of this novel radiofrequency ablation catheter when used for endoscopic palliative procedures. We report a retrospective study with the results of first in man percutaneous intraductal radiofrequency ablation in patients with malignant biliary obstruction. Methods. Thirty-nine patients with inoperable malignant biliary obstruction were included. These patients underwent intraductal biliary radiofrequency ablation of their malignant biliary strictures following external biliary decompression with an internal-external biliary drainage. Following ablation, they had a metal stent inserted. Results. Following this intervention, there were no 30-day mortality, hemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the 39 patients, 28 are alive and 10 patients are dead with a median survival of 89.5 (range 14-260) days and median stent patency of 84.5 (range 14-260) days. One patient was lost to follow-up. All but one patient had their stent patent at the time of last follow-up or death. One patient with stent blockage at 42 days postprocedure underwent percutaneous transhepatic drain insertion and restenting. Among the patients who are alive (n = 28) the median stent patency was 92 (range 14-260) days, whereas the patients who died (n = 10) had a median stent patency of 62.5 (range 38-210) days. Conclusions. In this group of patients, it appears that this new approach is feasible and safe. Efficacy remains to be proven in future, randomized, prospective studies.

  12. Magnetic Resonance Evaluation of the Presence of an Extensive Intraductal Component in Breast Cancer

    International Nuclear Information System (INIS)

    Ikeda, O.; Nishimura, R.; Miyayama, H.; Yasunaga, T.; Ozaki, Y.; Tsuji, A.; Yamashita, Y.

    2004-01-01

    Purpose: To determine whether the presence of extensive intraductal components (EIC) in breast carcinomas can be accurately evaluated on magnetic resonance (MR) images. Material and Methods: Ninety-three women with breast cancer, aged between 32 and 79 years (mean 54 years), underwent three-dimensional dynamic MR imaging (dyMRI) with fat suppression and magnetization transfer contrast before breast-conserving surgery. The tumors were classified on dyMRI as circumscribed, microlobulated, and/or speculated, and their size was measured. Spotty or linear continuous enhancement (SLE) from the main tumor to the nipple and segmental enhancement surrounding the main tumor (SE) were considered indicative of intraductal tumor spread. The correlation between preoperative MRI and macroscopic and microscopic findings was examined. Results: On MR images, the tumor sizes ranged from 0.8 to 3.4 cm. These measurements coincided with histologic measurements in circumscribed tumors. However, in tumors with microlobulated or spiculated borders, tumor size tended to be underestimated on MR images. Of 93 patients, 59 (63.4%) had histologically confirmed EIC; 42 of the 59 cancers (71.2%) manifested SLE or SE on MR images. The sensitivity, specificity, and accuracy of MR imaging in detecting EIC were 71%, 85%, and 76%, respectively. Conclusion: MR imaging facilitates the detection of EIC in breast masses. This information is valuable for the planning of breast-conserving surgery

  13. Urinary tract infection in children: Role of ultrasonography

    International Nuclear Information System (INIS)

    Lee, Hye Won; Lee, Sun Wha; Ko, Young Tae; Lim, Joo Won

    1994-01-01

    To evaluate diagnostic usefulness of ultrasonography(US) in pediatric patient with urinary tract infection. Fifty-five children with urinary tract infection underwent renal ultrasonography and voiding cystourethrography(VCUG). The imaging findings were analyzed retrospectively. Renal sonograms were normal in 34 of 55 children(62%). Five of 34 patients with normal sonogram had vesicoureteral reflux of grade I and III on VCUG. Renal sonograms were abnormal in 21 of 55 children(38%). Sonographic findings included hydronephrosis, hyperechoic kidney, nephromegaly, altrophic kidney, renal abscess, and duplex ureter. Eleven of 21 patient with abnormal sonogram had vesicoureteral reflux of grade I to IV on VCUG. Ultrasonography is an useful and reliable initial screening examination in the investigation of children with UTI. Unfortunately US is neither sufficiently sensitive nor specific for detecting VUR. VCUG provides confirmative and valuable information about vesicoureteral reflux, and VCUG should be considered as a next modality for UTI. The combined use of sonography and VCUG provides more valuable information in urinary tract infection

  14. Ultrasonography of the shoulder: pitfalls and variants

    International Nuclear Information System (INIS)

    Friedman, L.; Finlay, K.; Popowich, T.; Jurriaans, E.

    2002-01-01

    Ultrasonography (US) of the shoulder, particularly the evaluation of the rotator cuff, is the most common examination of the musculoskeletal system performed in most practices. Despite this, it remains one of the most difficult examinations to learn. There are many pitfalls and errors that can occur initially, but once mastered, US of the rotator cuff is one of the best methods available for diagnosing rotator cuff disease. The literature reports a 91%-95% sensitivity and close to 90% specificity and accuracy in the assessment of both partial and full thickness tears. This compares favourably with magnetic resonance imaging (MRI), where a more recent study reported an 84% sensitivity, 97% specificity and an accuracy of 93% for combined partial and full thickness tears of the rotator cuff. Advantages of US include low cost, easy access, high degree of accuracy in expert hands, ease of comparison with the opposite side, dynamic real-time examination, ability to focus on the exact site of the patient's pain and graded compression availability. It is for these reasons that we hope to outline the various pitfalls and common errors that can occur during the examination in a systematic fashion. It must also be pointed out that computed tomographic arthrography and magnetic resonance arthrography remain the investigations of choice for assessing labral disorders. (author)

  15. The role of intraductal US in the management of idiopathic recurrent pancreatitis without a definite cause on ERCP.

    Science.gov (United States)

    Kim, Hyun Su; Moon, Jong Ho; Choi, Hyun Jong; Lee, Jong Chan; Han, Seung Hyo; Hong, Su Jin; Lee, Tae Hoon; Cheon, Young Koog; Cho, Young Deok; Park, Sang-Heum; Lee, Moon Sung

    2011-06-01

    The cause of pancreatitis is unknown in as many as 30% of cases of recurrent acute pancreatitis, even after ERCP. To investigate the role of intraductal US (IDUS) for managing idiopathic recurrent pancreatitis (IRP). Prospective study. Tertiary referral hospital. Thirty-one patients with suspicious IRP with negative findings on ERCP. IDUS during ERCP. IDUS findings showing any possible cause of pancreatitis. IDUS revealed small bile duct stones (≤3 mm) in 5 patients (16.1%) and sludge in 3 patients (9.7%). The detection rate for a bile duct stone and sludge was significantly higher in patients with a dilated CBD than a nondilated CBD on ERCP (71.4 vs 12.5%; P < .05). Recurrent pancreatitis did not develop in 7 of 8 patients with biliary stones or sludge after an endoscopic sphincterotomy (EST). Two patients (6.5%) demonstrated a small polypoid lesion on the distal end of the pancreatic duct. One patient underwent surgery for intra-ampullary cancer, and another one underwent EST without another attack of pancreatitis. Three patients (9.7%) showed evidence of chronic pancreatitis with small pancreatic stones and/or calcifications on IDUS. Small number of patients. IDUS results were not compared with those of conventional EUS. There was no reference standard for chronic pancreatitis as diagnosed by IDUS. IDUS identified a possible cause of idiopathic recurrent pancreatitis in 42% of patients with negative findings on ERCP. The IDUS-guided approach combined with ERCP and EST may be useful for decreasing recurring attacks of pancreatitis. Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  16. Intraductal papillary mucinous neoplasms (IPMN of the pancreas: clinico-pathologic results Neoplasia papilar mucinosa intraductal del páncreas: resultados clínico-patológicos

    Directory of Open Access Journals (Sweden)

    J. A. Cienfuegos

    2010-05-01

    Full Text Available Background: intraductal papillary mucinous neoplasm (IPMN shows a series of lesions which evolve from benign lesions -adenoma- to invasive carcinoma. Aim: to analyze the clinical and pathological results of 15 patients diagnosed of IPMN, and surgically treated according to the guidelines of International Consensus Conference. Material and methods: a retrospective analysis of 15 patients surgically treated between March 1993 and September 2009, according to the International Consensus recommendation. Demographic, diagnostic tools, surgical report, pathologic database and actuarial survival were analyzed with a follow-up from one and a half month through nine years. Results: 6 patients underwent pancreaticoduodenectomies, 4 total pancreatectomies, 2 body or central pancreatectomies, 2 partial pancreatectomies (enucleation and 1 distal pancreatectomy. A morbidity of 46 and 0% hospital mortality were assessed, with a median length hospital stay of 10 days. In five cases, the IPMN was combined type (both main and branch pancreatic ducts involved in four main duct-type and branch duct-type in the another six as well. Several atypia (IPMN carcinoma in situ was observed in 2 patients and invasive carcinoma with negative lymph nodes was identified in 3 patients. A patient without invasive carcinoma died at 66 months of follow-up for pancreas adenocarcinoma. The actuarial survival up to recurrence or death was 105,133 months with a range of follow-up from 1 month and a half until 9 years. Conclusions: IPMN main duct or mixed type warrants complete resection due to its incidence of invasive carcinoma or precursor lesions of malignancy as well. Due to its multifocal pattern, patients should be followed in long-term surveillance. The management of asymptomatic IPMN type branch less than 3 cm is controversial.Introducción: la neoplasia papilar mucinosa intraductal (NPMI del páncreas comprende una serie de lesiones que evolucionan desde lesiones benignas

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

    Science.gov (United States)

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

    2018-01-01

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

  18. Ultrasonography and surgery of canine biliary diseases.

    Science.gov (United States)

    Vörös, K; Németh, T; Vrabély, T; Manczur, F; Tóth, J; Magdus, M; Perge, E

    2001-01-01

    Findings of hepatic and gallbladder ultrasonography were analyzed in 12 dogs with gallbladder and/or extrahepatic biliary tract obstruction and compared with the results of exploratory laparotomy. Hepatic ultrasonography demonstrated normal liver in 2 dogs and hepatic abnormalities in 10 animals. The following ultrasonographic diagnoses were established compared to surgical findings: gallbladder obstruction caused by bile sludge (correct/incorrect: 1/2, surgical diagnosis: choleliths in one case), gallbladder obstruction caused by neoplasm (0/1, surgical diagnosis: mucocele), gallbladder and extrahepatic biliary tract obstruction due to choleliths (3/3), extrahepatic biliary tract obstruction caused by pancreatic mass (1/1) and small intestinal volvulus (1/1). Bile peritonitis caused by gallbladder rupture (4/4) was correctly diagnosed by ultrasound, aided with ultrasonographically-guided abdominocentesis and peritoneal fluid analysis. Rupture of the gallbladder should be suspected in the presence of a small, echogenic gallbladder or in the absence of the organ together with free abdominal fluid during ultrasonography. Laparotomy was correctly indicated by ultrasonography in all cases. However, the direct cause of obstruction could not be determined in 2 of the 12 dogs by ultrasonography alone.

  19. Role of Ultrasonography in Acute Abdomen

    International Nuclear Information System (INIS)

    An, Ji Hyun; Lee, Yeon Hee; Kim, Tae Hoon; Yu, Pil Mun; Choi, Young Hi; Kim, Sang Joon; Kim, Seung Cheul; Cho, Jeong Hee; Jung, Jae Un

    1996-01-01

    Authors analyzed the distribution of diseases and compared ultrasonographic conclusions with confirmed diagnoses of emergency abdominal ultrasonographies in acute abdominal conditions. We evaluated the role of emergency abdominal ultrasonography especially in the decision of emergency operation. In one hundred and forty five patients, emergent abdominal ultrasonography was performed within on admission. We compared the sonographic conclusion with postoperative pathology and analyzed the diagnoses of medically treated diseases. Twenty-eight patients under vent surgery and 117 patients were treated conservatively. Among the surgically treated patients, 19 patients (70.4%) were correctly diagnosed by preoperative ultrasonography.These included acute appendicitis (N = 8), acute cholecystitis (n = 7), ovarian cyst torsion (n = 2), and liver abscess (n = 1). Correct preoperative diagnosis was not made in 9 patients, including acute appendicitis (n = 4),peritonitis due to bowel perforation (n = 2), ectopic pregnancy (n = 1), colonic diverticulitis (n = 1 ) and pelvic inflammatory disease (n = 1 ). Clinical follow up was possible in 50 patients among the non-operative patient group, and the clinical diagnoses were chronic liver disease (n = 14), acute pyelonephritis (n = 10), and biliary stone (n = 10). Emergent ultrasonography plays an important role in acute abdominal conditions by supporting the differential diagnosis of medical and surgical disease

  20. Role of Ultrasonography in Acute Abdomen

    Energy Technology Data Exchange (ETDEWEB)

    An, Ji Hyun; Lee, Yeon Hee; Kim, Tae Hoon; Yu, Pil Mun; Choi, Young Hi; Kim, Sang Joon; Kim, Seung Cheul; Cho, Jeong Hee [Dankook University College of Medicine, Cheonan (Korea, Republic of); Jung, Jae Un [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1996-12-15

    Authors analyzed the distribution of diseases and compared ultrasonographic conclusions with confirmed diagnoses of emergency abdominal ultrasonographies in acute abdominal conditions. We evaluated the role of emergency abdominal ultrasonography especially in the decision of emergency operation. In one hundred and forty five patients, emergent abdominal ultrasonography was performed within on admission. We compared the sonographic conclusion with postoperative pathology and analyzed the diagnoses of medically treated diseases. Twenty-eight patients underwent surgery and 117 patients were treated conservatively. Among the surgically treated patients, 19 patients (70.4%) were correctly diagnosed by preoperative ultrasonography.These included acute appendicitis (N = 8), acute cholecystitis (n = 7), ovarian cyst torsion (n = 2), and liver abscess (n = 1). Correct preoperative diagnosis was not made in 9 patients, including acute appendicitis (n = 4), peritonitis due to bowel perforation (n = 2), ectopic pregnancy (n = 1), colonic diverticulitis (n = 1) and pelvic inflammatory disease (n = 1). Clinical follow up was possible in 50 patients among the non-operative patient group, and the clinical diagnoses were chronic liver disease (n = 14), acute pyelonephritis (n = 10), and biliary stone (n = 10). Emergent ultrasonography plays an important role in acute abdominal conditions by supporting the differential diagnosis of medical and surgical disease

  1. Point-of-Care Ultrasonography to Assess Portal Vein Pulsatility and the Effect of Inhaled Milrinone and Epoprostenol in Severe Right Ventricular Failure: A Report of 2 Cases.

    Science.gov (United States)

    Tremblay, Jan-Alexis; Beaubien-Souligny, William; Elmi-Sarabi, Mahsa; Desjardins, Georges; Denault, André Y

    2017-10-15

    This article describes 2 patients with severe acute right ventricular failure causing circulatory shock. Portal vein pulsatility assessed by bedside ultrasonography suggested clinically relevant venous congestion. Management included cardiac preload reduction and combined inhalation of milrinone and epoprostenol to reduce right ventricular afterload. Portal vein ultrasonography may be useful in assessing right ventricular function in the acutely ill patient.

  2. The evaluation of extensive intraductal component (EIC) in breast carcinoma using MR mammography

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Yasuhiro; Mineta, Masayuki; Yamada, Tomonori [Asahikawa Medical Univ. (Japan)] [and others

    1997-10-01

    Twenty-one patients with breast cancer underwent MR mammography (MRM) for evaluation of extensive intraductal component (EIC). Linear or small nodular structures continuing to main tumor, irregular margin, and early stain on dynamic scan were considered to be suggestive of EIC. The sensitivity, specificity and accuracy of detecting EIC were 88.9%, 91.7% and 90.5%, respectively. Misleading structures or pathological conditions to distinguish from EIC on MRM were interstitial connective tissue, interstitial spreading of the cancer, mastitis, and vessels. Although MRM appears to be very useful in evaluating EIC of the breast cancer, it is necessary for the radiologist to understand that there are several misleading signal intensities or abnormal enhancement to discriminate from EIC. (author)

  3. Acute Cholangitis following Intraductal Migration of Surgical Clips 10 Years after Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    Natalie E. Cookson

    2015-01-01

    Full Text Available Background. Laparoscopic cholecystectomy represents the gold standard approach for treatment of symptomatic gallstones. Surgery-associated complications include bleeding, bile duct injury, and retained stones. Migration of surgical clips after cholecystectomy is a rare complication and may result in gallstone formation “clip cholelithiasis”. Case Report. We report a case of a 55-year-old female patient who presented with right upper quadrant pain and severe sepsis having undergone an uncomplicated laparoscopic cholecystectomy 10 years earlier. Computed tomography (CT imaging revealed hyperdense material in the common bile duct (CBD compatible with retained calculus. Endoscopic retrograde cholangiopancreatography (ERCP revealed appearances in keeping with a migrated surgical clip within the CBD. Balloon trawl successfully extracted this, alleviating the patient’s jaundice and sepsis. Conclusion. Intraductal clip migration is a rarely encountered complication after laparoscopic cholecystectomy which may lead to choledocholithiasis. Appropriate management requires timely identification and ERCP.

  4. Intraductal papillary mucinous neoplasms of the pancreas: reporting clinically relevant features.

    Science.gov (United States)

    Del Chiaro, Marco; Verbeke, Caroline

    2017-05-01

    Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas can exhibit a wide spectrum of macroscopic and microscopic appearances. This not only causes occasional difficulties for the reporting pathologist in distinguishing these tumours from other lesions, but is also relevant clinically. As evidence accumulates, it becomes clear that multiple macroscopic and histological features of these neoplasms are relevant to the risk for malignant transformation and, consequently, of prime importance for clinical patient management. The need for detailed reporting is therefore increasing. This review discusses the panoply of gross and microscopic features of IPMN as well as the recommendations from recent consensus meetings regarding the pathology reporting on this tumour entity. © 2016 John Wiley & Sons Ltd.

  5. Autoimmune pancreatitis type-1 associated with intraduct papillary mucinous neoplasm: report of two cases.

    Science.gov (United States)

    Vaquero, Eva C; Salcedo, Maria T; Cuatrecasas, Míriam; De León, Hannah; Merino, Xavier; Navarro, Salvador; Ginès, Angels; Abu-Suboh, Monder; Balsells, Joaquim; Fernández-Cruz, Laureano; Molero, Xavier

    2014-01-01

    Chronic pancreatitis lesions usually embrace both intraduct papillary mucinous neoplasm (IPMN) and pancreatic ductal adenocarcinoma (PDAC). Patients at genetically-determined high risk of PDAC often harbor IPMN and/or chronic pancreatitis, suggesting IPMN, chronic pancreatitis and PDAC may share pathogenetic mechanisms. Chronic autoimmune pancreatitis (AIP) may also herald PDAC. Concurrent IPMN and AIP have been reported in few patients. Here we describe two patients with IPMN who developed type-1 AIP fulfilling the Honolulu and Boston diagnostic criteria. AIP diffusively affected the whole pancreas, as well as peripancreatic lymph nodes and the gallbladder. Previous pancreatic resection of focal IPMN did not show features of AIP. One of the patients carried a CFTR class-I mutation. Of notice, serum IgG4 levels gradually decreased to normal values after IPMN excision. Common risk factors to IPMN and AIP may facilitate its coincidental generation. Copyright © 2014 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  6. Thread sign in biliary intraductal papillary mucinous neoplasm: a novel specific finding for MRI

    International Nuclear Information System (INIS)

    Hong, Gil-Sun; Byun, Jae Ho; Kim, Jin Hee; Kim, Hyoung Jung; Lee, Seung Soo; Lee, Moon-Gyu; Hong, Seung-Mo

    2016-01-01

    To evaluate thread sign of biliary intraductal papillary mucinous neoplasm (B-IPMN) on magnetic resonance imaging (MRI). Thread sign was defined as intraductal linear or curvilinear hypointense striations. Two radiologists independently evaluated the presence and location of thread sign on MR cholangiography (thin-slice, thick-slab and 3D MRC) and axial MR images (T2 TSE, T2 HASTE and DWI) in patients with B-IPMN (n = 38) and in matched control groups with benign (n = 36) or malignant (n = 35) biliary diseases. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of thread sign for diagnosing B-IPMN were evaluated. Thread sign was observed only in patients with B-IPMN on MRC (44.7-52.6 % [17/38-20/38], P < 0.001) and axial MR images (31.6 % [12/38], P < 0.001), except in one patient with recurrent pyogenic cholangitis on MRC (2.8 %, 1/36). The sensitivity, specificity, accuracy, PPV and NPV of thread sign for diagnosing B-IPMN on MRC were 0.53, 0.99, 0.83, 0.95 and 0.80, respectively (reader 1) and 0.45, 1.0, 0.81, 1.0 and 0.77, respectively (reader 2). Thread sign was detected mainly at the extrahepatic bile duct (52.6 %, 20/38). B-IPMN can manifest thread sign, a novel specific MR finding, mainly at the extrahepatic bile duct on MRI, especially on MRC. (orig.)

  7. [Immunoexpression of c-erbB-2 in intraductal proliferative lesions of the female breast].

    Science.gov (United States)

    Oliveira, Agliberto Barbosa de; De Luca, Laurival Antônio; Carvalho, Grigna Teixeira; Arias, Victor Eduardo Arua; Carvalho, Lídia Raquel de; Assunção, Maria do Carmo

    2004-01-01

    Genetic modifications are related to genesis and development of cancer. Neoplasias in various organs express the c-erbB-2 oncogene. In intraductal proliferations of the breast it has been assessed as a risk factor for subsequent development of carcinoma. The c-erbB-2 immunoexpression in intraductal epithelial proliferations and the relationship with histopathological characteristics of ductal carcinoma in situ (DCIS) were evaluated. File material from 88 women, which were tissue samples formalin-fixed, paraffin-embedded blocks, was used. Of these 51 presented with DCIS and 37 with ductal hyperplasia without atypia. Ages of the women ranged from 35 to 76 years. All cases were reviewed and nuclear grade, presence of necrosis, preponderance of histological subtype and its extension were verified. Specimens were obtained for the c-erB-2 immunohistochemical study of 84 of the women in question. No expression of the oncogene was verified in the hyperplasias without atypias and in tissues adjacent to all tissue samples. Expression of c-erbB-2 was verified in 9 (19.1%) of the DCIS (p = 0.0001). Immunoexpression was not related to the extension of the lesions. The c-erbB-2 immunoexpression in DCIS was correlated to the histological subtype (p = 0.019), necrosis (p = 0.0066), nuclear grade (p = 0.0084) and Van Nuys Classification (p = 0.039). Expression of c-erbB-2 was significant in proliferative lesions with risk (DCIS) and was correlated to histopathological characteristics: high nuclear grade, presence of necrosis and comedy subtype. There was no expression in the hyperplasias without atypias and adjacent tissues.

  8. Diabetic Nephropathy : Evaluation with Doppler Ultrasonography

    International Nuclear Information System (INIS)

    Sim, Jung Suk; Kim, Seung Hyup; Kang, Heung Sik; Park, Jae Hyung; Han, Man Chung

    1996-01-01

    To compare Doppler ultrasonography with laboratory tests in evaluation of diabetic nephropathy. Fifty-five patients (mean age = 60, M : F = 26 : 29) with diabetes mellitus underwent renal Doppler ultrasonography. Resistive indices were compared with degree of proteinuria, serum creatinine level, and creatinine clearance rate. Eighteen patients who showed no proteinuria or microscopic proteinuria had a mean resistive index (RI) of 0.72 (SD, 0.05), 16 patients with macroscopic proteinuria without nephrotic syndrome had a mean RI of 0.82 (SD, 0.13), and 21 patients with nephrotic syndrome had a mean RI of 0.90 (SD, 0.12). Renal RI correlated highly with serum creatinine level (r = 0.62) and creatinine clearance rate (r = -0.43). Renal Doppler ultrasonography provides a useful indication of renal function in diabetic nephropathy but cannot offer an advantage over conventional laboratory test

  9. Effect of adding screening ultrasonography to screening mammography on patient recall and cancer detection rates: A retrospective study in Japan

    International Nuclear Information System (INIS)

    Tohno, Eriko; Umemoto, Takeshi; Sasaki, Kyoko; Morishima, Isamu; Ueno, Ei

    2013-01-01

    Purpose: To determine whether adding screening ultrasonography to screening mammography can reduce patient recall rates and increase cancer detection rates. Materials and methods: We analyzed the results of mammography and ultrasonography breast screenings performed at the Total Health Evaluation Center Tsukuba, Japan, between April 2011 and March 2012. We also reviewed the modalities and results of diagnostic examinations from women with mammographic abnormalities who visited the Tsukuba Medical Center Hospital for further testing. Results: Of 11,753 women screened, cancer was diagnosed in 10 (0.22%) of the 4529 participants who underwent mammography alone, 23 (0.37%) of the 6250 participants who underwent ultrasonography alone, and 5 (0.51%) of the 974 participants who underwent mammography and ultrasonography. The recall rate due to mammographic abnormalities was 4.9% for women screened only with mammography and 2.6% for those screened with both modalities. The cancer detection rate was 0.22% for women screened only with mammography (positive predictive value, 4.5%) and 0.31% for those screened with both modalities (positive predictive value, 12.0%). Of the 211 lesions presenting as mammographic abnormalities investigated further, diagnostic ultrasonography found no abnormalities in 63 (29.9%) and benign findings in 69 (33.7%). The rest 36.4% needed mammography, cytological or histological examinations or follow-up in addition to diagnostic ultrasonography. Conclusions: It is possible to reduce the recall rate in screening mammography by combining mammography and ultrasonography for breast screening

  10. Scintigraphy and ultrasonography of various thyroid diseases

    International Nuclear Information System (INIS)

    Ban, Yoshio; Nagakura, Hozumi; Kawauchi, Akihiro; Fukunari, Nobuhiro; Itoh, Kunihiko; Higashi, Tomomitsu.

    1987-01-01

    We reported the usefulness of scintigraphy and ultrasonography of various thyroid diseases. The scintigraphy were useful information in the determination of functioning adenoma, location of ectopic thyroid glands and appearance of lang and bone metastasis of thyroid carcinoma. As ultrasonography were able to be observation of internal structure of thyroid gland, that maight be used to determined associated nodular lesions in diffuse goiter and differentiation between benign and malignant tumor in nodular goiter. In observation of calcifications of goiter, soft X rays apparatus were usefull tool. US, as initial diagnostic test before scintiscanning, provided useful information and minimized radiation exposure. (author)

  11. An analysis of 1018 cases of ultrasonography

    International Nuclear Information System (INIS)

    Kim, Chu Wan; Suh, Jeong Soo; Lee, Kwan Seh; Kim, Ki Hwan; Im, Chung Gie; Chang, Kee Hyun; Yeon, Kyung Mo; Han, Man Chung; Choo, Dong Woon

    1985-01-01

    1, transplanted kidney 1. 9. In 8 cases of polycystic disease of kidney, 1 case combined with liver involvement, other 1 case with liver, pancreas, splenic involvement. 10. Ob. and Gyn. fields 122; 1) 57 in Gyn. field -- normal 4, massive ascites 4, overian cyst 21, overian teratodermoid 7, uterine myoma 7, H-mole 6, cervix and rectal cancer follow-up 6, PID with abscess 2. 2) 65 in Ob. field -- normal scan 3, detection of early pregnancy 27, fetal cephalometry and presentation 16, placental localization 11, with normal 6, placenta previa 5, fetal death 5, multiple pregnancy 2. fetal anomaly (anencephaly) 1. 11. Eyeballs and orbit; of 14 cases, 7 cases of retinal detachment, vitreous opacity due to hemorrhage or exudation with clinical contribution in all cases. Exact localization and extent of disease could be done in 2 cases of choroidal melanoma. 12. We could have great diagnostic advantage in various aspects by ultrasonography, and if we use it as a complementary study with other diagnostic methods, we could expect better results under the previous experiences.

  12. Diagnosis of a Nonpalpable Intraductal Papilloma without Radiological Abnormality by Nipple Discharge Smear Examination: A Case Report

    Directory of Open Access Journals (Sweden)

    Anshul Singh

    2014-01-01

    Full Text Available Nipple discharge is the third most common breast complaint after breast pain and breast mass, most commonly associated with endocrine alterations and/or medications, pregnancy, lactation, post lactation, fibrocystic disease, intraductal papilloma, duct ectasia, nipple adenoma, infection, chronic mastitis, subareolar abscess, and least frequently, breast carcinoma. Cytological examination of nipple discharge (ND is a noninvasive method of diagnosing the underlying breast pathology. We report a 46 year old female, who presented with pain and blood-mixed ND from the right breast with an impalpable mass. Cytological examination of the discharge was done and diagnosis of papillary neoplasm with degeneration, metaplasia, and atypia was given, which was further confirmed on histology and positive IHC for HMWCK and p63. Final diagnosis was intraductal papilloma of the lactiferous duct with squamous metaplasia and infarction. Differentiating benign papilloma from a carcinoma is challenging to the cytopathologist and requires clinicopathological correlation and a good knowledge of cytology.

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

    Science.gov (United States)

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

    2014-01-01

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

  14. The current status and future prospects of breast cancer screening using ultrasonography at our facility

    International Nuclear Information System (INIS)

    Morikubo, Hiroshi; Ichimura, Miyuki; Abe, Satoko

    2011-01-01

    We report the results obtained by breast cancer screening of the general population using both ultrasonography and mammography conducted by the Tochigi Public Health Service Association. An investigation of breast cancer screening carried out on approximately 140,000 participants between 2000 and 2007 showed that ultrasonography and mammography are remarkably complementary for detection of breast cancer, particularly for women in their 40s and 50s, and that each modality improves the sensitivity of breast cancer detection by approximately 20%. The following issues are pivotal for establishing a breast cancer ultrasonography screening system that is able to maintain high precision and adequate efficiency: technical training of sonographers and physicians who must interpret the sonographic images, quality control of equipment, and an interpretation system that allows previous sonographs to be used as a reference. In independent combined screening systems using ultrasonography and mammography, the high recall rate becomes an issue. Comparative interpretation of sonographic images with previous sonographs is effective for resolving this. However, hopes abound for a comprehensive assessment system that allows simultaneous imaging and interpretation of both ultrasonography and mammography. (author)

  15. A case report: Cavitary infarction caused by pulmonary tumor thrombotic microangiopathy in a patient with pancreatic intraductal papillary mucinous neoplasm

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Kyoung Kyg; Kwon, Woon Jung; Choi, Seong Hoon; Lee, Jong Hwa; Cha, Hee Jeong [Ulsan University Hospital, University of Ulsan School of Medicine, Ulsan (Korea, Republic of)

    2015-08-15

    Pulmonary tumor embolism is commonly discovered at autopsy, but is rarely suspected ante-mortem. Microangiopathy is an uncommon and distinct form of simple tumor pulmonary embolism. Here, we present a 52-year-old male with tumor thrombotic microangiopathy and pulmonary infarction, which might have originated from intraductal papillary mucinous tumor of the pancreas. Multiple wedge-shaped consolidations were found initially and aggravated with cavitation. These CT features of pulmonary infarction were pathologically confirmed to result from pulmonary tumor thrombotic microangiopathy.

  16. Somatic mutations in PIK3CA and activation of AKT in intraductal tubulopapillary neoplasms of the pancreas.

    Science.gov (United States)

    Yamaguchi, Hiroshi; Kuboki, Yuko; Hatori, Takashi; Yamamoto, Masakazu; Shiratori, Keiko; Kawamura, Shunji; Kobayashi, Makio; Shimizu, Michio; Ban, Shinichi; Koyama, Isamu; Higashi, Morihiro; Shin, Nobuhiro; Ishida, Kazuyuki; Morikawa, Takanori; Motoi, Fuyuhiko; Unno, Michiaki; Kanno, Atsushi; Satoh, Kennichi; Shimosegawa, Tooru; Orikasa, Hideki; Watanabe, Tomoo; Nishimura, Kazuhiko; Harada, Youji; Furukawa, Toru

    2011-12-01

    Intraductal tubulopapillary neoplasm (ITPN) is a recently recognized rare variant of intraductal neoplasms of the pancreas. Molecular aberrations underlying the neoplasm remain unknown. We investigated somatic mutations in PIK3CA, PTEN, AKT1, KRAS, and BRAF. We also investigated aberrant expressions of phosphorylated AKT, phosphatase and tensin homolog (PTEN), tumor protein 53 (TP53), SMAD4, and CTNNB1 in 11 cases of ITPNs and compared these data with those of 50 cases of intraductal papillary mucinous neoplasm (IPMN), another distinct variant of pancreatic intraductal neoplasms. Mutations in PIK3CA were found in 3 of 11 ITPNs but not in IPMNs (P = 0.005; Fisher exact test). In contrast, mutations in KRAS were found in none of the ITPNs but were found in 26 of the 50 IPMNs (P = 0.001; Fisher exact test). PIK3CA mutations were associated with strong expression of phosphorylated AKT (P AKT was apparent in most ITPNs but only in a few IPMNs (P SMAD4, and CTNNB1 were not statistically different between these neoplasms. Mutations in PIK3CA and the expression of phosphorylated AKT were not associated with age, sex, tissue invasion, and patients' prognosis in ITPNs. These results indicate that activation of the phosphatidylinositol 3-kinase pathway may play a crucial role in ITPNs but not in IPMNs. In contrast, the mutation in KRAS seems to play a major role in IPMNs but not in ITPNs. The activated phosphatidylinositol 3-kinase pathway may be a potential target for molecular diagnosis and therapy of ITPNs.

  17. A nomogram based on mammary ductoscopic indicators for evaluating the risk of breast cancer in intraductal neoplasms with nipple discharge.

    Science.gov (United States)

    Lian, Zhen-Qiang; Wang, Qi; Zhang, An-Qin; Zhang, Jiang-Yu; Han, Xiao-Rong; Yu, Hai-Yun; Xie, Si-Mei

    2015-04-01

    Mammary ductoscopy (MD) is commonly used to detect intraductal lesions associated with nipple discharge. This study investigated the relationships between ductoscopic image-based indicators and breast cancer risk, and developed a nomogram for evaluating breast cancer risk in intraductal neoplasms with nipple discharge. A total of 879 consecutive inpatients (916 breasts) with nipple discharge who underwent selective duct excision for intraductal neoplasms detected by MD from June 2008 to April 2014 were analyzed retrospectively. A nomogram was developed using a multivariate logistic regression model based on data from a training set (687 cases) and validated in an independent validation set (229 cases). A Youden-derived cut-off value was assigned to the nomogram for the diagnosis of breast cancer. Color of discharge, location, appearance, and surface of neoplasm, and morphology of ductal wall were independent predictors for breast cancer in multivariate logistic regression analysis. A nomogram based on these predictors performed well. The P value of the Hosmer-Lemeshow test for the prediction model was 0.36. Area under the curve values of 0.812 (95 % confidence interval (CI) 0.763-0.860) and 0.738 (95 % CI 0.635-0.841) was obtained in the training and validation sets, respectively. The accuracies of the nomogram for breast cancer diagnosis were 71.2 % in the training set and 75.5 % in the validation set. We developed a nomogram for evaluating breast cancer risk in intraductal neoplasms with nipple discharge based on MD image findings. This model may aid individual risk assessment and guide treatment in clinical practice.

  18. Transabdominal Ultrasonography of the Small Bowel

    Directory of Open Access Journals (Sweden)

    Rudolf Kralik

    2013-01-01

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

  19. Emergency surgeon-performed hepatobiliary ultrasonography.

    LENUS (Irish Health Repository)

    Kell, M R

    2012-02-03

    BACKGROUND: Acute hepatobiliary pathology is a common general surgical emergency referral. Diagnosis requires imaging of the biliary tree by ultrasonography. The accuracy and impact of surgeon-performed ultrasonography (SUS) on the diagnosis of emergent hepatobiliary pathology was examined. METHODS: A prospective study, over a 6-month period, enrolled all patients with symptoms or signs of acute hepatobiliary pathology. Patients provided informed consent and underwent both SUS and standard radiology-performed ultrasonography (RUS). SUS was performed using a 2-5-MHz broadband portable ultrasound probe by two surgeons trained in ultrasonography, and RUS using a 2-5-MHz fixed unit. SUS results were correlated with those of RUS and pathological diagnoses. RESULTS: Fifty-three consecutive patients underwent 106 ultrasonographic investigations. SUS agreed with RUS in 50 (94.3 per cent) of 53 patients. SUS accurately detected cholelithiasis in all but two cases and no patient was inaccurately diagnosed as having cholelithiasis at SUS (95.2 per cent sensitivity and 100 per cent specificity). As an overall complementary diagnostic tool SUS provided the correct diagnosis in 96.2 per cent of patients. Time to scan was significantly shorter following SUS (3.1 versus 12.0 h, P < 0.05). CONCLUSION: SUS provides a rapid and accurate diagnosis of emergency hepatobiliary pathology and may contribute to the emergency management of hepatobiliary disease.

  20. Quantitative muscle ultrasonography in amyotrophic lateral sclerosis.

    NARCIS (Netherlands)

    Arts, I.M.P.; Rooij, F.G. van; Overeem, S.; Pillen, S.; Janssen, H.M.; Schelhaas, H.J.; Zwarts, M.J.

    2008-01-01

    In this study, we examined whether quantitative muscle ultrasonography can detect structural muscle changes in early-stage amyotrophic lateral sclerosis (ALS). Bilateral transverse scans were made of five muscles or muscle groups (sternocleidomastoid, biceps brachii/brachialis, forearm flexor group,

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

    Science.gov (United States)

    Behn, C; Bostedt, H

    2000-09-01

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

  2. Diagnosis of intraductal spread of breast cancer by high-resolution MR imaging. Correlation between MR imaging and pathohistological findings

    International Nuclear Information System (INIS)

    Date, Shuji

    1998-01-01

    The main purpose of this study was to investigate pathohistological factors that affect the MR findings of intraductal spread (IDS) of breast cancer. The subjects of the present study were 42 breast cancer patients who were examined by MR imaging. Fat-suppressed high-resolution T1-weighted spin-echo images (350/13/1 (TR/TE/excitations), 16-cm FOV, 5-mm section thickness, and 512 x 256 matrix) were obtained one minute after the intravenous administration of Gd-DTPA. In this protocol, contrast determination time was 1 min 48 sec. Of the 42 cases, IDS was found to be located more than 1 cm from the primary focus in 22 cases (52%). Rates of sensitivity, specificity and accuracy of MR imaging for the detection of IDS were 82%, 80%, and 81%, respectively. The probable cause of misdiagnosis was parenchymal enhancement due to severe fibrocystic disease and normal menstrual cycle. In 21 of 42 cases, the MR findings were precisely correlated with the pathohistologic findings of almost the same cross-section. The MR findings of IDS varied greatly with observation of linear, band-like, branch-like, plate-like and minute ring enhancements. These findings closely reflected the size, aggregation pattern, and distribution of intraductal lesions. In particular, minute ring enhancement was only observed in 4 comedo-type lesions. This pattern of enhancement is considered to reflect elevated intraductal cellular density with necrosis in the central region. (author)

  3. Diagnosis of intraductal spread of breast cancer by high-resolution MR imaging. Correlation between MR imaging and pathohistological findings

    Energy Technology Data Exchange (ETDEWEB)

    Date, Shuji [Hiroshima City Hospital (Japan)

    1998-04-01

    The main purpose of this study was to investigate pathohistological factors that affect the MR findings of intraductal spread (IDS) of breast cancer. The subjects of the present study were 42 breast cancer patients who were examined by MR imaging. Fat-suppressed high-resolution T1-weighted spin-echo images (350/13/1 (TR/TE/excitations), 16-cm FOV, 5-mm section thickness, and 512 x 256 matrix) were obtained one minute after the intravenous administration of Gd-DTPA. In this protocol, contrast determination time was 1 min 48 sec. Of the 42 cases, IDS was found to be located more than 1 cm from the primary focus in 22 cases (52%). Rates of sensitivity, specificity and accuracy of MR imaging for the detection of IDS were 82%, 80%, and 81%, respectively. The probable cause of misdiagnosis was parenchymal enhancement due to severe fibrocystic disease and normal menstrual cycle. In 21 of 42 cases, the MR findings were precisely correlated with the pathohistologic findings of almost the same cross-section. The MR findings of IDS varied greatly with observation of linear, band-like, branch-like, plate-like and minute ring enhancements. These findings closely reflected the size, aggregation pattern, and distribution of intraductal lesions. In particular, minute ring enhancement was only observed in 4 comedo-type lesions. This pattern of enhancement is considered to reflect elevated intraductal cellular density with necrosis in the central region. (author)

  4. The contribution of ultrasonography to the differential diagnosis of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ciatto, S; Rosselli del Turco, M; Catarzi, S; Morrone, D [Center for Cancer Study and Prevention, 50131 Florence (Italy)

    1994-12-31

    Overall consecutive breast abnormalities (259 carcinomas, 1820 benign) examined with breast ultrasonography (US) are reported US sensitive, specificity and positive predictive values were 67.6, 97.7 and 81.0 %, resp. (the corresponding values were 57.9, 97.9 and 77.2 % for palpation, 79.9, 93.5 and 73.7 % for mammography, and 97.6, 92.6 and 87.6 % for cytology). US sensitivity was unaffected by age, whereas it was strongly influenced by tumor size (pT1 - 76.1 %; pT2 - 87.1 %) and histologic type (intra-ductal - 7.4 %; invasive ductal lobular - 83.4 %; invasive special types -64.1%). The features of the lesions at US were significance associated with cancer (irregular margins, posterior acoustic shadowing) or benign lesions (anechoic structure, lateral shadowing, posterior acoustic enhancement) but had a limited diagnostic accuracy. Overall US visualized 174 (benign - 24, suspicious - 150) of 188 palpable, and 32 (benign - 7, suspicious - 25) of 71 nonpalpable cancers, US contribution was determinant to final diagnosis in 4 of 7 cancers, missed at palpation and mammography, but was at least partially, responsible for 8 unnecessary biopsies of benign lesions. A negative/benign US report contributed to avoid unnecessary biopsy in 71 suspicious cases at palpation/mammography. Routine US examination of clinical/mammographic abnormalities is recommended for the advantages of US-guided aspiration and to reduce the frequency of unnecessary biopsies. (author) 4 tabs., 21 refs.

  5. Comparison between MRI with MR cholangiopancreatography and endoscopic ultrasonography for differentiating malignant from benign mucinous neoplasms of the pancreas

    International Nuclear Information System (INIS)

    Hwang, Jiyoung; Hong, Seong Sook; Kim, Hyun-joo; Kim, Young Kon; Jeong, Woo Kyung; Min, Ji Hye

    2018-01-01

    To compare diagnostic performance of magnetic resonance imaging (MRI) and endoscopic ultrasonography (EUS) for differentiating malignant from benign intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms (MCN) of the pancreas. This retrospective study included 55 patients with 47 surgically confirmed IPMNs (12 malignant, 35 benign) and eight MCNs (two malignant, six benign) who underwent contrast-enhanced pancreas MRI and EUS. Contrast enhancement was not routinely used at EUS examination. Two observers independently evaluated the MRIs, and another reviewed EUS images. They recorded their confidence for malignancy with each imaging modality. We calculated diagnostic performance using the area under the receiver operating characteristic curves (A z ), and to determine the accuracy, sensitivity, specificity, and positive (PPV) and negative predictive (NPV) values. The A z values of MRI were higher than those of EUS (0.712 and 0.688 for MRI vs. 0.543 for EUS; p = 0.007). The diagnostic accuracies (74.5%), specificity (78.0% and 80.5%) and PPV (50.0%) of MRI in two observers were higher than those (56.4%, 58.5% and 29.2%, respectively) of EUS (p = 0.013-0.049). MRI showed better diagnostic performance than EUS for differentiating malignant from benign pancreatic IPMN and MCN. (orig.)

  6. Comparison between MRI with MR cholangiopancreatography and endoscopic ultrasonography for differentiating malignant from benign mucinous neoplasms of the pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Jiyoung; Hong, Seong Sook; Kim, Hyun-joo [Seoul Hospital, Department of Radiology, Soonchunhyang University College of Medicine, Seoul (Korea, Republic of); Kim, Young Kon; Jeong, Woo Kyung [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of); Min, Ji Hye [Chungnam National University College of Medicine, Department of Radiology, Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2018-01-15

    To compare diagnostic performance of magnetic resonance imaging (MRI) and endoscopic ultrasonography (EUS) for differentiating malignant from benign intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms (MCN) of the pancreas. This retrospective study included 55 patients with 47 surgically confirmed IPMNs (12 malignant, 35 benign) and eight MCNs (two malignant, six benign) who underwent contrast-enhanced pancreas MRI and EUS. Contrast enhancement was not routinely used at EUS examination. Two observers independently evaluated the MRIs, and another reviewed EUS images. They recorded their confidence for malignancy with each imaging modality. We calculated diagnostic performance using the area under the receiver operating characteristic curves (A{sub z}), and to determine the accuracy, sensitivity, specificity, and positive (PPV) and negative predictive (NPV) values. The A{sub z} values of MRI were higher than those of EUS (0.712 and 0.688 for MRI vs. 0.543 for EUS; p = 0.007). The diagnostic accuracies (74.5%), specificity (78.0% and 80.5%) and PPV (50.0%) of MRI in two observers were higher than those (56.4%, 58.5% and 29.2%, respectively) of EUS (p = 0.013-0.049). MRI showed better diagnostic performance than EUS for differentiating malignant from benign pancreatic IPMN and MCN. (orig.)

  7. Utility of whole-lesion ADC histogram metrics for assessing the malignant potential of pancreatic intraductal papillary mucinous neoplasms (IPMNs).

    Science.gov (United States)

    Hoffman, David H; Ream, Justin M; Hajdu, Christina H; Rosenkrantz, Andrew B

    2017-04-01

    To evaluate whole-lesion ADC histogram metrics for assessing the malignant potential of pancreatic intraductal papillary mucinous neoplasms (IPMNs), including in comparison with conventional MRI features. Eighteen branch-duct IPMNs underwent MRI with DWI prior to resection (n = 16) or FNA (n = 2). A blinded radiologist placed 3D volumes-of-interest on the entire IPMN on the ADC map, from which whole-lesion histogram metrics were generated. The reader also assessed IPMN size, mural nodularity, and adjacent main-duct dilation. Benign (low-to-intermediate grade dysplasia; n = 10) and malignant (high-grade dysplasia or invasive adenocarcinoma; n = 8) IPMNs were compared. Whole-lesion ADC histogram metrics demonstrating significant differences between benign and malignant IPMNs were: entropy (5.1 ± 0.2 vs. 5.4 ± 0.2; p = 0.01, AUC = 86%); mean of the bottom 10th percentile (2.2 ± 0.4 vs. 1.6 ± 0.7; p = 0.03; AUC = 81%); and mean of the 10-25th percentile (2.8 ± 0.4 vs. 2.3 ± 0.6; p = 0.04; AUC = 79%). The overall mean ADC, skewness, and kurtosis were not significantly different between groups (p ≥ 0.06; AUC = 50-78%). For entropy (highest performing histogram metric), an optimal threshold of >5.3 achieved a sensitivity of 100%, a specificity of 70%, and an accuracy of 83% for predicting malignancy. No significant difference (p = 0.18-0.64) was observed between benign and malignant IPMNs for cyst size ≥3 cm, adjacent main-duct dilatation, or mural nodule. At multivariable analysis of entropy in combination with all other ADC histogram and conventional MRI features, entropy was the only significant independent predictor of malignancy (p = 0.004). Although requiring larger studies, ADC entropy obtained from 3D whole-lesion histogram analysis may serve as a biomarker for identifying the malignant potential of IPMNs, independent of conventional MRI features.

  8. Dynamic contrast-enhanced CT appearances of the intraductal papillary neoplasms of the bile duct

    International Nuclear Information System (INIS)

    Song Fengxiang; Zhou Jianjun; Zeng Mengsu; Zhou Kangrong; Ding Yuqin; He Deming; Shi Yuxin; Zhou Jun

    2013-01-01

    Objective: To analyze the dynamic contrast-enhanced CT appearances of intraductal papillary neoplasms of the bile duct and improve its diagnostic accuracy. Methods: Sixteen patients with intraductal papillary neoplasms of the bile duct confirmed histopathologically after surgical operation underwent dynamic contrast-enhanced multi-detector row CT scans. All imaging data were reviewed and analyzed retrospectively in correlation with surgical and pathological findings. CT values of 38 well-visualized lesions in 12 of the 16 patients at the pre-contrast phase, arterial phase and venous phase were measured. Four of the 12 patients with 17 lesions had benign tumors, and 8 of the 12 patients with 21 lesions had malignant tumors. Comparisons of CT values at the three phases between the two groups were carried out using independent sample t test. The bile CT values were measured in these 12 cases, 40 normal volunteers, and 40 subjects with bile duct stones, and the Wilcoxon signed-rank test was applied to compare the bile CT values between tumor group and the normal group and between tumor group and the bile duct stone group. The diameters of the bile ducts proximal to and distal to tumors were also measured, and Fisher exact method was carried to analyze the data. Results: Lesions located at the left lobe in 8 out of the 16 patients, the right lobe in 1 case, both the left and right lobes in 1 case, the hepatic hilum in 1 case, the common bile duct in 3 cases, and both the right lobe and the common bile duct in 2 cases. Eleven lesions appeared as papillary masses, 3 as flat masses, 1 as mixed papillary and flat masses. In one case, tumor mass could not be definitely visualized, and only dilated bile ducts and stones were demonstrated. The mean CT values of the benign tumors were (25.8 ± 8.0), (37.7 ± 10.3) and (51.7 ± 17.1) HU respectively at pre-contrast phase, arterial phase, and venous phase, and the malignant tumors were (38.4 ± 10.2), (56.6 ± 18.0) and (68.4

  9. Web-based thyroid imaging reporting and data system: Malignancy risk of atypia of undetermined significance or follicular lesion of undetermined significance thyroid nodules calculated by a combination of ultrasonography features and biopsy results.

    Science.gov (United States)

    Choi, Young Jun; Baek, Jung Hwan; Shin, Jung Hee; Shim, Woo Hyun; Kim, Seon-Ok; Lee, Won-Hong; Song, Dong Eun; Kim, Tae Yong; Chung, Ki-Wook; Lee, Jeong Hyun

    2018-05-13

    The purpose of this study was to construct a web-based predictive model using ultrasound characteristics and subcategorized biopsy results for thyroid nodules of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) to stratify the risk of malignancy. Data included 672 thyroid nodules from 656 patients from a historical cohort. We analyzed ultrasound images of thyroid nodules and biopsy results according to nuclear atypia and architectural atypia. Multivariate logistic regression analysis was performed to predict whether nodules were diagnosed as malignant or benign. The ultrasound features, including spiculated margin, marked hypoechogenicity, calcifications, biopsy results, and cytologic atypia, showed significant differences between groups. A 13-point risk scoring system was developed, and the area under the curve (AUC) of the receiver operating characteristic (ROC) curve of the development and validation sets were 0.837 and 0.830, respectively (http://www.gap.kr/thyroidnodule_b3.php). We devised a web-based predictive model using the combined information of ultrasound characteristics and biopsy results for AUS/FLUS thyroid nodules to stratify the malignant risk. © 2018 Wiley Periodicals, Inc.

  10. Ultrasonography for neuraxial blocks: a review of the evidence.

    Science.gov (United States)

    Elgueta, Maria F; Duong, Silvia; Finlayson, Roderick J; Tran, De Q

    2017-05-01

    This narrative review summarizes the evidence derived from randomized controlled trials (RCTs) pertaining to the use of adjunctive ultrasonography (US) for neuraxial blocks. The literature search was conducted using the MEDLINE, EMBASE and PUBMED databases. For the MEDLINE and EMBASE searches, the MESH terms "ultrasonography" and key word "ultrasound" were queried; using the operator "and", they were combined with the MESH terms "neuraxial block," "epidural anesthesia," "epidural analgesia," "spinal anesthesia," "spinal analgesia," "intrathecal anesthesia," "intrathecal analgesia," "caudal anesthesia," and "caudal analgesia." For the PUBMED search, the search terms "ultrasound neuraxial," "ultrasound intrathecal," "ultrasound epidural" (limited to clinical trials), "ultrasound spinal" (limited to clinical trials), and "ultrasound caudal" (limited to clinical trials) were queried. Seventeen RCTs were retained for analysis. Compared to conventional palpation of landmarks, US assistance (i.e., preprocedural scanning) results in fewer needle passes/insertions and skin punctures for neuraxial blocks in obstetrical and surgical patients. These benefits seem most pronounced when expert operators carry out the sonographic exams and for patients displaying difficult spinal anatomy. Preliminary findings also suggest that US provides similar pain relief and functional improvement to fluoroscopy for epidural/caudal steroid injection in patients afflicted with chronic spinal pain. Although one trial demonstrated shorter needling time with US guidance (i.e., real-time scanning of needle advancement) compared to US assistance, these findings require further validation. Published reports of RCTs provide evidence to formulate limited recommendations regarding the use of adjunctive US for neuraxial blocks. Further well-designed RCTs are warranted.

  11. Can we better predict the biologic behavior of incidental IPMN? A comprehensive analysis of molecular diagnostics and biomarkers in intraductal papillary mucinous neoplasms of the pancreas.

    Science.gov (United States)

    Tulla, Kiara A; Maker, Ajay V

    2018-03-01

    Predicting the biologic behavior of intraductal papillary mucinous neoplasm (IPMN) remains challenging. Current guidelines utilize patient symptoms and imaging characteristics to determine appropriate surgical candidates. However, the majority of resected cysts remain low-risk lesions, many of which may be feasible to have under surveillance. We herein characterize the most promising and up-to-date molecular diagnostics in order to identify optimal components of a molecular signature to distinguish levels of IPMN dysplasia. A comprehensive systematic review of pertinent literature, including our own experience, was conducted based on the PRISMA guidelines. Molecular diagnostics in IPMN patient tissue, duodenal secretions, cyst fluid, saliva, and serum were evaluated and organized into the following categories: oncogenes, tumor suppressor genes, glycoproteins, markers of the immune response, proteomics, DNA/RNA mutations, and next-generation sequencing/microRNA. Specific targets in each of these categories, and in aggregate, were identified by their ability to both characterize a cyst as an IPMN and determine the level of cyst dysplasia. Combining molecular signatures with clinical and imaging features in this era of next-generation sequencing and advanced computational analysis will enable enhanced sensitivity and specificity of current models to predict the biologic behavior of IPMN.

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

    Science.gov (United States)

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

    2013-12-01

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

  13. Ultrasonography in Early Diagnosis of Heterotopic Ossification

    Directory of Open Access Journals (Sweden)

    Shan-Hui Lin

    2014-12-01

    Full Text Available We report here the case of a 32-year-old man with a history of traumatic brain injury who presented with swelling of his right thigh. Soft tissue ultrasonography performed 3 days after the onset of symptoms showed a heterogeneous hyperechoic lesion with the formation of cysts and hypervascularity in the right iliopsoas abutting the surface of the femoral bone. This became a diffuse echogenic plaque with a posterior acoustic shadowing 12 days later. A diagnosis of heterotopic ossification was made on the basis of the presence of typical ultrasonographic findings and was confirmed by pathology. We emphasize that an early diagnosis of heterotopic ossification can be made with ultrasonography and can lead to early treatment.

  14. Concurrent fibroadenoma and intraductal papilloma - A recurring complex lesion in a premenarcheal girl.

    Science.gov (United States)

    Alessandrini, Lara; Gobbi, Dalia; Zanon, Giovanni Franco; Dall'Igna, Patrizia; Cecchetto, Giovanni; Alaggio, Rita

    2013-02-15

    Breast diseases are rare in childhood and adolescence, most lesions being fibroadenomas and papillomas. We report the case of an 11-year old girl with a complex breast lesion with hybrid features of fibroadenoma and intraductal papilloma with an early recurrence. Microscopically, the lesion was composed of dilated ducts showing intraluminal papillary projections with small to broad fibrovascular stalks. The typical leaf-like appearance of fibroadenoma was determined by the presence at the periphery of ducts compressed and distorted by the prominent stromal component. Despite its florid epithelial hyperplasia and mild cytological atypia (more evident in the relapse), immunohistochemical staining for p63 and smooth muscle actin highlighted a continuum outer myoepithelial layer, confirming the non-invasive appearance of the lesion. Two pathogenetic links have been hypothesized: one is based on the morphological continuum between these two entities, which may represent different evolutive stages in the same lesion; the other is based on epithelial/mesenchymal interactions. The possible malignant transformation of such complex lesion is also discussed, along with its differential diagnoses. The relevance of this case lies in its rarity, as well as in the therapeutic strategies related to its biological potential and to the necessity of a conservative treatment, due to the young age of the patient. Copyright © 2012. Published by Elsevier GmbH.

  15. The Utilization of Imaging Features in the Management of Intraductal Papillary Mucinous Neoplasms

    Directory of Open Access Journals (Sweden)

    Stefano Palmucci

    2014-01-01

    Full Text Available Intraductal papillary mucinous neoplasms (IPMNs represent a group of cystic pancreatic neoplasms with large range of clinical behaviours, ranging from low-grade dysplasia or borderline lesions to invasive carcinomas. They can be grouped into lesions originating from the main pancreatic duct, main duct IPMNs (MD-IPMNs, and lesions which arise from secondary branches of parenchyma, denominated branch-duct IPMNs (BD-IPMNs. Management of these cystic lesions is essentially based on clinical and radiological features. The latter have been very well described in the last fifteen years, with many studies published in literature showing the main radiological features of IPMNs. Currently, the goal of imaging modalities is to identify “high-risk stigmata” or “worrisome feature” in the evaluation of pancreatic cysts. Marked dilatation of the main duct (>1 cm, large size (3–5 cm, and intramural nodules have been associated with increased risk of degeneration. BD-IPMNs could be observed as microcystic or macrocystic in appearance, with or without communication with main duct. Their imaging features are frequently overlapped with cystic neoplasms. The risk of progression for secondary IPMNs is lower, and subsequently an imaging based follow-up is very often proposed for these lesions.

  16. Molecular biomarkers for progression of intraductal papillary mucinous neoplasm of the pancreas.

    Science.gov (United States)

    Kuboki, Yuko; Shimizu, Kyoko; Hatori, Takashi; Yamamoto, Masakazu; Shibata, Noriyuki; Shiratori, Keiko; Furukawa, Toru

    2015-03-01

    We aimed to identify molecular biomarkers for assessing the progression of intraductal papillary mucinous neoplasm of the pancreas (IPMN). We retrospectively investigated molecular aberrations and their associations with clinicopathological features in 172 IPMNs. GNAS and KRAS mutations were detected in 48% and 56% of IPMNs, respectively. No mutations of EGFR, PIK3CA GNAO1, GNAQ, or GNAI2 were observed. Significant associations were observed between IPMN morphological types and GNAS mutations, KRAS mutations, the expression of phosphorylated MAPK (pMAPK), AKT, and phosphorylated AKT (pAKT), nuclear accumulation of β-catenin, SMAD4 loss, and TP53 overexpression; histological grades and the expression of EGFR, pMAPK, AKT, and pAKT, the nuclear β-catenin, SMAD4 loss, and TP53 overexpression; invasive phenotypes and KRAS mutations, the nuclear β-catenin, and SMAD4 loss; and prognosis and SMAD4 loss and TP53 overexpression. Multivariate analysis to compare prognostic impacts of multiple molecular features revealed that TP53 overexpression was an independent prognostic factor (P = 0.030; hazard ratio, 5.533). These results indicate that mutations in GNAS and KRAS, the expression of EGFR and pMAPK, the nuclear β-catenin, SMAD4 loss, and TP53 overexpression may be relevant for assessing the clinical course of IPMN, including its progression into different morphological types, invasion, and prognosis.

  17. Evaluation of the International Consensus Guidelines for the Surgical Resection of Intraductal Papillary Mucinous Neoplasms.

    Science.gov (United States)

    Tsukagoshi, Mariko; Araki, Kenichiro; Saito, Fumiyoshi; Kubo, Norio; Watanabe, Akira; Igarashi, Takamichi; Ishii, Norihiro; Yamanaka, Takahiro; Shirabe, Ken; Kuwano, Hiroyuki

    2018-04-01

    International consensus guidelines for intraductal papillary mucinous neoplasms (IPMNs) were revised in 2012. We aimed to evaluate the clinical utility of each predictor in the 2006 and 2012 guidelines and validate the diagnostic value and surgical indications. Forty-two patients with surgically resected IPMNs were included. Each predictor was applied to evaluate its diagnostic value. The 2012 guidelines had greater accuracy for invasive carcinoma than the 2006 guidelines (64.3 vs. 31.0%). Moreover, the accuracy for high-grade dysplasia was also increased (48.6 vs. 77.1%). When the main pancreatic duct (MPD) size ≥8 mm was substituted for MPD size ≥10 mm in the 2012 guidelines, the accuracy for high-grade dysplasia was 80.0%. The 2012 guidelines exhibited increased diagnostic accuracy for invasive IPMN. It is important to consider surgical resection prior to invasive carcinoma, and high-risk stigmata might be a useful diagnostic criterion. Furthermore, MPD size ≥8 mm may be predictive of high-grade dysplasia.

  18. Intraductal papillary mucinous neoplasms of the pancreas: Correlation of helical CT features with pathologic findings

    International Nuclear Information System (INIS)

    Liu Yu; Lin Xiaozhu; Upadhyaya, Manavendra; Song Qi; Chen Kemin

    2010-01-01

    Objective: To evaluate the CT features of intraductal papillary mucinous neoplasms of the pancreas (IPMNs), and to compare with pathological findings in order to identify CT features that can be helpful in differentiating benign IPMNs from malignant IPMNs. Materials and methods: The CT findings in 25 patients were reviewed for tumor location, tumor type, dilatation of the main pancreatic duct (MPD), MPD involvement, mural node or solid attenuating component, tumor size in branch duct or mixed duct type, dilatation of common bile duct (CBD) and invasion of surrounding structures. The data was subjected to Chi-Square Tests or Fisher's Exact Test using SPSS13.0 software with p value < 0.05 indicating significant statistical difference. Results: Presence of mural node or solid enhancing component, size of mural node or solid enhancing component ≥7 mm, dilatation of CBD was more common in malignant IPMNs (p < 0.05). None of tumor location, tumor type, dilatation of MPD, MPD involvement, tumor size, and invasion of surrounding structures was statistically significant in differentiating benign from malignant IPMNs. Conclusions: CT features suggestive of malignant or invasive IPMNs include presence of mural node or solid enhancing component, size of mural node or solid enhancing component ≥7 mm, and dilatation of CBD.

  19. The Management Strategy of Benign Solitary Intraductal Papilloma on Breast Core Biopsy.

    Science.gov (United States)

    Ko, Dayoung; Kang, Eunyoung; Park, So Yeon; Kim, Sun Mi; Jang, Mijung; Yun, Bo La; Chae, Sumin; Jang, Yerang; Kim, Hye Jin; Kim, Sung-Won; Kim, Eun-Kyu

    2017-08-01

    Intraductal papilloma (IDP) is well-known as one of the common benign breast lesions requiring excision. However, treatment of IDP without atypia is controversial. The aim of our study was to determine the proper management of solitary IDP by core needle biopsy (CNB). We retrospectively reviewed patients with solitary IDP confirmed by CNB from March 2003 to March 2015. We collected data about final pathology after excision, as well as clinical, histologic, and radiologic findings at initial diagnosis. The final pathology was categorized as benign or malignant. We evaluated the rate of upgrade to malignancy and factors associated with malignancy. We identified 405 patients who presented benign solitary IDP by CNB. The mean age was 46.1 years (range, 15-86 years). In total, 135 patients underwent surgical excision, and 211 underwent vacuum-assisted excision. Of 346 patients, malignant lesions were found in 8 patients (2.3%): 7 underwent surgical excision, and 1 underwent vacuum-assisted excision. Only the size of IDP was significantly associated with cancer upgrade (P = .003). Our study shows that overall malignancy upgrade rate of benign solitary IDP after excision is very low (2.3%). Even when the size of IDP was less than 1 cm, the upgrade rate to cancer was only 0.9%. Therefore, for patients with small solitary IDP, we recommend close follow-up with ultrasound instead of excision. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Vascular access: the impact of ultrasonography

    Science.gov (United States)

    de Almeida, Carlos Eduardo Saldanha

    2016-01-01

    ABSTRACT Vascular punctures are often necessary in critically ill patients. They are secure, but not free of complications. Ultrasonography enhances safety of the procedure by decreasing puncture attempts, complications and costs. This study reviews important publications and the puncture technique using ultrasound, bringing part of the experience of the intensive care unit of the Hospital Israelita Albert Einstein, São Paulo (SP), Brazil, and discussing issues that should be considered in future studies. PMID:28076607

  1. Differential diagnosis of calf pain by ultrasonography

    Directory of Open Access Journals (Sweden)

    Luciano Augusto Botter

    2008-03-01

    Full Text Available This paper aims to evaluate the recent and numerous applications of ultrasonography in the differential diagnosis of conditions that affect the popliteal fossa and lower limbs, resulting in calf pain. Popliteal cysts and their ruptures, aneurysms, hematomas, cellulitis, abscesses, soft tissue tumors and other fluid collections are easily identified by this technique. Moreover, post-trauma and inflammatory conditions affecting muscles and tendons, muscle necrosis, deep venous thrombosis and superficial thrombophlebitis are very well demonstrated by the ultrasonographic screening.

  2. Real time ultrasonography in obstructive jaundice

    International Nuclear Information System (INIS)

    Cho, Kyung Sik; Kim, Ho Kyun; Sung, Nak Kwan; Kim, Soon Yong

    1982-01-01

    Ultrasonography is a predominantly accurate, relatively simple unique diagnostic method of obstructive jaundice. The ultrasonographic findings of obstructive jaundice are dilated intra- and extrahepatic duct with intraluminal hyper reflective echo or mass in and/ or around the bile duct. The superiority of high resolution real time ultrasonography for the diagnosis of obstructive jaundice is bases on the easy detectability of extra- and intrahepatic bile ducts by its multiple sectional images in a short time, the flexibility of probe and small crystal size. Author evaluated real time sonographic findings 46 obstructive jaundice patients confirmed by surgery or radiographical examinations. The results were: 1. Diameter of extrahepatic duct in obstructive jaundice were varied from normal to 4.0 Cm, mostly 8 to 10 mm in diameter (26%). Degree of dilatation of biliary duct appeared more prominent in cancer patients than other causes of obstruction. 2. The site of obstruction was detected in 85% (39/46) and its common site was common bile duct in 63% (29/46). 3. The diagnostic accuracy of choledocholithiasis and cancer was 82% (22/27) and 44% (4/9), respectively. Diagnostic accuracy of the real time ultrasonography in obstructive jaundice was over all 75% (34/46)

  3. Emergency ultrasonography of the gastrointestinal tract of children

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Jae Yeon [Dept. of Radiology, Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of)

    2017-07-15

    Ultrasonography (US) is widely used to evaluate most body parts in pediatric patients because it is simple, noninvasive, easy to use, and applicable in a wide variety of clinical situations. US is the modality of choice for the initial evaluation of acute abdominal pain in pediatric patients because of their small body habitus and the presence of less fat tissue in the abdominal wall and peritoneal cavity. The most important factor in performing pediatric emergency US is the graded compression technique and selection of the proper transducer. The careful evaluation of bowel wall thickening combined with ancillary findings such as fluid collection, increased echogenicity of the mesenteric fat tissue, enlarged lymph nodes, hyperemic bowel changes, and abnormal bowel peristalsis can increase the diagnostic capability of US.

  4. Emergency ultrasonography of the gastrointestinal tract of children

    International Nuclear Information System (INIS)

    Hwang, Jae Yeon

    2017-01-01

    Ultrasonography (US) is widely used to evaluate most body parts in pediatric patients because it is simple, noninvasive, easy to use, and applicable in a wide variety of clinical situations. US is the modality of choice for the initial evaluation of acute abdominal pain in pediatric patients because of their small body habitus and the presence of less fat tissue in the abdominal wall and peritoneal cavity. The most important factor in performing pediatric emergency US is the graded compression technique and selection of the proper transducer. The careful evaluation of bowel wall thickening combined with ancillary findings such as fluid collection, increased echogenicity of the mesenteric fat tissue, enlarged lymph nodes, hyperemic bowel changes, and abnormal bowel peristalsis can increase the diagnostic capability of US

  5. Adjuvant Chemoradiotherapy After Pancreatic Resection for Invasive Carcinoma Associated With Intraductal Papillary Mucinous Neoplasm of the Pancreas

    International Nuclear Information System (INIS)

    Swartz, Michael J.; Hsu, Charles C.; Pawlik, Timothy M.; Winter, Jordan; Hruban, Ralph H.; Guler, Mehmet; Schulick, Richard D.; Cameron, John L.; Laheru, Daniel A.; Wolfgang, Christopher L.; Herman, Joseph M.

    2010-01-01

    Purpose: Intraductal papillary mucinous neoplasms are mucin-producing cystic neoplasms of the pancreas. One-third are associated with invasive carcinoma. We examined the benefit of adjuvant chemoradiotherapy (CRT) for this cohort. Methods and Materials: Patients who had undergone pancreatic resection at Johns Hopkins Hospital between 1999 and 2004 were reviewed. Of these patients, 83 with a resected pancreatic mass were found to have an intraductal papillary mucinous neoplasm with invasive carcinoma, 70 of whom met inclusion criteria for the present analysis. Results: The median age at surgery was 68 years. The median tumor size was 3.3 cm, and invasive carcinoma was present at the margin in 16% of the patients. Of the 70 patients, 50% had metastases to the lymph nodes and 64% had Stage II disease. The median survival was 28.0 months, and 2- and 5-year survival rate was 57% and 45%, respectively. Of the 70 patients, 40 had undergone adjuvant CRT. Those receiving CRT were more likely to have lymph node metastases, perineural invasion, and Stage II-III disease. The 2-year survival rate after surgery with vs. without CRT was 55.8% vs. 59.3%, respectively (p = NS). Patients with lymph node metastases or positive surgical margins benefited significantly from CRT (p = .047 and p = .042, respectively). On multivariate analysis, adjuvant CRT was associated with improved survival, with a relative risk of 0.43 (95% confidence interval, 0.19-0.95; p = .044) after adjusting for major confounders. Conclusion: Adjuvant CRT conferred a 57% decrease in the relative risk of mortality after pancreaticoduodenectomy for intraductal papillary mucinous neoplasms with an associated invasive component after adjusting for major confounders. Patients with lymph node metastases or positive margins appeared to particularly benefit from CRT after definitive surgery.

  6. The Place of Ultrasonography in the Evaluation of Rib Fractures

    OpenAIRE

    Fulya Bakılan; Gökhan Yüce; Ahmet Çağdaş Biçen; Tanju Keten

    2015-01-01

    Objective: The aim of this study was to investigate whether ultrasonography is superior to chest x-ray in detecting rib fractures in patients with minor blunt chest trauma and chest pain. Materials and Methods: Ultrasonography findings of 32 patients with minor blunt chest trauma showing no evidence of a rib fracture on anteroposterior chest x-rays, were documented. Presence of cortical discontinuities, acoustic shadows, reverberation artifacts, and hematoma by ultrasonography was...

  7. Current recommendations for surveillance and surgery of intraductal papillary mucinous neoplasms may overlook some patients with cancer.

    Science.gov (United States)

    Nguyen, Andrew H; Toste, Paul A; Farrell, James J; Clerkin, Barbara M; Williams, Jennifer; Muthusamy, V Raman; Watson, Rabindra R; Tomlinson, James S; Hines, O Joe; Reber, Howard A; Donahue, Timothy R

    2015-02-01

    The 2012 Sendai Criteria recommend that patients with 3 cm or larger branch duct intraductal papillary mucinous neoplasms (BD-IPMN) without any additional "worrisome features" or "high-risk stigmata" may undergo close observation. Furthermore, endoscopic ultrasound (EUS) is not recommended for BD-IPMN 3 cm were removed based on size alone. Our results suggest that "larger" size on noninvasive imaging can indicate high-grade/invasive cysts, and EUS-FNA may help identify "smaller" cysts with high-grade/invasive pathology.

  8. Intraductal mucin-hypersecreting neoplasm of the pancreas : US, CT and ERP findings

    International Nuclear Information System (INIS)

    Lee, Ki Yeol

    1997-01-01

    To evaluate US, CT and endoscopic retrograde pancreatography (ERP) findings of intraductal mucin-hypersecreting neoplasm(IMHN). We categorized an IMHN as belonging to a group of disease that can be clinically detected by the pooling of mucus produced by tumors inside the main duct or branch ducts of the pancreas, thus causing dilatation of these ducts. We retrospectively reviewed the US, CT and ERP findings of five patients(hyperplasia, 4;adenocarcinoma, 1). On US and/or CT, diffuse dilatation of the main pancreatic duct was demonstrated in five patients. In two cystic lesions corresponding to cystic dilatation of branch ducts were noted at the pancreatic head(n=1) and neck(n=1). In one patient, multiple cystic lesions were seen on CT along the entire pancreas, but these were not detected on US. In all patients, dilatation of the main duct and /or its branch ducts was seen on ERP. Filling defects resulting from mucin in the main duct or branch ducts were noted in all cases. Lymphadenopathy was not seen on US or CT, but carcinoma peritonei was found in the adenocarcinoma patient at the time of operation. IMHN usually shows smooth, diffuse dilatation of the main duct, and on US or CT, dilated branch ducts are occasionally noted. ERP findings are the most characteristic and conclusive;dilatation of the main duct and/or branch ducts is noted, with a filling defect corresponding to mucin. If overlooked during diagnosis, an IMHN might be interpreted simply as chronic pancreatitis, and so the recognition of this neoplasm is important

  9. Biological similarities and differences between pancreatic intraepithelial neoplasias and intraductal papillary mucinous neoplasms.

    Science.gov (United States)

    Moriya, Toshiyuki; Kimura, Wataru; Semba, Shuho; Sakurai, Fumiaki; Hirai, Ichiro; Ma, Jinfeng; Fuse, Akira; Maeda, Kunihiko; Yamakawa, Mitsunori

    2005-01-01

    Ever since the classification of pancreatic intraepithelial neoplasia (PanIN) was published, studies on the precursor lesions of pancreatic cancer have been advancing along a new directions, using standardized terminology. There are few studies that have examined the biological differences between PanIN and intraductal papillary mucinous neoplasm (IPMN) in detail. PanIN and IPMN, which are similar in morphology, were compared using various indicators, with the aim of identifying the similarities and differences between the two. A total of 46 PanINs and 37 ducts with IPMN were identified in 19 patients with invasive ductal carcinoma and 18 patients with IPMN. These PanINs and IPMNs were examined immunohistologically with respect to the expression patterns of HER2/neu, DPC4/Smad4, Akt/PKB, p53, cyclin A, Ki67, MUC1, and MUC2. Significant differences in the expression of MUC1 and MUC2 were observed between IPMNadenoma and PanIN-2 and between CIS and PanIN-3 (MUC1: p = 0.001 and p = 0.005, respectively; MUC2: p = 0.002 and p Smad4, and Akt/PKB, along with progression in the process of multistage carcinogenesis. Although the expression levels of these factors reflected the grade of atypism, they did not reflect any differences in the grade of biological malignancy between IPMN and PanIN. On the other hand, MUC1 and MUC2 may serve as indicators of the direction of differentiation, i.e., either progression to IDAC or IPMN. Positivity for MUC1 was believed to suggest differentiation into IDAC, and positivity for MUC2 appeared to be indicative of differentiation into IPMN. Such indication of the direction of differentiation seemed to appear in PanIN1-2, even before abnormalities of HER2/neu, Akt/PKB, DPC4/Smad4, p53, and cyclin A expression began to be detected.

  10. Intraductal papillary mucinous neoplasm of the pancreas (IPMN: clinico-pathological correlations and surgical indications

    Directory of Open Access Journals (Sweden)

    Cantù Massimiliano

    2010-04-01

    Full Text Available Abstract Background Intraductal papillary mucinous neoplasms (IPMNs are increasingly recognized entities, whose management remains sometimes controversial, due to the high rate of benign lesions and on the other side to the good survival after resection of malignant ones. Methods Retrospective analysis of a prospectively collected Western series of IPMN. Results Forty cases of IPMN were analysed (1992-2007. Most patients were symptomatic (72.5%; cholangio-MRI had the best diagnostic accuracy both for the tumour nature (83.3% and for the presence of malignancy (57.1%. ERCP was done in 8 cases (20%, and the results were poor. Thirteen patients were treated by pancreatic resection and 27 were maintained in follow-up. Total pancreatectomy was performed in 46% of the cases; in situ and invasive carcinoma were recognized in 15.4% and 38.4% of the cases, respectively. The mean follow-up was 42 months (range 12-72. One only patients with nodal metastases died 16 months after the operation for disease progression, while 91.6% of the operated patients are disease free. Out of the 27 not resected patients, 2 out of 4 presenting a lesion at high risk for malignancy died, while the remaining are in good conditions and disease free, with a mean follow-up of 31 months. Conclusion Therapeutic indication for IPMNs is mainly based upon radiological evaluation of the risk of malignancy. While the main duct tumours should be resected, preserving whenever possible a portion of the gland, the secondary ducts tumours may be maintained under observation, in absence of radiological elements of suspicion such as size larger than 3 cm, or a wall greater than 3 mm or nodules or papillae in the context of the cyst.

  11. Quantitative nucleic features are effective for discrimination of intraductal proliferative lesions of the breast

    Directory of Open Access Journals (Sweden)

    Masatoshi Yamada

    2016-01-01

    Full Text Available Background: Intraductal proliferative lesions (IDPLs of the breast are recognized as a risk factor for subsequent invasive carcinoma development. Although opportunities for IDPL diagnosis have increased, these lesions are difficult to diagnose correctly, especially atypical ductal hyperplasia (ADH and low-grade ductal carcinoma in situ (LG-DCIS. In order to define the difference between these lesions, many molecular pathological approaches have been performed. However, still we do not have a molecular marker and objective histological index about IDPLs of the breast. Methods: We generated full digital pathology archives from 175 female IDPL patients, including usual ductal hyperplasia (UDH, ADH, LG-DCIS, intermediate-grade (IM-DCIS, and high-grade (HG-DCIS. After total 2,035,807 nucleic segmentations were extracted, we evaluated nuclear features using step-wise linear discriminant analysis (LDA and a support vector machine. Results: High diagnostic accuracy (81.8–99.3% was achieved between pathologists' diagnoses and two-group LDA predictions from nucleic features for IDPL discrimination. Grouping of nuclear features as size and shape-related or intranuclear texture-related revealed that the latter group was more important when distinguishing between normal duct, UDH, ADH, and LG-DCIS. However, these two groups were equally important when discriminating between LG-DCIS and HG-DCIS. The Mahalanobis distances between each group showed that the smallest distance values occurred between LG-DCIS and IM-DCIS and between ADH and Normal. On the other hand, the distance value between ADH and LG-DCIS was larger than this distance. Conclusions: In this study, we have presented a practical and useful digital pathological method that incorporates nuclear morphological and textural features for IDPL prediction. We expect that this novel algorithm is used for the automated diagnosis assisting system for breast cancer.

  12. Quantitative nucleic features are effective for discrimination of intraductal proliferative lesions of the breast

    Science.gov (United States)

    Yamada, Masatoshi; Saito, Akira; Yamamoto, Yoichiro; Cosatto, Eric; Kurata, Atsushi; Nagao, Toshitaka; Tateishi, Ayako; Kuroda, Masahiko

    2016-01-01

    Background: Intraductal proliferative lesions (IDPLs) of the breast are recognized as a risk factor for subsequent invasive carcinoma development. Although opportunities for IDPL diagnosis have increased, these lesions are difficult to diagnose correctly, especially atypical ductal hyperplasia (ADH) and low-grade ductal carcinoma in situ (LG-DCIS). In order to define the difference between these lesions, many molecular pathological approaches have been performed. However, still we do not have a molecular marker and objective histological index about IDPLs of the breast. Methods: We generated full digital pathology archives from 175 female IDPL patients, including usual ductal hyperplasia (UDH), ADH, LG-DCIS, intermediate-grade (IM)-DCIS, and high-grade (HG)-DCIS. After total 2,035,807 nucleic segmentations were extracted, we evaluated nuclear features using step-wise linear discriminant analysis (LDA) and a support vector machine. Results: High diagnostic accuracy (81.8–99.3%) was achieved between pathologists’ diagnoses and two-group LDA predictions from nucleic features for IDPL discrimination. Grouping of nuclear features as size and shape-related or intranuclear texture-related revealed that the latter group was more important when distinguishing between normal duct, UDH, ADH, and LG-DCIS. However, these two groups were equally important when discriminating between LG-DCIS and HG-DCIS. The Mahalanobis distances between each group showed that the smallest distance values occurred between LG-DCIS and IM-DCIS and between ADH and Normal. On the other hand, the distance value between ADH and LG-DCIS was larger than this distance. Conclusions: In this study, we have presented a practical and useful digital pathological method that incorporates nuclear morphological and textural features for IDPL prediction. We expect that this novel algorithm is used for the automated diagnosis assisting system for breast cancer. PMID:26955499

  13. APPLICATION OF LAPAROSCOPIC ULTRASONOGRAPHY IN ADNEXAL OPERATIONS

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective:To explore the clinical value on application of laparoscopic ultrasonography (Lap US) in the adnexal operation. Methods:Eleven patients including 7 cases of tubal pregnancy, 3 cases of teratoma of ovary and 1 case of endometrial cyst of ovary were examined by LapUS, then operated with laparoscopy.Results:The results showed that the modality presented is a big progress over the traditional operative management for adnexal diseas. Conclusions:It is a good approach for micro-surgery in the adnexal operation by laparoscopy.

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

    Directory of Open Access Journals (Sweden)

    Anne-Sophie Riteau

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

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

    Science.gov (United States)

    Lu, R; Xiao, Y

    2017-07-18

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

  16. Percutaneous Intraductal Radiofrequency Ablation for Clearance of Occluded Metal Stent in Malignant Biliary Obstruction: Feasibility and Early Results

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Madhava, E-mail: madhava.pai@imperial.ac.uk [Hammersmith Hospital, Imperial College, HPB Unit, Department of Surgery (United Kingdom); Valek, Vlastimil; Tomas, Andrasina [University Hospital Brno Bohunice, Department of Radiology (Czech Republic); Doros, Attila [Semmelweis University, Radiology Unit, Department of Transplantation and Surgery (Hungary); Quaretti, Pietro [IRCCS Policlinico San Matteo, Department of Radiology (Italy); Golfieri, Rita; Mosconi, Cristina [University of Bologna, Department of Radiology, Policlinico S. Orsola-Malpighi (Italy); Habib, Nagy, E-mail: nagy.habib@imperial.ac.uk [Hammersmith Hospital, Imperial College, HPB Unit, Department of Surgery (United Kingdom)

    2013-07-11

    PurposeThe major complication occurring with biliary stents is stent occlusion, frequently seen because of tumour in-growth, epithelial hyperplasia, and sludge deposits, resulting in recurrent jaundice and cholangitis. We report a prospective study with the results of first in man percutaneous intraductal radiofrequency (RF) ablation to clear the blocked metal stents in patients with malignant biliary obstruction using a novel bipolar RF catheter.MethodsNine patients with malignant biliary obstruction and blocked metal stents were included. These patients underwent intraductal biliary RF ablation through the blocked metal stent following external biliary decompression with an internal–external biliary drainage.ResultsAll nine patients had their stent patency restored successfully without the use of secondary stents. Following this intervention, there was no 30-day mortality, haemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the nine patients, six are alive and three patients are dead with a median follow-up of 122 (range 50–488) days and a median stent patency of 102.5 (range 50–321) days. Six patients had their stent patent at the time of last follow-up or death. Three patients with stent blockage at 321, 290, and 65 days postprocedure underwent percutaneous transhepatic drain insertion and repeat ablation.ConclusionsIn this selective group of patients, it appears that this new approach is safe and feasible. Efficacy remains to be proven in future, randomized, prospective studies.

  17. Percutaneous Intraductal Radiofrequency Ablation for Clearance of Occluded Metal Stent in Malignant Biliary Obstruction: Feasibility and Early Results

    International Nuclear Information System (INIS)

    Pai, Madhava; Valek, Vlastimil; Tomas, Andrasina; Doros, Attila; Quaretti, Pietro; Golfieri, Rita; Mosconi, Cristina; Habib, Nagy

    2014-01-01

    PurposeThe major complication occurring with biliary stents is stent occlusion, frequently seen because of tumour in-growth, epithelial hyperplasia, and sludge deposits, resulting in recurrent jaundice and cholangitis. We report a prospective study with the results of first in man percutaneous intraductal radiofrequency (RF) ablation to clear the blocked metal stents in patients with malignant biliary obstruction using a novel bipolar RF catheter.MethodsNine patients with malignant biliary obstruction and blocked metal stents were included. These patients underwent intraductal biliary RF ablation through the blocked metal stent following external biliary decompression with an internal–external biliary drainage.ResultsAll nine patients had their stent patency restored successfully without the use of secondary stents. Following this intervention, there was no 30-day mortality, haemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the nine patients, six are alive and three patients are dead with a median follow-up of 122 (range 50–488) days and a median stent patency of 102.5 (range 50–321) days. Six patients had their stent patent at the time of last follow-up or death. Three patients with stent blockage at 321, 290, and 65 days postprocedure underwent percutaneous transhepatic drain insertion and repeat ablation.ConclusionsIn this selective group of patients, it appears that this new approach is safe and feasible. Efficacy remains to be proven in future, randomized, prospective studies

  18. Percutaneous intraductal radiofrequency ablation for clearance of occluded metal stent in malignant biliary obstruction: feasibility and early results.

    Science.gov (United States)

    Pai, Madhava; Valek, Vlastimil; Tomas, Andrasina; Doros, Attila; Quaretti, Pietro; Golfieri, Rita; Mosconi, Cristina; Habib, Nagy

    2014-02-01

    The major complication occurring with biliary stents is stent occlusion, frequently seen because of tumour in-growth, epithelial hyperplasia, and sludge deposits, resulting in recurrent jaundice and cholangitis. We report a prospective study with the results of first in man percutaneous intraductal radiofrequency (RF) ablation to clear the blocked metal stents in patients with malignant biliary obstruction using a novel bipolar RF catheter. Nine patients with malignant biliary obstruction and blocked metal stents were included. These patients underwent intraductal biliary RF ablation through the blocked metal stent following external biliary decompression with an internal-external biliary drainage. All nine patients had their stent patency restored successfully without the use of secondary stents. Following this intervention, there was no 30-day mortality, haemorrhage, bile duct perforation, bile leak, or pancreatitis. Of the nine patients, six are alive and three patients are dead with a median follow-up of 122 (range 50-488) days and a median stent patency of 102.5 (range 50-321) days. Six patients had their stent patent at the time of last follow-up or death. Three patients with stent blockage at 321, 290, and 65 days postprocedure underwent percutaneous transhepatic drain insertion and repeat ablation. In this selective group of patients, it appears that this new approach is safe and feasible. Efficacy remains to be proven in future, randomized, prospective studies.

  19. Intraductal papillary components in invasive ductal carcinoma of the pancreas are associated with long-term survival of patients.

    Science.gov (United States)

    Fukushima, N; Sakamoto, M; Mukai, K; Kanai, Y; Shimada, K; Kosuge, T; Hirohashi, S

    2001-08-01

    Most patients with pancreatic ductal carcinoma have a poor prognosis. However, in certain cases, 5-year survival can be achieved after surgical resection. Analysis of the pathologic findings associated with good survival rates will assist in identifying the optimum treatment. The clinicopathologic features of 67 patients who underwent surgical resection of ductal adenocarcinoma of the pancreas between 1990 and 1996 were reviewed and correlated with survival rates. There were 42 men and 25 women, with a mean age of 62.1 years (range, 44 to 82 years). The mean greatest diameter of the tumor was 4.3 cm (range, 1.5 to 11 cm). Nineteen patients (29.4%) survived more than 3 years, and 9 (13.2%) survived more than 5 years after surgical resection. The intraductal papillary component (IDPC) of the carcinoma was the main focus of the pathologic observations. IDPC was defined as intraductal papillary proliferative lesions seen in the tumor nodule with proliferative cells consistent with carcinomatous cellular atypia. IDPC was clearly present (++) in 24 patients and vaguely present (+) in 9 patients. Using the Mantel-Cox test, a statistically significant correlation was found between the presence of IDPC (either + or ++) and postoperative patient survival (P =.002). IDPC is a morphologic feature associated with longer patient survival and should be taken into consideration in assessing the pathway of tumor progression.

  20. Breast Intraductal Papillomas without Atypia in Radiologic-Pathologic Concordant Core Needle Biopsies: Predictors of Upgrade to Carcinoma at Excision

    Science.gov (United States)

    Pareja, Fresia; Corben, Adriana; Brennan, Sandra; Murray, Melissa P.; Bowser, Zenica; Jakate, Kiran; Sebastiano, Christopher; Morrow, Monica; Morris, Elizabeth; Brogi, Edi

    2016-01-01

    Background The surgical management of breast intraductal papilloma without atypia (IDP) identified at core needle biopsy (CNB) is controversial. We assessed the rate of upgrade to carcinoma at surgical excision, and identified parameters predictive of upgrade. Methods We identified women with CNB diagnosis of intraductal papilloma without atypia or carcinoma at our center between 2003 and 2013. Radiologic-pathologic concordance was assessed for all cases, and discordant cases were excluded. We correlated the radiologic and clinicopathologic features of patients with CNB diagnosis of IDP with upgrade to carcinoma at surgical excision. Results Our study population consists of 189 women with 196 IDPs; 166 women (171 IDPs) underwent excision. The upgrade rate was 2.3% (4/171). The upgrade lesions were 2 invasive lobular carcinomas and 2 cases of ductal carcinoma in situ (DCIS). One case of DCIS involved the residual IDP, whereas the other 3 carcinomas were ≥8 mm away. Twenty-four women (25 IDPs) did not undergo excision, and had stable imaging at follow-up (median of 23.5 months). Conclusions The upgrade rate at excision of IDP diagnosed at CNB with radiologic-pathologic concordance is 2.3%. Our findings suggest that observation is appropriate for patients with radiologic-pathologic concordant CNB yielding IDP, regardless of its size. PMID:27315013

  1. Diagnostic imaging of the equine fetlock region using radiography and ultrasonography. Part 2: the bony disorders.

    Science.gov (United States)

    Vanderperren, Katrien; Saunders, Jimmy H

    2009-08-01

    The metacarpophangeal/metatarsophalangeal (fetlock) joint in the horse is commonly associated with equine lameness and diagnostic imaging is routinely used to investigate disorders of the joint and its surrounding tissues. This review describes the osseous disorders of the fetlock as well as the technical aspects of taking radiographic and ultrasonographic images of the different lesions. In current clinical practice, a combination of radiography and ultrasonography is still the most frequently used approach to arrive at a diagnosis.

  2. Diagnostic value of ultrasonography in evaluation and management ...

    African Journals Online (AJOL)

    Results: Common causes of acute abdominal emergencies in pediatric patients as noted on ultrasonography included nonspecifi c pain (28%), abdominal abscess (21%), acute appendicitis (7%) and intussusception (7%). Ultrasonography was diagnostic in 45.2% cases and supportive in 12.3% of the cases. As for as the fi ...

  3. Nuclear medicine and ultrasonography in the acute cholecystitis diagnosis

    International Nuclear Information System (INIS)

    Schmillevitch, J.; Serson, D.; Camera, A.J.; Oliveira Nunes, J.E. de; Bazzo, J.M.B.

    1980-01-01

    Newer modalities for the evaluation of gallbladder include cholescintigraphy and ultrasonography. The IDA-Tc 99m presents functional informations with regard to cystic duct patency. The ultrasonography demonstrates the topographic anatomy of gallbladder, and morfologic alterations. Both analysis are preconized in acute cholecystitis. (Author) [pt

  4. Does Ultrasound-Guided Directional Vacuum-Assisted Removal Help Eliminate Abnormal Nipple Discharge in Patients with Benign Intraductal Single Mass?

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Jung Min; Cho, Na Ri Ya; Moon, Woo Kyung [Seoul National University Hospital, Seoul (Korea, Republic of); Park, Jeong Seon [Hanyang University Hospital, Seoul (Korea, Republic of); Chung, Se Yeong [Seoul National University Boramae Hospital, Seoul (Korea, Republic of); Jang, Mi Jung [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2009-12-15

    To evaluate whether the removal of an intraductal mass using an ultrasound (US)-guided directional vacuum-assisted device can eliminate symptoms in patients presenting with abnormal nipple discharge. Between March 2004 and October 2006, 36 patients who presented with abnormal nipple discharge, underwent US-guided, 11-gauge vacuum-assisted biopsy for a benign intraductal single mass on US. The ability of the procedure to eliminate nipple discharge was evaluated by physical examination during follow-up US. Lesion characteristics, biopsy variables, and histologic features were analyzed to identify factors affecting symptom resolution. Of the 36 lesions, 25 (69%) were intraductal papillomas, 10 (28%) were fibrocystic changes, and one (3%) was a fibroadenoma. The nipple discharge disappeared in 69% (25 of 36) of the women at a mean follow-up time of 25 months (range 12-42 month). There was no difference in the lesion characteristics, biopsy variables, and the histologic features between groups that eliminated the symptom compared those with persistent nipple discharge. US-guided directional vacuum-assisted removal of an intraductal mass appears to eliminate nipple discharge in only 69% of patients and thus, it should not be considered as an alternative to surgical excision.

  5. The Place of Ultrasonography in the Evaluation of Rib Fractures

    Directory of Open Access Journals (Sweden)

    Fulya Bakılan

    2015-12-01

    Full Text Available Objective: The aim of this study was to investigate whether ultrasonography is superior to chest x-ray in detecting rib fractures in patients with minor blunt chest trauma and chest pain. Materials and Methods: Ultrasonography findings of 32 patients with minor blunt chest trauma showing no evidence of a rib fracture on anteroposterior chest x-rays, were documented. Presence of cortical discontinuities, acoustic shadows, reverberation artifacts, and hematoma by ultrasonography was proposed as the diagnostic criteria for detecting the rib fracture. Results: Rib fracture was detected in 20 patients (62.5% according to ultrasonography results. A mildly displaced fracture was detected in 7 patients (35%, hematoma was detected in 3 patients (15% and multiple fractures (in 5th, 6th, 7th, and 8th ribs were detected in 1 patient (5%. Conclusion: The results of our study showed that ultrasonography is superior to chest x-ray, in detecting rib fractures.

  6. Higher Growth Rate of Branch Duct Intraductal Papillary Mucinous Neoplasms Associates With Worrisome Features.

    Science.gov (United States)

    Kolb, Jennifer M; Argiriadi, Pamela; Lee, Karen; Liu, Xiaoyu; Bagiella, Emilia; Lucas, Aimee L; Kim, Michelle Kang; Kumta, Nikhil A; Nagula, Satish; Sarpel, Umut; DiMaio, Christopher J

    2018-03-11

    For patients with branch duct intraductal papillary mucinous neoplasms (BD-IPMNs, cysts), it is a challenge to identify those at high risk for malignant lesions. We sought to identify factors associated with development of pancreatic cancer, focusing on neoplasm growth rate. We performed a retrospective study of 189 patients with BD-IPMNs who underwent at least 2 contrast-enhanced cross-sectional imaging studies, 1 year or more apart, at a tertiary referral center from January 2003 through 2013. Patients with cysts that had Fukuoka worrisome or high-risk features were excluded. Two radiologists reviewed all images. Cyst size was recorded at the initial and final imaging studies and growth rate was calculated. We collected patient demographic data, cyst characteristics, and clinical outcomes; univariate logistic regression models were used to determine the odds of developing worrisome features. The primary outcomes were to determine growth rate of low-risk BD-IPMNs and to assess whether cyst growth rate correlates high-risk features of IPMNs. Based on image analyses, cysts were initially a median 11 mm (range, 3-31 mm) and their final size was 12.5 mm (range, 3-42 mm). After a median follow-up time of 56 months (range, 12-163 months), the median cyst growth rate was 0.29 mm/year. Twelve patients developed worrisome features, no patients developed high-risk features, 4 patients had surgical resection, and no cancers developed. The rate of BD-IPMN growth was greater in patients who developed worrisome features than those who did not (2.84 mm/year vs 0.23 mm/year; P < .001). The odds of developing worrisome features increased for each unit (mm) increase in cyst size (odds ratio, 1.149; 95% CI, 1.035-1.276, P = .009). In a retrospective analysis of images from patients with BD-IPMN, we found low-risk BD-IPMNs to grow at an extremely low rate (less than 0.3 mm/year). BD-IPMNs in only about 6% of patients developed worrisome features, and none developed high-risk features

  7. Mammographic findings predicting an extensive intraductal component in early stage invasive breast cancer : analysis on microcalcification

    International Nuclear Information System (INIS)

    Kim, Jeong Ah; Kim, Mi Hye; Lee, Mi Kyung; Oh, Ki Keun; Kim, Eun Kyung

    2000-01-01

    To analyze the mammographic findings of extensive intraductal component (EIC)-positive early invasive breast carcinoma and to determine the mammographic features which predict an EIC positivity in an invasive carcinoma. The mammographic and pathologic findings in 71 patients aged 34-79 (mean 50) years in whom stage I or II invasive breast carcinoma had been diagnosed were retrospectively analysed. The mammographic findings were assigned to one of three groups: mass, mass with microcalcification, or microcalcification only. The shape and distribution of a calcification were classified according to the BI-RADS lexicon, and its extent was classified as either more or less than 3 cm. To detect the presence or absence of EIC and the type of ductal carcinoma in situ (DCIS), the findings were re-examined by means of slide mappings. Twenty-eight of 71 patients (39%) showed ECI positivity. The mammographic findings of EIC-positive invasive cancer (n=3D28) were mass with microcalcification (n=3D14), microcalcification only (n=3D7) and mass only (n=3D7). The mammographic finding which predicted EIC positivity was mass with microcalcification (PPV:0.67, NPV:0.33, p=3D0.02). A mammographic of mass only (n=3D39) showed a significantly high negative predictive value for EIC positivity. (PPV 0.18, NPV 0.82, P less than 0.01). A comparison of cases with or without calcification showed that those with microcalcifications (n=3D32) showed a significantly high PPV of 0.66 (NPV:0.34, p less than 0.01) while those without calcification (n=3D39) showed a significantly high NPV of 0.82 (PPV:0.18, p less than 0.01). There were no significant differences in positive predictive values for EIC between the shape, distribution and extent of calcifications. Whenever microcalcification with or without mass is seen on mammographs obtained during early breast cancer, we can predict EIC-positivity, regardless of shape or distribution according to the BI-RADS lexicon. (author)

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

    Directory of Open Access Journals (Sweden)

    Anderson Chun On Tsang

    2015-04-01

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

  9. Introital ultrasonography in female urinary incontinence

    Energy Technology Data Exchange (ETDEWEB)

    Weon, Young Cheol; Cho, Kyoung Sik; Lee, Jin Seong; Choi, Sang Hee; Kim, Keon Seok; Choo, Myung Soo [Ulsan Univ. Asan Medical Center, Seoul (Korea, Republic of)

    1996-06-01

    To evaluate the usefulness of introital ultrasonography in the assessment of female urinary incontinence. Introital ultrasonography was performed in fifteen with stress urinary incontinence(mean age 50) and six patients without symptoms of incontinence(mean age 37). Using a sagittal section of the anterior pelvis in the plane of the symphysis pubis the posterior urethrovesical angle, the pubourethral distance and the pubo-yregrak abgle were measured at rest and during stress(Valsalva's maneuver state). The student T-test and the ANOVA test were used in statistical analysis. The posterior urethrovesical angles of the controls were 125.3 deg ({+-}10.9) at rest and 125.7 deg ({+-}7.6) during stress. In the patients, the corresponding angles were 135.3 deg ({+-}11.3) and 139.6 deg({+-}10.8). The posterior urethrovesical angles increased 0.3 deg ({+-}4.7) in the controls and 5.6 deg ({+-}4.0) in the patients(p=0.018). In the controls, the pubo-urethral distances were 21.8 mm({+-}5.8) at rest and 18.2 mm({+-}7.1) during stress, while in the patients these distances were 18.4 mm({+-}3.9) and 12.6 mm({+-}4.4). The pubo-urethral distance decreased 3.5 mm ({+-}1.5) in the controls and 5.8 mm ({+-}2.3) in the patients(p=0.039). In the patients with mild incontinence(Grade I), the posterior urethrovesical angles increased 3.4 deg ({+-}2.8) : 132.3 deg ({+-}12.5) at rest and 135.6 deg (12.8) during stress. In the patients with moderate incontinence(Grade II), the angles increased 8.1 deg({+-}3.8) : 136.0 deg({+-}6.5) at rest and 144.1 deg({+-}5.9) during stress. The change of the posterior urethrovesical angle was related to the grade of urinary incontinence in the patients(p<0.05). There was no statistical significancy in the pubo-urethral angle (p=0.315). Introital ultrasonography may be useful for assessment of stress urinary incontinence.

  10. Collateral variations in circle of willis in atherosclerotic population assessed by means of transcranial color-coded duplex ultrasonography

    NARCIS (Netherlands)

    Hoksbergen, A. W.; Legemate, D. A.; Ubbink, D. T.; Jacobs, M. J.

    2000-01-01

    BACKGROUND AND PURPOSE: Transcranial color-coded duplex ultrasonography combined with common carotid artery (CCA) compression can be used to assess the collateral function of the circle of Willis. The aim of this study was to assess the unknown fraction of hemodynamic functional anterior and

  11. Percutaneous Intraductal Radiofrequency Ablation for Extrahepatic Distal Cholangiocarcinoma: A Method for Prolonging Stent Patency and Achieving Better Functional Status and Quality of Life

    International Nuclear Information System (INIS)

    Wu, Tian-tian; Li, Wei-min; Li, Hu-cheng; Ao, Guo-kun; Zheng, Fang; Lin, Hu

    2017-01-01

    PurposeThe clinical efficacy of intraductal radiofrequency ablation (RFA) with Habib™ EndoHPB catheter, a newly developed intervention for malignant extrahepatic biliary obstruction, remains uncertain. The aim of this study was to investigate the clinical efficacy of intraductal RFA.MethodsData from 71 patients with extrahepatic distal cholangiocarcinoma were retrospectively analyzed. The study patients were divided into RFA and control groups. The RFA group had undergone percutaneous transhepatic intraductal RFA with a Habib™ EndoHPB catheter, followed by placement of covered or uncovered biliary self-expandable metallic stents (SEMs) whereas the control group had undergone percutaneous transhepatic covered or uncovered SEMs placement. Procedure-related complications, stent patency, patient survival, and postoperative serum bilirubin concentrations were compared between the two groups. The Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire was administered to evaluate functional status, improvement in clinical manifestations, and quality of life.ResultsThe RFA group had a longer median stent patency than the control group (p = 0.001 for uncovered SEMs placement). Higher functional well-being, hepatobiliary-specific cancer subscale, Trial Outcome Index, and total FACT-Hep scores were observed during post-procedure follow-up in the RFA group. However, median survival did not differ significantly between the two groups (p > 0.05).ConclusionsProlongation of stent patency and better functional status and quality of life, which are all important clinical endpoints, were observed in patients treated with intraductal RFA. Prospective randomized controlled clinical trials are necessary to further investigate the clinical efficacy and long-term benefits of intraductal RFA.

  12. Percutaneous Intraductal Radiofrequency Ablation for Extrahepatic Distal Cholangiocarcinoma: A Method for Prolonging Stent Patency and Achieving Better Functional Status and Quality of Life

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Tian-tian, E-mail: matthewwu1979@hotmail.com; Li, Wei-min, E-mail: weimin-li-surgery@126.com [The 309th Hospital of PLA, Hepatobiliary Surgery Department (China); Li, Hu-cheng, E-mail: hucheng-li-surgery@126.com [The 307th Hospital of PLA, General Surgery Department (China); Ao, Guo-kun, E-mail: guokun-ao-radiology@126.com [The 309th Hospital of PLA, Radiology Department (China); Zheng, Fang, E-mail: fang-zheng-surgery@126.com [The 309th Hospital of PLA, Hepatobiliary Surgery Department (China); Lin, Hu, E-mail: hu-lin-radiology@126.com [The 309th Hospital of PLA, Radiology Department (China)

    2017-02-15

    PurposeThe clinical efficacy of intraductal radiofrequency ablation (RFA) with Habib™ EndoHPB catheter, a newly developed intervention for malignant extrahepatic biliary obstruction, remains uncertain. The aim of this study was to investigate the clinical efficacy of intraductal RFA.MethodsData from 71 patients with extrahepatic distal cholangiocarcinoma were retrospectively analyzed. The study patients were divided into RFA and control groups. The RFA group had undergone percutaneous transhepatic intraductal RFA with a Habib™ EndoHPB catheter, followed by placement of covered or uncovered biliary self-expandable metallic stents (SEMs) whereas the control group had undergone percutaneous transhepatic covered or uncovered SEMs placement. Procedure-related complications, stent patency, patient survival, and postoperative serum bilirubin concentrations were compared between the two groups. The Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire was administered to evaluate functional status, improvement in clinical manifestations, and quality of life.ResultsThe RFA group had a longer median stent patency than the control group (p = 0.001 for uncovered SEMs placement). Higher functional well-being, hepatobiliary-specific cancer subscale, Trial Outcome Index, and total FACT-Hep scores were observed during post-procedure follow-up in the RFA group. However, median survival did not differ significantly between the two groups (p > 0.05).ConclusionsProlongation of stent patency and better functional status and quality of life, which are all important clinical endpoints, were observed in patients treated with intraductal RFA. Prospective randomized controlled clinical trials are necessary to further investigate the clinical efficacy and long-term benefits of intraductal RFA.

  13. Ultrasonography of the pediatric hip and spine

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yeo Ryang; Koo, Joon Bun [Dept. of Radiology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang (Korea, Republic of)

    2017-07-15

    Ultrasonography (US) is a useful screening method for the diagnosis of developmental dysplasia of the hip (DDH) and congenital spinal anomalies in infants. In addition, US is a useful, noninvasive imaging modality for the diagnosis of transient synovitis in children. The early detection of DDH leads to a better prognosis without surgical intervention. Moreover, spinal US allows the detection of congenital malformations and can also demonstrate normal anatomy and normal variants that may resemble disorders. Therefore, radiologists should be familiar with the sonographic anatomy of the normal infant hip, scanning and measurement techniques for DDH, the US features of transient synovitis in children, spinal US techniques, and the US features of normal anatomical structures, normal variants, and congenital spinal anomalies.

  14. Current status of ultrasonography of the finger

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seun Ah; Kim, Baek Hyun [Dept. of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of); Kim, Seon Jeong [Dept. of Radiology, Myongji Hospital, Seonam University College of Medicine, Goyang (Korea, Republic of); Kim, Ji Na [Dept. of Radiology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon (Korea, Republic of); Park, Sun Young [Dept. of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang (Korea, Republic of); Choi, Kyung Hee [Incheon Baek Hospital, Incheon (Korea, Republic of)

    2016-03-15

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

  15. Shoulder Ultrasonography: Performance and Common Findings

    Directory of Open Access Journals (Sweden)

    Diana Gaitini

    2012-01-01

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

  16. Current status of automated breast ultrasonography

    Directory of Open Access Journals (Sweden)

    Hee Jung Shin

    2015-07-01

    Full Text Available Breast ultrasonography (US is currently considered the first-line examination in the detection Epub ahead of print and characterization of breast lesions. However, conventional handheld US (HHUS has several limitations such as operator dependence and the requirement of a considerable amount of radiologist time for whole-breast US. Automated breast US (ABUS, recently approved by the United States Food and Drug Administration for screening purposes, has several advantages over HHUS, such as higher reproducibility, less operator dependence, and less required physician time for image acquisition. In addition, ABUS provides both a coronal view and a relatively large field of view. Recent studies have reported that ABUS is promising in US screening for women with dense breasts and can potentially replace handheld second-look US in a preoperative setting.

  17. Current status of ultrasonography of the finger

    Directory of Open Access Journals (Sweden)

    Seun Ah Lee

    2016-04-01

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

  18. Ultrasonography of the pediatric hip and spine

    International Nuclear Information System (INIS)

    Kang, Yeo Ryang; Koo, Joon Bun

    2017-01-01

    Ultrasonography (US) is a useful screening method for the diagnosis of developmental dysplasia of the hip (DDH) and congenital spinal anomalies in infants. In addition, US is a useful, noninvasive imaging modality for the diagnosis of transient synovitis in children. The early detection of DDH leads to a better prognosis without surgical intervention. Moreover, spinal US allows the detection of congenital malformations and can also demonstrate normal anatomy and normal variants that may resemble disorders. Therefore, radiologists should be familiar with the sonographic anatomy of the normal infant hip, scanning and measurement techniques for DDH, the US features of transient synovitis in children, spinal US techniques, and the US features of normal anatomical structures, normal variants, and congenital spinal anomalies

  19. Prenatal diagnosis of hypophosphatasia congenita using ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Guguloth, Ashwitha [Dept. of Radiology, Bangalore Medical College and Research Institute, Bangalore (India); Aswani, Yashant; Anandpara, Karan Manoj [Dept. of Radiology, Seth G S Medical College and KEM Hospital, Mumbai (India)

    2016-01-15

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

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

    Science.gov (United States)

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

    2011-12-01

    neoplasia or atypical small acinar proliferation. • No significant differences were found among the three groups for cancer detection rate (P= 0.329). • Additionally, low sensitivity, specificity and accuracy of colour Doppler with or without SonoVue™ contrast agent were found. • Prostate cancer detection rate does not significantly improve with the use of colour Doppler ultrasonography with or without SonoVue™. • Although no collateral effects have been highlighted, the combined use of colour Doppler ultrasonography and SonoVue™ determines adjunctive costs and increases the mean time for taking a single prostate biopsy. © 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

  1. Survival Analysis of Occipital Nerve Stimulator Leads Placed under Fluoroscopic Guidance with and without Ultrasonography.

    Science.gov (United States)

    Jones, James H; Brown, Alison; Moyse, Daniel; Qi, Wenjing; Roy, Lance

    2017-11-01

    Electrical stimulation of the greater occipital nerves is performed to treat pain secondary to chronic daily headaches and occipital neuralgia. The use of fluoroscopy alone to guide the surgical placement of electrodes near the greater occipital nerves disregards the impact of tissue planes on lead stability and stimulation efficacy. We hypothesized that occipital neurostimulator (ONS) leads placed with ultrasonography combined with fluoroscopy would demonstrate increased survival rates and times when compared to ONS leads placed with fluoroscopy alone. A 2-arm retrospective chart review. A single academic medical center. This retrospective chart review analyzed the procedure notes and demographic data of patients who underwent the permanent implant of an ONS lead between July 2012 and August 2015. Patient data included the diagnosis (reason for implant), smoking tobacco use, disability, and age. ONS lead data included the date of permanent implant, the imaging modality used during permanent implant (fluoroscopy with or without ultrasonography), and, if applicable, the date and reason for lead removal. A total of 21 patients (53 leads) were included for the review. Chi-squared tests, Fishers exact tests, 2-sample t-tests, and Wilcoxon rank-sum tests were used to compare fluoroscopy against combined fluoroscopy and ultrasonography as implant methods with respect to patient demographics. These tests were also used to evaluate the primary aim of this study, which was to compare the survival rates and times of ONS leads placed with combined ultrasonography and fluoroscopy versus those placed with fluoroscopy alone. Survival analysis was used to assess the effect of implant method, adjusted for patient demographics (age, smoking tobacco use, and disability), on the risk of lead explant. Data from 21 patients were collected, including a total of 53 ONS leads. There was no statistically significant difference in the lead survival rate or time, disability, or patient age

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

    Science.gov (United States)

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

    2014-02-01

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

  3. Compression ultrasonography of the lower extremity with portable vascular ultrasonography can accurately detect deep venous thrombosis in the emergency department.

    Science.gov (United States)

    Crisp, Jonathan G; Lovato, Luis M; Jang, Timothy B

    2010-12-01

    Compression ultrasonography of the lower extremity is an established method of detecting proximal lower extremity deep venous thrombosis when performed by a certified operator in a vascular laboratory. Our objective is to determine the sensitivity and specificity of bedside 2-point compression ultrasonography performed in the emergency department (ED) with portable vascular ultrasonography for the detection of proximal lower extremity deep venous thrombosis. We did this by directly comparing emergency physician-performed ultrasonography to lower extremity duplex ultrasonography performed by the Department of Radiology. This was a prospective, cross-sectional study and diagnostic test assessment of a convenience sample of ED patients with a suspected lower extremity deep venous thrombosis, conducted at a single-center, urban, academic ED. All physicians had a 10-minute training session before enrolling patients. ED compression ultrasonography occurred before Department of Radiology ultrasonography and involved identification of 2 specific points: the common femoral and popliteal vessels, with subsequent compression of the common femoral and popliteal veins. The study result was considered positive for proximal lower extremity deep venous thrombosis if either vein was incompressible or a thrombus was visualized. Sensitivity and specificity were calculated with the final radiologist interpretation of the Department of Radiology ultrasonography as the criterion standard. A total of 47 physicians performed 199 2-point compression ultrasonographic examinations in the ED. Median number of examinations per physician was 2 (range 1 to 29 examinations; interquartile range 1 to 5 examinations). There were 45 proximal lower extremity deep venous thromboses observed on Department of Radiology evaluation, all correctly identified by ED 2-point compression ultrasonography. The 153 patients without proximal lower extremity deep venous thrombosis all had a negative ED compression

  4. Intraductal papilloma in an axillary lymph node of a patient with human immunodeficiency virus: a case report and review of the literature.

    Science.gov (United States)

    Cottom, Hannah; Rengabashyam, Bhavani; Turton, Philip E; Shaaban, Abeer M

    2014-05-23

    Inclusions of ectopic breast tissue in axillary lymph nodes are reported very infrequently and typically are only identified microscopically as an incidental finding. Furthermore the development of a benign proliferative lesion in the form of an intraductal papilloma from intranodal ectopic breast tissue is an extremely rare phenomenon with only three previous cases reported. This report describes an unusual and rare case of an intraductal papilloma arising in an axillary lymph node of a patient known to have the human immunodeficiency virus. A 40-year-old Black African woman underwent excision of an enlarged palpable axillary lymph node. In the preceding 7 years she had received at least six separate surgical excisions to her ipsilateral breast for papillomatosis. The last surgical intervention was performed 1 year prior to presentation with an enlarged axillary lymph node. Histological examination of her axillary lymph node revealed a papillomatous proliferative epithelial lesion within an apparent encompassing duct, resembling a mammary intraductal papilloma. In the surrounding lymphoid tissue small groups of duct-like structures were additionally noted. Immunostaining with a panel of myoepithelial markers in conjunction with oestrogen receptor produced a mixed heterogeneous staining pattern in both the papillomatous lesion and the peripheral duct-like structures. This confirmed the diagnosis of a benign intraductal papilloma within an axillary lymph node, considered to have arisen from ectopic breast tissue. This case demonstrates that intranodal ectopic breast tissue has the potential to undergo benign proliferative change albeit extremely rarely. Therefore this possibility must be considered to ensure the correct diagnosis is made. In addition, to the best of our knowledge, this is the first case report which has described recurrent intraductal papillomas and the subsequent development of an intraductal papilloma within an ipsilateral axillary lymph node, in

  5. Pretreatment axillary ultrasonography and core biopsy in patients with suspected breast cancer: Diagnostic accuracy and impact on management

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Ortega, Maria Jose, E-mail: rserranogan@telefonica.net [Breast Imaging Center, Radiology Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Alvarez Benito, Marina, E-mail: marinaalvarezbenito@telefonica.net [Breast Imaging Center, Radiology Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Fuentes Vahamonde, Elena, E-mail: elena.fuentes.sspa@juntadeandalucia.es [Pathology Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Rioja Torres, Pilar, E-mail: priojat@yahoo.es [Clinical Management Unit, Department of General and Digestive Surgery, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Benitez Velasco, Ana, E-mail: abvelazco@yahoo.es [Nuclear Medicine Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Martinez Paredes, Maria, E-mail: mariaparedes@uco.es [Radiology and Physical Medicine Area, University of Cordoba Medical School, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain)

    2011-07-15

    Preoperative diagnosis of axillary metastases in breast cancer patients enables treatment planning. We aimed to evaluate the diagnostic accuracy of axillary ultrasonography and percutaneous biopsy, both alone and in combination, in detecting axillary metastases in patients with breast cancer and to assess the impact of these techniques on the patients' management. Materials and methods: Retrospective study of consecutive patients with suspected breast cancer examined between October 2006 and December 2008. The diagnosis of a primary tumor was histologically confirmed in all patients. All patients underwent axillary ultrasonography and percutaneous core biopsy (14G) of suspicious lymph nodes. We evaluated the morphological characteristics of the lymph nodes by ultrasonography. We calculated the diagnostic accuracy of ultrasonography and of core biopsy, and assessed the impact of these techniques on patients' treatment. Results: We evaluated 675 axillary regions and performed 291 core biopsies of axillary lymph nodes in 662 patients. In 650 patients, breast cancer was histologically confirmed and in 12 patients malignant tumors in other locations were confirmed. The sensitivity and specificity of axillary ultrasonography were 63.2% and 88.7%, respectively. The absence of a fatty hilum within the lymph node was the ultrasonographic finding with the highest positive predictive value for malignancy (93.1%). The sensitivity and specificity of axillary core biopsy were 69.1% and 100%, respectively. Sentinel lymph node biopsy was avoided in 33% of initial candidates and immediate breast reconstruction was undertaken in 35.1% of the patients with mastectomy and negative axillary core biopsy. Conclusions: Ultrasonography and axillary core biopsy enable adequate pretreatment staging in patients with breast cancer and has a positive impact on their management.

  6. Endoscopic Ultrasonography in the Diagnosis of Gastric Subepithelial Lesions

    Directory of Open Access Journals (Sweden)

    Eun Jeong Gong

    2016-09-01

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

  7. Normal values for quantitative muscle ultrasonography in adults.

    NARCIS (Netherlands)

    Arts, I.M.P.; Pillen, S.; Schelhaas, H.J.; Overeem, S.; Zwarts, M.J.

    2010-01-01

    Ultrasonography can detect structural muscle changes caused by neuromuscular disease. Quantitative analysis is the preferred method to determine if ultrasound findings are within normal limits, but normative data are incomplete. The purpose of this study was to provide normative muscle

  8. Ultrasonography as a diagnostic method in addition to mammography

    Energy Technology Data Exchange (ETDEWEB)

    Otto, H.; Roer, E.

    1988-05-01

    By using ultrasonography in addition to mammography, experienced diagnosticians essentially enhance the safety of their diagnosis of mammary gland diseases. The same applies to gynecomastia, the condition after plastic surgery, and mastitis.

  9. Ultrasonography as a better diagnostic efficiency in rib fracture

    OpenAIRE

    UZUN, Metin; BEKSAÇ, Burak; KARATAŞ, Adnan; KÜÇÜKDURMAZ, Fatih; KIRCALI, Bahar ANAYURDU; TETİK, Cihangir

    2013-01-01

    In this study, our aim was to demonstrate the need of use of ultrasonography in rib fractures in order not to face medicolegal problems. One hundred patients admitted to our emergency service with mild to moderate blunt thorax trauma were included in our study prospectively. The inclusion criteria were pain upon palpation of ribs, deep inspiration, coughing but no any other pathologies like a pneumothorax, hemothorax. All patients are evaluated with ultrasonography (USG) and direct X-rays. X-...

  10. Ultrasonography of the lower extremity veins: Anatomy and basic approach

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Kyu; Ahn, Kyung Sik; Kang, Chang Ho; Cho, Sung Bum [Dept. of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2017-04-15

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

  11. Intraoperative ultrasonography in detection of hepatic metastases from colorectal cancer

    DEFF Research Database (Denmark)

    Rafaelsen, Søren Rafael; Kronborg, Ole; Fenger, Claus

    1995-01-01

    PURPOSE: This study was designed to compare diagnostic accuracies of measuring liver enzymes, preoperative ultrasonography, surgical examination, and intraoperative ultrasonography for detection of liver metastases from colorectal cancer. METHODS: Blind, prospective comparisons of diagnostic...... examinations mentioned above were performed in 295 consecutive patients with colorectal cancer. An experienced ultrasonologist performed the preoperative examinations, and results were unknown to the other experienced ultrasonologist who performed the intraoperative examinations. The latter, also was unaware...

  12. Ultrasonography of the lower extremity veins: Anatomy and basic approach

    International Nuclear Information System (INIS)

    Lee, Dong Kyu; Ahn, Kyung Sik; Kang, Chang Ho; Cho, Sung Bum

    2017-01-01

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

  13. Acute diverticulitis of the terminal ileum: ultrasonography and CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Jewon; Hong, Seong Sook; Hwang, Ji Young; Kim, Hyun Joo; Chang, Yun Woo [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    2015-01-15

    We describe a rare case of terminal ileal diverticulitis in a 68-year-old female with a day of history Epub ahead of print of right lower quadrant pain and tenderness, mimicking acute appendicitis. Ultrasonography revealed small sac-like out-pouching lesions with increased echogenicity of surrounding fat in thickened terminal ileum, suggesting inflamed diverticula. We diagnosed terminal ileal diverticulitis primarily by ultrasonography. The diagnosis was confirmed by subsequent computed tomography.

  14. The color Doppler ultrasonography in in the diagnosis of deep vein thrombosis

    International Nuclear Information System (INIS)

    Ameneiro Perez, Santiago; Alvarez Sanchez, Jose A.; Rodriguez Villalonga, Luis; Borras Migues, Marisela; Quinnones Castro, Mayda

    2004-01-01

    The paper was aimed at evaluating the accuracy of color Doppler ultrasonography, a noninvasive method, in the diagnosis of deep vein thrombosis of the lower limbs, comparing it to the results of the cruel and costly diagnostic g olden rule , that is, phlebography. Methods: Color Doppler ultrasonography served to assess 102 patients clinically suspected of deep vein thrombosis of the lower limbs, taking into account the following criteria: vein compressibility, echographic images, color, Vein Doppler signal modulation after several maneuvers and distal compression. Sensitivity, specificity, positive and negative predictive values and diagnostic efficacy were estimated for each criteria, taking the phlebography as a reference. Results: Total or partial lack of vein compressibility combined with the vein flow evaluation is the ultrasonographic criterion that reveals higher degree of sensitivity, specificity and efficacy (0,98; 0,95 and 0,97 respectively. Color Doppler ultrasonography is a highly effective noninvasive diagnostic method that detects deep vein thrombosis in proximal areas of the lower limbs

  15. Hydrodynamic study of syringomyelia by MRI and intraoperative ultrasonography

    International Nuclear Information System (INIS)

    Moritake, Kouzo; Takaya, Mikio; Minamikawa, Jun; Ishikawa, Masatsune; Kikuchi, Haruhiko; Minami, Shunsuke

    1989-01-01

    Syringomyelic cavities were studied with magnetic resonance imaging (MRI) in eleven patients with special reference to the hemodynamic contribution to the pathogenesis of syringomyelia. They were also studied intraoperatively with ultrasonography (USG) in five patients. Syrinx cavities combined with lumbosacral lipomyelomeningocele or with spinal stenosis did not present a flow-void phenomenon reflecting pulsatile movements of syrinx fluid. On serial MRI study in those the patients, enlargement of the syrinx cavity was not observed. Syrinx cavities occupying the caudal part of the spinal cord did not develop either. These cases were not treated surgically but followed conservatively. On the other hand, the flow-void sign in the syrinx cavities was present on MRI in patients who also had Chiari type I or type II malformations. They were treated with a syringo-subarachnoid shunt. In these cases, intraoperative USG disclosed marked fluctuation of syrinx cavity size synchronous with the motions of pulmonary ventilation. In all of them, clinical signs and symptoms improved postoperatively to various degrees. These results suggest that both the flow-void sign in the syrinx cavity on MRI and marked fluctaution of cavity size on intraoperative USG are indications for the shunt operation and support William's revised theory (1987). Fluctuation of cystic cavity size synchronous with ventilation suggests that venous pressure in the spinal subarachnoid space contributes to the pathogenesis of syringomyelic cavities. Further analysis of the fluctuation of cystic cavities by video monitoring will provide further information on the etiology and other clinical problems of syringomyelia. (author)

  16. Ultrasonography and arthrography in rotator cuff lesions: algorithmic approach

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eui Jong; Ryu, Kyung Nam; Lee, Sun Wha; Lim, Jae Hoon; Rhee, Yong Girl [Kyung Hee University Hospital, Seoul (Korea, Republic of); Yu, Pil Mun [Dankuk University College of Medicine, Chenona (Korea, Republic of)

    1992-11-15

    Twenty-six patients with chief complaint of shoulder pain who underwent both ultrasonographic examination and arthrography of the shoulder were analyzed. Ten out of 12 cases with clinical impression of frozen shoulder, showed normal findings on the ultrasonographic examination of the shoulder. Among these ten cases, nine cases showed adhesive capsulitis and one case showed rotator cuff tear on arthrography. Among six cases with the clinical impression of rotator cuff tear, five cases showed rotator cuff tear and one case showed combined calcific tendinitis and adhesive capsulitis on ultrasonographic examination. In arthrography, four cases of rotator cuff tear, one case of calcific tendinitis and biceps tendinitis and one case of normal finding were diagnosed. For the remaining eight cases in the ultrasonographic examination, normal finding or biceps tendinitis were found and for the remaining of the cases in arthrography adhesive capsulitis were found. With the above results, we recommend that the shoulder ultrasonography as the first line diagnostic modality for a patient with chief complaint of shoulder pain.

  17. Ultrasonography and arthrography in rotator cuff lesions: algorithmic approach

    International Nuclear Information System (INIS)

    Kim, Eui Jong; Ryu, Kyung Nam; Lee, Sun Wha; Lim, Jae Hoon; Rhee, Yong Girl; Yu, Pil Mun

    1992-01-01

    Twenty-six patients with chief complaint of shoulder pain who underwent both ultrasonographic examination and arthrography of the shoulder were analyzed. Ten out of 12 cases with clinical impression of frozen shoulder, showed normal findings on the ultrasonographic examination of the shoulder. Among these ten cases, nine cases showed adhesive capsulitis and one case showed rotator cuff tear on arthrography. Among six cases with the clinical impression of rotator cuff tear, five cases showed rotator cuff tear and one case showed combined calcific tendinitis and adhesive capsulitis on ultrasonographic examination. In arthrography, four cases of rotator cuff tear, one case of calcific tendinitis and biceps tendinitis and one case of normal finding were diagnosed. For the remaining eight cases in the ultrasonographic examination, normal finding or biceps tendinitis were found and for the remaining of the cases in arthrography adhesive capsulitis were found. With the above results, we recommend that the shoulder ultrasonography as the first line diagnostic modality for a patient with chief complaint of shoulder pain

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

    Science.gov (United States)

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

    2017-04-01

    Esophageal leiomyoma is the most common benign tumor of the esophagus, and it originates from mesenchymal tissue. This study analyzed the clinicopathological characteristics of esophageal leiomyoma and aimed to evaluate the role of endoscopic ultrasonography in the diagnosis and treatment selection for these lesions. Two hundred and twenty-five patients who had suspected esophageal leiomyomas in endoscopic ultrasonography were enrolled at the Endoscopy Center of The First Affiliated Hospital, Zhejiang University from January 1st, 2009 to May 31th, 2015. The main outcomes included the demographic and morphological characteristics, symptoms, comparisons of diagnosis and treatment methods, adverse events, and prognosis. One hundred and sixty-seven patients were diagnosed as having an esophageal leiomyoma by pathological examination. The mean patient age was 50.57±9.983 years. In total, 62.9% of the lesions originated from the muscularis mucosa, and the others originated from the muscularis propria. The median distance to the incisors was 30±12 cm. The median diameter was 0.72±0.99 cm. As determined by endoscopic ultrasonography, most existing leiomyomas were homogeneous, endophytic, and spherical. The leiomyomas from the muscularis mucosa were smaller than those from the muscularis propria and much closer to the incisors (pleiomyomas presented less adverse events and better recovery (pleiomyomas. Endoscopic ultrasonography has demonstrated high accuracy in the diagnosis of esophageal leiomyomas and provides great support in selecting treatments; however, EUS cannot completely avoid misdiagnosis, so combining it with other examinations may be a good strategy to solve this problem.

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

    Directory of Open Access Journals (Sweden)

    Ling-Jia Sun

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

  20. [Ultrasonography-guided therapeutic procedures in the neck region].

    Science.gov (United States)

    Brzac, Hrvojka Tomić

    2009-12-01

    Minimally invasive therapeutic procedures in medicine have become very popular because of the reduced risk compared to classic surgical treatment, speed of recovery, little or no side effects, and frequently lower cost. One of these methods is ultrasonography-guided percutaneous injection of 95% ethanol (PEIT, percutaneous ethanol injection therapy), which is especially suitable for the neck region. Other methods like laser photocoagulation (ILP) or radiofrequency ablation (RFA) are more aggressive and expensive. The procedure of sterile 95% ethanol injecting is performed on an outpatient basis, without preparation. A specific amount of alcohol is injected into the lesion using a thin spinal needle, under ultrasonography guidance. The amount of alcohol depends on the size of the lesion. Complications are rare and the procedure can be repeated several times. PEIT is used in the treatment of parathyroid glands, especially secondary hyperparathyroidism, thyroid nodules (toxic adenoma, goiters and cysts), other cysts on the neck, and cervical metastases of thyroid cancer. Direct ethanol injection into the tissue causes cellular dehydration and protein denaturation, followed by the development of necrosis, fibrosis, and thrombosis of the small blood vessels. In this way, reduction or disappearance of the nodes can be achieved, along with functional normalization (for parathyroid glands and toxic adenoma), with longer or shorter disease remission or complete recovery. Today, PEIT is mostly used in dialyzed patients with secondary hyperparathyroidism. The treatment gives best results in combination with vitamin D analogs, if 1-2 parathyroid glands are enlarged, and for residual parathyroid gland after parathyroidectomy. A success rate of 50%-70% has been reported, depending on the number of enlarged parathyroid glands. Therapeutic effect is manifested in the size reduction or complete fibrozation of the gland, reduction or disappearance of vascularization, and a decrease

  1. New endoscopic ultrasonography techniques for pancreticobiliary diseases

    Energy Technology Data Exchange (ETDEWEB)

    Kamata, Ken; Kitano, Masayuki; Omoto, Shunsuke; Kadosaka, Kumpei; Miyata, Takeshi; Minaga, Kosuke; Yamao, Kentaro; Imai, Hajime; Kudo, Masatoshii [Dept. of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka (Japan)

    2016-07-15

    Endoscopic ultrasonography (EUS) is widely used to evaluate pancreaticobiliary diseases, especially pancreatic masses. EUS has a good ability to detect pancreatic masses, but it is not sufficient for the differential diagnosis of various types of lesions. In order to address the limitations of EUS, new techniques have been developed to improve the characterization of the lesions detected by EUS. EUS-guided fine needle aspiration (EUS-FNA) has been used for diagnosing pancreatic tumors. In order to improve the histological diagnostic yield, a EUS-FNA needle with a core trap has recently been developed. Contrast-enhanced harmonic EUS is a new imaging modality that uses an ultrasonographic contrast agent to visualize blood flow in fine vessels. This technique is useful in the diagnosis of pancreatic solid lesions and in confirming the presence of vascularity in mural nodules for cystic lesions. EUS elastography analyzes several different variables to measure tissue elasticity, color patterns, and strain ratio, using analytical techniques such as hue-histogram analysis, and artificial neural networks, which are useful for the diagnosis of chronic pancreatitis and pancreatic cancer.

  2. Rupture of Achilles Tendon : Usefulness of Ultrasonography

    International Nuclear Information System (INIS)

    Kim, Nam Hyeon; Ki, Won Woo; Yoon, Kwon Ha; Kim, Song Mun; Shin, Myeong Jin; Kwon, Soon Tae

    1996-01-01

    To differentiate a complete rupture of Achilles tendon from an incomplete one which is important because its treatment is quite different. And it is necessary to know the exact site of the rupture preoperatively. Fifteen cases of fourteen patients which were diagnosed as Achilles tendon rupture by ultrasonography and surgery were reviewed. We compared sonographic rupture site with surgical findings. Ultrasonographic criteria for differentiation of complete and incomplete rupture was defined as follows : the discreteness, which means the proximal intervening hypoechogenicity to the interface echogenicity of distal margin of ruptured tendon : the slant sign, which represents the interface of ruptured distal margin which was seen over the 3/4 of the thickness of the tendon without intervening low echogeneicity : the invagination sign, which means the echogenic invagination from Kager triangle into posterior aspect of Achilles tendon over the half thickness of the tendon. The sites of complete tendon rupture were exactly corresponded to surgical finding in four cases of ten complete ruptures. And the discrepancy between sonographic and surgical findings in the site of complete rupture was 1.2 ± 0.4 cm in six cases. Three of ten complete ruptures showed the discreteness sign, all of ten showed the slant sign and two of ten showed the invagination sign. It is helpful to differentiate a complete from incomplete rupture of the Achilles tendon and to localize the site of the complete rupture with the ultrasonographic evaluation

  3. Ultrasonography of hydronephrosis and renal masses

    International Nuclear Information System (INIS)

    Lee, Kyung Weon; Kim, Chong Gun; Kim, Yeon Jin; Rhee, Byung Chull

    1984-01-01

    We have analyzed ultrasonographic findings of 55 cases of hydronephrosis and 34 cases of renal masses. The results are as follows: 1. 55 cases of hydronephrosis revealed renal enlargement in 55 cases, separation of central echo complex in 27 cases, multiple anechoic areas radiating from the center in 25 cases and dilated renal pelvis in 24 cases. 2. Among the masses in 34 cases, simple renal cyst were 15 cases, polycystic kidney in 8 cases, hypernephroma in 8 cases, Wilm's tumor in 2 cases and agiomyolipoma in 1 case. 3. Simple renal cyst revealed single in 14 cases (93%) and well defined anechoic mass with posterior enhancement in all cases. 4. Polycystic kidney revealed bilateral irregular shaped renal enlargement and multiple anechoic cysts throughout the kidney. 2 cases (25%) involved liver. 5. 6 cases (75%) of hypernephroma revealed ill defined moderately echogenic mass without posterior enhancement. 6. All cases of Wilm's tumor revealed well defined large mixed echogenic mass in right kidney. 7. Angiomyolipoma revealed bilateral dense echogenic mass with large hemorrhage cyst in right kidney. 8. The ultrasonography is useful noninvasive diagnostic modality of evaluation of renal masses and hydronephrosis.

  4. En bloc kidney transplantation: ultrasonography assessment

    International Nuclear Information System (INIS)

    Arenal, F.; Ganado, T.; Merino, M.S.; Contreras, E.; Hernandez, J.; Prats, D.

    1997-01-01

    The objective of our study is to assess the utility of ultrasonography in the study of the complications associated with en bloc kidney transplantation. Twenty-three recipients of double transplants from donors under the age of 3 years were studied. Ultrasound (mode B: pulsed Doppler and color Doppler) was performed within the first three postoperative days and was repeated at 6 and 12 months. The morphology of the graft and renal blood flow were assessed, and the indices of pulsatility, resistance and acceleration were measured. Four patients required graft explanation: three due to massive hemorrhagic infarction and one due to venous thrombosis. Vascular complications were detected in five transplants (21.7%), urological complications in four (17.4%) and medical complications in two (8.7%). The most common vascular complication was unilateral renal artery stenosis. Color Doppler ultrasound diagnosed all the medical and urological complications and three of the five cases of vascular pathology (60%). Renal size was seen to be increased during the first postoperative year. The ultrasonographic study is more difficult to perform in en bloc kidney transplantation than in single kidney grafting: however, given its marked sensitivity in the detection of postransplantation complications. Doppler ultrasound is the imaging technique of choice in the determination of the cause of deteriorated kidney function. (Author) 15 refs

  5. Double contrast-enhanced ultrasonography in the detection of periampullary cancer: Comparison with B-mode ultrasonography and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Ting [Department of Medical Image Center, Zhujiang Hospital, Southern Medical University, Guangzhou (China); Department of Medical Ultrasonics, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou (China); Su, Zhong-zhen; Wang, Ping; Wu, Tao [Department of Medical Ultrasonics, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou (China); Tang, Wen [Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou (China); Xu, Er-jiao; Ju, Jin-xiu [Department of Medical Ultrasonics, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou (China); Quan, Xian-yue, E-mail: quanxianyue2014@163.com [Department of Medical Image Center, Zhujiang Hospital, Southern Medical University, Guangzhou (China); Zheng, Rong-qin, E-mail: zhengrq@mail.sysu.edu.cn [Department of Medical Ultrasonics, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou (China)

    2016-11-15

    Purpose: To investigate the value of double contrast-enhanced ultrasonography (DCEUS) in the detection of periampullary cancer. Materials and methods: Ninety-nine patients with surgery or biopsy-proven periampullary cancer who underwent both DCEUS and magnetic resonance imaging (MRI) examinations before operation were enrolled in our study. DCEUS in which intravenous microbubbles were used in combination with oral contrast agent and MRI were performed preoperatively to make a detection diagnosis of periampullary cancer. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of DCEUS, B-mode ultrasonography (BUS) and MRI were calculated and compared. Receiver operating characteristic (ROC) curves were used to evaluate the accuracy of BUS, DCEUS and MRI in the detection. Stratified analyses were performed for different pathological types and different sizes of periampullary lesions. The inter- and intra-observer reliability of DCEUS for cancer detection was also investigated. Result: There were no significant differences in sensitivity, specificity, PPV, NPV or accuracy between DCEUS and MRI (all P > 0.05). ROC analysis showed that the accuracy of DCEUS or MRI was higher than that of BUS (P < 0.001), while no significant differences were noted in the accuracy between DCEUS and MR. In the 76 cases of periampullary cancer, DCEUS appeared to be superior to BUS for ampullary carcinoma, duodenum carcinoma and for lesions with an average diameter of less than 3 cm. DCEUS appeared equal to BUS in other groups. No significant differences were noted between DCEUS and MRI in the stratified analysis. A considerably well agreement between DCEUS and MRI was obtained using Kappa analysis (k = 0.649, P < 0.001). The intra- and inter-observer reproducibility were both good for detection of periampullary cancer by DCEUS, with a Kappa values of 0.783 (P < 0.01) and 0.732 (P < 0.01), respectively. Conclusion: DCEUS provides an

  6. A case of branch duct type intraductal papillary neoplasm of the bile duct treated by open surgery after 11 years of follow-up

    OpenAIRE

    FUJITA, MITSURU; WAKUI, NORITAKA; YAMAUCHI, YOSHIYA; TAKEDA, YUKI; SATO, TAKEMASA; UEKI, NOBUO; OTSUKA, TAKAFUMI; OBA, NOBUYUKI; NISHINAKAGAWA, SHUTA; MINAGAWA, MASAMI; TAKEDA, YASUSHI; SHIONO, SAORI; KOJIMA, TATSUYA

    2013-01-01

    The intraductal papillary neoplasm of the bile duct (IPNB) is a novel disease concept that was recently classified as a biliary cystic tumor by the revised World Health Organization classification. This is the case report of a 70-year-old female patient who experienced repeated episodes of obstructive jaundice and cholangitis since 2000, attributed to a mucus-producing hepatic tumor. Surgery was advised due to the repeated episodes; however, the patient refused. In May, 2011, the patient deve...

  7. Serial 2-point ultrasonography plus D-Dimer vs whole-leg color-coded doppler ultrasonography for diagnosing suspected symptomatic deep vein thrombosis - A randomized controlled trial

    NARCIS (Netherlands)

    Bernardi, Enrico; Camporese, Giuseppe; Buller, Harry R.; Siragusa, Sergio; Imberti, Davide; Berchio, Arrigo; Ghirarduzzi, Angelo; Verlato, Fabio; Anastasio, Raffaela; Prati, Carolina; Piccioli, Andrea; Pesavento, Raffaele; Bova, Carlo; Maltempi, Patrizia; Zanatta, Nello; Cogo, Alberto; Cappelli, Roberto; Bucherini, Eugenio; Cuppini, Stefano; Noventa, Franco; Prandoni, Paolo

    2008-01-01

    Context Patients with suspected deep vein thrombosis ( DVT) of the lower extremities are usually investigated with ultrasonography either by the proximal veins ( 2-point ultrasonography) or the entire deep vein system ( whole- leg ultrasonography). The latter approach is thought to be better based

  8. Granulomatous Prostatitis: Gray-scale Transrectal Ultrasonography and Color Doppler Ultrasonography Findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyoung Jung; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae; Kim, Eui Jong [Kyung Hee University Medical Center, Seoul (Korea, Republic of)

    2007-12-15

    We report here three cases of granulomatous prostatitis. All cases were confirmed by a transrectal ultrasonography (TRUS)-guided core biopsy of the prostate. Two cases received intravesical BCG therapy for a bladder tumor, and one case had no known predisposing condition. Gray-scale TRUS showed low echoic nodules in the outer gland in all cases. Color Doppler ultrasonography (CDUS) showed several dot-like blood flows within the low echoic nodules in two cases and several dot-like blood flows and short linear blood flows within the low echoic nodules in one case. Gray-scale TRUS findings of granulomatous prostatitis are similar to findings of prostate cancer. On CDUS, several dot-like blood flows or short linear blood flows were noted within the low echoic nodules in patients with granulomatous prostatitis. If low echoic nodules with dot-like or short linear blood flows are noted in patients with genitourinary tract tuberculosis or previous BCG therapy, granulomatous prostatitis should be included in the differential diagnosis. However, a prostatic biopsy is required for a final diagnosis

  9. CT findings of intraductal papillary neoplasm of the bile duct: Assessment with multiphase contrast-enhanced examination using multi-detector CT

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, H., E-mail: ogawa.hiroshi@h.mbox.nagoya-u.ac.jp [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Itoh, S. [Department of Radiology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya (Japan); Nagasaka, T. [Department of Medical Technology, Nagoya University School of Health Sciences, Nagoya (Japan); Suzuki, K. [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Ota, T. [Department of Radiology, Aichi Medical University Hospital, Nagakute Aichi (Japan); Naganawa, S. [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan)

    2012-03-15

    Aim: To evaluate multi-detector computed tomography (MDCT) findings of intraductal papillary neoplasm of the bile duct (IPNB), a neoplasm that is considered to be the biliary counterpart of pancreatic intraductal papillary mucinous neoplasm. Materials and methods: Two radiologists retrospectively evaluated multiphase contrast-enhanced CT images with 0.5 or 1 mm collimation in 37 consecutive patients with resected IPNB diagnosed by a single pathologist. The CT findings were correlated with the pathological findings concerning invasion of the surrounding organs and vessels. Results: All patients showed bile duct dilatation. An intraductal mass was detected in 36 patients and the following findings were observed: extensive infiltration along the bile duct more than 20 mm (n = 32), compared with normal hepatic parenchyma, isodense or hyperdense during the late arterial phase (n = 31), not hyperdense during the portal-venous and delayed phases (n = 36), and intense enhancement rim at the base of the mass during the portal-venous or delayed phase (n = 27). Parenchymal invasion of the surrounding organs was seen in eight of 16 tumours showing irregular or bulging margins. Vascular invasion was false positive in four of eight tumours. Conclusions: IPNB exhibits relatively characteristic findings with multiphase contrast-enhanced examination using MDCT. A tendency to overestimate invasion of the surrounding organs and vessels was seen.

  10. Endoscopic ultrasonography-guided rendezvous technique.

    Science.gov (United States)

    Tsuchiya, Takayoshi; Itoi, Takao; Sofuni, Atsushi; Tonozuka, Ryosuke; Mukai, Shuntaro

    2016-04-01

    Endoscopic retrograde cholangiopancreatography (ERCP) requires deep biliary cannulation. When deep biliary cannulation is failed, the endoscopic ultrasonography rendezvous technique (EUS-RV) is a useful salvage method. From the previous 15 articles that included 382 EUS-RV cases, the overall success rate of EUS-RV is 81 % with a complication rate of 10 %. In EUS-RV, the bile duct is punctured under EUS guidance and a guidewire is advanced into the duodenum via the papilla. The EUS scope is then switched to a duodenoscope and inserted into the bile duct over the guidewire exiting the papilla, or the guidewire is grasped with forceps and passed through the working channel; the catheter can then be inserted through the papilla over the wire. There are three puncture routes for EUS-RV: transgastric puncture of the intrahepatic bile duct (IHBD), transduodenal puncture of the extrahepatic bile duct (EHBD) via the proximal duodenum (D1), and transduodenal puncture of the EHBD via the second portion of the duodenum (D2). The puncture route for each patient should be selected based on the patient condition. GW selection for EUS-RV is critical, a hydrophilic GW is useful for this procedure. Although EUS-RV is now performed relatively routinely in a few high-volume centers, procedure standardization and the development of exclusive devices for EUS-RV are still underway. The development of exclusive devices for EUS-RV and prospective comparative studies with other salvage methods are needed to truly evaluate the procedure's usefulness and safety.

  11. Evaluation of Snake Bites with Bedside Ultrasonography

    Directory of Open Access Journals (Sweden)

    Josef E Jolissaint

    2018-04-01

    Full Text Available History of present illness: While watering his lawn, a 36-year-old man felt two sharp bites to his bilateral ankles. He reports that he then saw a light brown, 2-foot snake slither away from him. He came to the emergency department because of pain and swelling in his ankles and inability to bear weight. Physical examination revealed bilateral ankle swelling and puncture marks on his left lateral heel and medial right ankle. Palpation, passive flexion and extension elicited severe pain bilaterally. Blood work including prothrombin time (PT, partial thromboplastin time (PTT, international normalized ratio (INR, and fibrinogen were within normal limits. Consultation with Poison Control indicated the snake was likely a copperhead, which is a venomous snake whose bites rarely require antivenin. Significant findings: In this case, ultrasonography of the lateral surface of the left foot revealed soft tissue edema (red arrow and fluid collection (white asterisk adjacent to the extensor tendon (white arrow. The edematous area resembles cobblestones, with hypoechoic areas of fluid spanning relatively hyperechoic fat lobules. The tendon is surrounded by anechoic fluid, expanding the potential space in the sheath. No hyperechoic foreign objects were noted. Discussion: The patient was diagnosed with soft tissue injury and extensor tenosynovitis after a snake envenomation. Snake venom contains metalloproteinases and other enzymatic proteins that cause local tissue edema and necrosis.1 After a snake bite, ultrasound can be used to assess for retained fangs, soft tissue edema, tendon sheath fluid, muscle fasciculation, and injury to deeper musculature that may not be readily apparent on physical exam.2,3 Most patients with tenosynovitis will recover with immobilization of the joint and non-steroidal anti-inflammatory medications.4 Rarely, the tendon may become infected requiring antibiotics and surgical intervention.4 Topics: Ultrasound, snake envenomation

  12. II Brazilian consensus statement on endoscopic ultrasonography.

    Science.gov (United States)

    Maluf-Filho, Fauze; de Oliveira, Joel Fernandez; Mendonça, Ernesto Quaresma; Carbonari, Augusto; Maciente, Bruno Antônio; Salomão, Bruno Chaves; Medrado, Bruno Frederico; Dotti, Carlos Marcelo; Lopes, César Vivian; Braga, Cláudia Utsch; M Dutra, Daniel Alencar; Retes, Felipe; Nakao, Frank; de Sousa, Giovana Biasia; de Paulo, Gustavo Andrade; Ardengh, Jose Celso; Dos Santos, Juliana Bonfim; Sampaio, Luciana Moura; Okawa, Luciano; Rossini, Lucio; de Brito Cardoso, Manoel Carlos; Ribeiro Camunha, Marco Antonio; Clarêncio, Marcos; Lera Dos Santos, Marcos Eduardo; Franco, Matheus; Schneider, Nutianne Camargo; Mascarenhas, Ramiro; Roda, Rodrigo; Matuguma, Sérgio; Guaraldi, Simone; Figueiredo, Viviane

    2017-01-01

    At the time of its introduction in the early 80s, endoscopic ultrasonography (EUS) was indicated for diagnostic purposes. Recently, EUS has been employed to assist or to be the main platform of complex therapeutic interventions. From a series of relevant new topics in the literature and based on the need to complement the I Brazilian consensus on EUS, twenty experienced endosonographers identified and reviewed the pertinent literature in databases. The quality of evidence, strength of recommendations, and level of consensus were graded and voted on. Consensus was reached for eight relevant topics: treatment of gastric varices, staging of nonsmall cell lung cancer, biliary drainage, tissue sampling of subepithelial lesions (SELs), treatment of pancreatic fluid collections, tissue sampling of pancreatic solid lesions, celiac neurolysis, and evaluation of the incidental pancreatic cysts. There is a high level of evidence for staging of nonsmall cell lung cancer; biopsy of SELs as the safest method; unilateral and bilateral injection techniques are equivalent for EUS-guided celiac neurolysis, and in patients with visible ganglia, celiac ganglia neurolysis appears to lead to better results. There is a moderate level of evidence for: yield of tissue sampling of pancreatic solid lesions is not influenced by the needle shape, gauge, or employed aspiration technique; EUS-guided and percutaneous biliary drainage present similar clinical success and adverse event rates; plastic and metallic stents are equivalent in the EUS-guided treatment of pancreatic pseudocyst. There is a low level of evidence in the routine use of EUS-guided treatment of gastric varices.

  13. Ultrasonography in Gastroenterology: The Need for Training

    Directory of Open Access Journals (Sweden)

    João Pinto

    2018-02-01

    Full Text Available The use of ultrasonography (US as an imaging modality in medicine has spread across almost every clinical specialty. This diffusion is based on the simplicity, accessibility, portability and affordability of the technique producing real-time high-resolution images using non-ionising radiation. On the other hand, this trend also extended the technique to settings other than healthcare, such as public facilities, private houses or remote sites. This tendency can be observed worldwide, from developing countries to prestigious medical schools and tertiary referral hospitals. Furthermore, point-of-care US (POCUS, i.e., US executed at the patient’s bedside to obtain real-time objective information with diagnostic and clinical monitoring purposes or to guide invasive procedures, has been incorporated in many specialties. In gastroenterology, despite the essential role of endoscopy, clinical practice is highly dependent on non-endoscopic imaging techniques. However, as in other specialties, the indications of US in gastroenterology have been increasing steadily, covering a broad range of conditions. In response to the generalised employment of US by non-radiologists, institutions such as the European Federation of Societies for Ultrasound in Medicine and Biology and the Royal College of Radiologists issued recommendations to ensure high-quality practice. These theoretical and practical requisites include performing a certain number of examinations and mandatory skills in order to achieve certification to execute unsupervised US. Therefore, there is a need for modern gastroenterology to include US as a basic skill in its clinical practice. To ensure the provision of high-quality US, adequate instruction of future specialists should be guaranteed by the gastroenterology departments and required in the residency training programme.

  14. Evaluation of normal masseter muscles on ultrasonography

    International Nuclear Information System (INIS)

    Hwang, Hyoung Zoo; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan

    2008-01-01

    To assess the internal echo intensity and morphological variability of masseter muscles on ultrasonography and to establish diagnostic criterion of estimation. Participants consisted of 50 young adults (male 25, female 25) without pathologic conditions and with full natural dentitions. Sonographic examinations were done with real time ultrasound equipment as Logiq 500 (GE Medical Systems, Seoul, Korea) at 3 parts according to lines paralleling with ala-tragus line as reference line. The thickness and area of masseter muscles according to reference line in cross-sectional images were measured at rest and at maximum contraction. The visibility and width of the internal echogenic intensity of the masseter muscles were also assessed and the muscle appearance was classified into 4 types. Data were statistically analyzed by paired t-test and x2-test. 1. When comparing the thickness and area of masseter muscles concerning with gender, there was few significant difference between right and left sides, however, there were significant differences between males and females except for the greatest thickness of left side. 2. The changes of the greatest thickness and the area between rest and maximum contraction showed that the part of the least thickness manifested more increase at maximum contraction. 3. Each part the manifestations of the internal echogenic intensity of the masseter muscles were different depending on the locations. But there was no statistically significance. Changes of muscles thickness with contraction and internal echogenic intensity with locations showed great disparity within the masseter muscles, which will be diagnostic criteria for pathophysiologic and anatomic changes of masseter muscles.

  15. Main-duct intraductal papillary mucinous neoplasms of the pancreas: clinical predictors of malignancy and long-term survival following resection.

    Science.gov (United States)

    Salvia, Roberto; Fernández-del Castillo, Carlos; Bassi, Claudio; Thayer, Sarah P; Falconi, Massimo; Mantovani, William; Pederzoli, Paolo; Warshaw, Andrew L

    2004-05-01

    To describe clinical characteristics and outcomes of a large cohort of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas affecting the main pancreatic duct. IPMNs are being diagnosed with increasing frequency. Preoperative determination of malignancy remains problematic, and reported results of long-term survival following resection are conflicting. The combined databases from the Massachusetts General Hospital and the Pancreatic Unit of the University of Verona were analyzed. To avoid confusing overlap with mucinous cystic neoplasms, only patients with tumors of the main pancreatic duct (with or without side branch involvement) were included. A total of 140 tumors consecutively resected between 1990 and 2002 were classified as either benign (adenoma and borderline tumors) or malignant (carcinoma in situ or invasive cancer) to compare their characteristics and survival. Men and women were equally affected (mean age 65 years). Seven patients (12%) had adenomas, 40 (28%) borderline tumors, 25 (18%) carcinoma in situ, and 58 (42%) invasive carcinoma. The median age of patients with benign IPMN was 6.4 years younger than those with malignant tumors (P = 0.04). The principal symptoms were abdominal pain (65%), weight loss (44%), acute pancreatitis (23%), jaundice (17%), and onset or worsening of diabetes (12%); 27% of patients were asymptomatic. Jaundice and diabetes were significantly associated with malignant tumors. Five- and 10-year cancer-specific survival for patients with noninvasive tumors was 100%, and comparable survival of the 58 patients with invasive carcinoma was 60% and 50%. Cancer is found in 60% of patients with main-duct IPMNs. Patients with malignant tumors are 6 years older than their benign counterparts and have a higher likelihood of presenting with jaundice or new onset diabetes. No patients with benign tumors or carcinoma in situ died of their disease following resection, and those with invasive cancer had a markedly better

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

    Directory of Open Access Journals (Sweden)

    Aneet Kaur

    2011-01-01

    Full Text Available Objectives : Examination of pregnant women in the first trimester with transvaginal ultrasonography with the aim to study various fetal development markers, e.g., gestation sac, yolk sac, fetal heart motion, CRL length, and fetal anatomy in both normal and abnormal pregnancies. Comparative evaluation of transvaginal ultrasonography vis-ΰ-vis transabdominal scanning in the study of first trimester of pregnancy and its complications. To assess the relative merits and demerits of transvaginal ultrasonography in comparison with the transabdominal technique. Materials and Methods : The study will be conducted on 50 females patients during the first trimester of pregnancy. The study population will consist of both normal and abnormal pregnancies. These patients will be included on the basis of suspicion of or proven pregnancy of duration up to 12 weeks from LMP. The evaluation of the patients will include the following: Record of patients obstetrical history and clinical examination, record of pregnancy test and relevant investigations, ultrasonic examination of pregnancy. (a Transabdominal ultrasound scanning will be done with moderately distended bladder by using real time scanners with low frequency probe (3/3.5 MHz; (b transvaginal sonography will be done with the real-time sector scanner using high-frequency endovaginal probe (5/7.5 MHz, after the patient voids urine. Relevant images will be taken by using the multiformat automatic camera. Results and Conclusions : In the study of 46 normal intrauterine pregnancies, TVS showed additional information in 36 patients (78.3% as compared to TAS, in detection of gestation sac, yolk sac, double bleb sign, or better visualization of embryonic anatomy. In the abnormal pregnancy (n=17, TVS provided more information in 11 cases (64.9%, which included detection of embryonic demise, yolk sac, double bleb sign, or subchorionic hemorrhage. Regarding ectopic gestations (n=7, TVS gave additional information in 5

  17. Diagnostic imaging of the equine fetlock region using radiography and ultrasonography. Part 1: Soft tissues.

    Science.gov (United States)

    Vanderperren, Katrien; Saunders, Jimmy H

    2009-08-01

    The equine fetlock is the joint most commonly associated with lameness. Although the fetlock is regarded as a simple joint, diagnosis of a fetlock disorder can be a challenge and various imaging modalities are routinely used to arrive at an accurate diagnosis. This review describes the principal disorders affecting the soft tissues of the fetlock region and addresses some of the technical aspects involved in taking radiographic and ultrasonographic images of the different soft tissue lesions. A combination of radiography and ultrasonography is still the most commonly used diagnostic approach in clinical practice.

  18. Evaluation of abdominal trauma by computed tomography and ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Do Yun; Kim, Sang Jin; Lee, Jong Tae; Yoo, Hyung Sik [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1986-06-15

    Out of 75 patients who were admitted to our hospital because of abdominal trauma and were undergone the procedures such as ultrasonography and/or CT scan within 24 hours of abdominal trauma due to suspected abdominal organ injury. We analyzed the results of 38 patients who were confirmed of diagnosis by operation, follow-up CT scan or ultrasonography. We analyzed the results of 38 patients who were confirmed of diagnosis by operation, follow-up CT scan or ultrasonography. 1. In the abdominal organ injury, solid organ injury consists of 8 cases of spleen laceration, 1 of splenic subcapsular hematoma, 7 of hepatic laceration, 7 of pancreas laceration, 3 of renal laceration, and 3 of subcapsular hematoma of kidney. 2. In addition, there were 7 bowel and/or mesenteric laceration, 2 diaphragmatic hernia, and 1 urethral rupture. 3. 2 cases of retroperitoneal hematoma and 1 case in which hemo peritoneum occurred without abdominal organ injury were confirmed by follow-up CT or ultrasonography. 4. In all of the 4 patients with multiple organ injury, pancreatic laceration was associated. 5. In abdominal trauma patients, ultrasonography or CT can be used to survey rapidly the entire abdomen for possible associated injury, and be of great help to clinicians in identifying the patients who need immediate surgery or in minimizing the incidence of unnecessary emergency abdominal exploration.

  19. Evaluation of abdominal trauma by computed tomography and ultrasonography

    International Nuclear Information System (INIS)

    Lee, Do Yun; Kim, Sang Jin; Lee, Jong Tae; Yoo, Hyung Sik

    1986-01-01

    Out of 75 patients who were admitted to our hospital because of abdominal trauma and were undergone the procedures such as ultrasonography and/or CT scan within 24 hours of abdominal trauma due to suspected abdominal organ injury. We analyzed the results of 38 patients who were confirmed of diagnosis by operation, follow-up CT scan or ultrasonography. We analyzed the results of 38 patients who were confirmed of diagnosis by operation, follow-up CT scan or ultrasonography. 1. In the abdominal organ injury, solid organ injury consists of 8 cases of spleen laceration, 1 of splenic subcapsular hematoma, 7 of hepatic laceration, 7 of pancreas laceration, 3 of renal laceration, and 3 of subcapsular hematoma of kidney. 2. In addition, there were 7 bowel and/or mesenteric laceration, 2 diaphragmatic hernia, and 1 urethral rupture. 3. 2 cases of retroperitoneal hematoma and 1 case in which hemo peritoneum occurred without abdominal organ injury were confirmed by follow-up CT or ultrasonography. 4. In all of the 4 patients with multiple organ injury, pancreatic laceration was associated. 5. In abdominal trauma patients, ultrasonography or CT can be used to survey rapidly the entire abdomen for possible associated injury, and be of great help to clinicians in identifying the patients who need immediate surgery or in minimizing the incidence of unnecessary emergency abdominal exploration.

  20. Evaluation of breast symptoms with mammography and ultrasonography

    Directory of Open Access Journals (Sweden)

    Emine Devolli Disha

    2011-12-01

    Full Text Available Introduction: Aim of the study was to discern which are more frequent symptoms presented in malign and benign masses diagnosed by mammography and ultrasonography.Methods: Our study group consisted of 546 female patients, with breast symptoms such as palpable lumps (40.8%, pain in the breast (26%, localized lumpiness or nodularity (13.7%, nipple retraction (11.2%, nipplebloody discharge (5.1% and redness and swelling of the breast (3.1%. All 546 patients were examined by ultrasonography and mammography. Biopsy was performed according to the findings of mammography and ultrasonography.Results: In breast cancer detection ultrasonography showed an efficiency of 79.4% compared to 55.0% for mammography in detecting breast lump, in the case of nipple retraction mammography showed an efficiency of 89.1% compared to 80.4% for ultrasound, while the lowest efficiency for mammography was in the cases with localized lumpiness or nodularity 17.1% compared to 45.7% for ultrasound. In detecting fibrocystic changes where the most common symptoms was pain, ultrasonography showed an efficiency of 99.3 % compared to 84.2 % for mammography.Conclusions: Our study confirmed that breast lumps are detectable in the majority of patients with breast cancer. The most frequent symptoms in patient with benign lesions were pain or localized discomfort. The diagnostic accuracy for carcinomas of the breast and for benign lesions according to symptoms was higher for ultrasound than for mammography.

  1. Ultrasonography and radiography of the canine postpartum uterus

    International Nuclear Information System (INIS)

    Pharr, J.W.; Post, K.

    1992-01-01

    A vulvovaginal discharge following parturition in a bitch is often a cause of concern to owners and clinicians, especially if whelping was complicated in any way. Ultrasonography could potentially distinguish between normal and abnormal postpartum uterine states because the uterine wall and luminal contents can be imaged in detail. Five normal bitches were examined to determine the normal ultrasonographic appearance of the postpartum uterus and the sensitivity of ultrasonography in detecting the involuting uterus, comparing this sensitivity with that of radiography. Ultrasonography was done at 1, 4, 8, 12, 18 and 24 days postpartum, radiography at 1, 4, 8, 12 and 18 days postpartum. By 12 days postpartum, the uterus could not be seen on radiographs, while at 24 days postpartum the uterus was still sonographically identifiable. The ultrasonographic characteristics of the involuting uterus are described

  2. The diagnostic value of ultrasonography in the gyneocological emergency

    International Nuclear Information System (INIS)

    Su Hui; Chen Fanghua; Peng Xiulan

    2006-01-01

    Objective: To evaluate the ultrasonography in the diagnosis and differential diagnosis of gynecologic emergency. Methods: 138 patients suffered from gynecologic emergency were examined with ultrasonography. The images were retrospectively reviewed and compared with pathologic or clinical results. Results: The total correct diagnostic rate was 89.1%. Among 138 cases of gynecologic emergency, there were 45 cases of ectopic pregnancy, 27 cases of ruptured corpus luteum, 24 cases of torsion of ovarian cyst, and 42 cases of acute pelvic inflammation. The correct diagnostic rates were 91.1%, 81.5%, 87.5%, 92.2%, respectively. Conclusion: The ultrasonography plays an important role in the diagnosis of gynecological emergency. When the US findings were not typical, the clinical history, symptoms and HCG level should be considered in order to avoid misdiagnosis. (authors)

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

    Science.gov (United States)

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

    2016-01-01

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

  4. Technical Feasibility and Oncological Legitimacy of Enucleation of Intraductal Papillary Mucinous Neoplasm Located at the Pancreatic Head or Uncinate Process.

    Science.gov (United States)

    Soejima, Yuji; Toshima, Takeo; Motomura, Takashi; Yokota, Tomoyuki; Joko, Kouji; Oshiro, Yumi; Takahashi, Ikuo; Nishizaki, Takashi; Maehara, Yoshihiko

    2017-01-01

    Surgical indications and strategies for branch duct (BD)-intraductal papillary mucinous neoplasm (IPMN) at the pancreatic head (PH) are controversial issues. We investigated the technical feasibility and oncological legitimacy of enucleation for IPMN of the PH. The clinicopathological parameters of 11 patients with IPMN who underwent conventional pancreaticoduodenectomy (PD, n=7) or enucleation (n=4) during the same period were evaluated. The mean operative time (442 vs. 280 min, p<0.05) and blood loss (864 vs. 93 ml, p<0.05) were significantly better in the enucleation group. The final pathological diagnosis (low-/intermediate-/high-grade dysplasia) in the PD and enucleation groups was 4/2/1 and 3/1/0, respectively. The incidence of grade B pancreatic fistula and Clavien III complications was 14% vs. 0% and 43% vs. 25%, respectively. No recurrent pancreatitis or exocrine or endocrine dysfunction was noted in the enucleation group; however, de novo or exacerbated diabetes mellitus developed in three patients in the PD group. All patients were alive and no disease recurrence was noted at a mean follow-up of 1,059 days. Enucleation of BD-IPMN at the PH is a technically feasible and oncologically acceptable procedure which should be justified in patients with IPMNs with a low risk of malignancy. Copyright© 2017 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  5. Neutrophil-to-lymphocyte ratio and mural nodule height as predictive factors for malignant intraductal papillary mucinous neoplasms.

    Science.gov (United States)

    Watanabe, Yusuke; Niina, Yusuke; Nishihara, Kazuyoshi; Okayama, Takafumi; Tamiya, Sadafumi; Nakano, Toru

    2018-01-15

    Accurate preoperative prediction for malignant IPMN is still challenging. The aim of this study was to investigate the validity of neutrophil-to-lymphocyte ratio (NLR) and mural nodule height (MNH) for predicting malignant intraductal papillary mucinous neoplasm (IPMN). The medical records of 60 patients who underwent pancreatectomy for IPMN were retrospectively reviewed. NLR tended to be higher in malignant IPMN (median: 2.23) than in benign IPMN (median: 2.04; p = .14). MNH was significantly greater in malignant IPMN (median: 16 mm) than in benign IPMN (median: 8 mm; p MNH were 3.60 and 11 mm, respectively. The sensitivity and specificity of NLR ≥3.60 for predicting malignant IPMN were 40% and 93%, and those of MNH ≥11 mm were 73% and 77%, respectively. Univariate analysis revealed that NLR ≥3.60 (p MNH ≥11 mm (p MNH ≥11 mm were not. NLR and MNH are suboptimal tests in predicting malignant IPMN; however, they can be useful to assist in clinical decision-making.

  6. Implications of imaging criteria for the management and treatment of intraductal papillary mucinous neoplasms - benign versus malignant findings

    Energy Technology Data Exchange (ETDEWEB)

    Walter, Thula Cannon; Steffen, Ingo G.; Stelter, Lars H.; Hamm, Bernd; Denecke, Timm; Grieser, Christian [Charite - Universitaetsmedizin Berlin, Klinik fuer Radiologie, Campus Virchow-Klinikum, Berlin (Germany); Maurer, Martin H. [Universitaetsklinik Bern, Universitaetsinstitut fuer Radiologe, Inselspital, Bern (Switzerland); Bahra, Marcus; Faber, Wladimir; Klein, Fritz [Charite - Universitaetsmedizin Berlin, Klinik fuer Allgemein-, Viszeral- und Transplantationschirurgie Campus Virchow-Klinikum, Berlin (Germany); Blaeker, Hendrik [Charite - Universitaetsmedizin Berlin, Institut fuer Pathologie, Campus Charite Mitte, Berlin (Germany)

    2015-05-01

    Evaluation of computed tomography (CT) and magnetic resonance imaging (MRI) for differentiation of pancreatic intraductal papillary mucinous neoplasm (IPMN) subtypes based on objective imaging criteria. Fifty-eight patients with 60 histologically confirmed IPMNs were included in this retrospective study. Eighty-three imaging studies (CT,n = 42; MRI,n = 41) were analysed by three independent blinded observers (O1-O3), using established imaging criteria to assess likelihood of malignancy (-5, very likely benign; 5, very likely malignant) and histological subtype (i.e., low-grade (LGD), moderate-grade (MGD), high-grade dysplasia (HGD), early invasive carcinoma (IPMC), solid carcinoma (CA) arising from IPMN). Forty-one benign (LGD IPMN,n = 20; MGD IPMN,n = 21) and 19 malignant (HGD IPMN,n = 3; IPMC,n = 6; solid CA,n = 10) IPMNs located in the main duct (n = 6), branch duct (n = 37), or both (n = 17) were evaluated. Overall accuracy of differentiation between benign and malignant IPMNs was 86/92 % (CT/MRI). Exclusion of overtly malignant cases (solid CA) resulted in overall accuracy of 83/90 % (CT/MRI). The presence of mural nodules and ductal lesion size ≥30 mm were significant indicators of malignancy (p = 0.02 and p < 0.001, respectively). Invasive IPMN can be identified with high confidence and sensitivity using CT and MRI. The diagnostic problem that remains is the accurate radiological differentiation of premalignant and non-invasive subtypes. (orig.)

  7. Significance of aggressive surgery for an invasive carcinoma derived from an intraductal papillary mucinous neoplasm diagnosed preoperatively as borderline resectable.

    Science.gov (United States)

    Aimoto, Takayuki; Mizutani, Satoshi; Kawano, Youichi; Suzuki, Hideyuki; Uchida, Eiji

    2013-01-01

    We investigated the clinicopathological features of borderline resectable invasive carcinomas (BRICs) derived from intraductal papillary mucinous neoplasms (IPMNs) and examined the significance of the aggressive "surgery first" approach compared with the treatment of conventional borderline resectable pancreatic ductal adenocarcinomas (BRPDAs). We retrospectively studied 7 patients with BRICs derived from IPMNs and 14 patients with conventional BRPDAs. Several factors were reviewed: initial symptoms, preoperative imaging, serum level of CA19-9, perioperative factors, pathological findings, adjuvant chemotherapy, and outcome. All BRICs derived from IPMN were huge tumors (more than 3 cm in diameter) suspected to involve BRICs derived from IPMNs were larger than those of conventional BRPDAs (pBRICs derived from IPMN less frequently metastasized to lymph nodes (pBRICs derived from IPMNs (100%) than for conventional BRPDAs (19%, pBRICs derived from an intestinal or gastric IPMN are less aggressive than conventional BRPDAs and have a more favorable prognosis. In addition, aggressive "surgery first" approach may contribute to this better prognosis.

  8. Plasma protein profiling of patients with intraductal papillary mucinous neoplasm of the pancreas as potential precursor lesions of pancreatic cancer.

    Science.gov (United States)

    Ilies, Maria; Sappa, Praveen Kumar; Iuga, Cristina Adela; Loghin, Felicia; Gesell Salazar, Manuela; Weiss, Frank Ulrich; Beyer, Georg; Lerch, Markus M; Völker, Uwe; Mayerle, Julia; Hammer, Elke

    2018-02-01

    Efforts for the early diagnosis of the pancreatic ductal adenocarcinoma (PDAC) have recently been driven to one of the precursor lesions, namely intraductal papillary mucinous neoplasm of the pancreas (IPMN). Only a few studies have focused on IPMN molecular biology and its overall progression to cancer. Therefore, IPMN lacks comprehensive characterization which makes its clinical management controversial. In this study, we characterized plasma proteins in the presence of IPMNs in comparison to healthy controls, chronic pancreatitis, and PDAC by a proteomics approach using data-independent acquisition based mass spectrometry. We describe several protein sets that could aid IPMN diagnosis, but also differentiation of IPMN from healthy controls, as well as from benign and malignant diseases. Among all, high levels of carbonic anhydrases and hemoglobins were characteristic for the IPMN group. By employing ELISA based quantification we validated our results for human tissue inhibitor of metalloproteinase inhibitor 1 (TIMP-1). We consider IPMN management directed towards an early potential cancer development a crucial opportunity before PDAC initiation and thus its early detection and cure. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Validation of the 2012 Fukuoka Consensus Guideline for Intraductal Papillary Mucinous Neoplasm of the Pancreas From a Single Institution Experience.

    Science.gov (United States)

    Yu, Songfeng; Takasu, Naoki; Watanabe, Toshihiro; Fukumoto, Tsuyoshi; Okazaki, Shinji; Tezuka, Koji; Sugawara, Shuichiro; Hirai, Ichiro; Kimura, Wataru

    2017-08-01

    The 2012 Fukuoka consensus guideline has stratified the risks of malignant intraductal papillary mucinous neoplasm (IPMN) of the pancreas into "high-risk stigmata" (HRS) and "worrisome feature" (WF). This study aimed to evaluate its clinical validity based on a single institution experience. Eighty-nine patients who underwent surgical resection with pathological diagnosis of IPMN were retrospectively studied. High-risk stigmata was significantly correlated with the prevalence of malignant IPMN as compared with WF. The positive predictive values of HRS and WF were 66.7% and 35.7% for branch duct IPMN and 80% and 38.1% for main duct IPMN, respectively. Univariate analysis indicated that all the factors in HRS and WF had statistical significance. Whereas multivariate analysis revealed only enhanced solid component (odds ratio [OR], 50.01; P = 0.008), presence of mural nodule (OR, 73.83; P < 0.001) and lymphadenopathy (OR, 20.85; P = 0.03) were independent predictors. Scoring HRS and WF by different numbers of positive factors resulted in improved predictive value. The area under the curve of HRS score was significantly lower than that of WF or HRS + WF score (0.680 vs 0.900 or 0.902, respectively; P < 0.001). As supplementary to the 2012 Fukuoka guideline, we suggest that calculating scores of WF and HRS may have superior diagnostic accuracy in predicting malignant IPMN.

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

    Science.gov (United States)

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

    2015-04-01

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

  11. Traumatic Lumbar Hernia Diagnosed by Ultrasonography: A Case Report

    International Nuclear Information System (INIS)

    Lee, Kwang Lae; Yim, Yoon Myung; Lim, Oh Kyung; Park, Ki Deok; Choi, Chung Hwan; Lee, Ju Kang

    2009-01-01

    Traumatic lumbar hernia describes the extrusion of intraperitoneal or extraperitoneal contents through a defect in the posterolateral abdominal wall caused by a trauma. This is a rare entity and usually diagnosed by computed tomography. A 64-year-old male received an injury on his cervical spinal cord after an accident in which he fell down. He complained of a mass on his left posterolateral back area. We diagnosed the mass as a traumatic lumbar hernia by ultrasonography and confirmed it by computed tomography. We conclude that the ultrasonography can be a useful diagnostic tool for traumatic lumbar hernia

  12. Traumatic Lumbar Hernia Diagnosed by Ultrasonography: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kwang Lae; Yim, Yoon Myung; Lim, Oh Kyung; Park, Ki Deok; Choi, Chung Hwan; Lee, Ju Kang [Gachon University of Medicine and Science, Incheon (Korea, Republic of)

    2009-12-15

    Traumatic lumbar hernia describes the extrusion of intraperitoneal or extraperitoneal contents through a defect in the posterolateral abdominal wall caused by a trauma. This is a rare entity and usually diagnosed by computed tomography. A 64-year-old male received an injury on his cervical spinal cord after an accident in which he fell down. He complained of a mass on his left posterolateral back area. We diagnosed the mass as a traumatic lumbar hernia by ultrasonography and confirmed it by computed tomography. We conclude that the ultrasonography can be a useful diagnostic tool for traumatic lumbar hernia

  13. Paediatric ultrasonography of the liver, hepatobiliary tract and pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Rijn, R.R. van, E-mail: r.r.vanrijn@amc.uva.nl [Department of Radiology, Emma Children' s Hospital – Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Nievelstein, R.A.J. [Department of Radiology, Wilhelmina Children' s Hospital – University Medical Center, Heidelberglaan 100, 3584 CX Utrecht (Netherlands)

    2014-09-15

    In the field of paediatric radiology ultrasonography (US) is the most versatile imaging tool available. Children in general, by virtue of their body composition, are excellent candidates for US exams in whom abdominal anatomy and pathology can be visualised in great detail. The fact that during the US study a clinical history can be obtained strongly adds to the value of the US exam. This does require investment in time and expertise and ideally a paediatric radiologist performing the exam. In this review the role of ultrasonography (US) of the liver, biliary tract and pancreas in children is discussed.

  14. Ultrasonography of hydronephrosis in the newborn: A practical review

    International Nuclear Information System (INIS)

    Choi, Young Hun; Cheon, Jung Eun; Kim, Woo Sun; Kim, In One

    2016-01-01

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

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

    Science.gov (United States)

    2016-01-01

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

  16. Ultrasonography of hydronephrosis in the newborn: A practical review

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young Hun; Cheon, Jung Eun; Kim, Woo Sun; Kim, In One [Dept. of Radiology, Seoul National University College of Medicine, Seoul National University Children' s Hospital, Seoul (Korea, Republic of)

    2016-07-15

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

  17. Ultrasonography and computer tomography in the diagnosis of certain abdominal diseases

    International Nuclear Information System (INIS)

    Wawrzynek, Z.

    1981-01-01

    Ultrasonography and computer tomography in the diagnosis of digestive tract and spleen diseases as well as traumas are compared. It is concluded that ultrasonography is nearly as usefull as computer tomography. (author)

  18. Killian-Jamieson Diverticulum Mimicking a Thyroid Nodule on Ultrasonography: A Case Report

    International Nuclear Information System (INIS)

    Kim, Eun Soo; Lee, Kwan Seop; Yoon, Hoi Soo; Jeon, Eui Yong; Hwang, Hee Sung; Koh, Sung Hye; Kim, Min Jeong; Jang, Kyung Mi; Lee, Myung Jun; Lee, Yul

    2007-01-01

    Thyroid ultrasonography is widely used for diagnosis and cytologic evaluation of thyroid nodules. We encountered a case of Killian-Jamieson diverticulum, which was differentiated from a thyroid nodule using ultrasonography

  19. Accuracy of ultrasonography and plain-film abdominal radiography in the diagnosis of urologic abnormalities in men with urinary tract infection: critically appraised topic

    International Nuclear Information System (INIS)

    Daunt, S.W.

    2004-01-01

    An adult male patient presented with dysuria and urinary frequency. A subsequent urine culture confirmed the presence of a urinary tract infection. How accurate is the combination of ultrasonography and plain-film abdominal radiography in the diagnosis of urologic abnormalities in men with confirmed urinary tract infection? (author)

  20. Atlas-based knee osteophyte assessment with ultrasonography and radiography

    DEFF Research Database (Denmark)

    Koski, J M; Kamel, Ayadi; Waris, P

    2016-01-01

    OBJECTIVES: To investigate intra- and inter-reader agreement of ultrasonography (US) and conventional radiography (CR) for the evaluation of osteophyte presence and size within the tibiofemoral joint. In addition, to correlate these findings with arthroscopic degeneration of the articular cartila...

  1. Ultrasonography and color Doppler in juvenile idiopathic arthritis

    DEFF Research Database (Denmark)

    Laurell, Louise; Court-Payen, Michel; Nielsen, Susan

    2012-01-01

    The wrist region is one of the most complex joints of the human body. It is prone to deformity and functional impairment in juvenile idiopathic arthritis (JIA), and is difficult to examine clinically. The aim of this study was to evaluate the role of ultrasonography (US) with Doppler in diagnosis...

  2. An unanticipated diagnosis with bedside ultrasonography in patients ...

    African Journals Online (AJOL)

    Although abdominal pain is a common presentation in emergency departments, rectus sheath hematoma (RSH) is among the rarest diagnosis. Here we present 2 cases of RSH likely caused by coughing due to upper respiratory tract infection. The two described cases were diagnosed by bedside ultrasonography and ...

  3. The accuracy rate of Alvarado score, ultrasonography, and ...

    African Journals Online (AJOL)

    Objective: In this study, we aim to compare the relationship between the Alvarado score, ultrasonography, and multislice computerized tomography (CT) findings used for the diagnosis of the patients who presented to our emergency unit with clinical features suggestive of acute appendicitis. Materials and Methods: ...

  4. Imaging in hematology. Part 1: Ultrasonography and conventional radiology

    International Nuclear Information System (INIS)

    Zhechev, Y.

    2003-01-01

    Applications of conventional ultrasonography techniques (B-mode or real time) in oncohematology are presented. The newer adaptations (in particular colour Doppler) provide incremental advantages that support their inclusion in the imaging techniques available to modern hematology. Conventional radiologic studies include chest and bone X-ray, gastrointestinal contrast examination and bipedal lymphangiography

  5. Impact of magnetic resonance urography and ultrasonography on ...

    African Journals Online (AJOL)

    Background: (1) To evaluate the diagnostic value of magnetic resonance urography (MRU) in comparison with ultrasonography (US) to determine the extent of upper urinary tract dilation and (2) to evaluate the impact of MRU on therapy management. Materials and Methods: From January 2005 to December 2010, ...

  6. In-utero diagnosis of Norrie disease by ultrasonography.

    Science.gov (United States)

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

    1993-03-01

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

  7. Primary muscular hydatid: preoperative diagnosis Throught computerized tomography and ultrasonography

    International Nuclear Information System (INIS)

    Macho Fernandez, J.M.; Marin Cardenas, M.A.; Mazas Artasona, L.; Lample Lacasa, C.; Otero Sierra, C.; Hernandez Navarrete, M.J.; Gomez-Pereda, R.

    1995-01-01

    Primary muscular hydatid disease, is extremely rare,- but not exceptional-, comparatively with other atypical localization. In this article the authors revised 474 patients with hydatid disease over a ten years period. Three cases of primary muscular localization were found. The ultrasonography and computed tomography facilitates the preoperative diagnosis. (Author) 40 refs

  8. Evaluation of the hip joint by computed tomography and ultrasonography

    International Nuclear Information System (INIS)

    Anda, S.

    1991-04-01

    In patients with dysplastic hips the acetabular angles and femoral anteversion were determined in a CT investigation. Comparative investigations of femoral anteversion were made by ultrasonography and biomedical radiography. The investigations are described and the general conclusions discussed. 205 refs., 15 figs., 10 tabs

  9. Transesophageal Ultrasonography for Lung Cancer Staging

    DEFF Research Database (Denmark)

    Konge, Lars; Annema, Jouke; Vilmann, Peter

    2013-01-01

    Accurate mediastinal nodal staging is essential for patients with resectable non-small-cell lung cancer and is achieved by combined endobronchial ultrasound and transesophageal endoscopic ultrasound (EUS). Training requirements for EUS-guided fine-needle aspiration (FNA) for lung cancer staging...

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

    Science.gov (United States)

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

    2015-01-01

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

  11. Diagnostic Utility of Endoscopic Retrograde Cholangiography/Intraductal Ultrasound (ERC/IDUS) in Distinguishing Malignant from Benign Bile Duct Obstruction.

    Science.gov (United States)

    Chen, Lu; Lu, Yi; Wu, Jia-Chuan; Bie, Like; Xia, Lu; Gong, Biao

    2016-02-01

    Accurately differentiating malignant diseases from benign ones in patients having bile duct obstruction is of significant importance and remains a major clinical problem. This study investigated the diagnostic yield of endoscopic retrograde cholangiography/intraductal ultrasound (ERC/IDUS) in distinguishing malignant from benign bile duct obstruction and assessed some image findings from ERC/IDUS which might be useful in differentiation. From January 2008 to January 2015, patients who underwent ERC/IDUS for bile duct obstruction were enrolled. Patient's ERC/IDUS diagnosis was compared with the final diagnosis determined by pathologic findings and/or clinical outcome of follow-up. One hundred and ninety-three patients with bile duct obstruction were included. IDUS correctly identified 94 of 97 malignant diseases and 76 of 96 benign diseases with sensitivity, specificity, and accuracy rate of 96.91, 79.17, and 88.08 %, respectively. Additionally, the accuracy rate of IDUS for diagnosis of proximal bile duct obstruction was higher than that of distal bile duct obstruction (98.08 vs. 82.73 %, p = 0.006). Besides, there was a significant difference in the length at the obstruction site between benign and malignant diseases (13.76 ± 7.37 vs. 19.97 ± 11.37 mm, p 7 mm without extrinsic compression had a positive predictive value (PPV) of 100 % for including malignancy, while length ≧20 mm demonstrated a PPV of 93.44 %. ERC/IDUS is effective in distinguishing malignant from benign bile duct obstruction, thus helping in further clinical management.

  12. Pancreatic intraepithelial neoplasia in association with intraductal papillary mucinous neoplasms of the pancreas: implications for disease progression and recurrence.

    Science.gov (United States)

    Biankin, Andrew V; Kench, James G; Biankin, Sandra A; Lee, C-Soon; Morey, Adrienne L; Dijkman, Floriaan P; Coleman, Maxwell J; Sutherland, Robert L; Henshall, Susan M

    2004-09-01

    The development of pancreatic cancer (PC) several years after curative resection for noninvasive intraductal papillary mucinous neoplasm (IPMN) and the presence of PC distant from IPMN suggest that PC may develop independently of the IPMN. Here, we identified pancreatic intraepithelial neoplasia (PanIN) lesions, the putative precursors of PC, in the ducts of pancreata resected for IPMN and assessed the frequency of molecular aberrations common to PanIN and PC, within these lesions. The protein expression of p53, p21(WAF1/CIP1), cyclin D1, p16(INK4A) and DPC4/Smad4 were examined by immunohistochemistry in 267 PanIN lesions from a cohort of 23 patients with IPMN. Overexpression of p21(WAF1/CIP1) was present in PanIN-1A and -1B lesions and increased in frequency in PanIN-2 and PanIN-3. Overexpression of p53 and cyclin D1, and loss of p16(INK4A) expression were detected in PanIN-2 and PanIN-3 lesions. Loss of DPC4/Smad4 expression occurred only in the PanIN-3 lesions. PanIN lesions that were more dysplastic than the coincident IPMN were identified in 5 of 12 patients, and 2 of these contained a greater number of aberrations in protein expression than the IPMN. PanIN lesions seen in association with IPMN demonstrate molecular and histologic changes identical to PanIN lesions found in association with PC and, in some cases, are more advanced than the associated IPMN. These data suggest that PanIN lesions found in the ducts of a pancreas with IPMN may be relevant to the development of PC either coincident with IPMN or in the remnant pancreas after curative resection of IPMN.

  13. Global genomic analysis of intraductal papillary mucinous neoplasms of the pancreas reveals significant molecular differences compared to ductal adenocarcinoma.

    Science.gov (United States)

    Fritz, Stefan; Fernandez-del Castillo, Carlos; Mino-Kenudson, Mari; Crippa, Stefano; Deshpande, Vikram; Lauwers, Gregory Y; Warshaw, Andrew L; Thayer, Sarah P; Iafrate, A John

    2009-03-01

    To determine whether intraductal papillary mucinous neoplasms of the pancreas (IPMNs) have a different genetic background compared with ductal adenocarcinoma (PDAC). The biologic and clinical behavior of IPMNs and IPMN-associated adenocarcinomas is different from PDAC in having a less aggressive tumor growth and significantly improved survival. Up to date, the molecular mechanisms underlying the clinical behavior of IPMNs are incompletely understood. 128 cystic pancreatic lesions were prospectively identified during the course of 2 years. From the corresponding surgical specimens, 57 IPMNs were separated and subdivided by histologic criteria into those with low-grade dysplasia, moderate dysplasia, high-grade dysplasia, and invasive cancer. Twenty specimens were suitable for DNA isolation and subsequent performance of array CGH. While none of the IPMNs with low-grade dysplasia displayed detectable chromosomal aberrations, IPMNs with moderate and high-grade dysplasia showed frequent copy number alterations. Commonly lost regions were located on chromosome 5q, 6q, 10q, 11q, 13q, 18q, and 22q. The incidence of loss of chromosome 5q, 6q, and 11q was significantly higher in IPMNs with high-grade dysplasia or invasion compared with PDAC. Ten of 13 IPMNs with moderate dysplasia or malignancy had loss of part or all of chromosome 6q, with a minimal deleted region between linear positions 78.0 and 130.0. This study is the first to use array CGH to characterize IPMNs. Recurrent cytogenetic alterations were identified and were different than those described in PDAC. Array CGH may help distinguish between these 2 entities and give insight into the differences in their biology and prognosis.

  14. Breast intraductal papillomas without atypia in radiologic-pathologic concordant core-needle biopsies: Rate of upgrade to carcinoma at excision.

    Science.gov (United States)

    Pareja, Fresia; Corben, Adriana D; Brennan, Sandra B; Murray, Melissa P; Bowser, Zenica L; Jakate, Kiran; Sebastiano, Christopher; Morrow, Monica; Morris, Elizabeth A; Brogi, Edi

    2016-09-15

    The surgical management of mammary intraductal papilloma without atypia (IDP) identified at core-needle biopsy (CNB) is controversial. This study assessed the rate of upgrade to carcinoma at surgical excision (EXC). This study identified women with a CNB diagnosis of intraductal papilloma without atypia or carcinoma at a cancer center between 2003 and 2013. Radiologic-pathologic concordance was assessed for all cases, and discordant cases were excluded. The radiologic and clinicopathologic features of patients with a CNB diagnosis of IDP were correlated with an upgrade to carcinoma at EXC. The study population consists of 189 women with 196 IDPs; 166 women (171 IDPs) underwent EXC. The upgrade rate was 2.3% (4 of 171). The upgraded lesions were 2 invasive lobular carcinomas and 2 cases of ductal carcinoma in situ (DCIS). One case of DCIS involved the residual IDP, whereas the other 3 carcinomas were ≥ 8 mm away. Twenty-four women (25 IDPs) did not undergo EXC and had stable imaging on follow-up (median, 23.5 months). The upgrade rate at EXC for IDPs diagnosed at CNB with radiologic-pathologic concordance was 2.3%. These findings suggest that observation is appropriate for patients with radiologic-pathologic concordant CNB yielding IDP, regardless of its size. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2819-2827. © 2016 American Cancer Society. © 2016 American Cancer Society.

  15. Ultrasonography and cholescintigraphy in the diagnostics of biliary tree

    International Nuclear Information System (INIS)

    Iskrenova, Zh.; Minchev, D.

    1997-01-01

    The purpose is to determine whether a reversed sequence of bile flow (i.e. small bowel followed by gallbladder) could serve as an indicator of chronic cholecystitis. 43 hepatobiliary scans were reviewed retrospectively with attention to the relative order of gallbladder and small bowel appearance during the first hour. Usually radioactive bile flows initially into the gallbladder followed by passage into the small bowel. The scintigraphic findings were correlated with results from gallbladder histopathology and gallbladder ultrasonography in 11 patients. The specificity of a reversed sequence for chronic cholecystitis was 82% using ultrasonography and 100% for histopathology. The visualization of gallbladder after the small bowel appears in patients referred for possible biliary tract disease predicts chronic cholecystitis (author)

  16. Role of ultrasonography in the ocular and the orbital diseases

    International Nuclear Information System (INIS)

    Kim, S. R.; Kim, K. S.; Lee, Y. C.; Park, S. S.

    1984-01-01

    With conventional methods including orbital arteriography, orbital venography, penumoobitography and positive contrast orbitography, imaging of eyeball and orbit is not only difficult, invasive or expensive but also nonspecific in result. Ultrasonography provides safe, specific and reliable way to obtain image of eyeball and orbit. Fifty six ultrasonograms of 50 patients which were referred under the impression of various ophthalmic diseases were analyzed. 1. Sixteen cases were normal. 2. Ocular diseases were 26 cases and extraocular orbital diseases were 8 cases. 3. Among the ocular diseases, 9 foreign body cases, 6 retinal detachment cases, 5 vitreous hemorrhage 4. Among the extraocular orbital diseases, 6 pseudotumor cases, 1 pseudolymphoma, 1 eyelid cyst case were diagnosed. 5. Ultrasonic findings were specific enough to differentiated from diseases and well corresponded with clinical and pathological diagnosis. 6. It can be concluded that ultrasonography is one of the most reliable imaging method in ocular and extraocular orbital diseases

  17. Potentialities of computed tomography and ultrasonography in colonic cancer

    International Nuclear Information System (INIS)

    Gorshkov, A.N.

    2001-01-01

    Data of examination of 59 patients with colonic cancer were used to consider the potentialities of transabdominal, transrectal ultrasonography and X-ay compound tomography and to assess their value in diagnosing colonic cancer, including its minor forms. Ultrasound and computed tomographic semiotics of colonic cancer and determines a place of the above techniques in the algorithm of radiation and instrumental studies are described. Inclusion of these techniques into the diagnostic algorithm may solve a range of differentially diagnostic problems and allows a preliminary analysis to be made in a tumor lesion according to the International TNM classification. Ultrasonography and X-ray computed tomography should be included into a range of basic methods for diagnosis of colonic cancer [ru

  18. Ultrasonography of Midline Scalp Masses : A Preliminary Report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hyo Kyeong; Lee, Ho Kyu; Choi, Choong Gon; Kim, Kyeong Sook; Jung, Seung Mun; Suh, Dae Chul [Asan Medical Center University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    1995-06-15

    We report our ultrasonographic experiences in the evaluation of small midline scalp masses. Ultrasonography was performed in four patients with midline scalp mass less than 3cm and its connecting tract into the cranialcavity. Ultrasonographic findings were correlated with pathologic results. There were three cephaloceles and one cystic lymph angioma. Two encephalomenin-goceles, located in occipital region, were mixed cystic and solid lesions and one atretic meningocele in parietal region was a solid lesion. Ultrasonogram of all three cases showed calvarial defect and connecting tract into the cranial cavity. On the contrary, a cystic lymph angioma in occipital region was a purely cystic mass without an associated calvarial defect. We suppose that ultrasonography could be a useful screening tool in the evaluation of midline scalp masses

  19. Henoch-Schonlein purpura: ultrasonography of scrotal and penile involvement

    Directory of Open Access Journals (Sweden)

    Youngsik Lim

    2015-04-01

    Full Text Available Testicular or scrotal involvement has been reported in children with Henoch-Schonlein purpura (HSP, but there are very few reports on penile involvement. We report the initial and follow-up ultrasonographic findings of scrotal and penile involvement of HSP in a 5-year-old boy. On ultrasonography, scrotal soft tissue thickening and epididymal swelling with increased vascularity were noted, and on the penis, a focal mass-like lesion appeared on the dorsal surface of the distal penis, having a hypoechoic mass-like appearance without visible vascular flow on a Doppler study. After 2 days of treatment, follow-up ultrasonography showed normal scrotum and penis with a resolved soft tissue mass-like lesion. Therefore, we think that HSP ultrasonographic findings involving the scrotum and penis might help to diagnose scrotal and penile involvement in a case of HSP and to avoid unnecessary medication and/or surgical procedures.

  20. Diagnostic ultrasonography in cattle with abdominal fat necrosis.

    Science.gov (United States)

    Tharwat, Mohamed; Buczinski, Sébastien

    2012-01-01

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

  1. Interobserver Variation of the Renal Length Measurement on Ultrasonography

    International Nuclear Information System (INIS)

    Jeong, Yoong Ki; Chung, Hye Weon; Kim, Tae Sung; Ryoo, Jae Wook; Kim, Tae Kyoung; Kim, Seung Hyup

    1995-01-01

    We assessed interobserver variation in the measurement of the renal length on ultrasonography. Ultrasonographic examinations were performed in randomly selected 50 patients. The maximallenhths of both kidneys were measured with calipers during the scanning from frozen images by three observers in a blinded fashion. There was a relatively constant tendency of an observer to measure a renal length either longer or shorter than the other observer(Kendall coefficient>0.05). Average interobserver variations were 0.51 cm (±0.42 cm) in right kidney and 0.53 cm (±0.41 cm) in left kidney and were within 1 cm in 91% right and 89% of left kidney. Interobserver variation about 1cm should be considered in the measurement of the renal length on ultrasonography

  2. On use of ultrasonography in obstetrics and gynecology

    International Nuclear Information System (INIS)

    Woo, Kwang Suk; Lee, Yong Woo

    1984-01-01

    Ultrasonography is playing an very important in diagnosis of normal pregnancy and the other diseases in the fields of obstetrics and gynecology. It is mainly used B-mode and Real time linear scan for pregnancy such as fetal movement during its early stage, fetal position, placenta location and biparietal diameter during its middle stage, and amniotic fluid and placenta previa during its late stage, as well as tumor accompanying pregnancy. Ultrasonography has been extensively used in the fields of obstetrics and gynecology for obtaining detailed images of soft tissues without hazard to the fetus and pregnant woman. In view of the need for its professionalism of high degree of skill, this treatise will introduce clinical instances and images obtained in the sonography room of the Seoul National University Hospital

  3. Reliable and Valid Assessment of Point-of-care Ultrasonography

    DEFF Research Database (Denmark)

    Todsen, Tobias; Tolsgaard, Martin Grønnebæk; Olsen, Beth Härstedt

    2015-01-01

    physicians' OSAUS scores with diagnostic accuracy. RESULTS: The generalizability coefficient was high (0.81) and a D-study demonstrated that 1 assessor and 5 cases would result in similar reliability. The construct validity of the OSAUS scale was supported by a significant difference in the mean scores......OBJECTIVE: To explore the reliability and validity of the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale for point-of-care ultrasonography (POC US) performance. BACKGROUND: POC US is increasingly used by clinicians and is an essential part of the management of acute surgical...... conditions. However, the quality of performance is highly operator-dependent. Therefore, reliable and valid assessment of trainees' ultrasonography competence is needed to ensure patient safety. METHODS: Twenty-four physicians, representing novices, intermediates, and experts in POC US, scanned 4 different...

  4. The image of urachus adenocarcinoma on Doppler ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Oyar, Orhan E-mail: o_oyar@hotmail.com; Yesildag, Ahmet; Gulsoy, Ufuk Kemal; Perk, Hakki

    2002-10-01

    Malignant urachal lesions are exceedingly rare and occur predominantly in adult life. In this case report, an adult patient with urachal carcinoma is presented with abdominal plain film, intravenous urography, gray-scale ultrasonography (US), Doppler US, and computed tomography (CT). Doppler US successfully showed the neovascularity with low resistive index value in the urachus tumor. We believe that Doppler US examination is helpful in the differential diagnosis of urachal carcinoma.

  5. Is ultrasonography essential before surgery in eyes with advanced cataracts?

    Directory of Open Access Journals (Sweden)

    Salman Amjad

    2006-01-01

    Full Text Available Background: Ultrasonography is an important tool for evaluating the posterior segment in eyes with opaque media. Aim: To study the incidence of posterior segment pathology in eyes with advanced cataract and to see whether certain features could be used as predictors for an abnormal posterior segment on ultrasound. Setting: Tertiary care hospital in South India. Methods and Materials: In this prospective study conducted over a 6-month period, all eyes with dense cataracts precluding visualization of fundus underwent assessment with ultrasound. Presence of certain patient and ocular "risk" factors believed to be associated with a higher incidence of abnormal posterior segment on ultrasound were looked for and the odds ratio (OR for posterior segment pathology in these eyes was calculated. Results: Of the 418 eyes assessed, 36 eyes (8.6% had evidence of posterior segment pathology on ultrasound. Retinal detachment (17 eyes; 4.1% was the most frequent abnormality detected. Among patient features, diabetes mellitus (OR= 4.9, P=0.003 and age below 50 years (OR= 15.4, P=0.001 were associated with a high incidence of abnormal ultrasound scans. In ocular features, posterior synechiae (OR= 20.2, P=0.000, iris coloboma (OR= 34.6, P=0.000, inaccurate projection of rays (OR= 15.1, P=0.002, elevated intraocular pressure (OR= 15.1, P=0.004, and keratic precipitates (OR= 22.4, P=0.004 were associated with high incidence of posterior segment pathology. Only four eyes (1.5% without these features had abnormal posterior segment on ultrasonography. Conclusions: Certain patient and ocular features are indicative of a high risk for posterior segment pathology and such patients should be evaluated by ultrasonography prior to cataract surgery. In the absence of these risk factors, the likelihood of detecting abnormalities on preoperative ultrasonography in eyes with advanced cataracts is miniscule.

  6. Comparison of ultrasonography and radiography in diagnosis of rib fractures

    OpenAIRE

    Pishbin, Elham; Ahmadi, Koorosh; Foogardi, Molood; Salehi, Maryam; Seilanian Toosi, Farrokh; Rahimi-Movaghar, Vafa

    2017-01-01

    Purpose: Rib fractures are the most common skeletal thoracic injuries resulting from blunt chest trauma. Half of the rib fractures are not detected upon a precise physical evaluation and radiographs. Recently ultrasonography (USG) has been investigated to detect rib fractures. But based on literature the usefulness of USG varies widely. This study was conducted to investigate the role of USG in the detection of possible rib fractures in comparison with radiography. Methods: In this cross-s...

  7. Pictorial essay: B-scan ultrasonography in ocular abnormalities

    International Nuclear Information System (INIS)

    Aironi, VD; Gandage, SG

    2009-01-01

    B-scan ultrasonography (USG) is a simple, noninvasive tool for diagnosing lesions of the posterior segment of the eyeball. Common conditions such as cataract, vitreous degeneration, retinal detachment, ocular trauma, choroidal melanoma, and retinoblastoma can be accurately evaluated with this modality. B-scan USG is cost-effective, which is an important consideration in the rural setting. In addition, it is noninvasive and easily available and the results are reproducible

  8. Ultrasonography of the omasum in 30 Saanen goats

    Directory of Open Access Journals (Sweden)

    Jacquat Désirée

    2011-02-01

    Full Text Available Abstract Background Primary diseases of the omasum are uncommon in goats, although the omasum may be involved in various gastrointestinal disorders. Examination of the caprine omasum via ultrasonography requires a good understanding of the normal appearance of the organ. However, in contrast to cattle, there is a lack of reference information on this topic in goats. Thus, the goal of the present study was to describe the results of ultrasonography of the omasum in 30 healthy Saanen goats. Results Ultrasonography was carried out in standing, non-sedated goats using a 5.0 MHz linear transducer. The location and size of the omasum, thickness of the omasal wall and visualisation of the abomasal laminae, contents and contractions were assessed. The omasum was visible from the 9th intercostal space (ICS in all the goats, and from the 8th and 10th ICSs in 29 and 24 goats, respectively. The omasum was seen medial to the liver, but only the omasal wall closest to the transducer was visible. The dorsal omasal limit formed a dorsally convex curve running from cranioventral to caudodorsal and was furthest from the dorsal midline in the 6th ICS. The ventral omasal limit formed a ventrally convex curve. The size of the omasum was largest (10.2 ± 3.1 cm in the 9th ICS and decreased cranially and caudally from this position. Active omasal motility was recorded in 20 goats with 0.3 to 2.0 contractions per minute. Conclusions The findings of this study provide reference ranges for the interpretation of the location and size of the omasum in goats with suspected omasal abnormalities. Ultrasonography is an ideal diagnostic tool for evaluation of the omasum, which is not accessible to conventional examination techniques, such as inspection, palpation, percussion and auscultation.

  9. Value of gallbladder B-scan ultrasonography.

    Science.gov (United States)

    Tabrisky, J; Lindstrom, R R; Herman, M W; Castagna, J; Sarti, D

    1975-05-01

    The gallbladder B-scans of 20 patients who had subsequent surgery were separated into three categories based upon certain sonographic criteria. Our data, in this limited series, revealed gallbladder pathology in each patient who had any one or combination of the following scan characteristics: (1) internal echos, (2) irregular wall, or (3) absence of recognizable gallbladder sonolucency. The category which demonstrated a normal sonographic gallbladder, namely a smooth wall and no internal echos, contained a number of false negatives which proved to have either small stone cholelithiasis or extraphepatic ductal obstruction. Within the described limitations, the B-scan can be a valuable test in confirming the significance of a radiographically nonvisualized gallbladder or in detecting a biliary tract lesion in a patient with a disease entity that precludes radiographic visualization by conventional techniques.

  10. Ultrasonography of the equine shoulder: technique and normal appearance.

    Science.gov (United States)

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

    1999-01-01

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

  11. Evaluation of arterial embolization in treating hyperthyroidism by colour ultrasonography

    International Nuclear Information System (INIS)

    Sun Xiuying; Yang Jijin; Chen Ningning; Gu Limin; Wang Ying; Chen Jianquan

    2003-01-01

    Objective: To assess the effect of arterial embolization in treating hyperthyroidism by colour ultrasonography. Methods: Forty two cases of hyperthyroidism were treated with thyroid-arteries embolization. A few days before and 1, 3, 6 months after embolization, the echograms of thyroids were observed including the volumes of thyroids and the internal diameters of thyroid-arteries were measured with colour ultrasonography respectively. The Vs, Vd, Vm, PI, RI were measured with the Doppler and the quantities of blood flow were calculated. The relationships of changes for all these parameters and T 3 , T 4 and TSH were analysed. Results: Before artery embolization all thyroids were enlarged with diffusely homogenous or heterogenous low-echoes and nodules in some patients accompanied by widening of the thyroid arteries and their branches full of blood supply. The volume of thyroids decreased after artery embolization. 1-3 months later the echo of thyroids enhanced and got coarse with decrease of the thyroid vasculature and narrowing of vessel calibers except a few star- or stop-like blood streams were sometimes seen within the thyroids and no blood flow signals found in some cases. 3-6 months after embolization, the echo of thyroids decreased gradually or unevenly distributed. All the parameters of blood flow before and after the treatment showed statistically significant differences (P < 0.05). Conclusions: Embolization of thyroid arteries is a relatively new and effective technique in treating hyperthyroidism. Colour Doppler ultrasonography plays an important role for correct diagnosis and prognostication

  12. Peritoneal inclusion cysts: Changes on follow-up ultrasonography

    International Nuclear Information System (INIS)

    Kim, Jung Sik; Lee, Jin Hee; Lee, Hee Jung; Lee, Sung Moon; Woo, Seong Ku

    2003-01-01

    To evaluate the volume change of peritoneal inclusion cysts on the follow-up ultrasonography (US). From March 1995 to May 1999, thirty seven women with ultrasonographically diagnosed peritoneal inclusion cysts were included in this study. Six patients underwent surgery for several reasons. Follow-up ultrasonography was performed 70-456 days (mean=191 days) after initial US examination in 12 of the remaining 31 patient with no further treatment. US was performed with a 3.5 or 4 MHz transabdominal probe in all 18 patients who underwent either surgery or follow-up US, and additional tranvaginal US examination using a 5-7 MHz probe in 15 of 18 patients. The volume change of the cysts was recorded for each US examination. Three cysts (25%) (volume=170 cm 3 , 61 cm 3 , and 38 cm 3 , respectively) were completely resolved on the follow-up US while the other nine cysts showed a decreased volume in seven patients (58%) and increased volume in two patients (17%). Spontaneous regression of peritoneal inclusion cysts is more common than it is believed to be, and ultrasonography may be a useful follow-up examination for peritoneal inclusion cysts.

  13. Ultrasonography in the evaluation of tongue and mouth pathology

    International Nuclear Information System (INIS)

    Lee, Chan Wha; Chung, Tae Sub; Suh, Jung Ho; Kim, Dong Ik; Lee, Jong Tae; Hong, Won Pyo; Park, Hyung Sik

    1991-01-01

    The evaluation of the tongue and mouth floor using the CT scan can be limited due to dental artifacts. Because the therapeutic plan depends on the nature and the cancer staging of lesions, it is essential to obtain accurate evaluation of lesions. In this study are explored the of Ultrasonography for the evaluation of tongue and mouth floor pathology. We have obtained ultrasonograms in 20 patients who had benign and malignant lesions in the tongue and mouth floor. Comparative analysis was made on 15 patients who underwent both CT and ultrasonography. We used the bimanual compression technique and the phonation technique during real-time scanning. Out of 15 cases, six had tongue cancer, and seven of them had cancer of the mouth floor. The other cases included a ranula, a dermoid cyst, a Ludwig's angina, and abscess of salivary gland, and one care with stones of the submandibular gland. All the benign and malignant masses appeared hypoechoic. Even though the lesions of tongue and mouth floor could not be evaluated by CT scan due to dental artifacts and extremely small size in 5 cases, ultrasonogram using the bimanual compression technique demonstrated good localization of the lesion, and also was greatly helpful in visualizing the invasion of the surrounding structures. Ultrasonography of the tongue and mouth floor proved to be superior to the CT scan not only in delineating the size and extent of the primary lesion, but also in visualizing invasion of surrounding structures

  14. Intraductal Carcinoma of the Prostate on Diagnostic Needle Biopsy Predicts Prostate Cancer Mortality: A Population-Based Study.

    Science.gov (United States)

    Saeter, Thorstein; Vlatkovic, Ljiljana; Waaler, Gudmund; Servoll, Einar; Nesland, Jahn M; Axcrona, Karol; Axcrona, Ulrika

    2017-06-01

    Intraductal carcinoma of the prostate (IDC-P) is a distinct histopathologic feature associated with high-grade, advanced prostate cancer. Although studies have shown that IDC-P is a predictor of progression following surgical or radiation treatment for prostate cancer, there are sparse data regarding IDC-P on diagnostic needle biopsy as a prognosticator of prostate cancer mortality. This was a population-based study of all prostate cancer patients diagnosed using needle biopsy and without evidence of systemic disease between 1991 and 1999 within a defined geographic region of Norway. Patients were identified by cross-referencing the Norwegian Cancer Registry. Of 318 eligible patients, 283 had biopsy specimens available for central pathology review. Clinical data were obtained from medical charts. We examined whether IDC-P on diagnostic needle biopsy was associated with adverse clinicopathological features and prostate cancer mortality. Patients with IDC-P on diagnostic needle biopsy had a more advanced stage and a higher Gleason score compared to patients without IDC-P. IDC-P was also associated with an intensively reactive stroma. The 10-year prostate cancer-specific survival was 69% for patients with IDC-P on diagnostic needle biopsy and 89% for patients without IDC-P (Log rank P-value prostate cancer mortality after adjustments for clinical prognostic factors and treatment. After adjustment for the newly implemented Grade Group system of prostate cancer, IDC-P showed a strong tendency toward statistical significance. However, IDC-P did not remain a statistically significant predictor in the multivariable analysis. IDC-P on diagnostic needle biopsy is an indicator of prostate cancer with a high risk of mortality. Accordingly, a diagnosis of IDC-P on needle biopsy should be reported and considered a feature of high-risk prostate cancer. Moreover, the association between IDC-P and reactive stroma provides evidence in support of the idea that stromal factors

  15. MRI versus ultrasonography to assess meniscal abnormalities in acute knees.

    Science.gov (United States)

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

    2014-08-01

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

  16. [Low grade renal trauma (Part II): diagnostic validity of ultrasonography].

    Science.gov (United States)

    Grill, R; Báca, V; Otcenásek, M; Zátura, F

    2010-04-01

    The aim of the study was to verify whether ultrasonography can be considered a reliable method for the diagnosis of low-grade renal trauma. The group investigated included patients with grade I or grade II blunt renal trauma, as classified by the AAST grading system, in whom ultrasonography alone or in conjunction with computed tomography was used as a primary diagnostic method. B-mode ultrasound with a transabdominal probe working at frequencies of 2.5 to 5.0 MHz was used. Every finding of post-traumatic changes in the renal tissues, i.e., post-contusion hypotonic infiltration of the renal parenchyma or subcapsular haematoma, was included. The results were statistically evaluated by the Chi-square test with the level of significance set at 5%, using Epi Info Version 6 CZ software. The group comprised 112 patients (43 women, 69 men) aged between 17 and 82 years (average, 38 years). It was possible to diagnose grade I or grade II renal injury by ultrasonography in only 60 (54%) of them. The statistical significance of ultrasonography as the only imaging method for the diagnosis of low-grade renal injury was not confirmed (p=0.543) Low-grade renal trauma is a problem from the diagnostic point of view. It usually does not require revision surgery and, if found during repeat surgery for more serious injury of another organ, it usually does not receive attention. Therefore, the macroscopic presentation of grade I and grade II renal injury is poorly understood, nor are their microscopic findings known, because during revision surgery these the traumatised kidneys are not usually removed and their injuries at autopsy on the patients who died of multiple trauma are not recorded either. The results of this study demonstrated that the validity of ultrasonography for the diagnosis of low-grade renal injury is not significant, because this examination can reveal only some of the renal injuries such as perirenal haematoma. An injury to the renal parenchyma is also indicated by

  17. Variability of intraductal papillomas of the mammary gland: Clinical, roentgenologic and morphologic investigations

    International Nuclear Information System (INIS)

    Rummel, W.

    1974-01-01

    The radiodiagnostical method of choice is the galactographic technique. However, a specific X-ray image of the papilloma does not exist. The galactographic technique has to be adapted to the surgical and histologic one. Only by combining these three techniques good results can be achieved. It is not possible to draw conclusions from the colour of the pathologic discharge about the type and character of the pathologic process. Contrary to the findings documented in the literature, we were able to diagnose with our technique not only small tumours, but also tumours situated in the periphery of the lactiferous duct. Because of our investigations it is no longer possible to maintain and keep the strict division of the proliferative changes occurring at the lactiferous duct walls. In this study, the most significant morphologic results are described in detail. In all patients with pathologic discharge of the mammary gland, the so-called papillo-carcinoma was found only in one case. As clinical consequence it has therefore to be demanded that in all women with the symptom of pathologic mamillary discharge first of all the origin of this discharge has to be localised by means of galactography. Only the individual morphologic picture of a proliferative change of the lactiferous duct provides some prognostic value. The prerequisites for such an individual assessment are differentiated roentgenologic, surgical and histological techniques. (orig./MG) [de

  18. Transgastric pure-NOTES peritoneoscopy and endoscopic ultrasonography for staging of gastrointestinal cancers

    DEFF Research Database (Denmark)

    Donatsky, Anders Meller; Vilmann, Peter; Meisner, Søren

    2012-01-01

    BACKGROUND: Human natural orifice transluminal endoscopic surgery (NOTES) has mainly been based on simultaneous laparoscopic assistance (hybrid NOTES), forgoing the theoretical benefits of the NOTES technique. This is due to a lack of NOTES-specific instruments and endoscopes, making pure-NOTES...... procedures difficult and time consuming. An area where pure NOTES could be adopted at its present stage of development is minimally invasive staging of gastrointestinal (GI) cancer. The aim of this study is to evaluate the feasibility of combining transgastric (TG) pure-NOTES peritoneoscopy...... and intraperitoneal endoscopic ultrasonography (ip-EUS) with intraluminal EUS (il-EUS) for peritoneal evaluation. METHODS: This was a feasibility and survival study where il-EUS followed by ip-EUS and peritoneoscopy was performed in 10 pigs subjected to TG pure NOTES. A score was given with regard to achieved...

  19. Diagnostic imaging of the equine tarsal region using radiography and ultrasonography. Part 1: the soft tissues.

    Science.gov (United States)

    Vanderperren, Katrien; Raes, Els; Hoegaerts, Michel; Saunders, Jimmy H

    2009-02-01

    The equine tarsus is the most commonly affected hindlimb region associated with lameness. Diagnostic imaging is routinely applied but because of its complexity, being composed of 10 multifaceted bones and different joints, multiple ligaments, tendons and bursae, imaging this region can be a challenge. This is the first part of a two-part review of the structures and disorders of the equine tarsus. It describes the principal disorders affecting the soft tissues of the tarsal region and addresses some of the technical aspects in taking radiographic, ultrasonographic and scintigraphic images of the different soft tissue lesions. Where applicable, comments on the diagnostic use of contrast radiography, arthroscopy and tenoscopy are made. In current clinical practice a combination of radiography and ultrasonography is still most frequently used to arrive at a diagnosis.

  20. Ultrasonography evaluation during the weaning process: the heart, the diaphragm, the pleura and the lung.

    Science.gov (United States)

    Mayo, P; Volpicelli, G; Lerolle, N; Schreiber, A; Doelken, P; Vieillard-Baron, A

    2016-07-01

    On a regular basis, the intensivist encounters the patient who is difficult to wean from mechanical ventilatory support. The causes for failure to wean from mechanical ventilatory support are often multifactorial and involve a complex interplay between cardiac and pulmonary dysfunction. A potential application of point of care ultrasonography relates to its utility in the process of weaning the patient from mechanical ventilatory support. This article reviews some applications of ultrasonography that may be relevant to the process of weaning from mechanical ventilatory support. The authors have divided these applications of ultrasonography into four separate categories: the assessment of cardiac, diaphragmatic, and lung function; and the identification of pleural effusion; which can all be evaluated with ultrasonography during a dynamic process in which the intensivist is uniquely positioned to use ultrasonography at the point of care. Ultrasonography may have useful application during the weaning process from mechanical ventilatory support.

  1. Imaging of the acute scrotum: is there a place for contrast-enhanced ultrasonography?

    Directory of Open Access Journals (Sweden)

    H. Moschouris

    2009-12-01

    Full Text Available Purpose: To present and evaluate the findings of contrast-enhanced ultrasonography (CEUS in typical cases of acute painful scrotum. Materials and methods: Nineteen patients aged from 19 to 61 years old were included in the study. All patients underwent grey-scale and color Doppler ultrasonography (US of the scrotum, followed by imaging after i.v. administration of 2.4 mL of a second generation ultrasound contrast agent (microbubbles of sulphur hexafluoride. A dedicated, contrast-sensitive technique was used (Contrast Tissue Imaging - CnTI. The diagnosis was confirmed surgically in 6 cases while in the remaining 8 cases it was based on the combination of clinical, imaging and laboratory findings. Results: The final diagnosis was testicular torsion (n = 4, epididymitis (n = 2, one of the cases complicated by abscess, testicular abscess (n = 1, scrotal abscess (n = 1, testicular trauma of varying severity (n = 6. Five out of 19 cases were true negatives: neither clinical examination nor laboratory tests revealed any pathology. CEUS showed complete lack of enhancement in all cases of torsion, permitting a rapid and definitive diagnosis. In the cases of infection complicated by abscesses, CEUS delineated the lesions much better than the combination of B-mode/Color Doppler US. The severely traumatized testicles showed minimal, inhomogeneous or patchy enhancement, while cases of minor trauma showed no significant enhancement defects. Hematomas were presented as non-enhancing lesions. Conclusion: Generally, there was no advantage over Doppler US as has been previously shown. However, CEUS can be used supplementary to traditional Doppler US in the investigation of blunt testicular trauma especially when there is uncertainty in diagnosis after appropriate clinical and radiographic evaluations occurs. Further studies are required to clearly define the indications of this method.

  2. The role of contrast-enhanced ultrasonography in image-guided liver ablations

    International Nuclear Information System (INIS)

    Pescatori, Lorenzo Carlo; Sconfienza, Luca Maria; Mauri, Giovanni

    2016-01-01

    We read with great interest the paper by Kim et al. entitled “Local ablation therapy with contrast enhanced ultrasonography for hepatocellular carcinoma: a practical review,” recently published in Ultrasonography. We think that contrast-enhanced ultrasonography (CEUS), together with the development of reliable navigation systems, is likely to represent one of the most important advances in image-guided ablations in recent years. Thus, we offer some considerations on the topic

  3. Prenatal diagnosis of Beckwith-Wiedemann syndrome by two- and three-dimensional ultrasonography

    Directory of Open Access Journals (Sweden)

    Edward Araujo Junior

    2013-12-01

    Full Text Available Beckwith-Wiedemann syndrome is a genetic syndrome characterized by macroglossia, omphalocele, fetal gigantism and neonatal hypoglycemia. The authors report a case of Beckwith-Wiedemann syndrome diagnosed in a 32-year-old primigravida in whom two-dimensional ultrasonography revealed the presence of abdominal wall cyst, macroglossia and polycystic kidneys. Three-dimensional ultrasonography in rendering mode was of great importance to confirm the previous two-dimensional ultrasonography findings.

  4. Evaluation of abdominal palpation, radiography and ultrasonography for pregenancy diagnosis in bitches

    International Nuclear Information System (INIS)

    Arunmozhi, N.; Naidu, K.V.; Sreenu, M.; Rao, A.S.

    2005-01-01

    Abdominal palpation, radiography and ultrasonography were compared for pregnancy diagnosis in bitches. The earliest correct diagnosis of pregnancy was made by 22 and 21 days with abdominal palpation and ultrasonography respectively, while radiography led to more accurate diagnosis in last trimester of pregnancy. All the methods revealed 100 per cent accuracy in last trimester where as ultrasonography gave constant results from day 21 up to termination of pregnancy followed by abdominal palpation

  5. Comparison of the results of abdominal ultrasonography and exploratory laparotomy in the dog and cat.

    Science.gov (United States)

    Pastore, Gina E; Lamb, Christopher R; Lipscomb, Victoria

    2007-01-01

    Results of preoperative ultrasonography and exploratory laparotomy were reviewed retrospectively in a series of 100 small animals to assess the agreement between ultrasonographic and surgical findings and to identify abdominal lesions likely to be missed by ultrasonography. Good agreement occurred between ultrasound reports and surgical reports in 64% of the animals, which supported the use of ultrasonography in potential surgical candidates. A major discrepancy was observed between the ultrasound report and surgical findings in 25% of the animals. Of the various types of pathology encountered in the study, gastrointestinal ulceration or perforation was the most likely lesion to be missed by ultrasonography.

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

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Ji Young [Dept. of Radiology, Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

    2017-04-15

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

  7. Comparative study of scintigraphy, ultrasonography and computed tomography in the evaluation of liver tumours

    International Nuclear Information System (INIS)

    Tohyama, Junko; Ishigaki, Takeo; Ishikawa, Tsutomu

    1982-01-01

    A comparative study of scintigraphy, ultrasonography and computed tomography in 67 proven patients with clinically suspected liver tumours was reported. Scintigraphy was superior in sensitivity to ultrasonography and computed tomography. However, in specificity, scintigraphy was inferior to other two. Diagnostic efficacy of ultrasonography and computed tomography in detecting focal masses of the liver was not greatly different, and simultaneous interpretation of ultrasonogram and computed tomogram was more helpful than independent interpretation. So they were thought to be complementary. In conclusion, scintigraphy was thought to be the initial procedure in the diagnostic approach for focal liver masses and ultrasonography was second procedure because of no radiation hazards. And computed tomography should follow then. (author)

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

    Directory of Open Access Journals (Sweden)

    Ji Young Hwang

    2017-04-01

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

  9. Ultrasonography survey and thyroid cancer in the Fukushima Prefecture

    Energy Technology Data Exchange (ETDEWEB)

    Jacob, Peter; Kaiser, Jan Christian; Ulanovsky, Alexander [Helmholtz Zentrum Muenchen-German Research Center for Environmental Health, Department of Radiation Sciences, Institute of Radiation Protection, Neuherberg (Germany)

    2014-05-15

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

  10. Stomach: ultrasonography evaluation and post mortem inspection in adult horses

    Directory of Open Access Journals (Sweden)

    Cristiano Chaves Pessoa da Veiga

    2014-06-01

    Full Text Available ABSTRACT. Veiga C.C.P., Cascon C.M., Souza B.G., Braga L.S.M., Souza V.C., Ferreira A.M.R. & Leite J.S. [Stomach: ultrasonography evaluation and post mortem inspection in adult horses.] Avaliação ultrassonográfica e anatomopatológica macroscópica do estômago de equinos destinados ao abate comercial. Revista Brasileira de Medicina Veterinária, 36(2:125-130, 2014. Instituto de Veterinária, Universidade Federal Rural do Rio de Janeiro, BR 465, km 7, Seropédica, 23890-000, RJ, Brasil. E-mail: radiovet@ufrrj.br The equine gastric ulcer syndrome (EGUS includes all symptomatic or asymptomatic cases of erosions, ulcers, gastritis, gastric emptying disorders, duodenitis, duodenal ulcers and complications of these disorders. Occupies a prominent place in the equine clinic where you can go for the death of the animal. Ultrasonography of the stomach is indicated when the animals showed clinical signs of gastric disease. The aim of this study was to describe the sonographic evaluation and macroscopic pathological findings of the stomach of adult horses intended for commercial slaughter. To this 39 intended for commercial slaughter horses were evaluated. Sonographic evaluation before slaughter transabdominal via the left side of abdomen for evaluation of the stomach was performed. After the slaughter of these animals their stomachs were collected, evaluated and photographed. The study concluded that ultrasonography identified the stomach in all animals evaluated, but did not allow a careful evaluation of the entire length of the viscera, especially the aglandular region and pleated border. All animals evaluated had injury to the gastric mucosa in different degrees. In animals evaluated, the stomach region was most affected by injuries glandular region, although the most severe lesions have been found in the ruffled border adjacent to aglandular region.

  11. High-resolution ultrasonography in assessing temporomandibular joint disc position.

    Science.gov (United States)

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

    2018-02-04

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

  12. Breeding soundness evaluation of bulls by semen analysis, testicular fine needle aspiration cytology and trans-scrotal ultrasonography

    Directory of Open Access Journals (Sweden)

    Chapwanya A

    2008-05-01

    Full Text Available Abstract The aim of this study was to evaluate the usefulness of trans-scrotal ultrasonography and testicular fine needle aspiration cytology in assessing bulls for breeding suitability. These two techniques were also compared with semen analysis. Bulls presented for breeding soundness evaluation were assessed using all three techniques. The findings of each technique were compared. There was agreement in classification of fertile bulls using all three techniques, suggesting that the combined use of these techniques enhances routine breeding soundness examination. Use of the three techniques also enhances detailed investigation of suspected sub-fertile bulls while accurately identifying testicular cause(s of sire sub-fertility.

  13. Diagnostic accuracy of the ultrasonography in complicated pregnancy

    International Nuclear Information System (INIS)

    Cha, Kyung Soo; Kim, Kun Sang; Park, Soo Soung

    1983-01-01

    Ultrasonography is an invaluable diagnostic method in Obstetrics. It provides safe, speedy and repeatable way to obtain image of normal and abnormal pregnancy. The ultrasonograms of 167 patients with suspicion of complicated pregnancy were analyzed. The results were as follows. 1. 86 patients showed normal ultrasonogram(50.9%). 100% in intrauterine fetal death and gross fetal anomaly, 100% in abnormal fetal position and number, 95% in pregnancy with pelvic mass, 83% in ectopic pregnancy, 81% in abortion, 78% in molar pregnancy, 74% in plancenta previa. 3. Ultrasonic diagnosis of abrupto placenta was difficult. 4. Diagnostic accuracy was 80% in bicornuate uterus and double vagina

  14. Clinical application of endoscopic ultrasonography for esophageal achalasia.

    Science.gov (United States)

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

    2015-04-01

    Endoscopic ultrasonography (EUS) has been widely used for evaluating the nature of diseases of various organs. The possibility of applying EUS for esophageal motility diseases has not been well discussed despite its versatility. At present, peroral endoscopic myotomy (POEM) for esophageal achalasia and related diseases has brought new attention to esophageal diseases because POEM provides a more direct approach to the inner structures of the esophageal wall. In the present study, we discuss the clinical utility of EUS in evaluating and treating esophageal motility diseases such as esophageal achalasia and related diseases. © 2015 The Authors. Digestive Endoscopy © 2015 Japan Gastroenterological Endoscopy Society.

  15. Assessment of a Revised Management Strategy for Patients With Intraductal Papillary Mucinous Neoplasms Involving the Main Pancreatic Duct.

    Science.gov (United States)

    Sugimoto, Motokazu; Elliott, Irmina A; Nguyen, Andrew H; Kim, Stephen; Muthusamy, V Raman; Watson, Rabindra; Hines, O Joe; Dawson, David W; Reber, Howard A; Donahue, Timothy R

    2017-01-18

    According to the 2012 International Consensus Guidelines, the diagnostic criterion of intraductal papillary mucinous neoplasms (IPMNs) involving the main duct (MD IPMNs) or the main and branch ducts (mixed IPMNs) of the pancreatic system is a main pancreatic duct (MPD) diameter of 5.0 mm or greater on computed tomography (CT) or magnetic resonance imaging (MRI). However, surgical resection is recommended for patients with an MPD diameter of 10.0 mm or greater, which is characterized as a high-risk stigma. An MPD diameter of 5.0 to 9.0 mm is not an indication for immediate resection. To determine an appropriate cutoff (ie, one with high sensitivity and negative predictive value) of the MPD diameter on CT or MRI as a prognostic factor for malignant disease and to propose a new management algorithm for patients with MD or mixed IPMNs. This retrospective cohort study included 103 patients who underwent surgical resection for a preoperative diagnosis of MD or mixed IPMN and in whom IPMN was confirmed by surgical pathologic findings at a single institution from July 1, 1996, to December 31, 2015. Malignant disease was defined as high-grade dysplasia or invasive adenocarcinoma on results of surgical pathologic evaluation. An appropriate MPD diameter on preoperative CT or MRI to predict malignant disease was determined using a receiver operating characteristic curve analysis. The prognostic value of the new management algorithm that incorporated the new MPD diameter cutoff was evaluated. Among the 103 patients undergoing resection for an MD or mixed IPMN (59 men [57.3%]; 44 women [42.7%]; median [range] age, 71 [48-86] years), 64 (62.1%) had malignant disease. Diagnostic accuracy for malignant neoplasms was highest at an MPD diameter cutoff of 7.2 mm (area under the receiver operating characteristic curve, 0.70; 95% CI, 0.59-0.81). An MPD diameter of 7.2 mm or greater was also an independent prognostic factor for malignant neoplasms (odds ratio, 12.76; 95% CI, 2

  16. Usefulness of ultrasonography in follow-up evaluation after Ilizarov procedure : comparison with plain radiography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Hoon; Jee, Sung Woo; Lee, Ho Won; Lee, Sung Moon; Kim, Jung Sik; Kim, Hong; Song, Kwang Soon; Woo, Sung Ku [Keimyung University, Taegu (Korea, Republic of). School of Medicine; Cho, Kil Ho [Yeungnam Univ., Taegu (Korea, Republic of). School of Medicine

    1998-06-01

    The purpose of this study is to compare the usefulness of ultrasonography in follow up evaluation after the Ilizarov procedure with that of plain radiography. We analyzed ultrasound findings in twelve patients who had undergone the Ilizarov procedure, and retrospectively compared the results with the findings of plain radiography. The procedure was performed due to post-traumatic limb deformity or non-union (nine of twelve patients), congenital pseudoarthrosis (one case), sequelae of poliomyelitis (one case), and short stature (one case). The patients` mean age was 29 years; eleven of twelve were male. Ten of twelve procedures were performed on the tibia and two on the femur. After 7-10 days, distraction was initiated at a rate of 0.25 mm four times a day. Ultrasonography was performed with a 5-10 MHz linear or convex transducer; new bone formation was defined as dotted or linear echogenic foci within a hypoechoic distraction gap. Initial ultrasonographic examination was performed 2-4 weeks after distraction, and the results were compared with those of plain radiography. Color doppler imaging was performed in three cases. After the Ilizarov bone lengthening procedure, ultrasound appears to be useful for follow-up examination. New bone formation, as well as complications, can be detected earlier; it can indicate whether ultrasound-guided interventional procedure is required, and if combined with color doppler study, is able to detect the periosteal blood supply. Further evaluation of the clinical significance of preserved periosteal blood supply seems however, to be needed. (author). 18 refs., 4 figs.

  17. Ultrasonography of the liver anatomy, procedure, normal and abnormal findings in diseased states

    International Nuclear Information System (INIS)

    Fukuda, Morimichi

    1996-01-01

    Although the very first attempt to use ultrasound for diagnostic purpose in medicine may be traced back to the 1940's, the modern ultrasound imaging has only been started in 1963 by G. Kossoff, who developed the idea of grayscale ultrasonography together with the automatic waterbath scanner, Octoson, to examine pelvic and other abdominal organs. The signal processing, logarithmic compression of incoming backscattered echo signals, greatly Improved image quality and thus facilitated the use of ultrasound imaging in clinical diagnostic purposes. The bistable, black and white ultrasound equipment were used in the 60's, and even sophisticated B-mode contact scanners had been completely replaced by the real-time B-mode equipment and then the technique started to be used widely in medical imaging in clinical and radiology departments. These rather drastic changes took place since the introduction of the phased array technique introduced by Somer in 1967 and later the linear array method introduced by Bom in 1970. Other rare metabolic diseases have to be analyzed carefully for the differential diagnosis. In summary, ultrasonography is a useful measure to identify the presence of pathologic changes in the liver. The information obtained is mostly of morphological nature, though some additional findings could be obtained by careful analysis of the sonographic features. Examination is quick, non-invasive and findings are fairly reproducible and even very small lesions could be identified. Combined use of the ultrasound imaging with other modalities such as the radio isotope scanning, X ray, CT or MRI will be very helpful in identifying and characterising the lesions in the liver

  18. Usefulness of ultrasonography in follow-up evaluation after Ilizarov procedure : comparison with plain radiography

    International Nuclear Information System (INIS)

    Lee, Jong Hoon; Jee, Sung Woo; Lee, Ho Won; Lee, Sung Moon; Kim, Jung Sik; Kim, Hong; Song, Kwang Soon; Woo, Sung Ku; Cho, Kil Ho

    1998-01-01

    The purpose of this study is to compare the usefulness of ultrasonography in follow up evaluation after the Ilizarov procedure with that of plain radiography. We analyzed ultrasound findings in twelve patients who had undergone the Ilizarov procedure, and retrospectively compared the results with the findings of plain radiography. The procedure was performed due to post-traumatic limb deformity or non-union (nine of twelve patients), congenital pseudoarthrosis (one case), sequelae of poliomyelitis (one case), and short stature (one case). The patients' mean age was 29 years; eleven of twelve were male. Ten of twelve procedures were performed on the tibia and two on the femur. After 7-10 days, distraction was initiated at a rate of 0.25 mm four times a day. Ultrasonography was performed with a 5-10 MHz linear or convex transducer; new bone formation was defined as dotted or linear echogenic foci within a hypoechoic distraction gap. Initial ultrasonographic examination was performed 2-4 weeks after distraction, and the results were compared with those of plain radiography. Color doppler imaging was performed in three cases. After the Ilizarov bone lengthening procedure, ultrasound appears to be useful for follow-up examination. New bone formation, as well as complications, can be detected earlier; it can indicate whether ultrasound-guided interventional procedure is required, and if combined with color doppler study, is able to detect the periosteal blood supply. Further evaluation of the clinical significance of preserved periosteal blood supply seems however, to be needed. (author). 18 refs., 4 figs

  19. Quadriceps Function and Knee Joint Ultrasonography after ACL Reconstruction.

    Science.gov (United States)

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

    2018-02-01

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

  20. Three-dimensional ultrasonography in the diagnosis of deep endometriosis.

    Science.gov (United States)

    Guerriero, Stefano; Saba, Luca; Ajossa, Silvia; Peddes, Cristina; Angiolucci, Marco; Perniciano, Maura; Melis, Gian Benedetto; Alcázar, Juan Luis

    2014-06-01

    In the use of 'tenderness-guided' transvaginal ultrasound, is the diagnostic accuracy of three-dimensional (3D) ultrasonography better than two-dimensional (2D) ultrasonography in the identification of deep endometriosis? Three-dimensional ultrasonography has a significantly higher diagnostic accuracy in the diagnosis of posterior locations of deep endometriosis without intestinal involvement, such as the uterosacral ligaments, vaginal and rectovaginal endometriosis. The only previous study of the diagnosis of posterior compartment endometriosis reported an poor sensitivity of 3D ultrasonography for uterosacral and sigmoid colon involvement. This diagnostic test study included 202 patients scheduled for surgery because of clinical suspicion of deep pelvic endometriosis and was carried out between January 2009 and September 2012. Modified transvaginal ultrasonography was performed on all of the women by a single examiner. Two locations of deep endometriosis were considered: intestinal involvement and other posterior lesions (including vaginal location, rectovaginal septum and uterosacral ligaments). Once the 2D ultrasonography had been performed, the 3D acquisition was performed and the obtained volume was stored. To avoid the risk of recall bias, the same operator evaluated the 3D volumes 6 months after the last examination using virtual navigation to provide a presumptive diagnosis of the presence and localization of deep endometriosis. In addition, to evaluate the reproducibility of 3D, two operators with different levels of expertise performed a retrospective review of 3D volumes from a random sample of 35 patients, twice, 1 week apart to also assess intraobserver agreement. The diagnostic performance of both tests was expressed as area under the receiver-operating characteristics curve (AUC), sensitivity, specificity, positive and negative predictive values, positive (LR+) and negative (LR-) likelihood ratios, with their respective 95% confidence interval (CI

  1. Intraoperative ultrasonography of liver, bile ducts and pancreas

    Directory of Open Access Journals (Sweden)

    Luciana Mendes de Oliveira Cerri

    Full Text Available The use of intraoperative ultrasonography (IOUS to evaluate liver, bile ducts and pancreatic disease, as compared to the results of preoperative ultrasonography and CT, is discussed. Forty-two patients who underwent abdominal surgery for suspected hepatobiliary and/or pancreatic disease were studied. The intraoperative study was carried out with a portable apparatus (Aloka 500, Japan, using 5.0 MHz and 7.5 MHz linear sterile transducers. The main indications for IOUS were the search for and/or evaluation of primary hepatic masses,hepatic abscesses or metastases, obstructive jaundice, or neuroendocrine tumors. In 15 cases (38.5 percent from the hepatobiliary group and in 7 cases (58.3 percent from the pancreatic group, a difference between preoperative and intraoperative findings was observed. The main difference was observed in relation to the number and size of hepatic and pancreatic lesions. The relationship between the lesions and the vascular structures was evaluated through IOUS. The method was also used to guide surgical procedures such as biopsies, the alcoholization of nodules, and the drainage of abscesses. IOUS plays an important role in detecting small hepatic and pancreatic nodules, in the assessment of anatomical relationships between the lesions and the vascular structures, and in the performance of interventionist procedures.

  2. Validation of equations for pleural effusion volume estimation by ultrasonography.

    Science.gov (United States)

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

    2017-12-01

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

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

    Science.gov (United States)

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

    2012-10-01

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

  4. Ultrasonography and computed tomography in the study of orbital tumors and pseudo-tumoral lesions

    International Nuclear Information System (INIS)

    Marins, J.L.C.; Pereira, R.M.; Prando, A.; Selos Moreira, A.R. de

    1987-01-01

    The computerized tomography and the ultrasonography in the ocular and orbital patologies were considered as complementary each other. the ultrasonography method as choice for the detection of the eye lesions in the adult, particularly of vascular origin and in the follow-up of inflammatory and pseudo-tumoral lesions was chosen. (L.M.J.) [pt

  5. The detection of prostatic carcinoma. 4- or 7-MHz transrectal ultrasonography?

    NARCIS (Netherlands)

    Vleeming, R.; Noordzij, J. W.; de Reijke, T. M.; Kurth, K. H.

    1993-01-01

    In this prospective study a comparison of 4-versus 7-MHz transrectal ultrasonography for the detection of prostatic carcinoma is reported. A total of 150 prostates were biopsied due to suspicion of malignancy arising at either digital rectal examination, 4- and/or 7-MHz transrectal ultrasonography,

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

    Science.gov (United States)

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

    2017-11-01

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

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

    NARCIS (Netherlands)

    Emanuel, M. H.; Verdel, M. J.; Wamsteker, K.; Lammes, F. B.

    1995-01-01

    We determined the diagnostic value of transvaginal ultrasonography for endometrial and intrauterine abnormalities in patients with abnormal uterine bleeding. Between June 1, 1992, and June 1, 1993, 279 consecutive patients underwent transvaginal ultrasonography. Findings were compared with the final

  8. Muscle-tendon-related abnormalities detected by ultrasonography are common in symptomatic hip dysplasia

    DEFF Research Database (Denmark)

    Jacobsen, Julie Sandell; Bolvig, Lars; Hölmich, Per

    2018-01-01

    INTRODUCTION: Hip dysplasia is characterized by reduced acetabular coverage of the femoral head leading to an increased mechanical load on the hip joint and the acting hip muscles. Potentially, the muscles and tendons functioning close to the hip joint may present with overuse......-related ultrasonography findings. The primary aim was to report the prevalence of muscle-tendon-related abnormalities detected by ultrasonography in 100 patients with symptomatic hip dysplasia. The secondary aim was to investigate correlations between muscle-tendon-related abnormalities detected by ultrasonography......-tendon-related abnormalities detected by ultrasonography in the hip and groin region are common in patients with symptomatic hip dysplasia, and the ultrasonography findings of the iliopsoas and gluteus medius/minimus tendons are weakly to moderately correlated to pain related to muscles and tendons in these structures. Both...

  9. Ultrasonography and prostate-specific antigen (PSA) in differential diagnosis of prostate cancer and benign prostatic hyperplasia

    International Nuclear Information System (INIS)

    Mechev, D.S.; Shcherbyina, O.V.; Yatsik, V.Yi.; Gladka, L.Yu.

    2003-01-01

    The purpose of the work is analysis of diagnostic possibilities of transrectal ultrasonography and PSA in differential diagnosis of prostate cancer and benign prostatic hyperplasia. 142 patients have been investigated by transrectal ultrasonography. he transrectal ultrasonography and PSA are sensible tests in diagnosis of prostate cancer and in differential diagnosis of benign prostatic hyperplasia and prostate cancer

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

    International Nuclear Information System (INIS)

    Lee, Myoung Seok; Cho, Jeong Yeon; Kim, Sang Youn; Kim, Seung Hyup; Park, Joong Shin; Jun, Jong Kwan

    2017-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myoung Seok [Dept. of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul (Korea, Republic of); Cho, Jeong Yeon; Kim, Sang Youn; Kim, Seung Hyup [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Park, Joong Shin; Jun, Jong Kwan [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    2017-01-15

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

  12. Ultrasonography-guided cobalt-60 brachytherapy for malignant glioma

    International Nuclear Information System (INIS)

    Sakai, Noboru; Takenaka, Katsunobu; Ueda, Tatsuya

    1989-01-01

    Brachytherapy with cobalt-60 source is reported. In this method it is characterized that the source is inserted interstitially with remote control system by after-loading method via outer catheter (using tandem tube), which was established in the center of residual tumor, using ultrasonography guide with trepanation, or intraoperatively put within the dead space after tumor resection. Six cases of deep-seated and recurrent malignant glioma, were treated with this method. A total dose of 20 to 45 Gy (10 to 15 Gy/day for 2 to 3 days) was delivered to the target. Additionally conventional external irradiation was followed. The effect of cobalt-60 brachytherapy on such tumors were favorable especially for well-circumscribed glioma less than 3 cm on CT scan. (author)

  13. Ultrasonography, CT, and ERCP in the diagnosis of choledochal stones

    International Nuclear Information System (INIS)

    Pasanen, P.; Partanen, K.; Pikkarainen, P.; Alhava, E.; Pirinen, A.; Janatuinen, E.

    1992-01-01

    A prospective study of jaundiced (n = 187) and nonjaundiced (n = 33) cholestatic patients was carried out to evaluate the sensitivity of ultrasonography (US), CT and endoscopic retrograde cholangiopancreatography (ERCP) in the detection of choledochal stone disease. Altogether 83 patients had the final diagnosis of choledocholithiasis. In the jaundiced patients, the sensitivity of US, CT, and ERCP was 22,5%, 23,2%, and 80,6%, respectively. In cases of cholestasis without jaundice, the values were 20%, 37,5%, and 66,7%. In patients in whom all 3 imaging studies were done (n = 64), the differences between US and ERCP and between CT and ERCP were statistically significant (p < 0.0001). In most false-negative ERCP studies (10/15), the clinical course of the disease strongly suggested a passed choledochal stone. On the basis of this study, we recommend prompt ERCP to be performed if choledochal stone disease is suspected on clinical grounds. (orig.)

  14. Medical auditing of whole-breast screening ultrasonography.

    Science.gov (United States)

    Kim, Min Jung

    2017-07-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

  16. The core content of clinical ultrasonography fellowship training.

    Science.gov (United States)

    Lewiss, Resa E; Tayal, Vivek S; Hoffmann, Beatrice; Kendall, John; Liteplo, Andrew S; Moak, James H; Panebianco, Nova; Noble, Vicki E

    2014-04-01

    The purpose of developing a core content for subspecialty training in clinical ultrasonography (US) is to standardize the education and qualifications required to provide oversight of US training, clinical use, and administration to improve patient care. This core content would be mastered by a fellow as a separate and unique postgraduate training, beyond that obtained during an emergency medicine (EM) residency or during medical school. The core content defines the training parameters, resources, and knowledge of clinical US necessary to direct clinical US divisions within medical specialties. Additionally, it is intended to inform fellowship directors and candidates for certification of the full range of content that might appear in future examinations. This article describes the development of the core content and presents the core content in its entirety. © 2014 by the Society for Academic Emergency Medicine.

  17. Medical auditing of whole-breast screening ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Min Jung [Dept. of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2017-07-15

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

  18. Endoscopic ultrasonography and rectal duplication cyst in an adult.

    Science.gov (United States)

    Castro-Poças, Fernando M; Araújo, Tarcísio P; Silva, Jorge D; Gonçalves, Vicente S

    2017-01-01

    Rectal duplication cysts account for 4% of all duplications of the alimentary tract. Presentation in adulthood is rare. An asymptomatic 54-year-old man was referred for endoscopic colorectal cancer screening. A bulging mass covered by normal mucosa was identified in the rectum. Endoscopic ultrasonography (EUS) with fine needle aspiration (FNA) was made for a diagnosis of rectal duplication cyst. The patient was operated and the diagnosis was confirmed. The diagnosis of the rectal duplication cyst is a challenge. EUS may have a singular role when identifying a muscular layer, because this is the only absolutely necessary criterion for the diagnosis. FNA by EUS may eventually identify colorectal and/or heterotypic epithelium that are the other diagnostic criteria of the duplication cyst.

  19. Cholangiocarcinoma in Magnetic Resonance Cholangiopancreatography and Fascioliasis in Endoscopic Ultrasonography

    Directory of Open Access Journals (Sweden)

    Amir Houshang Mohammad Alizadeh

    2011-10-01

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

  20. Clinical impact of endoscopic ultrasonography at a county hospital

    DEFF Research Database (Denmark)

    Ainsworth, A P; Mortensen, M B; Durup, J

    2002-01-01

    BACKGROUND AND STUDY AIMS: Although endoscopic ultrasonography (EUS) is a well-described examination method, there have been few reports concerning its clinical impact. The aim of this study was to describe EUS as it is performed at a county hospital, with an emphasis on the indications...... and clinical outcome. PATIENTS AND METHODS: Patients examined using EUS between December 1997 and November 2000 were recorded prospectively. Follow-up was conducted by examining each patient's medical records at least 3 months after the investigation. The EUS findings were compared with the patient's final...... management strategy in 80 patients (24 %). CONCLUSIONS: EUS has a high level of accuracy and a substantial clinical impact when performed in an unselected population. The estimated numbers of investigations needed appear to justify setting up an EUS center at institutions with a catchment population of 350...

  1. Ultrasonography of small intestinal obstructions: a contemporary approach.

    Science.gov (United States)

    Garcia, D A A; Froes, T R; Vilani, R G D O C; Guérios, S D; Obladen, A

    2011-09-01

    To assess the accuracy of intestinal ultrasound for diagnosis of intestinal obstruction in dogs and cats. A prospective clinical study was performed. Inclusion criteria were dogs and cats with clinical signs suggestive of gastrointestinal obstruction. Animals with no obstruction detected on ultrasound were excluded if they could not be monitored for 48 hours to confirm absence of obstruction. Sonographic diagnosis of small intestinal obstruction was based on identification of at least two findings suggestive of intestinal obstruction. Ninety-two patients suspected of having intestinal obstruction were included. Correct diagnosis of intestinal obstruction was made in 21 cases (23%), and in 68 (74%) this diagnosis was excluded. Interpretation of the images on prospective analysis had sensitivity, positive predictive, specificity and negative predictive values of 100%, 87.5%, 95.8% and 100%, respectively. Ultrasonography is an excellent method for investigation of animals with gastrointestinal disorders, and is particularly useful for excluding obstructive processes. © 2011 British Small Animal Veterinary Association.

  2. Bedside Ultrasonography: A Useful Tool For Traumatic Pneumothorax

    International Nuclear Information System (INIS)

    Mumtaz, U.; Zahur, Z.; Chaudhry, M. A.; Warraich, R. A.

    2016-01-01

    Objective: To compare the diagnostic accuracy of bedside ultrasound and supine chest radiography for the diagnosis of traumatic pneumothorax. Study Design: Analytical study. Place and Duration of Study: PIMS and PAEC General Hospital, Islamabad, from November 2014 to August 2015. Methodology: Patients coming to emergency departments of the study centres, who had sustained chest injuries, were inducted. Their portable bedside ultrasound and supine chest radiographs were taken for assessing pneumothorax and subsequently CT chest was done for confirmation as gold standard. Result: Based on CT findings, sensitivity for ultrasonography and chest radiography was found to be 83.33 percentage and 54.76 percentage, respectively and specificity of 100 percentage for both modalities. Conclusion: Ultrasound can be used as a useful and suitable adjunct to CT in trauma patients as it is easily available, non-invasive, bedside, easily examined with no radiation risk. (author)

  3. An audit of ultrasonography performed and reported by trainee radiologists.

    Science.gov (United States)

    Eze, K C; Marchie, T T; Eze, C U

    2009-01-01

    Proforma information, instructions and procedures of training in radiology are lacking in Nigeria. To describe the errors in ultrasonography performed by unsupervised trainee radiologists. The radiology records of all ultrasound scans (USS) carried out and all reports that came back to the unit of the authors on account of misdiagnosis, doubtful diagnosis, misinformation or error in the reports were studied. The patients with the returned reports were rescanned where available by consultants and the collected data analysed. A total of 4680 patients had ultrasound studies without supervision resulting in 605 (12.93%) queried reports. The USS scans of 235 (5.02%) patients were repeated with consultants in attendance resulting in significant change in reports of 95 (2.03%) patients. Analysis of the request cards of 605 queried reports showed omission of relevant clinical information 463 (76.53%), outright wrong information 65 (10.73%),and unconventional abbreviations 139 (22.98%), while 493 (81.49%) were completed by a nurse, medical student or junior resident. Typographical errors comprised 174 (28.76%) of the 605 queried reports. False negative error was the highest type of error seen in 55 (57.89%) of the 95 patients with significant change in their report after repeat scan as lesions not detected were not documented. Trainee radiologists make significant errors in carrying out and reporting ultrasonography without adequate direct supervision of the study by their training consultants. Majority of the errors originate from lack of accurate filling of the patients request cards by the requesting physicians, lack of adequate preparation for the intended study, and typographical errors in writing reports. False negative reports are by far the greatest cause of errors recorded as lesions not detected were not documented.

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

    Science.gov (United States)

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

    2013-03-01

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

  5. Contrast-enhanced endoscopic ultrasonography in digestive diseases.

    Science.gov (United States)

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

    2012-10-01

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

  6. Interobserver agreement on the interpretation of automated whole breast ultrasonography

    International Nuclear Information System (INIS)

    Kim, Eun Jeong; KIm, Sung Hun; Kang, Bong Joo; Kim, Yun Ju

    2014-01-01

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

  7. Interobserver agreement on the interpretation of automated whole breast ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Jeong; KIm, Sung Hun; Kang, Bong Joo; Kim, Yun Ju [Dept. of Radiology, Seoul St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

    2014-12-15

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

  8. Surveillance Duplex Ultrasonography of Stent Grafts for Popliteal Aneurysms.

    Science.gov (United States)

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

    2016-05-01

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

  9. Ultrasonography of pleural effusion. The quantification of minimal detectable volume

    International Nuclear Information System (INIS)

    Sustic, A.; Medved, I.; Ekl, D.; Simic, O.; Kovac, D.; Ivanis, N.

    2001-01-01

    Background. The aim of this study was to establish a minimal volume of free thoracic fluid in the pleural space of the supine cadaver detectable by ultrasonography. Material and methods. A prospective study with an experimental model on 20 cadavers (10 male, 10 female; age 66 ±11 yr.; height 172 ±9 cm; weight 75 ±12.6 kg; body surface area (BSA) 1.87 ±0.2 m 2 ) was used. Each cadaver was punctured bilaterally in 5 th or 6 th intercostal space at the medioclavicular line with venous cannula infusing in NaCl 0,9% solution at randomised speed in the chest. During the procedure the laterodorsal part of the thoracic wall next to the pulmonal base and phrenicocostal sinus was ultrasonographically scanned. At the moment of the visualisation of anechogenic line pertaining to the free fluid between dorsal thoracic wall and lungs, the installation was stopped and the amount of injected fluid verified. Results. Minimal, by ultrasonography detectable amount of free fluid in the right pleural space was 223±52 ml with the significant positive correlation to height (r = 0.69; p < 0.001), weight (r 0.68; p < 0.01) and the BSA (r = 0.71; p < 0.001) of cadaver. Detectable volume in the left pleural space was notably smaller than contra lateral, namely 172±53 ml also with a significant correlation to the cadaver's height (r = 0.55; p < 0.05), weight (r = 0.59; p < 0.01) and BSA (r = 0.60; p < 0.01). Conclusions. The authors affirm that ultrasonographically detectable quantity of free fluid in the chest positively correlates with height, weight and BSA of cadavers, and that the measured amount in the supine position is approximately 223 ml for the right space versus 172 ml for the left pleural space. (author)

  10. Feasibility of ultrasonography and MR arthrography during evaluation of rotator cuff injury

    International Nuclear Information System (INIS)

    Hu, Jin Guang; Lee, Jong Min; Ryeom, Hun Kyu

    2005-01-01

    To evaluate the feasibility of MR arthrography and ultrasonography in evaluating shoulder pain. The subject group consisted of all patients who visited our institute complaining of shoulder pain or instability form June 2002 to December 2004. There were a total of 92 patients with an mean age of 48. On the basis of arthroscopic results, the sensitivity, specificity, and accuracy of ultrasonography and MR arthrography were evaluated by comparing them with each other. In the diagnosis of separateness tendon tears, ultrasonography had sensitivity and specificity of 100% and 64%, respectively, whereas MR arthrography had sensitivity and specificity of 80% and 94%, respectively. Ultrasonography also had high sensitivity and specificity in the diagnosis of subscapularis tendon tears (100% and 90%). MR arthrography was appropriate for identifying glenoid labral abnormalities (sensitivity, 95% and specificity, 61%). Similar results from ultrasonography and MR arthrography were obtained in the diagnosis of subscapular tendon tears or full-thickness tears of the rotator cuff tendons (kappa value, 0.644 and 0.911). While evaluating rotator cuff abnormalities, ultrasonography was appropriate for screening, whereas MR arthrography was useful to confirm the results of the ultrasonography

  11. Comparison between mammography and ultrasonography for palpable breast mass: focusing fibroadenoma and breast cancer

    International Nuclear Information System (INIS)

    Kim, Do Kyun; Koh, Mi Kyung; Choi, Chul Soon; Chung, Soo Young; Yi, Jeong Geun; Yoon, Dae Young; Kim, Ho Chul; Bae, Sang Hoon

    1997-01-01

    The purpose of our study was to compare the diagnostic accuracy of mammography and breast ultrasonography between fibroadenoma and palpable breast cancer and to evaluate the feasibility of ultrasonography as a primary diagnostic modality to differentiate between these two tumor types. In 36 cases of fibroadenoma and 35 of breast cancer, all palpable and pathologically-proven, the diagnostic accuracy of mammography and ultrasonography was retros-pectively analysed. In fibroadenoma cases, the diagnostic accuracy of mammography and ultrasonography was 53% and 80%, respectively, and the difference was statistically significant(p=3D0.0162). In cases of breast cancer, the corresponding figures were 74% and 82%, respectively;the difference was not statistically signigicant(p-0.55). Overall, the diagnostic accuracy of mammography and ultrasonog-raphy was 63% and 82%, respectively, and this difference was statistically significant(p=3D0.0164). The total diagnostic accuracy of both studies was 90%, and this was signigicantly different(p=3D0.044) from that of ultrasonography(82%). In patients who have clinically palpable breast masses, ultrasonography can be recommended as the primary diagnostic modality, though for other breast lesions, mammography is the recommended primary modality.=20

  12. Comparison between mammography and ultrasonography for palpable breast mass: focusing fibroadenoma and breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Do Kyun; Koh, Mi Kyung; Choi, Chul Soon; Chung, Soo Young; Yi, Jeong Geun; Yoon, Dae Young; Kim, Ho Chul; Bae, Sang Hoon [Hallym Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-09-01

    The purpose of our study was to compare the diagnostic accuracy of mammography and breast ultrasonography between fibroadenoma and palpable breast cancer and to evaluate the feasibility of ultrasonography as a primary diagnostic modality to differentiate between these two tumor types. In 36 cases of fibroadenoma and 35 of breast cancer, all palpable and pathologically-proven, the diagnostic accuracy of mammography and ultrasonography was retros-pectively analysed. In fibroadenoma cases, the diagnostic accuracy of mammography and ultrasonography was 53% and 80%, respectively, and the difference was statistically significant(p=3D0.0162). In cases of breast cancer, the corresponding figures were 74% and 82%, respectively;the difference was not statistically signigicant(p-0.55). Overall, the diagnostic accuracy of mammography and ultrasonog-raphy was 63% and 82%, respectively, and this difference was statistically significant(p=3D0.0164). The total diagnostic accuracy of both studies was 90%, and this was signigicantly different(p=3D0.044) from that of ultrasonography(82%). In patients who have clinically palpable breast masses, ultrasonography can be recommended as the primary diagnostic modality, though for other breast lesions, mammography is the recommended primary modality.=20.

  13. Comparison of helical computed tomography and ultrasonography in diagnosis of acute appendicitis

    International Nuclear Information System (INIS)

    Nafees, M.; Abbas, G.; Sarwar, S.

    2010-01-01

    The objective of study is to compare the diagnostic accuracy of helical computed tomography and ultrasonography in acute appendicitis using histopathology as gold standard. Thirty cases of clinically suspected acute appendicitis were included in the study selected on non probability convenience sampling technique. Computed tomography and graded compression ultrasonography of right lower quadrant of abdomen were conducted and results compared with histopathological findings. Amongst 30 patients who underwent computed tomography and graded compression ultrasonography examinations of right lower quadrant for diagnosis of acute appendicitis, on computed tomography 19 were diagnosed with acute appendicitis, 10 were diagnosed as not having the disease and 01 patient diagnosed as not having appendicitis on computed tomography did not improve clinically, was operated upon and histopathology proved it as acute appendicitis. While on graded compression ultrasonography 15 were diagnosed with acute appendicitis, 11 were diagnosed as not having the disease and 04 patients diagnosed as not having appendicitis on ultrasonography, did not improve clinically, were operated upon and histopathology proved it as acute appendicitis. This showed that CT scan has sensitivity of 95%, specificity 100%, positive predictive value 100%, negative predictive value 90.91% and overall accuracy of 96.67% while ultrasonography has sensitivity of 78.9%, specificity 100%, positive predictive value 100%, negative predictive value 73.33% and overall accuracy of 86.67%. We concluded that Helical computed tomography is highly accurate in diagnosing acute appendicitis as compared to ultrasonography and it helps to reduce negative appendectomy rate. (author)

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ji Hyun Youk

    2017-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Youk, Ji Hyun; Gweon, Hye Mi; Son, Eun Ju [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2017-10-15

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

  17. Determination of gestational age by ultrasonography - wrong, wrong and wrong again?

    International Nuclear Information System (INIS)

    Bratlid, D.

    1991-01-01

    The article is a critical review of principal weaknesses in the current use of ultrasonography for determination of gestational age and discusses the fact that the method in its practical use disregards any biological variation in biparietal diameter. It is concluded that second trimester determination of gestational age by ultrasonography has an accuracy no greater than ±1.5 weeks. This is comparable to the accuracy of the clinical assessment of maturation in the newborn baby. Ultrasonography as the main indicator of gestational age should be used only when the pregnant woman's own menstrual history is obviously incorrect. 6 refs., 1 fig

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

    Science.gov (United States)

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

    2014-05-01

    A retrospective review of case records of ultrasonography and necropsy outcomes of 62 koalas was used to investigate the accuracy of ultrasonography in assessing koala urogenital tract structural disease at the Port Macquarie Koala Hospital. The results showed high concordance, supporting ultrasonography as an effective tool for evaluating structural disease of the koala urogenital tract, most commonly seen with chlamydiosis. The study also illustrates the advances benefiting animal welfare that can be made by wildlife carer groups through using a scientific, evidence-based approach. © 2014 Australian Veterinary Association.

  19. Role of ultrasonography in the evaluation of children with acute abdomen in the emergency set-up

    Directory of Open Access Journals (Sweden)

    Aviral

    2005-01-01

    Full Text Available Background: Acute abdomen in children has been aptly described as Pandora′s box. Unlike computerized tomography (CT scan, ultrasonography (USG has no radiation hazard and the present study analyses the diagnostic yield of the USG in acute abdomen in children. Materials and Methods: Between September 2001 to October 2003, 75 patients with acute abdomen underwent clinical examination, routine biochemical tests, erect X-ray abdomen, USG and CT scan. Laparotomy and histological examination established final diagnosis. Results: The accuracy of correct diagnosis was 60%, 66.6%, 64%, 98.7% with clinical examination alone, USG alone, clinical examination combined with conventional radiography, and clinical evaluation combined with conventional radiography and USG respectively. USG helped to prevent unnecessary laparotomy in 16.3% of patients. Conclusions: USG is good investigative modality in the management of acute abdomen in children.

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

    Science.gov (United States)

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

    2017-12-01

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

  1. Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study.

    Science.gov (United States)

    Sovio, Ulla; White, Ian R; Dacey, Alison; Pasupathy, Dharmintra; Smith, Gordon C S

    2015-11-21

    Fetal growth restriction is a major determinant of adverse perinatal outcome. Screening procedures for fetal growth restriction need to identify small babies and then differentiate between those that are healthy and those that are pathologically small. We sought to determine the diagnostic effectiveness of universal ultrasonic fetal biometry in the third trimester as a screening test for small-for-gestational-age (SGA) infants, and whether the risk of morbidity associated with being small differed in the presence or absence of ultrasonic markers of fetal growth restriction. The Pregnancy Outcome Prediction (POP) study was a prospective cohort study of nulliparous women with a viable singleton pregnancy at the time of the dating ultrasound scan. Women participating had clinically indicated ultrasonography in the third trimester as per routine clinical care and these results were reported as usual (selective ultrasonography). Additionally, all participants had research ultrasonography, including fetal biometry at 28 and 36 weeks' gestational age. These results were not made available to participants or treating clinicians (universal ultrasonography). We regarded SGA as a birthweight of less than the 10th percentile for gestational age and screen positive for SGA an ultrasonographic estimated fetal weight of less than the 10th percentile for gestational age. Markers of fetal growth restriction included biometric ratios, utero-placental Doppler, and fetal growth velocity. We assessed outcomes for consenting participants who attended research scans and had a livebirth at the Rosie Hospital (Cambridge, UK) after the 28 weeks' research scan. Between Jan 14, 2008, and July 31, 2012, 4512 women provided written informed consent of whom 3977 (88%) were eligible for analysis. Sensitivity for detection of SGA infants was 20% (95% CI 15-24; 69 of 352 fetuses) for selective ultrasonography and 57% (51-62; 199 of 352 fetuses) for universal ultrasonography (relative sensitivity 2

  2. Discrepancy between ultrasonography and hysteroscopy and histology of endometrium in postmenopausal breast cancer patients using tamoxifen

    NARCIS (Netherlands)

    Mourits, MJE; Van der Zee, AGJ; Willemse, PHB; Ten Hoor, KA; Hollema, H; De Vries, EGE

    Background. The increased risk of endometrial carcinoma following the use of tamoxifen has stimulated studies on endometrial diagnostic screening methods. In tamoxifen users the endometrial thickening observed with transvaginal ultrasonography (TVU) frequently cannot be confirmed by hysteroscopy or

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

    Directory of Open Access Journals (Sweden)

    Hakim Athar

    2010-01-01

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

  4. Ultrasonography of pediatric urogenital emergencies: review of classic and new techniques

    Directory of Open Access Journals (Sweden)

    Masahiro Kitami

    2017-07-01

    Full Text Available Urogenital emergencies are fairly common in the pediatric population, and a timely and correct diagnosis is necessary to avoid possible future infertility. In this field, ultrasonography is essential, as it has the advantages of being radiation-free and readily accessible. In particular, a high-frequency transducer allows precise evaluation of the morphology and vascularity of the scrotum, which is on the surface of the body. Beyond conventional techniques, new advanced imaging techniques have been developed, including elastography and contrast-enhanced ultrasonography. However, several pitfalls remain in the diagnosis of urogenital diseases using ultrasonography. Thus, accurate knowledge and sufficient experience with the technique are essential for making a correct diagnosis. This review provides an overview of pediatric urogenital emergency pathologies and recent ultrasonography techniques.

  5. Reliability of ultrasonography in detecting shoulder disease in patients with rheumatoid arthritis.

    LENUS (Irish Health Repository)

    Bruyn, G A W

    2009-03-01

    To assess the intra and interobserver reproducibility of musculoskeletal ultrasonography (US) among rheumatologists in detecting destructive and inflammatory shoulder abnormalities in patients with rheumatoid arthritis (RA) and to determine the overall agreement between US and MRI.

  6. Ultrasonography of pediatric urogenital emergencies: review of classic and new techniques

    Energy Technology Data Exchange (ETDEWEB)

    Kitami, Masahiro [Dept. of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai (Japan)

    2017-07-15

    Urogenital emergencies are fairly common in the pediatric population, and a timely and correct diagnosis is necessary to avoid possible future infertility. In this field, ultrasonography is essential, as it has the advantages of being radiation-free and readily accessible. In particular, a high-frequency transducer allows precise evaluation of the morphology and vascularity of the scrotum, which is on the surface of the body. Beyond conventional techniques, new advanced imaging techniques have been developed, including elastography and contrast-enhanced ultrasonography. However, several pitfalls remain in the diagnosis of urogenital diseases using ultrasonography. Thus, accurate knowledge and sufficient experience with the technique are essential for making a correct diagnosis. This review provides an overview of pediatric urogenital emergency pathologies and recent ultrasonography techniques.

  7. The use of multi-detector computed tomography and ultrasonography for evaluation of pleural lesions

    Directory of Open Access Journals (Sweden)

    Adel Salah Bediwy

    2015-01-01

    Conclusion: MDCT is an important noninvasive imaging tool in accurate detection and characterization of pleural lesions with complementary MPR images that solve many diagnostic problems. Ultrasonography is a safer alternative but with less diagnostic value.

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

    Directory of Open Access Journals (Sweden)

    Iwona Sudoł-Szopińska

    2017-09-01

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

  9. Reliability of ultrasonography in detecting shoulder disease in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Bruyn, G. A. W.; Naredo, E.; Moeller, I.; Moragues, C.; Garrido, J.; de Bock, G. H.; d'Agostino, M-A; Filippucci, E.; Iagnocco, A.; Backhaus, M.; Swen, W. A. A.; Balint, P.; Pineda, C.; Milutinovic, S.; Kane, D.; Kaeley, G.; Narvaez, F. J.; Wakefield, R. J.; Narvaez, J. A.; de Augustin, J.; Schmidt, W. A.; Moller, I.; Swen, N.; de Agustin, J.

    Objective: To assess the intra and interobserver reproducibility of musculoskeletal ultrasonography ( US) among rheumatologists in detecting destructive and inflammatory shoulder abnormalities in patients with rheumatoid arthritis ( RA) and to determine the overall agreement between US and MRI.

  10. Solitary extramedullary plasmacytomas of thyroid in Hashimoto's thyroiditis: Mimicking benign cystic nodule on ultrasonography

    International Nuclear Information System (INIS)

    Kwon, Yohan; Kim, Soo Jin; Hur, Joon Ho; Park, Sung Hee; Lee, Sun Jin; Lee, Tae Jin

    2013-01-01

    Solitary extramedullary plasmacytoma (SEP) of the thyroid is uncommon and mostly occur in patients with a Hashimoto's thyroiditis (82%). We present a case on SEP of thyroid in Hashimoto's thyroiditis, which mimics growing benign cystic masses on serial ultrasonography.

  11. Magnetic resonance pancreatography: comparison of two- and three-dimensional sequences for assessment of intraductal papillary mucinous neoplasm of the pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin-Young; Choi, Sun Young [Yonsei University Health System, Department of Radiology, Research Institute of Radiological Science, Seoul (Korea); Lee, Jeong Min; Kim, Soo Jin; Han, Joon Koo; Choi, Byung Ihn [Seoul National University College of Medicine, Department of Radiology and Institute of Radiation Medicine, Seoul (Korea); Lee, Min Woo [Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center, Seoul (Korea); Kim, Ji Yang [Seoul National University Hospital, Healthcare System Gangnam Center, Seoul (Korea)

    2009-09-15

    The purpose was to compare two-dimensional (2D) magnetic resonance pancreatography (MRP) with 3D MRP to evaluate intraductal papillary mucinous neoplasm (IPMN). Thirty-four patients (22 men, 12 women; age range, 45-80 years) with IPMN (n = 40) were examined with MRP on 2D and 3D sequences. Two readers independently reviewed the images to assess the overall image quality, artifacts, lesion location, communication with main pancreatic duct, and potential for malignancy. The readers assigned their confidence level (1-5) for predicting ductal communication of the lesion. The results of MRP were compared with endoscopic retrograde pancreatography and surgical and histopathologic findings. Studies obtained with 3D MRP were of significantly higher technical quality than those obtained with 2D MRP. Although 3D MRP showed higher area under the ROC curve (Az) values for predicting ductal communication of the lesion, there was no statistical significance between Az values of 2D and 3D MRP (Az for 2D = 0.821, 0.864 for readers 1 and 2, respectively, and Az for 3D= 0.964, 0.921). Accuracies for discriminating benign from malignant lesions were 70 and 67.5% (reader 1 and 2, respectively, for 2D) and 62.5 and 80.1% (3D). 3D MRP showed superior image quality to that of 2D MRP but did not increase the diagnostic accuracy for predicting ductal communication of the lesion. (orig.)

  12. Magnetic resonance pancreatography: comparison of two- and three-dimensional sequences for assessment of intraductal papillary mucinous neoplasm of the pancreas

    International Nuclear Information System (INIS)

    Choi, Jin-Young; Choi, Sun Young; Lee, Jeong Min; Kim, Soo Jin; Han, Joon Koo; Choi, Byung Ihn; Lee, Min Woo; Kim, Ji Yang

    2009-01-01

    The purpose was to compare two-dimensional (2D) magnetic resonance pancreatography (MRP) with 3D MRP to evaluate intraductal papillary mucinous neoplasm (IPMN). Thirty-four patients (22 men, 12 women; age range, 45-80 years) with IPMN (n = 40) were examined with MRP on 2D and 3D sequences. Two readers independently reviewed the images to assess the overall image quality, artifacts, lesion location, communication with main pancreatic duct, and potential for malignancy. The readers assigned their confidence level (1-5) for predicting ductal communication of the lesion. The results of MRP were compared with endoscopic retrograde pancreatography and surgical and histopathologic findings. Studies obtained with 3D MRP were of significantly higher technical quality than those obtained with 2D MRP. Although 3D MRP showed higher area under the ROC curve (Az) values for predicting ductal communication of the lesion, there was no statistical significance between Az values of 2D and 3D MRP (Az for 2D = 0.821, 0.864 for readers 1 and 2, respectively, and Az for 3D= 0.964, 0.921). Accuracies for discriminating benign from malignant lesions were 70 and 67.5% (reader 1 and 2, respectively, for 2D) and 62.5 and 80.1% (3D). 3D MRP showed superior image quality to that of 2D MRP but did not increase the diagnostic accuracy for predicting ductal communication of the lesion. (orig.)

  13. Smoking increased the risk of prostate cancer with grade group ≥ 4 and intraductal carcinoma in a prospective biopsy cohort.

    Science.gov (United States)

    Tang, Bo; Han, Cheng-Tao; Gan, Hua-Lei; Zhang, Gui-Ming; Zhang, Cui-Zhu; Yang, Wei-Yi; Shen, Ying; Zhu, Yao; Ye, Ding-Wei

    2017-06-01

    To investigate the association between smoking and different prostate cancer (PCa) pathological subtypes incidence in Chinese men. We prospectively included 1795 patients who underwent prostate biopsies in one tertiary center between March 2013 and April 2016. Clinical data and biopsy outcomes were collected. Logistic regression was used to evaluate the association between cigarette smoking and PCa incidence. A total of 737 men, 480 men and 58 men were diagnosed with PCa, high-grade PCa (HGPCa, grade group ≥ 4 as accepted by the 2014 ISUP) and intraductal carcinoma of the prostate (IDC-P), respectively. Current smokers had a significantly higher risk of HGPCa than never smokers (OR = 1.89, 95%CI: 1.44-2.48). No such association was observed for low-grade disease and cigarette smoking (OR = 0.84, 95%CI: 0.61-1.16). In a sub-analysis, men who had smoked longer than 30 years had a higher risk of HGPCa, compared with men who had smoked fewer than 30 years (OR = 1.50, 95%CI: 1.09-2.06). Current smokers were more likely to develop IDC-P than never smokers (OR = 2.29, 95%CI: 1.14-4.59). Among men in this Chinese biopsy cohort, current smoking was associated with highly malignant PCa incidence, such as HGPCa and IDC-P. The duration of smoking may be associated with HGPCa. © 2017 Wiley Periodicals, Inc.

  14. Pancreatic-duct-lavage cytology in candidates for surgical resection of branch-duct intraductal papillary mucinous neoplasm of the pancreas: should the International Consensus Guidelines be revised?

    Science.gov (United States)

    Sai, Jin Kan; Suyama, Masafumi; Kubokawa, Yoshihiro; Watanabe, Sumio; Maehara, Tadayuki

    2009-03-01

    The International Consensus Guidelines are helpful for the management of branch-duct intraductal papillary mucinous neoplasms (IPMNs), because they allow us to exclude malignancy. However, it is not possible to predict malignancy with certainty, and further preoperative differentiation between benign and malignant IPMNs is required to avoid the false-positive results. To examine the usefulness of pancreatic-duct-lavage cytology by using an originally designed double-lumen catheter for discriminating benign and malignant IPMNs of the branch-duct type in candidates for surgical resection based on the International Consensus Guidelines. Pancreatic-duct-lavage cytology was investigated in 24 patients with branch-duct IPMNs who underwent surgical resection based on the International Consensus Guidelines, namely, they either had intramural nodules or the ectatic branch duct was >30 mm in diameter. Single-center retrospective study. Academic medical center. The sensitivity and specificity of pancreatic-duct-lavage cytology for discriminating benign from malignant IPMNs. More than 30 mL of pancreatic-duct-lavage fluid was obtained from each patient, and there were no patients with noninformative results. The sensitivity, specificity, positive predictive value, and negative predictive value of the cytologic diagnosis were 78%, 93%, 88%, and 88%, respectively. Single-center and small number of patients. Pancreatic-duct-lavage cytology can improve differentiation between benign and malignant IPMNs of the branch-duct type in candidates for surgical resection based on the International Consensus Guidelines.

  15. Mucinous Cystic Neoplasm of the Liver or Intraductal Papillary Mucinous Neoplasm of the Bile Duct? A Case Report and a Review of Literature.

    Science.gov (United States)

    Kunovsky, Lumir; Kala, Zdenek; Svaton, Roman; Moravcik, Petr; Mazanec, Jan; Husty, Jakub; Prochazka, Vladimir

    2018-01-01

    Mucinous cystic neoplasm of the liver (MCN-L) and intraductal papillary mucinous neoplasm of the bile duct (IPMN-B) are diagnoses that were classified by the World Health Organization in 2010 as mucin-producing bile duct tumors of the hepatobiliary system. The preoperative differential diagnosis between these two entities is difficult; the presence of a communication with the bile duct is usually considered as a typical sign of IPMN-B. However, the presence of an ovarian-like stroma (OLS) has been established to define the diagnosis of MCN-L. We present the case of a 33-year-old woman with a rapid progression of a cystic tumor of the liver. In 2 years, the lesion increased from 27 to 64 mm and a dilation of the left hepatic duct appeared. Percutaneous transhepatic drainage with a biopsy was performed. No malignant cells were found on biopsy. Because of the rapid progression of the cystic tumor and unclear malignant potential, left hemihepatectomy was performed. Even though tumor masses were present in the biliary duct, on the basis of the presence of OLS, histology finally confirmed MCN-L with intermediate-grade intraepithelial dysplasia to high-grade intraepithelial dysplasia. The patient is currently under oncologic follow-up with no signs of recurrence of the disease. We present a rare case where MCN-L caused a dilation of the left hepatic duct, a sign that is usually a characteristic of IPMN-B.

  16. Does secretin stimulation add to magnetic resonance cholangiopancreatography in characterising pancreatic cystic lesions as side-branch intraductal papillary mucinous neoplasm?

    International Nuclear Information System (INIS)

    Purysko, Andrei S.; Gandhi, Namita S.; Veniero, Joseph C.; Walsh, R.M.; Obuchowski, Nancy A.

    2014-01-01

    To assess the value of secretin during magnetic resonance cholangiopancreatography (MRCP) in demonstrating communication between cystic lesions and the pancreatic duct to help determine the diagnosis of side-branch intraductal papillary mucinous neoplasm (SB-IPMN). This is an IRB-approved, HIPAA-compliant retrospective study of 29 SB-IPMN patients and 13 non-IPMN subjects (control) who underwent secretin-enhanced MRCP (s-MRCP). Two readers blinded to the final diagnosis reviewed three randomised image sets: (1) pre-secretin HASTE, (2) dynamic s-MRCP and (3) post-secretin HASTE. Logistic regression, generalised linear models and ROC analyses were used to compare pre- and post-secretin results. There was no significant difference in median scores for the pre-secretin [reader 1: 1; reader 2: 2 (range -2 to 2)] and post-secretin HASTE [reader 1: 1; reader 2: 1 (range -2 to 2)] in the SB-IPMN group (P = 0.14), while the scores were lower for s-MRCP [reader 1: 0.5 (range -2 to 2); reader 2: 0 (range -1 to 2); P = 0.016]. There was no significant difference in mean maximum diameter of SB-IPMN on pre- and post-secretin HASTE, and s-MRCP (P > 0.05). Secretin stimulation did not add to MRCP in characterising pancreatic cystic lesions as SB-IPMN. (orig.)

  17. Does a family history of pancreatic ductal adenocarcinoma and cyst size influence the follow-up strategy for intraductal papillary mucinous neoplasms of the pancreas?

    Science.gov (United States)

    Mandai, Koichiro; Uno, Koji; Yasuda, Kenjiro

    2014-08-01

    This study aimed to evaluate the relationship between pancreatic ductal adenocarcinoma (PDAC) family history and PDAC development in patients followed up for intraductal papillary mucinous neoplasms (IPMNs) and to assess the cyst size relevance in determining follow-up strategies. We analyzed 300 patients with branch duct and mixed-type IPMN who were followed up at our facility. Among the patients aged 70 years or older, the frequency of PDAC did not differ significantly between those with 1 first-degree relative with PDAC and those without a family history. Although patients with IPMNs of greater than or equal to 30 mm were followed up for a significantly shorter duration than those patients with IPMNs of less than 30 mm, the frequency of IPMN progression and malignant IPMN was significantly greater in the former. The frequency of IPMN progression and pancreatic cancer did not differ significantly according to IPMN size (family history. Special attention should be paid to IPMN progression and malignant transformation in patients with IPMNs of greater than or equal to 30 mm, but cyst size need not be considered when determining follow-up strategies for patients with IPMNs of less than 30 mm without mural nodules.

  18. Post-ERCP pancreatogastric fistula associated with an intraductal papillary-mucinous neoplasm of the pancreas – a case report and literature review

    Directory of Open Access Journals (Sweden)

    Yasuda Yoshikazu

    2005-10-01

    Full Text Available Abstract Background Fistula formation has been reported in intraductal papillary-mucinous neoplasms (IPMNs with or without invasion of the adjacent organs. The presence or absence of invasion is mostly determined by postoperative histological examination rather than by preoperative work-up. Case presentation A 72 year-old Japanese woman showed remarkable dilatation of the main pancreatic duct (MPD in the distal region of the pancreas. Subsequent ERCP also showed MPD dilatation, after which the patient suffered moderate pancreatitis. A subsequent gastroscopy revealed a small ulceration that had not been observed in a gastroscopy performed 3 months prior. Mucinous discharge from the ulceration suggested it might be the orifice of a fistula connected to the MPD. En bloc resection including the distal region of the pancreas, spleen, stomach and part of the transverse colon was performed under the pre- and intraoperative diagnosis of an invasive malignant IPMN. However, histopathology revealed the lesion to be of "borderline malignancy" without apparent invasion of the stomach. Light microscopy showed inflammatory cellular infiltrates (mainly neutrophils around the pancreatogastric fistula, but there was no evidence of neoplastic epithelia lining the fistulous tract. Conclusion This case highlights that a pancreatogastric fistula can develop after acute inflammation of the pancreas in the absence of cancer invasion. Further information regarding IPMN-associated fistulae is necessary to clarify the pathogenesis, diagnosis, appropriate surgical intervention and prognosis for this disorder.

  19. Molecular alterations in lesions of anogenital mammary-like glands and their mammary counterparts including hidradenoma papilliferum, intraductal papilloma, fibroadenoma and phyllodes tumor.

    Science.gov (United States)

    Konstantinova, Anastasia M; Vanecek, Tomas; Martinek, Petr; Kyrpychova, Liubov; Spagnolo, Dominic V; Stewart, Colin J R; Portelli, Francesca; Michal, Michal; Kazakov, Dmitry V

    2017-06-01

    Lesions affecting anogenital mammary-like glands (AGMLG) are histopathologically very similar to those seen in the breast but whether this morphological similarity is also reflected at the genetic level is unknown. To compare the underlying molecular mechanisms in lesions of AGMLG and their mammary counterparts, we analyzed the mutational profile of 16 anogenital neoplasms including 5 hidradenomas papilliferum (HP), 1 lesion with features of HP and fibroadenoma (FA), 7 FA, 3 phyllodes tumors (PhT)) and 18 analogous breast lesions (6 intraductal papillomas (IDP), 9 FA, and 3 PhT) by high-coverage next generation sequencing (NGS) using a panel comprising 50 cancer-related genes. Additionally, all cases were analyzed for the presence of a mutation in the MED12 gene. All detected mutations with allele frequencies over 20% were independently validated by Sanger sequencing (concordance: 100%). Mutations in PIK3CA, AKT1, MET, ABL1 and TP53 genes were found in lesions of AGMLG and also their mammary counterparts. The PI3K-AKT cascade plays a role in tumors arising at both sites. It appears that some histopathologically similar anogenital and breast lesions develop along similar molecular pathways. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Risk Factors for Progression or Malignancy in Main-Duct and Mixed-Type Intraductal Papillary Mucinous Neoplasm of the Pancreas.

    Science.gov (United States)

    Jang, Dong Kee; Ryu, Ji Kon; Chung, Kwang Hyun; Lee, Ban Seok; Park, Joo Kyung; Lee, Sang Hyub; Kim, Yong-Tae

    2016-08-01

    The 2012 international guidelines state that surgery should be considered for all surgically fit patients with pancreatic main-duct (MD)/mixed intraductal papillary mucinous neoplasms (IPMNs). This study evaluated the follow-up results of MD/mixed IPMNs and risk factors for progression or malignancy. Patients with MD/mixed IPMNs were retrospectively enrolled and divided into surgical and nonsurgical groups. These 2 groups were compared and further categorized as progression/malignancy or not. In the nonsurgical group, disease progression was defined as radiologic tumor growth or adjacent organ invasion. Data from 101 patients (73 males; mean [SD] age, 66.3 [9.1] years), including 27 and 74 in the nonsurgical and surgical groups, respectively, were analyzed. Mural nodules were more frequently detected in the surgical group (7.4% vs 31.1%, P = 0.018), whereas more multifocal cysts were observed in the nonsurgical group (40.7% vs 20.3%, P = 0.037). Forty-one patients (40.6%) showed progression or malignancy. Multivariate analysis showed that main pancreatic duct of 10 mm or greater (odds ratio, 4.368; P = 0.024) and pre-existing diabetes (odds ratio, 3.077; P = 0.046) were independent risk factors for progression or malignancy. A watchful waiting strategy could be feasible for some patients with MD/mixed IPMNs, particularly those with a main pancreatic duct of less than 10 mm and without diabetes.

  1. An economic evaluation of second-trimester genetic ultrasonography for prenatal detection of down syndrome.

    Science.gov (United States)

    Vintzileos, A M; Ananth, C V; Fisher, A J; Smulian, J C; Day-Salvatore, D; Beazoglou, T; Knuppel, R A

    1998-11-01

    The objective of this study was to perform an economic evaluation of second-trimester genetic ultrasonography for prenatal detection of Down syndrome. More specifically, we sought to determine the following: (1) the diagnostic accuracy requirements (from the cost-benefit point of view) of genetic ultrasonography versus genetic amniocentesis for women at increased risk for fetal Down syndrome and (2) the possible economic impact of second-trimester genetic ultrasonography for the US population on the basis of the ultrasonographic accuracies reported in previously published studies. A cost-benefit equation was developed from the hypothesis that the cost of universal genetic amniocentesis of patients at increased risk for carrying a fetus with Down syndrome should be at least equal to the cost of universal genetic ultrasonography with amniocentesis used only for those with abnormal ultrasonographic results. The main components of the equation included the diagnostic accuracy of genetic ultrasonography (sensitivity and specificity for detecting Down syndrome), the costs of the amniocentesis package and genetic ultrasonography, and the lifetime cost of Down syndrome cases not detected by the genetic ultrasonography. After appropriate manipulation of the equation a graph was constructed, representing the balance between sensitivity and false-positive rate of genetic ultrasonography; this was used to examine the accuracy of previously published studies from the cost-benefit point of view. Sensitivity analyses included individual risks for Down syndrome ranging from 1:261 (risk of a 35-year-old at 18 weeks' gestation) to 1:44 (risk of a 44-year-old at 18 weeks' gestation). This economic evaluation was conducted from the societal perspective. Genetic ultrasonography was found to be economically beneficial only if the overall sensitivity for detecting Down syndrome was >74%. Even then, the cost-benefit ratio depended on the corresponding false-positive rate. Of the 7

  2. Effect of Ultrasonography on Student Learning of Shoulder Anatomy and Landmarks.

    Science.gov (United States)

    de Vries, Kristen D; Brown, Rebecca; Mazzie, Joseph; Jung, Min-Kyung; Yao, Sheldon C; Terzella, Michael J

    2018-01-01

    Ultrasonography is becoming more common in clinical use, and it has been shown to have promising results when introduced into medical school curricula. To determine whether the use of ultrasonography as an educational supplement can improve osteopathic medical students' confidence and ability to locate 4 specific shoulder anatomical landmarks: the coracoid process, the transverse process of T1, the long head of the biceps within the bicipital groove, and the supraspinatus tendon. In this randomized controlled study, first-year osteopathic medical students aged 18 years or older were recruited and randomly assigned to a group with exposure (ultrasonography group) or without exposure (control group) to an ultrasonography machine. First, a survey was administered to measure students' baseline knowledge of shoulder anatomy, confidence in palpation skills, and opinion on anatomical landmark identification teaching methods. Next, students were shown presentations on shoulder anatomy and allowed to practice locating and palpating the specified landmarks. Students in the ultrasonography group were also given instruction on the use of ultrasonography. All students were asked to locate each of the 4 specified anatomical landmarks and then given a follow-up survey. A Mann Whitney U test was used to compare the confidence of the students before and after the intervention. A secondary analysis was performed to compare the degree of deviance from the correct position of the specified anatomical landmark between the ultrasonography and control groups. P values less than .05 were considered statistically significant. Sixty-four students participated. Compared with the control group, students in the ultrasonography group had a greater increase in confidence after the session in their ability to locate the coracoid process, bicipital tendon, and supraspinatus tendon (P=.022, P=.029, P=.44, respectively). Students in the ultrasonography group were also able to more accurately palpate

  3. HIGH-RESOLUTION ULTRASONOGRAPHY OF SHOULDER FOR ROTATOR CUFF TEAR: CORRELATION WITH ARTHROSCOPIC FINDINGS

    OpenAIRE

    Vishnumurthy H. Y; Jagdeesh K. S; Anand K; Ranoji Mane; Sanath G. Kamte; Fathima Zohra; Banerji B. H; Sathish Servegar

    2016-01-01

    INTRODUCTION Rotator cuff disease is the most common cause of shoulder pain. Ultrasonography being non-invasive, widely available, more cost-effective method and is the first choice in imaging of rotator cuff tears. Arthroscopy of shoulder is considered as the gold standard for diagnosis of rotator cuff tears. Objective of this study was to compare the diagnostic accuracy of high-resolution ultrasonography of shoulder for rotator cuff tears with arthroscopy of shoulder. METHODS...

  4. Two cases of posterior scleritis and findings of computerized tomography and ultrasonography

    International Nuclear Information System (INIS)

    Ohara, Takakazu; Uji, Yukitaka; Fujioka, Chieko; Mori, Kazuma

    1982-01-01

    Two cases of unilateral posterior scleritis, seen in 56-year-old and 68-year-old females, are reported. Computerized tomography showed characteristic findings, as follows: 1) Thickening of the posterior sclera and surrounding tissue. 2) Irregularity of the posterior wall of the eyeball. 3) Increased radiographic density in the posterior wall of the eyeball. Ultrasonography also suggested thickening of the posterior sclera. Computerized tomography and ultrasonography are considered useful in the diagnosis of posterior scleritis. (author)

  5. Comparison of ultrasonography with radiography for the detection of cervical esophageal foreign body

    OpenAIRE

    Reza Pourrashidi; Shervin Sharifkashani; Hashem Sharifian; Habib Mazaher; Peyman Salamati; Batool Ghorbani yekta

    2013-01-01

    Background: Detection of retained foreign bodies remains a significant problem in the emergency department. Foreign bodies can go undetected causing infectious complications ultrasonography is too inaccessible and expensive. The purpose of this study is comparison of ultrasonography with radiography for the detection of cervical esophageal foreign bodiesMethods: This cross-sectional study evaluated 58 patients referred with suspected upper esophageal foreign body in the Emergency Department, ...

  6. Positioning Ultrasonography Into Clinical Practice for the Management of Crohn’s Disease

    Science.gov (United States)

    Zorzi, Francesca; Lolli, Elisabetta; Pallone, Francesco

    2015-01-01

    Over the past few years, the technical evolution of ultrasound equipment, the use of oral and intravenous contrast agents, and an increase in the expertise of operators have enhanced the role that ultrasonography plays in the assessment of the gastrointestinal tract. For patients with chronic inflammatory conditions, particularly Crohn’s disease, it has been suggested that ultrasonography can be used not only for diagnostic purposes but also in disease management. These developments are reviewed in this article. PMID:27118932

  7. Computed tomography, ultrasonography, and endoscopic retrograde cholangiopancreatography in the diagnosis of pancreatic disease

    International Nuclear Information System (INIS)

    Foley, W.D.; Stewart, E.T.; Lawson, T.L.; Maher, L.; Unger, G.F.; Geenan, J.; Loguidice, J.

    1980-01-01

    A prospective study was performed comparing the sensitivity of computed tomography, ultrasonography, and endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of pancreatic disease. Forty patients with suspected pancreatic carcinoma, acute recurrent or chronic pancreatitis, and/or jaundice were studied. CT was the most sensitive study in evaluation of pancreatitis. ERCP was most accurate in evaluation of pancreatic malignancy. Ultrasonography was the least sensitive method in detecting pancreatic disease and dilatation of the extrahepatic biliary ducts. (orig.) [de

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

    Science.gov (United States)

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

    2006-04-01

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

  9. The accuracy of combined physical examination and ultrasonography for the detection of abdominal aorta aneurysm.

    Science.gov (United States)

    Cârstea, Doina; Streba, Letiţia Adela Maria; Glodeanu, Adina; Cârstea, A P; Vancu, Mihaela; Ninulescu, Ana-Maria

    2008-01-01

    Atherosclerosis is the most frequent cause in the appearance of an abdominal aorta aneurysm (AAA) and plays an important role in his development. Most AAA does not cause any symptoms, especially when talking about elderly patients, however, many of those aneurysms can be detected during physical examination. Their detection is very important because the natural evolution and the major reason in treating AAA is their tendency to rupture. We present the case of an adult man with a complex clinical pathology, but not related to the AAA. The diagnosis of the AAA has been suspicion through palpation, and the abdominal ultrasound exam confirmed it. This case is particular interesting, as the AAA requires surgical intervention, while patient's health status was poor. An essential issue is establishing the importance of the AAA screening, when there are no symptoms present. For now, there are not satisfactory studies to be used as a guide.

  10. Ultrasonography compared to magnetic resonance imaging in thyroid-associated Graves' ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Vlainich, Ana R.; Romaldini, Joao H.; Pedro, Ana B.; Farah, Chady S.; Sinisgalli Junior, Cicero A., E-mail: anavlainich@uol.com.b [Hospital do Servidor Publico Estadual de Sao Paulo (IAMSPE), SP (Brazil)

    2011-04-15

    Objective: to compare ultrasonography (US) to magnetic resonance imaging (MRI) and the clinical activity score (CAS) in Graves' ophthalmopathy. Subjects and methods: Nineteen patients underwent extraocular muscle thickness measurements by US and MRI, reflectivity by US and signal-intensity ratio by MRI. There were also twelve US control subjects. Results: US median thicknesses were greater than in controls. Correlation was found between US and MRI in the median thickness of the left eye rectus medial muscle as well as between signal-intensity ratio (SIR) and thickness by US. An inverse correlation was found between reflectivity and SIR in the inferior and lateral rectus. On associating the tests for detecting activity the best results were obtained with CAS plus MRI (sensitivity 75%), and US and MRI (positive predictive value 77% and specificity 80%). Conclusion: CAS and US results showed poor correlation with MRI results suggesting that they cannot replace each other but when combined these methods can improve the evaluation of thyroid-associated ophthalmopathy. (author)

  11. Ultrasonography compared to magnetic resonance imaging in thyroid-associated Graves' ophthalmopathy

    International Nuclear Information System (INIS)

    Vlainich, Ana R.; Romaldini, Joao H.; Pedro, Ana B.; Farah, Chady S.; Sinisgalli Junior, Cicero A.

    2011-01-01

    Objective: to compare ultrasonography (US) to magnetic resonance imaging (MRI) and the clinical activity score (CAS) in Graves' ophthalmopathy. Subjects and methods: Nineteen patients underwent extraocular muscle thickness measurements by US and MRI, reflectivity by US and signal-intensity ratio by MRI. There were also twelve US control subjects. Results: US median thicknesses were greater than in controls. Correlation was found between US and MRI in the median thickness of the left eye rectus medial muscle as well as between signal-intensity ratio (SIR) and thickness by US. An inverse correlation was found between reflectivity and SIR in the inferior and lateral rectus. On associating the tests for detecting activity the best results were obtained with CAS plus MRI (sensitivity 75%), and US and MRI (positive predictive value 77% and specificity 80%). Conclusion: CAS and US results showed poor correlation with MRI results suggesting that they cannot replace each other but when combined these methods can improve the evaluation of thyroid-associated ophthalmopathy. (author)

  12. Heterotopic pregnancy after in vitro fertilization and embryo transfer: the role of routine transvaginal ultrasonography

    International Nuclear Information System (INIS)

    Lee, Eun Ju

    1994-01-01

    Spontaneous heterotopic pregnancy (HP) is a rare condition, however, the rising incidence after in-vitro fertilization and embryo transfer (IVF-ET) may present serious problems as the diagnosis of this potentially fatal condition is often missed. The purposes of this study were to investigate the frequency of HP after IVF-ET, to analyze the clinical presentation and the outcome of coincidental intrauterine pregnancy, and to evaluate the value of routine transvaginal ultrasonography in early diagnosis and treatment of HP. There were 11 cases of HP among 484 pregnancies after IVF-ET (The incidence was 2.3%) in recent 2 years. We evaluated the clinical findings and the findings of transvaginal sonography in those 11 patients. The combined extrauterine pregnancies were tubal (n = 9), cornual (n = 1), and both the tubal and cornual (n = 1). Vaginal bleeding was absent in 4 cases and one of them was asymptomatic. HP may be suspected if there was an elevated serum hCG in the absence of intrauterine multiple gestations. In all cases, the condition was diagnosed by transvaginal sonography performed prior to surgical intervention. The coincidental intrauterine pregnancies were ended in successful full-term delivery in 7 cases, while one pregnancy was ongoing at that time. The incidence of HP was evidently higher in IVF-ET than in spontaneous pregnancies. Transvaginal sonography was useful in accurate diagnosis in clinically suspected cases and even in asymptomatic cases. Routine transvaginal sonography played an important role in early diagnosis and prompt management of HP

  13. Chromosomal aneuploidies and copy number variations in posterior fossa abnormalities diagnosed by prenatal ultrasonography.

    Science.gov (United States)

    Lei, Ting; Feng, Jie-Ling; Xie, Ying-Jun; Xie, Hong-Ning; Zheng, Ju; Lin, Mei-Fang

    2017-11-01

    To explore the genetic aetiology of fetal posterior fossa abnormalities (PFAs). This study involved cases of PFAs that were identified by prenatal ultrasonographic screening and confirmed postnatally between January 2012 and January 2016. Conventional cytogenetic analyses and chromosomal microarray analysis were performed, and chromosomal aneuploidies and copy number variations (CNVs) were identified. Among 74 cases included in this study, 8 were of Blake's pouch cyst; 7, Dandy-Walker malformation; 11, vermian hypoplasia; 32, enlarged cisterna magna; and 16, cerebellar hypoplasia. The rates of nonbenign chromosomal aberrations (including chromosomal aneuploidies, pathogenic CNVs, and variants of unknown significance) were 2/8 (25.0%), 2/7 (28.5%), 8/11 (72.7%), 7/32 (21.9%), and 6/16 (37.5%), respectively. Cases were also classified as isolated PFAs (30/74), PFAs with other central nervous system (CNS) abnormalities (13/74), or PFAs with extra-CNS structural abnormalities (31/74). No fetuses with isolated PFAs or PFAs accompanied by other CNS abnormalities exhibited chromosomal aneuploidies or pathogenic CNVs. The rate of pathogenic chromosomal aberrations in the remaining fetuses was 17/31 (22.9%). The combined use of chromosomal microarray analysis and karyotype analysis might assist the prenatal diagnosis and management of PFAs, with extra-CNS structural abnormalities being detected by ultrasonography. © 2017 John Wiley & Sons, Ltd.

  14. The value of fetal ultrasonography and magnetic resonance imaging in the assessment of diaphragmatic hernias

    International Nuclear Information System (INIS)

    Amim, Bruno; Guerra, Fernando; Marchiori, Edson; Gasparetto, Emerson Leandro

    2008-01-01

    To demonstrate the relevance of ultrasonography and magnetic resonance imaging findings in the prenatal characterization and prognostic evaluation in cases of congenital diaphragmatic hernia. Materials And Methods: Fourteen pregnant women (mean gestational age = 28.7 weeks) who had undergone ultrasonography for suspicion of fetuses with congenital diaphragmatic hernia were assessed by means of magnetic resonance imaging on a 1.5 tesla equipment, following the standard protocol. Two radiologists evaluated the images and the findings were defined by consensus. Results: Twelve fetuses had left diaphragmatic hernia and two, right diaphragmatic hernia. Ultrasonography showed the fetal liver inside the thorax of five fetuses (three with left diaphragmatic hernia, and two with right diaphragmatic hernia) and magnetic resonance imaging in eight fetuses (six with left diaphragmatic hernia, and two with right diaphragmatic hernia). Stomach and small bowel loop herniation was observed in all of the fetuses with left diaphragmatic hernia (n = 12) at both magnetic resonance imaging and ultrasonography. Eight fetuses (seven with left diaphragmatic hernia and one with right diaphragmatic hernia) survived after surgical treatment. Conclusion: Ultrasonography and magnetic resonance imaging are complementary imaging methods in the evaluation of congenital diaphragmatic hernia. Magnetic resonance imaging is a helpful diagnostic method complementary to ultrasonography for evaluation of the fetal liver positioning, considering its relevance as a prognostic factor in cases of congenital diaphragmatic hernia. (author)

  15. Transcranial Doppler ultrasonography predicts cardiovascular events after TIA

    International Nuclear Information System (INIS)

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

    2009-01-01

    Transient ischemic attack (TIA) patients are at high vascular risk. We assessed the value of extracranial (ECD) and transcranial (TCD) Doppler and duplex ultrasonography to predict clinical outcome after TIA. 176 consecutive TIA patients admitted to the Stroke Unit were recruited in the study. All patients received diffusion-weighted imaging, standardized ECD and TCD. At a median follow-up of 27 months, new vascular events were recorded. 22 (13.8%) patients experienced an ischemic stroke or TIA, 5 (3.1%) a myocardial infarction or acute coronary syndrome, and 5 (3.1%) underwent arterial revascularization. ECD revealed extracranial ≥ 50% stenosis or occlusions in 34 (19.3%) patients, TCD showed intracranial stenosis in 15 (9.2%) and collateral flow patterns due to extracranial stenosis in 5 (3.1%) cases. Multivariate analysis identified these abnormal ECD and TCD findings as predictors of new cerebral ischemic events (ECD: hazard ratio (HR) 4.30, 95% confidence interval (CI) 1.75 to 10.57, P = 0.01; TCD: HR 4.73, 95% CI 1.86 to 12.04, P = 0.01). Abnormal TCD findings were also predictive of cardiovascular ischemic events (HR 18.51, 95% CI 3.49 to 98.24, P = 0.001). TIA patients with abnormal TCD findings are at high risk to develop further cerebral and cardiovascular ischemic events

  16. Ultrasonography and computed tomography in diffuse liver disease with cholestasis

    International Nuclear Information System (INIS)

    Partanen, K.; Pikkarainen, P.; Pasanen, P.; Alhava, E.; Soimakallio, S.; Kuopio Univ. Central Hospital; Kuopio Univ. Central Hospital

    1990-01-01

    Ultrasonography (US) and computed tomography (CT) were performed on respectively 67 and 42 (altogether 72) patients, for the assessment of intrahepatic cholestasis. The diagnostic ability to differentiate between malignant (17 patients) and benign (55 patients) liver disease was analyzed. Coarse echogenicity of the liver led to inconclusive results in differentiating between cirrhosis (2 out of 29 patients) and malignant infiltration (4 out of 15 patients) by US. Other benign liver diseases in 23 patients, including acute hepatitis, chronic active hepatitis, fatty liver, and liver congestion, were correctly interpreted as benign. CT correctly disclosed malignant liver disease in all cases. A false positive diagnosis of malignancy was encountered in 4 (out of 17) patients with decompensated hepatic cirrhosis because of non-homogeneous expansive areas on CT in 3 cases. The true cause was in 2 patients non-uniform fatty infiltration, and in one patient with acute hepatitis A, small hypodense lesions. Among cholestatic patients, decompensated cirrhosis and malignant liver infiltration could not always be differentiated on US or CT. (orig.)

  17. Ultrasonography of Skin Changes in Legs with Chronic Venous Disease.

    Science.gov (United States)

    Caggiati, A

    2016-10-01

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

  18. Deep venous thrombus characterization: ultrasonography, elastography and scattering operator

    Directory of Open Access Journals (Sweden)

    Thibaud Berthomier

    2017-04-01

    Full Text Available A thrombus or a blood clot is the result of blood coagulation which is a natural process to prevent bleeding. An inappropriate formation of a thrombus in a deep vein is known as Deep Venous Thrombosis (DVT. The main complication of a DVT is a Pulmonary Embolism (PE which occurs when a thrombus breaks loose and travels to the lungs. DVT, PE, or both are also known as Venous thromboembolism (VTE. It affects an estimated 300,000–600,000 Individuals just in the United States per year and can cause considerable morbidity and mortality. This multifactorial disease related to advanced age, immobility, surgery or obesity is an important public health issue. Our project is looking to link the VTE epidemiology (risk factors, patient history, PE to the thrombus structure. To reach our goals, we are collecting ultrasonography (echogenicity and elastography (stiffness of human thrombus. This manuscript describes our approach to create and preprocess a database using Toshiba Aplio 500. Our approaches to characterize the thrombus structure with ultrasound images are also described. The feature extraction is made with the scattering operator. Obtained features are then reduced using Principal Component Analysis and are analyzed to evaluate our approach.

  19. Ultrasonography findings and tumour quantification in patients with pseudomyxoma peritonei

    International Nuclear Information System (INIS)

    Krause, J.; Bergman, A.; Graf, W.; Nilsson, A.; Mahteme, H.

    2012-01-01

    Pseudomyxoma peritonei (PMP) is a disease with various clinical presentations and the diagnostic value of ultrasonography (US) is under investigated. The purpose of this study was to identify the most common US finding in PMP and to investigate US sensitivity, specificity, positive and negative predictive value in quantifying tumour burden in different abdomino-pelvic regions in PMP patients. Between February 2006 and December 2008, 54 patients were treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) due to PMP. The results from preoperative US examination with and without intravenously administrated contrast (SonoVue) were compared to surgical findings. The mean US peritoneal cancer index (PCI) was 6 (range 0–25) and the surgical PCI was 18 (range 3–27) p < 0.0001. The histo-pathological subtypes did not influence the US findings. Ascites, bowel loops adhesions and omental cake were mostly visualised correctly by US. The sensitivity of US in quantification of tumour nodules was 91.5% (range 74–100%) and specificity was 33.8% (range 18–55%). The positive predictive value of US examination in PMP was 22% (range 11–44%) and the negative predictive value was 93% (range 77–100%). US can detect the most common PMP findings (ascites and omental cake). The sensitivity of US to quantify PMP tumour burden in different abdominio-pelvic region was relatively high, however, this imaging tool had low specificity.

  20. Availability of ultrasonography in health examination of atomic bomb survivors

    International Nuclear Information System (INIS)

    Kato, Masafumi; Mito, Kazuyo; Ishibashi, Shinzo; Takayama, Sadamatsu; Ito, Chikako

    1989-01-01

    A total of 1424 A-bomb survivors, consisting of 596 men and 827 women, participated in the health screening during the period from August 1985 through March 1988. Abnormal findings of ultrasonography were observed in 64% for men and 53% for women. According to age groups, the incidence of abnormal findings tended to increase with aging in men. In women, it was independent of aging. The most common abnormal finding was billiary calculus (13%), followed by renal cyst, splenomegaly, hepatomegaly, and liver disturbance. Suspected hepatic tumor, hepatomegaly, liver disturbance, fatty liver, and liver cirrhosis were more frequent in men than women. The incidence of billiary or gallbladder calculus was significantly higher in women than men. Among 56 survivors (13%) with suspected malignancy, it was confirmed in 25 survivors (19 with primary or metastatic liver carcinoma, 3 with renal cell carcinoma, 2 with cholangiocarcinoma, and one with pancreatic carcinoma). Of 9 hepatoma patients, 8 had an increased alpha-fetoprotein. Hematologic findings were normal in all of the patients with renal cell carcinoma. (N.K.)

  1. Fetal central nervous system anomalies: fast MRI vs ultrasonography

    International Nuclear Information System (INIS)

    Yang Wenzhong; Xia Liming; Yang Minjie; Feng Dingyi; Hu Junwu; Zou Mingli; Wang Chengyuan; Chen Xinlin; Yang Xiaohong

    2006-01-01

    Objective: To evaluate the ability of fast MRI to detect fetal central nervous system (CNS) anomalies and to compare its performance with that of prenatal ultrasonography (US). Methods Forty-eight pregnant women were detected by conventional prenatal US and MRI. Twenty-two fetuses with CNS anomalies were conformed by autopsy and follow-up. The MR and US appearances of fetal CNS structure were compared to each other and to that of autopsy. Results: A total of 26 CNS anomalies were identified by autopsy (n=17) and follow-up (n=9) including anencephaly (n=6), rachischisis (n=2), encephalocele (n=3), congenital hydrocephalus (n=7), alobar holoprosencephaly (n=1), porencephalia (n=3), arachnoid cyst (n=2) and choroids plexus cyst (n=2). US diagnosed 24 CNS anomalies, the correct diagnostic rate was 92.3%, the false-positive rate was 3.8%, the missed-diagnostic rate was 3.8%. MRI diagnosed 23 CNS anomalies, the correct-diagnostic rate was 88.5%, the false-positive rate was 3.8% ,the missed-diagnostic rate was 7.7%. There was no difference between US and MRI (P>0.05), but MRI have larger FOV, higher tissues resolution, and can demonstrate gray-white matter in detail. Conclusions: MR imaging has a similar sensitivity to that of US in the detection of fetal CNS anomalies. (authors)

  2. Musculoskeletal ultrasonography delineates ankle symptoms in rheumatoid arthritis.

    Science.gov (United States)

    Toyota, Yukihiro; Tamura, Maasa; Kirino, Yohei; Sugiyama, Yumiko; Tsuchida, Naomi; Kunishita, Yosuke; Kishimoto, Daiga; Kamiyama, Reikou; Miura, Yasushi; Minegishi, Kaoru; Yoshimi, Ryusuke; Ueda, Atsuhisa; Nakajima, Hideaki

    2017-05-01

    To clarify the use of musculoskeletal ultrasonography (US) of ankle joints in rheumatoid arthritis (RA). Consecutive RA patients with or without ankle symptoms participated in the study. The US, clinical examination (CE), and patients' visual analog scale for pain (pVAS) for ankles were assessed. Prevalence of tibiotalar joint synovitis and tenosynovitis were assessed by grayscale (GS) and power Doppler (PD) US using a semi-quantitative grading (0-3). The positive US and CE findings were defined as GS score ≥2 and/or PD score ≥1, and joint swelling and/or tenderness, respectively. Multivariate analysis with the generalized linear mixed model was performed by assigning ankle pVAS as a dependent variable. Among a total of 120 ankles from 60 RA patients, positive ankle US findings were found in 21 (35.0%) patients. The concordance rate of CE and US was moderate (kappa 0.57). Of the 88 CE negative ankles, US detected positive findings in 9 (10.2%) joints. Multivariate analysis revealed that ankle US, clinical disease activity index, and foot Health Assessment Questionnaire, but not CE, was independently associated with ankle pVAS. US examination is useful to illustrate RA ankle involvement, especially for patients who complain ankle pain but lack CE findings.

  3. Characterisation of focal liver lesions with contrast enhanced ultrasonography

    International Nuclear Information System (INIS)

    Dietrich, Christoph F.

    2004-01-01

    Ultrasound contrast agents (USCA) have improved the detection rate of liver tumours in recent years. Conventional ultrasound has been reported to be relatively unreliable in the characterisation of liver tumours. SonoVue [reg] (Bracco Imaging Spa) has been shown to be particularly advantageous in the differentiation of benign and malignant liver tumours and, therefore, possibly represents a new cost-effective competitive alternative to other liver imaging modalities (e.g. computed tomography and magnetic resonance imaging), thus allowing these important technologies to be available for other indications (e.g. brain, thorax). More detailed and specific liver tumour characterisation is possible in about 80% of liver tumours due to typical vascularity and perfusion patterns. The role of USCA for better characterisation, which is possible through the analysis of flow characteristics in real time, places a particular emphasis on agent use. Contrast enhanced real-time imaging techniques with SonoVue [reg] allow real-time analysis of tumour perfusion in patients with liver lesions. Liver tumours known to be hyperperfused in the arterial phase (e.g. focal nodular hyperplasia, hepatocellular adenoma and carcinoma, and hyperperfused metastases) can be better detected and characterised. Hypoperfused tumours (e.g. liver metastases of the gastrointestinal tract) can be recognised in the portal venous phase as less perfused 'black spots'. In this article we discuss liver tumour characterisation by contrast enhanced ultrasonography

  4. Utility of Ultrasonography for Urinary Tract Infections of Infants

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Chul Ho; Kim, Yun Jeong [Dongnam Health Univ., Seoul (Korea, Republic of)

    2009-06-15

    In this study, we investigated utility of ultrasonography for urinary tract infections of infants. The results of the research is as follows : 1. The number of infants under one year old was 100 out of 122 infants who were diagnosed as a unitary infection. The ratio of males to females was 1.7 : 1. Seventy-seven infants who underwent three kinds of radiologic examinations such as kidney sonography (51%), {sup 99m}TC DMSA-scan (42%), and VCUG (22%). 2. In comparison of correlation between kidney sonography and VCUG, the sensitivity of kidney sonography was 82% while the specificity of kidney sonography was 58%. In comparison of correlation between kidney sonography and {sup 99m}TC DMSA-scan, the sensitivity of kidney sonography was 66% while the specificity of kidney sonography was 67%. 3. Utility of kidney sonography showed the highest efficiency when we considered pain, discomfort, a sense of shame, psychological stress when infants may undergo at the examination, side-effect of a contrast agent after the examination, and complication of exposure to radiation.

  5. The usefulness of transvaginal ultrasonography and MRI in endometrial carcinoma

    International Nuclear Information System (INIS)

    Yoshihara, Eisuke

    1992-01-01

    Between October 1988 and March 1991, 29 patients with endometrial carcinoma had both transvaginal ultrasonography (TVUS) and magnetic resonance imaging (MRI) performed following hysterectomy at the Department of Gynecology and Obstetrics, Okayama University Medical School. The findings were compared with the pathological findings to determine the usefulness of each method. The sensitivity of detecting myometrial invasion was 100% by TVUS and 96% by MRI. The accuracy was 86% by each method. The depth of myometrial invasion was classified into 3 degrees [no myometrial invasion, superficial invasion (≤1/2), deep invasion (>1/2)]. The correct diagnostic rate was 86% by TVUS and MRI. The minimum width and the minimum/maximum width ratio of the intact myometrium obtained by each method in the pathological deep invasion group were significantly lower than those obtained in the other two groups (p<0.01). The sensitivity, the accuracy and the specificity for detecting cervical invasion were 89%, 93% and 95% by both methods. There was no difference between TVUS and MRI for diagnosing myometrial and cervical invasion of endometrial carcinoma. (author)

  6. Contrast-Enhanced Endoscopic Ultrasonography for Pancreatic Tumors

    Directory of Open Access Journals (Sweden)

    Yasunobu Yamashita

    2015-01-01

    Full Text Available Objectives. To investigate the usefulness of contrast-enhanced endoscopic ultrasonography (CE-EUS for histological differentiation of pancreatic tumors. Methods. CE-EUS was performed for consecutive patients having a pancreatic solid lesion, and tumors were classified into three vascular patterns (hypervascular, isovascular, and hypovascular at two time phases (early-phase and late-phase. Correlation between vascular patterns and histopathology of resected pancreatic cancer (PC tissues was ascertained. Results. The final diagnoses of 147 examined tumors were PC (n=109, inflammatory mass (n=11, autoimmune pancreatitis (n=9, neuroendocrine tumor (n=8, and others (n=10. In late-phase images, 104 of 109 PCs had the hypovascular pattern, for a diagnostic sensitivity and specificity of 94% and 71%, respectively. Of 28 resected PCs, 10 had isovascular, and 18 hypovascular, patterns on the early-phase image. Early-phase isovascular PCs were more likely to be differentiated than were early-phase hypovascular PCs (6 well and 4 moderately differentiated versus 3 well, 14 moderately, and 1 poorly differentiated, P=0.028. Immunostaining revealed that hypovascular areas of early-phase images reflected heterogeneous tumor cells with fibrous tissue, necrosis, and few vessels. Conclusion. CE-EUS could be useful for distinguishing PC from other solid pancreatic lesions and for histological differentiation of PCs.

  7. Clinical diagnostic potentials of thyroid ultrasonography and scintigraphy; An evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Torizuka, Tatsuo; Kasagi, Kanji; Hatabu, Hiroto; Misaki, Takashi; Iida, Yasuhiro; Konishi, Junji (Kyoto Univ. (Japan). Hospital); Endo, Keigo

    1993-06-01

    This prospective study was designed to evaluate the potential contributions of high resolution ultrasonography (US) and Tc-99m scintigraphy in the routine diagnosis of thyroid disease. The diagnostic impacts of US and Tc-99m scintigraphy results in 177 patients visiting our thyroid clinic were assessed and scored according to the following criteria: when the information provided by either test supported, confirmed or changed the initial clinical diagnosis, they received scores of 2, 3 and 4 respectively, while score 1 was given when the test itself was useless for the differential diagnosis. US identified focal lesions that both palpation and scintigraphy had failed to detect in 14 (12.1%) of 116 patients with diffuse thyroid diseases, suggesting the necessity of Hashimoto's thyroiditis, adenoma, adenocarcinoma and adenomatous goiter, and vice versa in the diagnosis of hyperthyroid and euthyroid Graves's diseases. Thus, the advantages of US over scintigraphy for morphological evaluation were confirmed. US was particularly useful for the differential diagnosis of adenomatous goiter from Hashimoto's thyroiditis or a single nodular disease. In contrast, scintigraphy gave functional images, being especially helpful for the differential diagnosis of thyrotoxicosis. (author).

  8. Utility of Ultrasonography for Urinary Tract Infections of Infants

    International Nuclear Information System (INIS)

    Yoon, Chul Ho; Kim, Yun Jeong

    2009-01-01

    In this study, we investigated utility of ultrasonography for urinary tract infections of infants. The results of the research is as follows : 1. The number of infants under one year old was 100 out of 122 infants who were diagnosed as a unitary infection. The ratio of males to females was 1.7 : 1. Seventy-seven infants who underwent three kinds of radiologic examinations such as kidney sonography (51%), 99m TC DMSA-scan (42%), and VCUG (22%). 2. In comparison of correlation between kidney sonography and VCUG, the sensitivity of kidney sonography was 82% while the specificity of kidney sonography was 58%. In comparison of correlation between kidney sonography and 99m TC DMSA-scan, the sensitivity of kidney sonography was 66% while the specificity of kidney sonography was 67%. 3. Utility of kidney sonography showed the highest efficiency when we considered pain, discomfort, a sense of shame, psychological stress when infants may undergo at the examination, side-effect of a contrast agent after the examination, and complication of exposure to radiation.

  9. Imperforate Anus: Determination of Type Using Transperineal Ultrasonography

    International Nuclear Information System (INIS)

    Choi, Young Hun; Kim, In One; Cheon, Jung Eun; Kim, Woo Sun; Yeon, Kyung Mo

    2009-01-01

    This study was designed to assess the usefulness of transperineal ultrasonography (US) for the determination of imperforate anus (IA) type. From January 2000 to December 2004, 46 of 193 patients with an IA underwent transperineal US prior to corrective surgery. Sonographic findings were reviewed to identify the presence of internal fistulas and to determine 'distal rectal pouch to perineum (P-P)' distances. IA types were determined based on the sonographic findings, and the diagnostic accuracy of transperineal US was evaluated based on surgical findings. Of the 46 patients, 17 patients were surgically confirmed as having a high-type IA, three patients were confirmed as having an intermediate-type IA and 26 patients were confirmed as having a low-type IA. The IA type was correctly diagnosed by the use of transperineal US in 39 of the 46 patients (85%). In 14 of the 17 patients with a high-type IA, internal fistulas were correctly identified. All cases with a P-P distance > 16 mm were high-type IAs and all cases with a P-P distance < 5 mm were low-type IAs. Transperineal US is a good diagnostic modality for the identification of internal fistulas in cases of high-type IA and for defining the IA level

  10. Value of ultrasonography in the diagnosis of acute appendicitis

    International Nuclear Information System (INIS)

    Sohn, Seok Ho; Jung, Kun Sik; Kim, Jung Sik; Woo, Seong Ku; Chung, Ki Yong; Kim, Hee Jin

    1993-01-01

    During a 12-month period high-resolution, real-time ultrasonography (US) with graded compression was performed on 268 consecutive patients with clinically suspected acute appendicitis and its complications. US visualization of a fluid-filled, non-compressed appendix or a decompressed, thick-walled appendix was the primary criterion for a diagnosis of acute appendicitis. The sonographic findings were correlated with surgical-pathologic outcome in 92 cases and with the findings of clinical follow-ups in the remainder. US was found to be accurate in the diagnosis of acute appendicitis and its complication with a sensitivity of 93.3%, a specificity of 98.9%, and an accuracy of 97%. The predictive value of a positive test was 97.7%; that of a negative test was 96.7%. There were two false-positive examinations in patients with a thick-walled appendix or periapperdiceal abscess, which were surgically confirmed as appendiceal adenocarcinoma and perforated cecal diverticulitis respectively. There were six false-negative examinations in patients with a sonographically no-visible appendix, which were confirmed surgically as acute appendicitis (n=5) and perforated appendicitis (n=1). Our results show that high-resolution, real-time US is an accurate imaging modality in the diagnosis of acute appendicitis and the evaluation of its complications

  11. Ultrasonography - A diagnostic modality for oral and maxillofacial diseases

    Directory of Open Access Journals (Sweden)

    Priya Shirish Joshi

    2014-01-01

    Full Text Available Background: Many diseases present themselves in oral and maxillofacial regions and various modalities may be applied for their diagnosis, including intraoral and panoramic radiography, ultrasonography (USG, computer tomography, magnetic resonance imaging, and nuclear medicine methods such as positron emission tomography. Of these modalities, USG is easy to-use for the detection of non-invasive and soft tissue related diseases in oral and maxillofacial regions. USG plays an important role in analyzing normal and abnormal structures. In particular, in oral and maxillofacial regions, the USG may be clinically applied to evaluate lymph nodes, subcutaneous, and oral cavity-related diseases. Aims: The aim was to correlate the findings of USG and histopathology for the diagnosis of oral and maxillofacial pathology and to evaluate whether USG can be used as an adjunct in diagnosing oral and maxillofacial pathology. Materials and Methods: A total of 10 clinically diagnosed patients with intraoral cancerous growths, swellings in maxillary and neck region were included in this study. Incision biopsy was obtained for confirming provisional clinical diagnosis. The selected cases were advised USG. All patients were then posted either for hemi-glossectomy, hemi-mandibulectomy, and partial maxillectomy with or without radical neck dissection. Statistical Analysis: Student′s t-test and coefficient of correlation was used to statistically analyze significant relationship of both the methods. Result: In all 10 cases, USG correlated well with histopathology findings, it could also delineate tumor extent and measure tumor thickness. Conclusion: USG is an excellent method for the diagnosis of soft tissue lesions and can be used as an adjunct in diagnosing oral and maxillofacial pathology.

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  13. Evaluation of real time ultrasonography of the normal pancreas

    International Nuclear Information System (INIS)

    Kim, H. K.; Ko, Y. T.; Kim, S. Y.; Ahn, C. Y.

    1981-01-01

    91 cases who were free of pancreatic disease and the related conditions, were studied by high resolution and wide field real time ultrasonographic scanner with 3.5 MHz linear array electronically focusing transducers. The pancreatic examination method and the anatomic structures in and around the pancreas were investigated, and the normal pancreatic findings by real time ultrasonography were as follows: 1. Among all 91 cases, 44 cases were male and 47 cases female, and the frequent age groups were the 4th to the sixth decade. 2. The pancreatic images were obtained in 86% and the good images in 65%. 3. The shapes of pancreas were sausage (40%), dumb-bell (34%), tadpole (9%), and club (17%). 4. Pancreatic size was 1.56 ± 0.37, 2.4, 0.8 cm (Mean ± SD, Max., Min.) in head, 1.32 ± 0.29, 2.0, 0.8 cm in isthmus, and 1.62 ± 0.31, 2.4, 1.0 cm in tail. 5. The successful rate of pancreatic duct visualization was 46%. The shapes of pancreatic duct were linear (22%), tramline (16%), and tubular (8%). 6. The pancreatic echogenecity is greater than that of the liver in 68%, and equivalent to that of the liver in 32%, and no normal pancreas displayed less echogenecity than the liver. 7. Pancreatic echogenecity is lesser than that of adjacent soft tissue in 79% and equivalent to that of adjacent soft tissue in 21%. 8. The pancreatic echogenecity is homogenous in 79%. 9. The pancreatic margin is smooth in 62%, undulated in 11%, and ill defined in 27%

  14. Quantitative Assessment of Hepatic Fibrosis by Contrast-enhanced Ultrasonography

    Institute of Scientific and Technical Information of China (English)

    Ming-bo Zhang; En-ze Qu; Ji-Bin Liu; Jin-rui Wang

    2011-01-01

    Objective To explore the contrast-enhanced ultrasonographic features for quantitative assessment of hepatic fibrosis.Methods 86 patients with chronic viral hepatitis B were enrolled in this study from March 2007 to August 2009.The patients were classified into 5 groups (S0-S4) according to fibrosis stage evaluated with ultrasound guided liver biopsy.New contrast-enhanced ultrasonography (CEUS) features including area under the time-intensity curve (TIC) of portal venous phase/hepatic arterial phase (Qp/Qa) and intensity of portal venons phase/hepatic arterial phase (Ip/Ia) were used to detect the blood supply ratio (portal vein/hepatic artery) in each group.Arrival time of portal vein trunk (Tp) and decreasing rate of TIC (β) were also analyzed.Results Qp/Qa and Ip/Ia decreased from So to S4,while Tp and β increased These 4 features were significantly correlated with the degree of fibrosis (P<0.001) and were significantly different among the five groups (P<0.001).Sensitivity and specificity of Ip/Ia were 80% and 86% for groups ≥S1,75% and 86% for groups ≥ S2,71% and 84% for groups ≥ S3,and 76% and 80% for group S4,respectively.Sensitivity and specificity of Qp/Qa were 70% and 88% for groups ≥ S1,80% and 76% for groups ≥ S2,74% and 70% for groups ≥ S3,and 81% and 95% for group S4,respectively.Conclusion Ip/Ia and Qp/Qa could be adopted as reliable,non-invasive features for quantitative assessment of hepatic fibrosis.

  15. Evaluation of peripheral enthesitis in spondyloarthritis: Ultrasonography versus clinical examination

    Directory of Open Access Journals (Sweden)

    Anupam Wakhlu

    2017-01-01

    Full Text Available Background: Enthesitis is an important feature of spondyloarthritis but may often be subclinical. Data is sparse, especially from India, on the ultrasonography (USG detection of enthesitis in these patients. The present study aimed to find the prevalence and pattern of entheseal involvement assessed clinically and by USG. Methods: Fifty-two spondyloarthritis, 26 rheumatoid arthritis, and 26 healthy controls were evaluated for enthesitis by clinical examination and by USG using 2014 OMERACT consensus group definitions at bilateral Achilles insertion on the calcaneus, plantar fascia attachment on the calcaneus, quadriceps tendon insertion on the patella, patellar tendon origin from the inferior pole of the patella, and patellar tendon insertion on the tibial tuberosity. At least one ultrasonographic finding at any of the above sites was considered positive for enthesitis. Results: The number of entheseal sites screened in spondyloarthritis patients was 520 and 260 each in rheumatoid arthritis and healthy controls. USG (sensitivity - 94.2% was better in detecting enthesitis than clinical examination (sensitivity - 69.2%. Clinical examination was highly specific (100% compared to USG (55.7% in differentiating from rheumatoid arthritis and healthy controls. USG alone without clinical findings was positive at 23.8% of sites while clinical examination alone without USG findings was positive at 5.2% of sites. Frequency of enthesitis in rheumatoid arthritis was not more than healthy controls (6.1% vs. 8.1%, respectively and was much less than spondyloarthritis (34%. Conclusion: USG is a good screening tool for detection of enthesitis but cannot replace clinical examination completely.

  16. Incidence of bacteremia in cirrhotic patients undergoing upper endoscopic ultrasonography.

    Science.gov (United States)

    Fernández-Esparrach, Gloria; Sendino, Oriol; Araujo, Isis; Pellisé, Maria; Almela, Manel; González-Suárez, Begoña; López-Cerón, María; Córdova, Henry; Sanabria, Erwin; Uchima, Hugo; Llach, Josep; Ginès, Àngels

    2014-01-01

    The incidence of bacteremia after endoscopic ultrasonography (EUS) or EUS-guided fine-needle aspiration (EUS-FNA) is between 0% and 4%, but there are no data on this topic in cirrhotic patients. To prospectively assess the incidence of bacteremia in cirrhotic patients undergoing EUS and EUS-FNA. We enrolled 41 cirrhotic patients. Of these, 16 (39%) also underwent EUS-FNA. Blood cultures were obtained before and at 5 and 30 min after the procedure. When EUS-FNA was used, an extra blood culture was obtained after the conclusion of radial EUS and before the introduction of the sectorial echoendoscope. All patients were clinically followed up for 7 days for signs of infection. Blood cultures were positive in 16 patients. In 10 patients, blood cultures grew coagulase-negative Staphylococcus, Corynebacterium species, Propionibacterium species or Acinetobacterium Lwoffii, which were considered contaminants (contamination rate 9.8%, 95% CI: 5.7-16%). The remaining 6 patients had true positive blood cultures and were considered to have had true bacteremia (15%, 95% CI: 4-26%). Blood cultures were positive after diagnostic EUS in five patients but were positive after EUS-FNA in only one patient. Thus, the frequency of bacteremia after EUS and EUS-FNA was 12% and 6%, respectively (95% CI: 2-22% and 0.2-30%, respectively). Only one of the patients who developed bacteremia after EUS had a self-limiting fever with no other signs of infection. Asymptomatic Gram-positive bacteremia developed in cirrhotic patients after EUS and EUS-FNA at a rate higher than in non-cirrhotic patients. However, this finding was not associated with any clinically significant infections. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  17. Prediction of cerebrovascular reserve by the MRI and doppler ultrasonography

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    Lee, Hui Joong; Kim, Yong Sun [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2005-07-15

    We investigated acute stroke patterns on diffusion weighted images and with doppler ultrasonography studies of ICA and MCA steno-occlusive diseases in order to predict the cerbrovascular reserve (CVR), as was measured by acetazolamide (ACZ)-challenged Tc-99m ECD brain perfusion SPECT. A retrospective analysis was performed of 76 patients who underwent MRI/MRA, ACZ-challenged Tc-99m ECD brain perfusion SPECT, and carotid and vertebral artery Doppler sonography. After dividing these patients into four groups-MCA and ICA ateno-occlusions, we analyzed the relationship between the CVR and topologic MR patterns and the flow volume, as was measured by Doppler sonography. The CVRs were preserved in 26 of 76 patients. The CVRs were impaired in those cases of occlusion that were detected on MRA and also by the pattern of the territorial involvement on the diffusion weighted image ({rho} < 0.05, x{sup 2} test). Yet in cases of preserved CVRs, the flow volume of the contralateral ICA, the anterior circulation, and the total cerebral flow volume were increased, as was checked by Doppler sonography ({rho} < 0.05, t-test). As calculated by logistic regression analysis, the accuracy for predicting the preserved CVR by using the statistically significant variables was 78%. We believe that the MRI-SPECT correlation study was helpful for understanding the hemodynamics and topographic patterns of ischemia in patients with ICA and MCA steno-occlusive disease, and that the flow volume measurement, which was done by using duplex US, was useful for predicting the CVR.

  18. Comparison of the capsular width measured on ultrasonography and MR image of the temporomandibular joint

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Tae Wan; Yoo, Dong Soo; Han, Won Jeong; Kim, Eun Kyung [Dankook University, Seoul (Korea, Republic of)

    2006-03-15

    To evaluate the reliability and clinical usefulness of ultrasonography in the temporomandibular joint(TMJ). Parasagittal and paracoronal 1.5 T MR images and 7.5 MHz ultrasonography of 40 TMJs in 20 asymptomatic volunteers were obtained. Disc position using MR imaging was evaluated and the distance between the lateral surface of mandibular condyle and the articular capsule using MR image and ultrasonography of 27 TMJs with normal disc position was measured and compared. Intraobserver and interobserver measurements reliability was evaluated by using interclass correlation coefficients (ICC) and measurement error. Also, the distance measured on ultrasonography was compared, according to mouth position and disc position. The normal disc position was found in 27 of 40 asymptomatic joints. At the intraobserver reliability of measurement, ICC at the closed and open mouth position were 0.89 and 0.91. The measurement error was 0.4% and 0.5%. At the interobserver reliability, ICC at the closed and open mouth position, the distances between the lateral surface of mandibular condyle and the articular capsule measured on MR images and ultrasonography were 2.0{+-} 0.7 mm, 1.8{+-}0.5 mm, respectively (p<0.05). On the ultrasonography, the distances at open mouth position were 1.2{+-}0.5 mm (p<0.05). At the TMJ with medially displaced disc, the distances at the closed and open mouth position were 1.3{+-}0.3 mm and 0.9{+-}0.2 mm (p<0.05). The results suggest ultrasonography of TMJ is a reliable imaging technique for assessment of normal disc position.

  19. Reliability of Ultrasonography in Confirming Endotracheal Tube Placement in an Emergency Setting

    Science.gov (United States)

    Thomas, Vimal Koshy; Paul, Cherish; Rajeev, Punchalil Chathappan; Palatty, Babu Urumese

    2017-01-01

    Background and Objectives: Over the past few years, ultrasonography is increasingly being used to confirm the correct placement of endotracheal tube (ETT). In our study, we aimed to compare it with the traditional clinical methods and the gold standard quantitative waveform capnography. Two primary outcomes were measured in our study. First was the sensitivity and specificity of ultrasonography against the other two methods to confirm endotracheal intubation. The second primary outcome assessed was the time taken for each method to confirm tube placement in an emergency setting. Methods: This is a single-centered, prospective cohort study conducted in an emergency department of a tertiary care hospital. We included 100 patients with indication of emergency intubation by convenient sampling. The intubation was performed as per standard hospital protocol. As part of the study protocol, ultrasonography was used to identify ETT placement simultaneously with the intubation procedure along with quantitative waveform capnography (end-tidal carbon dioxide) and clinical methods. Confirmation of tube placement and time taken for the same were noted by three separate health-care staffs. Results and Discussion: Out of the 100 intubation attempts, five (5%) had esophageal intubations. The sensitivity and specificity of diagnosis using ultrasonography were 97.89% and 100%, respectively. This was statistically comparable with the other two modalities. The time taken to confirm tube placement with ultrasonography was 8.27 ± 1.54 s compared to waveform capnography and clinical methods which were 18.06 ± 2.58 and 20.72 ± 3.21 s, respectively. The time taken by ultrasonography was significantly less. Conclusions: Ultrasonography confirmed tube placement with comparable sensitivity and specificity to quantitative waveform capnography and clinical methods. But then, it yielded results considerably faster than the other two modalities. PMID:28584427

  20. Bedside Ultrasonography versus Brain Natriuretic Peptide in Detecting Cardiogenic Causes of Acute Dyspnea

    Directory of Open Access Journals (Sweden)

    Keihan Golshani

    2016-04-01

    Full Text Available Acute dyspnea is a common cause of hospitalization in emergency departments (ED.Distinguishing the cardiac causes of acute dyspnea from pulmonary ones is a major challenge for responsible physicians in EDs. This study compares the characteristics of bedside ultrasonography with serum level of blood natriuretic peptide (BNP in this regard. Methods: This diagnostic accuracy study compares bedside ultrasonography with serum BNP levels in differentiating cardiogenic causes of acute respiratory distress. Echocardiography was considered as the reference test. A checklist including demographic data (age and sex, vital signs, medical history, underlying diseases, serum level of BNP, as well as findings of chest radiography, chest ultrasonography, and echocardiography was filled for all patients with acute onset of dyspnea. Screening characteristics of the two studied methods were calculated and compared using SPSS software, version 20. Results: 48 patients with acute respiratory distress were evaluated (50% female. The mean age of participants was 66.94 ± 16.33 (28-94 years. Based on the results of echocardiography and final diagnosis, the cause of dyspnea was cardiogenic in 20 (41.6% cases. Bedside ultrasonography revealed the cardiogenic cause of acute dyspnea in 18 cases (0 false positive and BNP in 44 cases (24 false positives. The area under the ROC curve for bedside ultrasonography and BNP for differentiating the cardiogenic cause of dyspnea were 86.4 (95% CI: 74.6-98.3 and 66.3 (95% CI: 49.8-89.2, respectively (p = 0.0021. Conclusion: It seems that bedside ultrasonography could be considered as a helpful and accurate method in differentiating cardiogenic causes of acute dyspnea in emergency settings. Nevertheless, more study is needed to make a runaway algorithm to evaluate patients with respiratory distress using bedside ultrasonography, which leads to rapid therapeutic decisions in a short time.

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

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    Erkut Ozturk

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

  2. Detection of rib fractures in minor chest injuries: a comparison between ultrasonography and radiography performed on the same day

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    Cho, Yong Soo; Back, Chang Hee; Lee, Kyung Rae; Shin, Yun Hack; Whang, Yeong Seop; Jeong, Ku Young [Yeosu Baek Hospital, Yeosu (Korea, Republic of); Chung, Soo Hyun [NamWon Medical Center, NamWon (Korea, Republic of); Whang, Cheol Mog [Konyang University Hospital, Daejeon (Korea, Republic of)

    2007-04-15

    We wished to compare the ability of ultrasonography and radiography performed on the same day to detect rib fractures in minor chest injuries. Two hundred and fifteen patients with minor chest injuries were selected. Radiography and ultrasonography were performed on the same day with these patients. Chest wall pain was the only presenting symptom. Two radiologists performed ultrasonography. Fractures were identified by a disruption of the anterior margin of the rib and costal cartilage. The incidence and location of fractures and complications revealed by radiography and ultrasonography were compared. Radiographs revealed the presence of 70 rib fractures in 50 (23%) of 215 patients and ultrasonography revealed the presence of 203 rib fractures in 133 (62%) of 215 patients. Ultrasonography uniquely identified 133 rib fractures in 83 patients. Ultrasonography identified a 2.9 fold increase in the number of fractures in a 2.6 fold number of subjects as compared to radiography. Of the 203 sonographically detected fractures, 201 were located in the rib, one was located at the costochondral junction, and one in the costal cartilage. There were no complications seen by either radiography or ultrasonography. Ultrasonography reveals more fractures than those that may be overlooked on radiography for minor chest injuries.

  3. Detection of rib fractures in minor chest injuries: a comparison between ultrasonography and radiography performed on the same day

    International Nuclear Information System (INIS)

    Cho, Yong Soo; Back, Chang Hee; Lee, Kyung Rae; Shin, Yun Hack; Whang, Yeong Seop; Jeong, Ku Young; Chung, Soo Hyun; Whang, Cheol Mog

    2007-01-01

    We wished to compare the ability of ultrasonography and radiography performed on the same day to detect rib fractures in minor chest injuries. Two hundred and fifteen patients with minor chest injuries were selected. Radiography and ultrasonography were performed on the same day with these patients. Chest wall pain was the only presenting symptom. Two radiologists performed ultrasonography. Fractures were identified by a disruption of the anterior margin of the rib and costal cartilage. The incidence and location of fractures and complications revealed by radiography and ultrasonography were compared. Radiographs revealed the presence of 70 rib fractures in 50 (23%) of 215 patients and ultrasonography revealed the presence of 203 rib fractures in 133 (62%) of 215 patients. Ultrasonography uniquely identified 133 rib fractures in 83 patients. Ultrasonography identified a 2.9 fold increase in the number of fractures in a 2.6 fold number of subjects as compared to radiography. Of the 203 sonographically detected fractures, 201 were located in the rib, one was located at the costochondral junction, and one in the costal cartilage. There were no complications seen by either radiography or ultrasonography. Ultrasonography reveals more fractures than those that may be overlooked on radiography for minor chest injuries

  4. Use of gray-scale ultrasonography in the diagnosis of reproductive disease in the bitch: 18 cases (1981-1984)

    International Nuclear Information System (INIS)

    Poffenbarger, E.M.; Feeney, D.A.

    1986-01-01

    Gray-scale ultrasonography was utilized in addition to radiography in the diagnosis of reproductive disease in 18 bitches. In 72% of the cases, ultrasonography was considered diagnostic because it revealed information on organ architecture, relationships of radiographically silhouetting soft tissue structures, and fetal viability that was unobtainable by radiography alone. In the remainder of the cases, ultrasonography was contributory to the diagnostic process by supporting the clinical and radiographic diagnoses. The benefits of ultrasonography are discussed, as is the ultrasonographic appearance of a variety of reproductive tract diseases

  5. Ultrasonography for Proper Endotracheal Tube Placement Confirmation in Out-of-hospital Cardiac Arrest Patients: Two-center Experience

    Directory of Open Access Journals (Sweden)

    Jen-Tang Sun

    2014-06-01

    Conclusion: Real-time tracheal ultrasonography is an accurate method for identifying endotracheal tube position during cardiopulmonary resuscitation without the need for interruption of chest compression.

  6. A case of branch duct type intraductal papillary neoplasm of the bile duct treated by open surgery after 11 years of follow-up.

    Science.gov (United States)

    Fujita, Mitsuru; Wakui, Noritaka; Yamauchi, Yoshiya; Takeda, Yuki; Sato, Takemasa; Ueki, Nobuo; Otsuka, Takafumi; Oba, Nobuyuki; Nishinakagawa, Shuta; Minagawa, Masami; Takeda, Yasushi; Shiono, Saori; Kojima, Tatsuya

    2013-11-01

    The intraductal papillary neoplasm of the bile duct (IPNB) is a novel disease concept that was recently classified as a biliary cystic tumor by the revised World Health Organization classification. This is the case report of a 70-year-old female patient who experienced repeated episodes of obstructive jaundice and cholangitis since 2000, attributed to a mucus-producing hepatic tumor. Surgery was advised due to the repeated episodes; however, the patient refused. In May, 2011, the patient developed jaundice and fever and was treated with antibiotics. Since there was no improvement, the patient was admitted to the Tokyo Rosai Hospital. Abdominal computed tomography (CT) revealed a 50-mm cystic mass with an internal septum in the left hepatic lobe. Although the tumor size had remained almost unchanged compared to the initial CT scan performed in 2000, intra- and extra-hepatic bile duct dilation was more prominent on the second CT scan. Following admission, endoscopic retrograde cholangiopancreatography was performed and revealed an expanded papilla of Vater due to a mucous plug. A balloon catheter was inserted into the bile duct to remove the mucous plug, resulting in the drainage of copious amounts of mucus and infected bile. The patient finally consented to surgery and left hepatic lobectomy was performed. Consequently, the diagnosis of low-grade IPNB was made. Branch duct type IPNB, which is characterized by imaging appearance of a cystic mass and slow progression, is attracting increasing attention. In the present case, a cystic mass was identified in the left hepatic lobe, with no significant change in size after 11 years of follow-up, leading to the diagnosis of branch duct type IPNB. Considering the fact that IPNB is usually treated surgically at the time of diagnosis, the present case, due to the long-term follow-up, provides valuable insight into the natural history of the tumor.

  7. Size of mural nodule as an indicator of surgery for branch duct intraductal papillary mucinous neoplasm of the pancreas during follow-up

    International Nuclear Information System (INIS)

    Uehara, Hiroyuki; Ishikawa, Osamu; Katayama, Kazuhiro

    2011-01-01

    A mural nodule is a strong predictive factor for malignancy in branch duct intraductal papillary mucinous neoplasm (IPMN) of the pancreas, but the nodule size has hardly been considered. The aim of this study was to investigate whether a mural nodule of 10 mm was appropriate as an indicator of surgery for IPMN during follow-up. The follow-up outcomes of 100 patients who had branch duct IPMN without mural nodules or who had branch duct IPMN with mural nodules of less than 9 mm in a tertiary care setting were investigated retrospectively. The patients underwent abdominal ultrasound (US) every 3 months and additional imaging examinations or cytologic examination of pancreatic juice when necessary. Surgery was recommended to them when a mural nodule developed or when a nodule enlarged and reached 10 mm. During an average follow-up period of 97 months, branch duct IPMNs developed mural nodules that reached 10 mm in 5 patients (0.62% per year). In one patient the IPMN was revealed to be non-invasive carcinoma by resection, 1 IPMN was shown to be malignant by further follow-up, and 3 were not resected because of refusal or the patient's age. In 7 patients, mural nodules stayed within 9 mm. The remaining 88 patients lacked mural nodules in their branch duct IPMNs throughout the follow-up. The occurrence of invasive carcinoma around the IPMN was not indicated by imaging examinations in any patient. Univariate analysis showed that the size of the cyst at baseline significantly predicted the development of a mural nodule that reached 10 mm during follow-up (P=0.05). A mural nodule of 10 mm is appropriate as an indicator of surgery in the follow-up of branch duct IPMN. (author)

  8. Abnormal serum pancreatic enzymes, but not pancreatitis, are associated with an increased risk of malignancy in patients with intraductal papillary mucinous neoplasms.

    Science.gov (United States)

    Roch, Alexandra M; Parikh, Janak A; Al-Haddad, Mohammad A; DeWitt, John M; Ceppa, Eugene P; House, Michael G; Nakeeb, Attila; Schmidt, C Max

    2014-10-01

    Pancreatitis is associated with intraductal papillary mucinous neoplasm (IPMN). This association is in part due to inflammation from pancreatic ductal obstruction. Although the correlation between pancreatitis and the malignant potential of IPMN is unclear, the 2012 International Consensus Guidelines (ICG) consider pancreatitis a "worrisome feature." We hypothesized that serum pancreatic enzymes, markers of inflammation, are a better predictor of malignancy than pancreatitis in patients with IPMN. Between 1992 and 2012, 364 patients underwent resection for IPMN at a single university hospital. In the past decade, serum amylase and lipase were collected prospectively as an inflammatory marker in 203 patients with IPMN at initial surveillance and "cyst clinic" visits. The latest serum pancreatic enzyme values within 3 months preoperatively were studied. Pancreatitis was defined according to the 2012 revision of the Atlanta Consensus. Of the 203 eligible patients, there were 76 with pancreatitis. Pancreatitis was not associated with an increased rate of malignancy (P = .51) or invasiveness (P = .08). Serum pancreatic enzymes categorically outside of normal range (high or low) were also not associated with malignancy or invasiveness. In contrast, as a continuous variable, the higher the serum pancreatic enzymes were, the greater the rate of invasive IPMN. Of the 127 remaining patients without pancreatitis, serum pancreatic enzymes outside of normal range (low and high) were each associated with a greater rate of malignancy (P enzyme levels above normal range (high) were associated with a greater rate of invasiveness (P = .02). In patients with IPMN without a history of pancreatitis, serum pancreatic enzymes outside of the normal range are associated with a greater risk of malignancy. In patients with a history of pancreatitis, there is a positive correlation between the levels of serum pancreatic enzymes and the presence of invasive IPMN. These data suggest

  9. Evaluation of the activity of synovitis in patients with rheumatoid arthritis: Value of power Doppler ultrasonography

    International Nuclear Information System (INIS)

    Ahn, Joong Mo; Lim, Hyo Keun; Kim, Seung Hoon; Kim, Sung Hyun; Koh, Eun Mi; Kim, Jin Seok; Cha, Hoon Suk

    2001-01-01

    To correlate the grades on power Doppler ultrasonography with clinical disease activity indices and acute phase reactant values for assessing the activity of synovitis in patients with rheumatoid arthritis. Twenty patients with rheumatoid arthritis diagnosed on the basis of American College of power Doppler ultrasonography. Two experienced radiologists evaluated, in consensus, the power Doppler signals as follows: grade I=no flow or minimal flow, grade 2=mild flow, grade 3=moderate flow and grade 4= marked flow. The clinical disease activity indices consisted of the counts of tender joints and swollen joints, patient's assessment of pain, patient's global assessment of disease activity, physician's globe assessment of disease activity and patient's assessment of physical function. Acute-phase reactants included CRP and ESR. The grades on power Doppler ultrasonography were correlated with clinical disease activity indices as well as acute-phases reactant values by a use of Spearman rank correlation coefficient. The grades on power Doppler ultrasonography showed a statistically significant correlation with tender joint count (rs=.835; p<.05), swollen joint count (rs=.833; p<.05), physician's global assessment of disease activity (rs=.857; p<.05), CRP (rs=.838; P<.05) and ESR (rs=.838; p<.05). The power Doppler ultrasonography is an useful diagnostic modality for assessing the activity of synovitis in patients with rheumatoid arthritis.

  10. Contrast-enhanced ultrasonography depicts small tumor vessels for the evaluation of pancreatic tumors

    International Nuclear Information System (INIS)

    Okamoto, Yuko; Kawamoto, Hirofumi; Takaki, Akinobu; Ishida, Etsuji; Ogawa, Tsuneyoshi; Kuwaki, Kenji; Kobayashi, Yoshiyuki; Sakaguchi, Kohsaku; Shiratori, Yasushi

    2007-01-01

    Objective: The aim of this study is to evaluate the efficacy of contrast-enhanced ultrasonography for the diagnosis of pancreatic tumors. Materials and methods: Contrast-enhanced ultrasonography with Levovist was performed on 62 consecutive patients (53 with pancreatic cancer, 4 with islet cell tumor, 3 with inflammatory pancreatic tumor, and 2 with metastatic tumor). The vascular and perfusion image phases of the tumors were evaluated and compared with the findings of contrast-enhanced computed tomography. Results: Contrast-enhanced ultrasonography showed tumor vessels around and/or in the tumor at the vascular image phase in 79% of pancreatic cancer patients (42/53). At the perfusion image phase, 96% of pancreatic cancers (51/53) were classified as hypo-enhancement type. However, tiny spotty or irregular heterogeneous enhanced lesions were found in 84% of hypo-enhanced pancreatic cancer patients (43/51). The presence of small vessels at the vascular image phase was closely correlated with the presence of these intratumor regional enhanced lesions at the perfusion image phase (κ coefficient = 0.42). The sensitivity of contrast-enhanced ultrasonography (100%) for pancreatic cancer was superior to that of contrast-enhanced computed tomography (91%), but no significant difference was observed between the two (McNemar test: p = 0.063). Conclusion: Contrast-enhanced ultrasonography with Levovist successfully visualizes fine vessels and enhancement in pancreatic tumors, and is useful for evaluating pancreatic tumors

  11. Ultrasonography of symptomatic rotator cuff tears compared with MR imaging and surgery

    International Nuclear Information System (INIS)

    Fotiadou, Anastasia N.; Vlychou, Marianna; Papadopoulos, Periklis; Karataglis, Dimitrios S.; Palladas, Panagiotis; Fezoulidis, Ioannis V.

    2008-01-01

    Purpose: To compare the accuracy of ultrasonography and magnetic resonance imaging in the detection of rotator cuff tears. Materials and methods: Ninety-six patients with clinically suspected rotator cuff pathology underwent ultrasonography and magnetic resonance imaging of the shoulder. The findings in 88 patients were compared with arthroscopy or open surgery. Results: Full-thickness tear was confirmed in 57 cases, partial-thickness tear in 30 cases and degenerative changes without tear in 1. In all 57 cases of full-thickness tear and in 28 out of 30 cases of partial-thickness tear the supraspinatus tendon was involved. The accuracy in the detection of full-thickness tears was 98 and 100% for ultrasonography and magnetic resonance imaging, respectively. The accuracy in the detection of bursal or articular partial-thickness tears was 87 and 90% for ultrasonography and magnetic resonance imaging, respectively. Conclusions: In experienced hands ultrasonography should be considered as an accurate modality for the initial investigation of rotator cuff, especially supraspinatus, tears

  12. Ultrasonography of symptomatic rotator cuff tears compared with MR imaging and surgery

    Energy Technology Data Exchange (ETDEWEB)

    Fotiadou, Anastasia N. [Radiology Department, University Hospital of Larissa, Mezourlo 41110, Larissa (Greece); Radiology Department, G. Papanikolaou Hospital, Exochi 32100, Thessaloniki (Greece)], E-mail: natfot@yahoo.gr; Vlychou, Marianna [Radiology Department, University Hospital of Larissa, Mezourlo 41110, Larissa (Greece)], E-mail: mvlychou@med.uth.gr; Papadopoulos, Periklis [University Orthopaedic Clinic, G. Papanikolaou Hospital, Exochi 32100, Thessaloniki (Greece)], E-mail: perpap@otenet.gr; Karataglis, Dimitrios S. [University Orthopaedic Clinic, G. Papanikolaou Hospital, Exochi 32100, Thessaloniki (Greece)], E-mail: dkarataglis@yahoo.gr; Palladas, Panagiotis [Radiology Department, G. Papanikolaou Hospital, Exochi 32100, Thessaloniki (Greece)], E-mail: palladaspan@in.gr; Fezoulidis, Ioannis V. [Radiology Department, University Hospital of Larissa, Mezourlo 41110, Larissa (Greece)], E-mail: oswestanast@yahoo.gr

    2008-10-15

    Purpose: To compare the accuracy of ultrasonography and magnetic resonance imaging in the detection of rotator cuff tears. Materials and methods: Ninety-six patients with clinically suspected rotator cuff pathology underwent ultrasonography and magnetic resonance imaging of the shoulder. The findings in 88 patients were compared with arthroscopy or open surgery. Results: Full-thickness tear was confirmed in 57 cases, partial-thickness tear in 30 cases and degenerative changes without tear in 1. In all 57 cases of full-thickness tear and in 28 out of 30 cases of partial-thickness tear the supraspinatus tendon was involved. The accuracy in the detection of full-thickness tears was 98 and 100% for ultrasonography and magnetic resonance imaging, respectively. The accuracy in the detection of bursal or articular partial-thickness tears was 87 and 90% for ultrasonography and magnetic resonance imaging, respectively. Conclusions: In experienced hands ultrasonography should be considered as an accurate modality for the initial investigation of rotator cuff, especially supraspinatus, tears.

  13. An experimental comparative study of radiography, ultrasonography and CT imaging in the IV catheter fragment

    International Nuclear Information System (INIS)

    Kweon, Dae Cheol

    2016-01-01

    The objective of this study was to detect the fragments generated during IV (intravenous) catheter injection of contrast medium and drug administration in a clinical setting and removal was performed by experimentally producing a phantom, and to compare the radiography, ultrasonography, and multi-detector computed tomography (MDCT) imaging and radiation dose. A 1 cm fragment of an 18 gage Teflon® IV catheter with saline was inserted into the IV control line. Radiography, CT, and ultrasonography were performed and radiography and CT dose were calculated. CT and ultrasonography showed an IV catheter fragment clinically and radiography showed no visible difference in the ability to provide a useful image of an IV catheter fragment modality (p >.05). Radiography of effective dose (0.2139 mSv·Gy-1·cm-2) form DAP DAP (0.93 μGy·m2 ), and dose length product (DLP) (201 mGy·cm) to effective dose was calculated as 0.483 mSv. IV catheter fragment were detected of radiography, ultrasonography and CT. These results can be obtained by menas of an excellent IV catheter fragment of detection capability CT. However, CT is followed by radiation exposure. IV catheter fragment confirming the position and information recommend an ultrasonography

  14. The diagnostic concordance of endoanal ultrasonography and endoanal MRI in cases of anorectal fistula

    International Nuclear Information System (INIS)

    Kim, Wan Tae; Yoo, Weon Young; Moon, Hee Jung; Shin, Hyun Ja; Joo, Jae Sik

    2000-01-01

    To evaluate the preoperative diagnostic concordance of morphologic classification of anorectal fistula by endoanal ultrasonography (EUSG) and endoanal magnetic resonance imaging (EMRI). Between January 1998 and March 1999, 17 patients with anorectal fistula underwent endoanal ultrasonography and magnetic resonance imaging for preoperative assessment. The types of fistula and abscess formation were evaluated, and the findings compared with those obtained during surgery. The overall accordance of anorectal fistula was 76% (13 of 17 cases) on ultrasonography and 94% (16 of 17 cases) on magnetic resonance imaging. According to the findings of EUSG, the accordance of each type of anorectal fistula was as follows: transphineteric, 92% (11 of 12 cases); suprasphinteric, 33% (1 of 3); and extrasphincteric, 50% (1 of 2), while for EMRI, the respective figures were 100% (12 of 12 cases), 67% (2 of 3), and 100% (2 of 2). An analysis of reproducibility using kappa value showed that overall concordance between endoanal ultrasonography and surgery (κ=0.820) as well as between endoanal MRI and surgery (κ=0.866), was very close. For the evaluation of anorectal fistula, preoperative endoanal magnetic resonance imaging was more accurate and informative than endoanal ultrasonography

  15. Comparison of ultrasonography and radiography in diagnosis of rib fractures.

    Science.gov (United States)

    Pishbin, Elham; Ahmadi, Koorosh; Foogardi, Molood; Salehi, Maryam; Seilanian Toosi, Farrokh; Rahimi-Movaghar, Vafa

    2017-08-01

    Rib fractures are the most common skeletal thoracic injuries resulting from blunt chest trauma. Half of the rib fractures are not detected upon a precise physical evaluation and radiographs. Recently ultrasonography (USG) has been investigated to detect rib fractures. But based on literature the usefulness of USG varies widely. This study was conducted to investigate the role of USG in the detection of possible rib fractures in comparison with radiography. In this cross-sectional study, consecutive patients with minor blunt chest trauma and suspected rib fractures presenting in Imam Reza Hospital located in Mashhad-Iran, between April 2013 and October 2013 were assessed by USG and radiography. The radiography was performed in a posteroanterior (PA) chest projection and oblique rib view centered over the area of trauma. The time duration spent in taking USG and radiography were recorded. The prevalence and location of fractures revealed by USG and radiography were compared. Sixty-one suspected patients were assessed. The male to female ratio was 2.4:1 (43 men and 18 women) with a mean ± SD age of (44.3 ± 19.7) years. There were totally 59 rib fractures in 38 (62.3%) patients based on radiography and USG, while 23 (37.7%) patients had no diagnostic evidence of rib lesions. USG revealed 58 rib fractures in 33 (54.1%) of 61 suspected patients and radiographs revealed 32 rib fractures in 20 (32.8%) of 61 patients. A total of 58 (98.3%) rib fractures were detected by USG, whereas oblique rib view and PA chest radiography showed 27 (45.8%) and 24 (40.7%) rib fractures, respectively. The average duration of USG was (12 ± 3) min (range 7-17 min), whereas the duration of radiography was (27 ± 6) min (range 15-37 min). The kappa coefficient showed a low level of agreement between both USG and PA chest radiography (kappa coefficient = 0.28), and between USG and oblique rib view (kappa coefficient = 0.32). USG discloses more fractures than radiography in

  16. Predictors of diagnostic success with renal artery duplex ultrasonography.

    Science.gov (United States)

    Hedayati, Nasim; Del Pizzo, David J; Harris, Sean E; Kuskowski, Michael; Pevec, William C; Lee, Eugene S; Pifer, Christy; Dawson, David L

    2011-05-01

    Renal artery duplex ultrasonography (RA-DUS) is commonly used for the evaluation and follow-up of renal artery atherosclerotic disease. In a complete study, renal artery flow is evaluated from the vessel origin to the intraparenchymal branches. The quality of RA-DUS is in part technologist-dependent, but many factors may affect the ability to complete a diagnostic examination. This study evaluated the clinical and technical factors that predict the ability to obtain a complete RA-DUS examination. A prospective evaluation of all patients undergoing RA-DUS between July 2008 and February 2009 was performed. Factors such as patient age, gender, body mass index, technologists' years of experience, patient care setting (inpatient vs. outpatient), bedside examination, smoking before the examination, fasting status, and recent abdominal surgery were all recorded. Multivariate logistic regression analysis was performed. A p value of ≤ 0.05 was considered significant. During the study period, 250 patients underwent RA-DUS (mean age: 59.9 ± 17.8 years, 57% [143] female). A total of 87 (35%) examinations were incomplete. This included nondiagnostic examinations which did not exhibit any segment of the renal artery. Factors that were associated with an incomplete examination included technologists' years of experience (OR = 0.92, p = 0.042), bedside examination (OR = 4.17, p = 0.016), and recent abdominal surgery (OR = 3.45, p = 0.047). Body mass index, fasting status, and smoking before the examination did not affect the ability to obtain a complete study. One-third of the RA-DUS studies were classified as incomplete by the strict criteria used in this prospective study. An experienced ultrasound technologist is more likely to obtain a complete RA-DUS examination. Recent abdominal surgery and bedside examinations were predictive of a limited examination as well. Vascular laboratories should consider these factors when scheduling examinations so as to obtain complete RA

  17. Measurement of Gallbladder Volume with Ultrasonography in Pregnant Women

    Directory of Open Access Journals (Sweden)

    Sait Kapicioglu

    2000-01-01

    Full Text Available Fasting and postprandial gallbladder volumes were investigated using ultrasonography in three groups (10 subjects in each of healthy women: third trimester pregnant women, postpartum women up to 10 days after giving birth and nonpregnant controls. The scans were performed at 09:00 after a 12 h fast. After the basal measurement was taken, gallbladder volumes were rescanned in 15 min intervals for 60 mins. At the end of this period, all volunteers received a standard liquid test meal, and scans were performed again for 1 h. The mean basal gallbladder volume was 22.2±4.2 mL in the nonpregnant (control group. In the third trimester group, the basal volume was 37.8±10.5 mL – 70.5% higher than in the nonpregnant group (P<0.001. In the postpartum group, the mean basal volume was 37.9% lower (27.4±6.5 mL than that of the third trimester group (P<0.02. This basal volume was 23.6% greater than that of the control group (P<0.05. After administration of a test meal, the postprandial gallbladder volumes decreased during the first few minutes compared with baseline values. The volumes decreased by 10.2% to 39.8% (23.5±7.3 to 34.0±10.2; P<0.01 in the third trimester group, by 14.9% to 43.2% (16.6±4.3 to 23.3±5.5; P<0.01, 0.001 in the postpartum group and by 19.2% to 51.6% (11.9±3.5 to 17.9±3.6; P<0.02, 0.05, 0.01, 0.001 in the control group. Postprandial mean gallbladder volumes of the third trimester (P<0.02 and postpartum groups (P<0.02 to 0.01 were significantly different from those of the control group. In conclusion, incomplete emptying of the gallbladder after eating during the third trimester of pregnancy may contribute to cholesterol-gallstone formation, and pregnancy may thus increase the risk of gallstones.

  18. Diagnosis and treatment of postoperative intraperitoneal abscess using ultrasonography and abdominal computed tomography

    International Nuclear Information System (INIS)

    Kamachi, Hisashi; Kumashiro, Ryunosuke; Maekawa, Takafumi; Saku, Haruhisa; Naitoh, Hideaki; Inutsuka, Sadamitsu; Higashi, Yoshitaka

    1988-01-01

    Ultrasonography and/or abdominal computed tomography revealed 9 patients with subphrenic abscesses derived from gastrointestinal surgery. Out of them 4 cases underwent conservative treatment is chosen with aggresive chemotherapy, but 5 were re-surgically treated including drainage of the intraperitonial abscess or repairing the leakage of the anastomosis. On the conservative treatment for the intraperitonial abscess, frequent monitoring with ultrasonography was very conventional for successful treatment. However, in the cases with severe leukocytosis, leakage of anastomosis or recurrent intraperitonial abscess, resurgical treatment will be required. Thus the monitoring with ultrasonography is quite usefull not only in the drainaging of the intraperitonial abscess, but also in the judgement of treatment whether conservetive or re-operative. (author)

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

    Science.gov (United States)

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

    2016-01-01

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

  20. Atrophy of foot muscles in diabetic patients can be detected with ultrasonography

    DEFF Research Database (Denmark)

    Severinsen, Kaare; Obel, Annette; Jakobsen, Johannes

    2007-01-01

    OBJECTIVE: To establish a bedside test with ultrasonography for evaluation of foot muscle atrophy in diabetic patients. RESEARCH DESIGN AND METHODS: Thickness and cross-sectional area (CSA) of the extensor digitorum brevis muscle (EDB) and of the muscles of the first interstitium (MILs) were...... determined in 26 diabetic patients and in 26 matched control subjects using ultrasonography. To estimate the validity, findings were related to the total volume of all foot muscles determined at magnetic resonance imaging (MRI-FM(vol)). Furthermore, the relations of ultrasonographic estimates to nerve...... than in nonneuropathic diabetic patients (5.8 +/- 2.1 vs. 7.5 +/- 1.7 mm [P foot muscles determined at ultrasonography is directly related to foot muscle volume determined by MRI and to various...

  1. Contrast-Enhanced Ultrasonography in Differential Diagnosis of Benign and Malignant Ovarian Tumors

    Science.gov (United States)

    Qiao, Jing-Jing; Yu, Jing; Yu, Zhe; Li, Na; Song, Chen; Li, Man

    2015-01-01

    Objective To evaluate the accuracy of contrast-enhanced ultrasonography (CEUS) in differential diagnosis of benign and malignant ovarian tumors. Methods The scientific literature databases PubMed, Cochrane Library and CNKI were comprehensively searched for studies relevant to the use of CEUS technique for differential diagnosis of benign and malignant ovarian cancer. Pooled summary statistics for specificity (Spe), sensitivity (Sen), positive and negative likelihood ratios (LR+/LR−), and diagnostic odds ratio (DOR) and their 95%CIs were calculated. Software for statistical analysis included STATA version 12.0 (Stata Corp, College Station, TX, USA) and Meta-Disc version 1.4 (Universidad Complutense, Madrid, Spain). Results Following a stringent selection process, seven high quality clinical trials were found suitable for inclusion in the present meta-analysis. The 7 studies contained a combined total of 375 ovarian cancer patients (198 malignant and 177 benign). Statistical analysis revealed that CEUS was associated with the following performance measures in differential diagnosis of ovarian tumors: pooled Sen was 0.96 (95%CI = 0.92∼0.98); the summary Spe was 0.91 (95%CI = 0.86∼0.94); the pooled LR+ was 10.63 (95%CI = 6.59∼17.17); the pooled LR− was 0.04 (95%CI = 0.02∼0.09); and the pooled DOR was 241.04 (95% CI = 92.61∼627.37). The area under the SROC curve was 0.98 (95% CI = 0.20∼1.00). Lastly, publication bias was not detected (t = −0.52, P = 0.626) in the meta-analysis. Conclusions Our results revealed the high clinical value of CEUS in differential diagnosis of benign and malignant ovarian tumors. Further, CEUS may also prove to be useful in differential diagnosis at early stages of this disease. PMID:25764442

  2. Comparative study of diagnostic efficiency of mammography and ultrasonography for breast cancer

    International Nuclear Information System (INIS)

    Koike, Yasuo; Terai, Naoki; Wakabayashi, Toru; Tsuchiya, Shin-ichi

    1995-01-01

    We performed a study of 448 women with breast cancer who visited the breast clinic of Nagano Cancer Center, and underwent mammography (MMG) and ultrasonography (US) at the last examination, between October 1983 and December 1993. These women subsequently underwent surgery at several hospitals after referral from our center. Definitive diagnoses of breast cancer were made histopathologically. Both MMG and US findings were graded using five-step criteria (indicating the level of malignancy) from I (normal) to V (definite malignancy). The diagnostic efficiencies of the two examinations were then compared clinicopathologically. Furthermore, on the basis of the results obtained, we considered supplemental diagnostic methods that could be introduced for mass screening of breast cancer. There was a significant difference between the incidence of cases diagnosed as V IV III b (malignancy) by US (71.9%) and those diagnosed by MMG (60.9%). Among cases suspected to be breast cancer by palpation, the proportion diagnosed as V IV III b (malignancy) by US (83.3%) was significantly higher than that diagnosed by MMG (73.7%). Among cases suspected to be mastopathy by palpation, the proportion diagnosed as malignant by US was higher than that diagnosed by MMG. The false negativity rate for palpation combined with MMG was higher than that for palpation with US. Among cases without palpable masses, the proportion diagnosed as malignant by MMG was higher than that diagnosed by US. However, for palpable tumors less than 5.0 cm in diameter, the proportion of cases diagnosed as malignant by US was higher than that diagnosed by MMG. In terms of the gross appearance of the cut surface, grade of cancer invasion, histological type and grade of chubbiness, the diagnostic efficiency of US was shown to be slightly better than that of MMG. The above results suggest that US should be considered as a supplemental method for introduction to mass screening of breast cancer. (author)

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

    Science.gov (United States)

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

    2017-01-01

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

  4. Ultrasonographic detection of hepatocellular carcinoma: correlation of preoperative ultrasonography and resected liver pathology

    International Nuclear Information System (INIS)

    Lim, J.H.; Kim, S.H.; Lee, W.J.; Choi, D.; Kim, S.H.; Lim, H.K.

    2006-01-01

    AIM: The aim of this study was to determine the sensitivity of ultrasonography for detecting hepatocellular carcinoma in patients who underwent surgical liver resection. MATERIALS AND METHODS: The preoperative ultrasonography reports of 103 patients who underwent hepatic resection surgery were retrospectively reviewed. The patients had chronic liver disease with good liver function and a relatively normal liver echotexture. The presence of a mass or masses in the resected part of the liver segments on preoperative ultrasonography was regarded as possible hepatocellular carcinoma, and these results were compared with the surgically resected hepatic lobes or segments. Accuracy for detection was assessed on a lesion-by-lesion basis, on a segment-by-segment basis, and on a patient basis. RESULTS: One hundred and fifty-seven hepatocellular carcinomas were found in 244 hepatic segments of 103 patients. One hundred and one of 157 hepatocellular carcinomas were detected using ultrasonography in 97 patients resulting in a sensitivity of 64%. In six patients, a solitary hepatocellular carcinoma was missed in each patient, a patient sensitivity being 94%. Using ultrasonography, 87 of 100 (87%) hepatocellular carcinomas larger than 2 cm in diameter, and 14 of 57 (25%) hepatocellular carcinomas 2 cm or smaller in diameter were revealed. On the basis of segment-by-segment analysis, the sensitivity was 78% (99 of 127 segments), specificity was 97% (114 of 117 segments), accuracy was 87% (213 of 244 segments), positive predictive value was 97% (99 of 102 segments), and negative predictive value was 80% (114 of 142 segments). CONCLUSION: In patients with chronic liver disease and good hepatic function, ultrasonography has a sensitivity of 94% in the identification of affected patients, but for individual lesions, the sensitivity is only 64%

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

    Science.gov (United States)

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

    2015-12-01

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

  6. The pitfalls of ultrasonography in the evaluation of soft tissue masses

    International Nuclear Information System (INIS)

    Kwok, Henry CK.; Pinto, Clinton H.; Doyle, Anthony J.

    2012-01-01

    Ultrasonography is associated with a high error rate in the evaluation of soft tissue masses. The purposes of this study were to examine the nature of the diagnostic errors and to identify areas in which reporting could be improved. Patients who had soft tissue tumours and received ultrasonography during a 10-year period (1999–2009) were identified from a local tumour registry. The sonographic and pathological diagnoses were categorised as either ‘benign’ or ‘non-benign’. The accuracy of ultrasonography was assessed by correlating the sonographic with the pathological diagnostic categories. Recommendations from radiologists, where offered, were assessed for their appropriateness in the context of the pathological diagnosis. One hundred seventy-five patients received ultrasonography, of which 60 had ‘non-benign’ lesions and 115 had ‘benign’ lesions. Ultrasonography correctly diagnosed 35 and incorrectly diagnosed seven of the 60 ‘non-benign’ cases, and did not suggest a diagnosis in 18 cases. Most of the diagnostic errors related to misdiagnosing soft tissue tumours as haematomas (four out of seven). Recommendations for further management were offered by the radiologists in 144 cases, of which 52 had ‘non-benign’ pathology. There were eight ‘non-benign’ cases where no recommendation was offered, and the sonographic diagnosis was either incorrect or unavailable. Ultrasonography lacks accuracy in the evaluation of soft tissue masses. Ongoing education is required to improve awareness of the limitations with its use. These limitations should be highlighted to the referrers, especially those who do not have specific training in this area.

  7. Evaluation of Ultrasonography as a Diagnostic Tool in Maxillofacial Space Infections

    Directory of Open Access Journals (Sweden)

    Praveen Kumar Pandey

    2011-11-01

    Full Text Available Objectives: The purpose of the study was to establish the role of ultrasonography in determining the involvement of specific fascial spaces in maxillofacial region and the stage of infection, in indicating the appropriate time for surgical intervention and to compare clinical and ultrasonographic findings.Material and Methods: Twenty five patients with fascial space infection in maxillofacial region were subjected to ultrasonographic examination following a detailed clinical and radiological examination. Ultrasonography guided needle aspiration was performed. Based on the findings, patients diagnosed with abscess were subjected to incision and drainage and those with cellulitis were subjected to medical line of treatment.Results: More than one fascial space was involved in all patients. On clinical examination 64 spaces were involved, of them 34 spaces had abscess formation and 30 spaces were in the stage of cellulitis. On ultrasonography examination, 28 spaces were reported to have abscess formation and 36 spaces were diagnosed to be in the stage of cellulitis. On comparative analysis of both clinical and ultrasonographic findings, ultrasonography was found to be sensitive in 65% of the cases and having specificity of 80%. It was registered statistically significant (P < 0.001 agreement between these two methods of assessment (kappa index = 0.814.Conclusions: Ultrasonography is a quick, widely available, relatively inexpensive, and painless procedure and can be repeated as often as necessary without risk to the patient. Thus ultrasonography is a valuable diagnostic aid to the oral and maxillofacial surgeon for early and accurate diagnosis of fascial space infection, their appropriate treatment and to limit their further spread.

  8. Randomized clinical trial of laparoscopic ultrasonography before laparoscopic colorectal cancer resection

    DEFF Research Database (Denmark)

    Ellebaek, S B; Fristrup, C W; Hovendal, C

    2017-01-01

    BACKGROUND: Intraoperative ultrasonography during open surgery for colorectal cancer may be useful for the detection of unrecognized liver metastases. Laparoscopic ultrasonography (LUS) for the detection of unrecognized liver metastasis has not been studied in a randomized trial. This RCT tested...... in the LUS than in the control group (7·8 (95 per cent c.i. 3·8 to 13·8) and 0·8 (0 to 4·2) per cent respectively; P = 0·010), but the suspected M1 disease was benign in half of the patients. CONCLUSION: Routine LUS during resection of colorectal cancer is not recommended. Registration number: NCT02079389...

  9. A Case of Fetal Herpes Simplex Encephalitis Diagnosed Prenatally by Ultrasonography in the Third Trimester

    International Nuclear Information System (INIS)

    Lee, Mi Bum; Kim, Yu Ri; Hwang, Han Sung; Park, Yong Won; Kim, Young Han

    2007-01-01

    Almost all reported incidences of herpes simplex virus (HSV) infection in newborns result as a complication of rupture of the amniotic membranes or the delivery of the baby, but infection via the placenta and amniotic membranes is rare. Ventriculomegaly was detected at 36 weeks of gestation by prenatal ultrasonography, and an emergency cesarean section was then performed at 36 weeks of gestation. We report a case of herpes simplex encephalitis detected at 36 weeks of gestation by prenatal ultrasonography, which was confirmed by a postnatal serologic test and CSF test with a brief review of literature

  10. Reproducibility of ultrasonography for assessing abdominal fat distribution in a population at high risk of diabetes

    DEFF Research Database (Denmark)

    Philipsen, A; Carstensen, Bendix; Sandbæk, Annelli

    2013-01-01

    the reproducibility of this method have been published.Objective:The aim of this study was to investigate the reproducibility of ultrasonography in the assessment of abdominal fat distribution in a population at high risk of type 2 diabetes.Design and Methods:Ultrasonography was used to estimate visceral......- and interobserver variation, and Bland-Altman plots were drawn for all three substudies.Results:Coefficients of variation for intra- and interobserver variation were in the range 3.4-6.1%, except for interobserver variation for subcutaneous fat (9.5%). Short-term variation over a median of 35 days had a coefficient...

  11. Color Doppler Ultrasonography-Targeted Perforator Mapping and Angiosome-Based Flap Reconstruction

    DEFF Research Database (Denmark)

    Gunnarsson, Gudjon Leifur; Tei, Troels; Thomsen, Jørn Bo

    2016-01-01

    Knowledge about perforators and angiosomes has inspired new and innovative flap designs for reconstruction of defects throughout the body. The purpose of this article is to share our experience using color Doppler ultrasonography (CDU)-targeted perforator mapping and angiosome-based flap reconstr......Knowledge about perforators and angiosomes has inspired new and innovative flap designs for reconstruction of defects throughout the body. The purpose of this article is to share our experience using color Doppler ultrasonography (CDU)-targeted perforator mapping and angiosome-based flap...

  12. Comparison of radiography and ultrasonography in the evaluation of renal lesions in the dog

    International Nuclear Information System (INIS)

    Konde, L.J.; Park, R.D.; Wrigley, R.H.; Lebel, J.L.

    1986-01-01

    Survey abdominal radiographs, excretory urograms, and nephrosonograms were obtained from 14 dogs with renal lesions. Renal enlargement was suspected on survey radiographs and confirmed by excretory urography in 13 dogs. Radiographic differentiation between a solid and cystic renal lesion was not possible in 9 dogs. Ultrasonography determined the presence of solid masses in 12 dogs, established the presence of a renal cyst in the opposite kidney in 1 dog, and revealed hydronephrosis in 2 dogs. Ultrasonography appeared to be more sensitive than radiography in differentiating the internal characteristics of renal lesions

  13. A Case of Fetal Herpes Simplex Encephalitis Diagnosed Prenatally by Ultrasonography in the Third Trimester

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Mi Bum; Kim, Yu Ri; Hwang, Han Sung; Park, Yong Won; Kim, Young Han [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2007-12-15

    Almost all reported incidences of herpes simplex virus (HSV) infection in newborns result as a complication of rupture of the amniotic membranes or the delivery of the baby, but infection via the placenta and amniotic membranes is rare. Ventriculomegaly was detected at 36 weeks of gestation by prenatal ultrasonography, and an emergency cesarean section was then performed at 36 weeks of gestation. We report a case of herpes simplex encephalitis detected at 36 weeks of gestation by prenatal ultrasonography, which was confirmed by a postnatal serologic test and CSF test with a brief review of literature

  14. HIGH-RESOLUTION ULTRASONOGRAPHY OF SHOULDER FOR ROTATOR CUFF TEAR: CORRELATION WITH ARTHROSCOPIC FINDINGS

    Directory of Open Access Journals (Sweden)

    Vishnumurthy H. Y

    2016-09-01

    Full Text Available INTRODUCTION Rotator cuff disease is the most common cause of shoulder pain. Ultrasonography being non-invasive, widely available, more cost-effective method and is the first choice in imaging of rotator cuff tears. Arthroscopy of shoulder is considered as the gold standard for diagnosis of rotator cuff tears. Objective of this study was to compare the diagnostic accuracy of high-resolution ultrasonography of shoulder for rotator cuff tears with arthroscopy of shoulder. METHODS Thirty patients clinically suspected to have rotator cuff tear who underwent ultrasonography and arthroscopy of shoulder were included in the study. Duration of study was for two years. All ultrasonography examinations were conducted in ultrasound machine using GE Voluson 730 PRO high frequency (10-12 MHz linear array transducer done by two experienced radiologists. Arthroscopies were done by two experienced shoulder arthroscopic surgeons. RESULTS Age of the patients with rotator cuff tears ranged from 40 to 80 years. 57% were females and 43% were males among the patients who had rotator cuff tears. 71.43% of the rotator cuff tears were found in the dominant arm. 64.28% of patients with rotator cuff tear had given history of fall or trauma to the corresponding shoulder within 6 months prior to presentation. 39.28% of patients who had rotator cuff tears were known diabetics. Supraspinatus tendon was the most commonly affected tendon, followed by infraspinatus and subscapularis tendons. For overall detection of rotator cuff tears, ultrasonography in comparison with the arthroscopy has sensitivity and specificity of 92.85% and 100%. For detection of full thickness rotator cuff tear, its sensitivity and specificity was 94.73% and 100% and for partial thickness rotator cuff tears 76.92% and 100%. Ultrasonography has 100% sensitivity and specificity for detection of supraspinatus full thickness tear. For supraspinatus partial thickness tear, sensitivity and specificity was 88

  15. Fatty liver diagnostic from medical examination to analyze the accuracy between the abdominal ultrasonography and liver hounsfield units

    International Nuclear Information System (INIS)

    Oh, Wang Kyun; Kim, Sang Hyun

    2017-01-01

    In abdominal Ultrasonography, the fatty liver is diagnosed through hepatic parenchymal echo increased parenchymal density and unclear blood vessel boundary, and according to many studies, abdominal Ultrasonography has 60 ∼ 90% of sensitivity and 84 ∼ 95% of specificity in diagnosis of fatty liver, but the result of Ultrasonography is dependent on operators, so there can be difference among operators, and quantitative measurement of fatty infiltration is impossible. Among examinees who same day received abdominal Ultrasonography and chest computed tomography (CT), patients who were diagnosed with a fatty liver in the Ultrasonography were measured with liver Hounsfield Units (HU) of chest CT imaging to analyze the accuracy of the fatty liver diagnosis. Among 720 subject examinees, those who were diagnosed with a fatty liver through abdominal Ultrasonography by family physicians were 448, which is 62.2%. The result of Liver HU measurement in the chest CT imaging of those who were diagnosed with a fatty liver showed that 175 out of 720 had the measured value of less than 40 HU, which is 24.3%, and 173 were included to the 175 among 448 who were diagnosed through Ultrasonography, so 98.9% corresponded. This indicates that the operators' subjective ability has a great impact on diagnosis of lesion in Ultrasonography diagnosis of a fatty liver, and that in check up chest CT, under 40 HU in the measurement of Liver HU can be used for reference materials in diagnosis of a fatty liver

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

    Science.gov (United States)

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

    2009-04-01

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

  17. Fatty liver diagnostic from medical examination to analyze the accuracy between the abdominal ultrasonography and liver hounsfield units

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Wang Kyun [Dept. of Radiology, Cheongju Medical Center, Cheongju (Korea, Republic of); Kim, Sang Hyun [Dept. of Radiological Science, Shinhan University, Uijeongbu (Korea, Republic of)

    2017-06-15

    In abdominal Ultrasonography, the fatty liver is diagnosed through hepatic parenchymal echo increased parenchymal density and unclear blood vessel boundary, and according to many studies, abdominal Ultrasonography has 60 ∼ 90% of sensitivity and 84 ∼ 95% of specificity in diagnosis of fatty liver, but the result of Ultrasonography is dependent on operators, so there can be difference among operators, and quantitative measurement of fatty infiltration is impossible. Among examinees who same day received abdominal Ultrasonography and chest computed tomography (CT), patients who were diagnosed with a fatty liver in the Ultrasonography were measured with liver Hounsfield Units (HU) of chest CT imaging to analyze the accuracy of the fatty liver diagnosis. Among 720 subject examinees, those who were diagnosed with a fatty liver through abdominal Ultrasonography by family physicians were 448, which is 62.2%. The result of Liver HU measurement in the chest CT imaging of those who were diagnosed with a fatty liver showed that 175 out of 720 had the measured value of less than 40 HU, which is 24.3%, and 173 were included to the 175 among 448 who were diagnosed through Ultrasonography, so 98.9% corresponded. This indicates that the operators' subjective ability has a great impact on diagnosis of lesion in Ultrasonography diagnosis of a fatty liver, and that in check up chest CT, under 40 HU in the measurement of Liver HU can be used for reference materials in diagnosis of a fatty liver.

  18. The Effectiveness of Ultrasonography in Detecting Emergent Pediatric Pathologies and Requirement for Additional Imaging Techniques: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Betül Tiryaki Baştuğ

    2018-04-01

    Full Text Available Introduction: In emergency cases, ultrasonography is used in guiding resuscitation, to provide procedural guidance, and confirm a clinical diagnosis. In addition, it may prevent unnecessary exposure of the patient to ionizing radiation and risks caused by transporting the patient away from monitoring. This paper aimed to evaluate the effectiveness of ultrasonography in detecting emergent pediatric pathologies in a state hospital radiology unit, and to identify whether additional imaging techniques, such as computed tomography, were required. Methods: This study was designed as a retrospective investigation. A group of 536 patients were randomly selected from 1.401 pediatric patients who underwent ultrasonography for non-traumatic emergent pathologies between 2015 and 2016. Results: Of the 536 patients, 46 were diagnosed with appendicitis, 14 with pathologies of the urinary system, 1 with ileus, 29 with mesenteric lymphadenitis, 4 with intussusception, 3 with ovarian cyst rupture, 1 with ovarian torsion, and 32 with scrotal pathologies. Computed tomography was performed for 20 patients. Ureteral calculi and appendicitis were confirmed by computed tomography in 5 and 14 patients, respectively, after being identified as secondary findings by ultrasonography. In 1 patient, ileus was verified by computed tomography. The sensitivity of ultrasonography was determined to be 85.7%. Only 14% of patients were not given definite pathological diagnoses by ultrasonography alone. Subsequent computed tomography for verifying secondary findings detected by ultrasonography was essential in only 20 patients. Conclusion: Our results promote the use of ultrasonography as the initial imaging test for evaluating pediatric patients with suspected emergency pathologies.

  19. Gestational ultrasonography and Dopplerfluxometry in capuchin monkeys (Sapajus apella) zoometric.

    Science.gov (United States)

    Miranda, S A; Leão, D L; Oliveira, K G; Sodré, I S; Domingues, S F S

    2018-03-01

    The objectives of the current study were as follows: 1) to evaluate blood flow in the uterine (UA) and umbilical (Uma) arteries in pregnant capuchin monkeys by measuring the resistive index (RI) and pulsatility index (PI); 2) to determine the presence or absence of the early diastolic notch and diastolic flow in the UA and Uma flow waveforms, respectively; 3) to perform conceptus echobiometry for fetal growth assessment during pregnancy; 4) to describe the moment that the fetal organs were initially observed; and 5) to determine when the diagnosis of fetal gender is possible. Seven healthy, sexually mature female Sapajus apella were examined in Weeks -20 to -1 before whelping (whelping Week 0). Triplex Doppler was used to assess the blood flow and fetal heart rate, and B-mode ultrasonography was used to assess the fetal organs and conceptus measurements, including the gestational sac latero-lateral longitudinal (LLL) and latero-lateral transversal (LLT), the crown rump length (CRL), biparietal diameter (BPD), occipito-frontal diameter (OFD), head circumference (HC), abdominal circumference (AC), femur length (FL) and fetal organ. All the pregnancies ended with a normal whelping and the birth of a live newborn. Prior to whelping, all conceptus dimensions increased significantly, whereas the RI and PI of both the UA and Uma decreased significantly. For the UA, the RI and PI were (mean ± SEM) 0.835 ± 0.017 and 2.157 ± 0.129, 0.808 ± 0.008 and 1.920 ± 0.041, and 0.761 ± 0.006 and 1.759 ± 0.036 on periods -3, -2 and -1, respectively. For the Uma, the RI and PI were 0.97 ± 0.01 and 2.50 ± 0.02 at Week -17 and were 0.64 ± 0.02 and 0.98 ± 0.04 at Week -1, respectively. The complete disappearance of the early diastolic notch in the UA, and the complete appearance of diastolic flow in the Uma occurred on Week -1 and Week -11, respectively. Linear regression analyses regarding the relationship of the weeks before whelping (WBW) with the

  20. Improvement of diagnostic accuracy, and clinical evaluation of computed tomography and ultrasonography for deep seated cancers

    International Nuclear Information System (INIS)

    Arimizu, Noboru

    1980-01-01

    Cancers of the liver, gallbladder, and pancreas which were difficult to be detected at an early stage were studied. Diagnostic accuracy of CT and ultrasonography for vesectable small cancers was investigated by the project team and coworkers. Only a few cases of hepatocellular carcinoma, cancer of the common bile duct, and cancer of the pancreas head, with the maximum diameter of 1 - 2 cm, were able to be diagnosed by CT. There seemed to be more false negative cases with small cancers of that size. The limit of the size which could be detected by CT was thought to be 2 - 3 cm. Similar results were obtained by ultrasonography. Cancer of the pancreas body with the maximum diameter of less than 3.5 cm could not be detected by both CT and ultrasonography. Diagnostic accuracy of CT for liver cancer was improved by selective intraarterial injection of contrast medium. Improvement of the quality of ultrasonograms was achieved through this study. Merits and demerits of CT and ultrasonography were also compared. (Tsunoda, M.)

  1. The Role of Ultrasonography in In-vitro Fertilization And Embryo ...

    African Journals Online (AJOL)

    Randomized controlled trials show that ultrasoundguided transfer techniques have better outcomes than the clinical touch technique in terms of on-going pregnancies and clinical pregnancies. Ultrasonography is now the key instrument for diagnosing and monitoring pregnancy following embryo transfer, biochemical ...

  2. Application of Intraoperative Ultrasonography for Guiding Microneurosurgical Resection of Small Subcortical Lesions

    International Nuclear Information System (INIS)

    Wang, Jia; Duan, Yun You; Liu, Xi; Wang, Yu; Gao, Guo Dong; Qin, Huai Zhou; Wang, Liang

    2011-01-01

    We wanted to evaluate the clinical value of intraoperative ultrasonography for real-time guidance when performing microneurosurgical resection of small subcortical lesions. Fifty-two patients with small subcortical lesions were involved in this study. The pathological diagnoses were cavernous hemangioma in 25 cases, cerebral glioma in eight cases, abscess in eight cases, small inflammatory lesion in five cases, brain parasite infection in four cases and the presence of an intracranial foreign body in two cases. An ultrasonic probe was sterilized and lightly placed on the surface of the brain during the operation. The location, extent, characteristics and adjacent tissue of the lesion were observed by high frequency ultrasonography during the operation. All the lesions were located in the cortex and their mean size was 1.3 ± 0.2 cm. Intraoperative ultrasonography accurately located all the small subcortical lesions, and so the neurosurgeon could provide appropriate treatment. Different lesion pathologies presented with different ultrasonic appearances. Cavernous hemangioma exhibited irregular shapes with distinct margins and it was mildly hyperechoic or hyperechoic. The majority of the cerebral gliomas displayed irregular shapes with indistinct margins, and they often showed cystic and solid mixed echoes. Postoperative imaging identified that the lesions had completely disappeared, and the original symptoms of all the patients were significantly alleviated. Intraoperative ultrasonography can help accurately locate small subcortical lesions and it is helpful for selecting the proper approach and guiding thorough resection of these lesions.

  3. Application of Intraoperative Ultrasonography for Guiding Microneurosurgical Resection of Small Subcortical Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jia; Duan, Yun You; Liu, Xi; Wang, Yu; Gao, Guo Dong; Qin, Huai Zhou; Wang, Liang [Tangdu Hospital of the Fourth Military Medicine University, Xi an (China)

    2011-10-15

    We wanted to evaluate the clinical value of intraoperative ultrasonography for real-time guidance when performing microneurosurgical resection of small subcortical lesions. Fifty-two patients with small subcortical lesions were involved in this study. The pathological diagnoses were cavernous hemangioma in 25 cases, cerebral glioma in eight cases, abscess in eight cases, small inflammatory lesion in five cases, brain parasite infection in four cases and the presence of an intracranial foreign body in two cases. An ultrasonic probe was sterilized and lightly placed on the surface of the brain during the operation. The location, extent, characteristics and adjacent tissue of the lesion were observed by high frequency ultrasonography during the operation. All the lesions were located in the cortex and their mean size was 1.3 {+-} 0.2 cm. Intraoperative ultrasonography accurately located all the small subcortical lesions, and so the neurosurgeon could provide appropriate treatment. Different lesion pathologies presented with different ultrasonic appearances. Cavernous hemangioma exhibited irregular shapes with distinct margins and it was mildly hyperechoic or hyperechoic. The majority of the cerebral gliomas displayed irregular shapes with indistinct margins, and they often showed cystic and solid mixed echoes. Postoperative imaging identified that the lesions had completely disappeared, and the original symptoms of all the patients were significantly alleviated. Intraoperative ultrasonography can help accurately locate small subcortical lesions and it is helpful for selecting the proper approach and guiding thorough resection of these lesions.

  4. Improvement of diagnostic accuracy, and clinical evaluation of computed tomography and ultrasonography for deep seated cancers

    Energy Technology Data Exchange (ETDEWEB)

    Arimizu, N [Chiba Univ. (Japan). School of Medicine

    1980-06-01

    Cancers of the liver, gallbladder, and pancreas which were difficult to be detected at an early stage were studied. Diagnostic accuracy of CT and ultrasonography for resectable small cancers was investigated by the project team and co-workers. Only a few cases of hepatocellular carcinoma, cancer of the common bile duct, and cancer of the pancreas head, with the maximum diameter of 1 - 2 cm, were able to be diagnosed by CT. There seemed to be more false negative cases with small cancers of that size. The limit of the size which could be detected by CT was thought to be 2 - 3 cm. Similar results were obtained by ultrasonography. Cancer of the pancreas body with the maximum diameter of less than 3.5 cm could not be detected by both CT and ultrasonography. Diagnostic accuracy of CT for liver cancer was improved by selective intraarterial injection of contrast medium. Improvement of the quality of ultrasonograms was achieved through this study. Merits and demerits of CT and ultrasonography were also compared.

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Science.gov (United States)

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

    1996-01-01

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

  7. Ultrasonography of the larynx for diagnosis of the vocal folds mobility impairment

    Directory of Open Access Journals (Sweden)

    Petr S. Vetshev

    2017-03-01

    Full Text Available Purpose. To study a possibility of performance and diagnostic accuracy of ultrasonography (US of a larynx in identification of motility disorders of VF (vocal folds in comparison with the laryngoscope which is traditionally applied for this purpose. Materials and methods. According to the objectives of the study, two patient groups were formed. In first group of patients (n = 466 we studied acceptability of ultrasonografy to discriminate various laryngeal structures. In second group of patient (n = 432 we evaluated the diagnostic accuracy of ultrasonography in point of detection of vocal muscles paresis. Results. Laryngeal structures were available to examination by ultrasound (without taking in account age and sex in 92.7% of patients. Two patterns have been identified in the course of this part of the study: deterioration of visibility of the vocal folds with increasing patient age and better visibility of the vocal folds in women than in men. According to the comparative analysis, ultrasonography accuracy rate (in those patients who had had clearly visible vocal folds during ultrasonography did not differ from that during videolaryngoscopy. Conclusion. During the conducted research it was found that the US of the larynx is an effective and perspective method for detection of a paresis of VF with sensitivity and specificity 93,55% and 100% respectively. Among those patients who' VF are available to ultrasound evaluation the accuracy of method is comparable with a videolaryngoscopy and can be used with success in daily work of units of endocrine surgery.

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

    Science.gov (United States)

    Valley, V T; Shermer, C D

    2001-01-01

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

  9. Laparoscopic ultrasonography--a method for staging of upper gastrointestinal cancer

    DEFF Research Database (Denmark)

    Durup Scheel-Hincke, J; Mortensen, M B; Pless, T

    1999-01-01

    Laparoscopic ultrasonography (LUS) is a method that can be useful in the staging of upper gastrointestinal cancer. Dedicated transducers are available, and preliminary studies have proposed indications for the use of LUS staging of hepatic, esophageal, gastric, and pancreatic cancer disease. In t...

  10. Ultrasonography, computed tomography, and cholescintigraphy in suspected obstructive jaundice--a prospective comparative study

    DEFF Research Database (Denmark)

    Matzen, P; Malchow-Møller, A; Brun, B

    1983-01-01

    In order to compare their capacity to visualize the bile ducts, ultrasonography, computed tomography, and cholescintigraphy were performed in 56 consecutive jaundiced patients in whom extrahepatic cholestasis was clinically suspected. The predictions as to the patency of the large bill ducts were...

  11. Ultrasonography and magnetic resonance imaging in early rheumatoid arthritis: recent advances

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Døhn, Uffe M; Ejbjerg, Bo J

    2006-01-01

    Efficient methods for diagnosis, monitoring, and prognostication are essential in early rheumatoid arthritis. Data on the value of ultrasonography and MRI are accumulating rapidly, fueling their increasing use in early rheumatoid arthritis. This review focuses on recent advances in the clinical...

  12. Is salivary gland ultrasonography a useful tool in Sjogren's syndrome? A systematic review

    NARCIS (Netherlands)

    Jousse-Joulin, Sandrine; Milic, Vera; Jonsson, Malin V.; Plagou, Athena; Theander, Elke; Luciano, Nicoletta; Rachele, Pascale; Baldini, Chiara; Bootsma, Hendrika; Vissink, Arjan; Hocevar, Alojzija; De Vita, Salvatore; Tzioufas, Athanasios G.; Alavi, Zarin; Bowman, Simon J.; Devauchelle-Pensec, Valerie

    Objective. Ultrasonography (US) is a sensitive tool in the diagnosis of major salivary gland abnormalities in primary Sjogren's syndrome (pSS). The aim of this systematic review was to assess the metric properties of this technique. Methods. PUBMED and EMBASE databases were searched. All

  13. Prediction of late failure after medical abortion from serial beta-hCG measurements and ultrasonography

    DEFF Research Database (Denmark)

    Rørbye, C; Nørgaard, M; Nilas, Lisbeth

    2004-01-01

    BACKGROUND: Surgical treatment of failed medical abortion may be performed several weeks after initiation of the abortion. There are no recognized methods for early identification of these late failures. We assessed the prognostic values of beta-hCG and ultrasonography in predicting late failure ...

  14. Dynamic Contrast-Enhanced Magnetic Resonance Enterography and Dynamic Contrast-Enhanced Ultrasonography in Crohn's Disease

    DEFF Research Database (Denmark)

    Wilkens, Rune; Peters, David A; Nielsen, Agnete Hedemann

    2017-01-01

    Purpose e Cross-sectional imaging methods are important for objective evaluationof small intestinal inflammationinCrohn'sdisease(CD).The primary aim was to compare relative parameters of intestinal perfusion between contrast-enhanced ultrasonography (CEUS) and dynamic contrast-enhanced magnetic...

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

    Science.gov (United States)

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

    2012-01-01

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

  16. Ability of subtraction and dynamic MR imaging to detect breast tumors. Comparison with ultrasonography and mammography

    International Nuclear Information System (INIS)

    Terao, Eri; Takeuchi, Hiroaki; Iwamura, Akira; Murakami, Yoshitaka; Harada, Junta; Tada, Shinpei

    1994-01-01

    We evaluated the ability of subtraction and dynamic MR imaging to accurately detect breast tumors. Sixty-five breast carcinomas and 24 fibroadenomas were examined by an SE pulse sequence using a 0.2 Tesla unit. Subtraction MR images were obtained every minute during dynamic study with Gd-DTPA. Almost all breast tumors were seen as very bright masses, and the margin of the mass was clearly demonstrated on subtraction MR images. Breast carcinomas and fibroadenomas showed characteristic time-intensity curves on dynamic study. Time-intensity curves of the early peak type and plateau type were seen in 97% of breast carcinomas, while the gradually increasing type was seen in 92% of fibroadenomas. The detectability of breast carcinoma was 98% by MRI, 98% by ultrasonography, and 87% by mammography. That of fibroadenoma was 95% by MRI, 91% by ultrasonography and 60% by mammography. Sensitivity and specificity for breast carcinoma were 98% and 92% for MRI and 97% and 71% for ultrasonography. For fibroadenoma, they were 96% and 98% for MRI and 89% and 92% for ultrasonography. (author)

  17. Ability of subtraction and dynamic MR imaging to detect breast tumors. Comparison with ultrasonography and mammography

    Energy Technology Data Exchange (ETDEWEB)

    Terao, Eri; Takeuchi, Hiroaki; Iwamura, Akira; Murakami, Yoshitaka; Harada, Junta; Tada, Shinpei (Jikei Univ., Tokyo (Japan). School of Medicine)

    1994-09-01

    We evaluated the ability of subtraction and dynamic MR imaging to accurately detect breast tumors. Sixty-five breast carcinomas and 24 fibroadenomas were examined by an SE pulse sequence using a 0.2 Tesla unit. Subtraction MR images were obtained every minute during dynamic study with Gd-DTPA. Almost all breast tumors were seen as very bright masses, and the margin of the mass was clearly demonstrated on subtraction MR images. Breast carcinomas and fibroadenomas showed characteristic time-intensity curves on dynamic study. Time-intensity curves of the early peak type and plateau type were seen in 97% of breast carcinomas, while the gradually increasing type was seen in 92% of fibroadenomas. The detectability of breast carcinoma was 98% by MRI, 98% by ultrasonography, and 87% by mammography. That of fibroadenoma was 95% by MRI, 91% by ultrasonography and 60% by mammography. Sensitivity and specificity for breast carcinoma were 98% and 92% for MRI and 97% and 71% for ultrasonography. For fibroadenoma, they were 96% and 98% for MRI and 89% and 92% for ultrasonography. (author).

  18. Diagnostic value of liver scintigraphy, computed tomography and ultrasonography of fatal hepatitis

    International Nuclear Information System (INIS)

    Komori, Hideshi; Hirasa, Masahiro; Ibuki, Yasuyoshi

    1983-01-01

    The purpose of this study was investigate the diagnostic value of liver scintigraphy, computed tomography (CT) and ultrasonography in acute hepatic failure, subacute hepatitis and acute hepatitis. By scintigraphy low uptake in the liver and high uptake in the spleen and bone marrow were observed in hepatic failure. However, uneven liver edge and heterogenous RI destribution were not corresponded to massive necrosis. In fulminant hepatitis, liver size and other findings were variable in patient by patient. But in subacute hepatitis, the findings were typical. The finding of left lobe swelling was observed in a half of patients with acute hepatic failure based on chronic hepatitis. Localized low density area by the CT was detected in most of the cases of subacute hepatitis, and acute hepatitis with submassive hepatic necrosis. But in fulminant hepatitis, that was rare. In these cases, irregular and strong lesion was also obsurved by ultrasonography. These findings by the CT and ultrasonography were corresponded to massive necrosis histrogically ultrasonography revealed narrowing of hepatic vein in fatal hepatitis. Localized low density area by the CT in subacute hepatitis was shown surrounding hepatic vein. We conclude that development of massine hepatic necrosis concern to secondary hepatic ischemia. (author)

  19. Liver metastases: Sulphur hexafluoride-enhanced ultrasonography for lesion detection: a systematic review

    NARCIS (Netherlands)

    Cabassa, Paolo; Bipat, Shandra; Longaretti, Laura; Morone, Mario; Maroldi, Roberto

    2010-01-01

    This is a systematic review to evaluate the accuracy of contrast-enhanced ultrasonography (CEUS) performed with "SonoVue" (sulphur hexafluoride) in the detection of hepatic metastases. The MEDLINE, EMBASE and COCHRANE Databases were searched, regardless of language, for relevant articles published

  20. Portal blood flow volume measurement in schistosomal patients: evaluation of Doppler ultrasonography reproducibility

    International Nuclear Information System (INIS)

    Leao, Alberto Ribeiro de Souza; Santos, Jose Eduardo Mourao; Moulin, Danilo Sales; Shigueoka, David Carlos; D'Ippolito, Giuseppe; Colleoni, Ramiro

    2008-01-01

    Objective: To evaluate the reproducibility of Doppler ultrasonography in the measurement of portal blood flow volume in schistosomal patients. Materials and methods: Prospective, transversal, observational and self-paired study evaluating 21 patients with hepatosplenic schistosomiasis submitted to Doppler ultrasonography performed by three independent observers for measurement of portal blood flow. Pairwise interobserver agreement was calculated by means of the intraclass correlation coefficient, paired t-test and Pearson's correlation coefficient. Results: Interobserver agreement was excellent. Intraclass correlation ranged from 80.6% to 93.0% (IC at 95% [65.3% ; 95.8%]), with the Pearson's correlation coefficient ranging between 81.6% and 92.7% with no statistically significant interobserver difference regarding the mean portal blood flow volume measured by Doppler ultrasonography (p = 0.954 / 0.758 / 0.749). Conclusion: Doppler ultrasonography has demonstrated to be a reliable method for measuring the portal blood flow volume in patients with portal hypertension secondary to schistosomiasis, with a good interobserver agreement. (author)

  1. Ultrasonography to quantify hepatic fat content : Validation by H-1 Magnetic Resonance Spectroscopy

    NARCIS (Netherlands)

    Edens, M.A.; van Ooijen, P.M.A.; Post, W.J.; Haagmans, M.J.F.; Kristanto, W.; Sijens, P.E.; van der Jagt, E.J.; Stolk, R.P.

    2009-01-01

    An abundance of fat stored within the liver, or steatosis, is the beginning of a broad hepatological spectrum, usually referred to as fatty liver disease (FLD). For studies on FLD, quantitative hepatic fat ultrasonography would be an appealing study modality. Objective of this study was to develop a

  2. Ultrasonography, scintigraphy and computerized tomography in the investigation of the biliary tract

    International Nuclear Information System (INIS)

    Elie, G.; Drouillard, J.; Leccia, F.; Bergeron, J.-L.; Ducassou, D.; Tarvernier, J.

    1981-01-01

    New methods of investigation of the gallbladder and jaundice, without discomfort for the patients, have changed the usual algorythms. The main investigation is ultrasonography, without irradiation, not expensive, it is the best way to appreciate the dilatation of the biliary tract [fr

  3. Imaging in early rheumatoid arthritis: roles of magnetic resonance imaging, ultrasonography, conventional radiography and computed tomography

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Ejbjerg, Bo; Szkudlarek, Marcin

    2005-01-01

    Efficient methods for diagnosis, monitoring and prognostication are essential in early rheumatoid arthritis (RA). While conventional X-rays only visualize the late signs of preceding disease activity, there is evidence for magnetic resonance imaging (MRI) and ultrasonography being highly sensitiv...

  4. Serial cranial ultrasonography or early MRI for detecting preterm brain injury?

    NARCIS (Netherlands)

    Plaisier, Annemarie; Raets, Marlou M A; Ecury-Goossen, Ginette M; Govaert, Paul; Feijen-Roon, Monique; Reiss, Irwin K M; Smit, Liesbeth S; Lequin, Maarten H; Dudink, Jeroen

    OBJECTIVE: To investigate detection ability and feasibility of serial cranial ultrasonography (CUS) and early MRI in preterm brain injury. DESIGN: Prospective cohort study. SETTING: Level III neonatal intensive care unit. PATIENTS: 307 infants, born below 29 weeks of gestation. METHODS: Serial CUS

  5. Portal blood flow volume measurement in schistosomal patients: evaluation of Doppler ultrasonography reproducibility

    Energy Technology Data Exchange (ETDEWEB)

    Leao, Alberto Ribeiro de Souza; Santos, Jose Eduardo Mourao; Moulin, Danilo Sales; Shigueoka, David Carlos; D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Escola Paulista de Medicina. Dept. de Diagnostico por Imagem]. E-mail: ar.leao@uol.com.br; Colleoni, Ramiro [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Escola Paulista de Medicina. Dept. de Gastroenterologia

    2008-09-15

    Objective: To evaluate the reproducibility of Doppler ultrasonography in the measurement of portal blood flow volume in schistosomal patients. Materials and methods: Prospective, transversal, observational and self-paired study evaluating 21 patients with hepatosplenic schistosomiasis submitted to Doppler ultrasonography performed by three independent observers for measurement of portal blood flow. Pairwise interobserver agreement was calculated by means of the intraclass correlation coefficient, paired t-test and Pearson's correlation coefficient. Results: Interobserver agreement was excellent. Intraclass correlation ranged from 80.6% to 93.0% (IC at 95% [65.3% ; 95.8%]), with the Pearson's correlation coefficient ranging between 81.6% and 92.7% with no statistically significant interobserver difference regarding the mean portal blood flow volume measured by Doppler ultrasonography (p = 0.954 / 0.758 / 0.749). Conclusion: Doppler ultrasonography has demonstrated to be a reliable method for measuring the portal blood flow volume in patients with portal hypertension secondary to schistosomiasis, with a good interobserver agreement. (author)

  6. Implementation of laparoscopic splenectomy in children and the incidence of portal vein thrombosis diagnosed by ultrasonography

    NARCIS (Netherlands)

    Oomen, Matthijs W. N.; Bakx, Roel; van Minden, Minke; van Rijn, Rick R.; Peters, Marjolein; Heij, Hugo A.

    2013-01-01

    The aim of this study is to evaluate if symptomatic or asymptomatic PVT, as diagnosed with ultrasonography (US), occurs more often in children after the introduction and implementation of LS compared to open splenectomy. A retrospective cohort of 76 splenectomized patients for benign hematological

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

    Science.gov (United States)

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

  8. Ultrasonography of occipital arteries to diagnose giant cell arteritis: a case series and literature review.

    Science.gov (United States)

    Pinnell, Jonathan; Tiivas, Carl; Perkins, Phillip; Blake, Tim; Saravana, Shanmugam; Dubey, Shirish

    2018-02-01

    We describe four cases of giant cell arteritis (GCA) that presented with occipital headache in the last 6 months. Typical ultrasound features of GCA were found in the occipital arteries which helped to confirm the diagnosis. One patient had already suffered significant visual loss by the time the diagnosis was made, reflecting the similarity in prognosis to the more typical GCA patients. These cases prompted a review of the literature to evaluate the evidence regarding the use of occipital artery ultrasonography in the investigation of GCA. We searched PubMed, Google Scholar and Web of Science and identified 17 papers but only four of these were relevant studies. The studies available show that typical features of GCA can be detected in the occipital arteries using ultrasonography. They also suggest that ultrasonography can detect changes in the occipital arteries when temporal arteries are not involved. However, occipital artery abnormalities were less common than temporal artery abnormalities in GCA. We advocate maintaining a high index of suspicion for GCA in patients presenting with atypical features, such as occipital headache. Ultrasonography has a vital role to play in the diagnosis of these patients. We recommend priority imaging of the affected area to facilitate prompt and accurate diagnosis of GCA, especially when atypical vessels are involved.

  9. Guiding histological assessment of uterine lesions using 3D in vitro ultrasonography and stereotaxis

    DEFF Research Database (Denmark)

    Vandermeulen, Liselore; Cornelis, Ann; Rasmussen, Christina Kjærgaard

    2017-01-01

    , the uterus was re-evaluated by 3D in vitro ultrasonography and in vitro gel instillation sonography (iGIS). The lesion of interest was pinpointed by inserting an intramuscular injection needle using a free-hand 2D-ultrasound guided technique to focus the macroscopic and the microscopic examination...

  10. Brain ultrasonography findings in neonates with exposure to cocaine during pregnancy

    NARCIS (Netherlands)

    van Huis, M.; van Kempen, A.A.M.W.; Peelen, M.; Timmers, M.; Boer, K.; Smit, B.J.; van Rijn, R.R.

    2009-01-01

    BACKGROUND: Cocaine exposure during pregnancy has been reported to have detrimental effects on the fetus. OBJECTIVE: To describe the findings on cranial ultrasonography (CUS) as part of a neonatal screening programme for exposed neonates. MATERIALS AND METHODS: The study was a semiprospective

  11. Current relevance of cervical ultrasonography in staging cancer of the esophagus and gastroesophageal junction

    NARCIS (Netherlands)

    Schreurs, Liesbeth; Verhoef, C.C.; van der Jagt, E.J.; van Dam, G.M.; Groen, H.; Plukker, J.T.

    Purpose: To evaluate the value of external ultrasonography (US) of the neck in current dedicated preoperative staging of patients with cancer of the esophagus and gastroesophageal junction (GEJ). Materials and methods: We analyzed 180 consecutive patients (154 men, 26 women, and mean age 63 (38-84)

  12. Diagnosis of ovarian tumors by ultrasonography and x-ray CT

    International Nuclear Information System (INIS)

    Watanabe, Hiromu

    1986-01-01

    A drawback in ultrasonography, an indispensable technique in imaging ovarian malignancies, is that it sometimes shows false positive for benign tumors including dermoid cyst and ovarian endometriosis. To overcome this, the concurrent use of X-Ray CT seems warrantable and this led us to carry out the study summarized below. CT was carried out on 268 of 322 ovarian disease cases which had undergone ultrasonography. The results obtained were as follows. Sensitivity of ultrasonography and CT in ovarian malignancies were 82 % and 88 % respectively. Of the cases subjected to both techniques, those who were deemed false positive were 39 in ultrasonography and 12 in CT. Ultrasonographic imagings of dermoid cyst and ovarian endometriosis were classified on the basis of their patterns. The results obtained revealed that those in which it was difficult to discriminate the image from ovarian malignancy were types V and VI in dermoid cyst and type III-C in ovarian endometriosis. In both dermoid cyst and ovarian endometriosis, nearly a 100 % accuracy rate was obtainable with CT for diagnosis of benign tumors. This strongly suggested that concurrent use of CT was required, in diagnosing ovarian diseases with the V or VI and III-C patterns referred to above. (author)

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

    Science.gov (United States)

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

    2016-01-01

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

  14. QUANTITATIVE MUSCLE ULTRASONOGRAPHY IN THE FOLLOW-UP OF JUVENILE DERMATOMYOSITIS

    NARCIS (Netherlands)

    Habers, G. Esther A.; van Brussel, Marco; Bhansing, Kavish J.; Hoppenreijs, Esther P.; Janssen, Anjo J. W. M.; van Royen-Kerkhof, Annet; Pillen, Sigrid

    2015-01-01

    Introduction: We explored the use of quantitative muscle ultrasonography (QMUS) for follow-up of juvenile dermatomyositis (JDM). Methods: Seven JDM patients were evaluated at diagnosis and 1, 3, 6, 12, and 24 months using the Childhood Myositis Assessment Scale (CMAS) and QMUS. Muscle thickness (MT)

  15. Ultrasonography in arthritis of the knee. A comparison with MR imaging

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Court-Payen, M; Gideon, P

    1995-01-01

    Ultrasonography (US) of the knee in gonarthritis was evaluated with gadolinium-DTPA-enhanced MR imaging as a reference. The study included 13 patients with gonarthritis, 2 patients with osteoarthritis and 5 healthy controls. Compared to MR, US identified 100% (12/12) of joint effusions, 100% (5...

  16. Diagnostic Accuracy of Ultrasonography in the Initial Evaluation of Patients with Penetrating Chest Trauma

    Directory of Open Access Journals (Sweden)

    Farhad Heydari

    2014-03-01

    Full Text Available Introduction: Traumatic chest injuries (TCI are one of the most common causes of referring to the emergency departments, with high mortality and disability. This study was designed to evaluate the diagnostic accuracy of ultrasonography versus chest X ray (CXR in detection of hemo-pneumothorax for patients suffering penetrating TCI. Methods: The present cross-sectional study was performed to evaluate the diagnostic accuracy of ultrasonography in penetrating TCI victims referred to the emergency department of Shahid Kashani and Alzahra hospitals of Isfahan, Iran, from July 2012 to June 2013. Bedside ultrasonography and plain CXR was done on arrival and three hours after admission. The results of ultrasonography and radiography were separately evaluated by an emergency medicine specialist and a radiologist, who were blind to the aims of the study. Then, sensitivity, specificity, positive predictive value (PPV, negative predictive value (NPV, and kappa coefficient was considered to evaluate the accuracy of ultrasonography. Results: In this research 64 patients with penetrating chest trauma were assessed (98.4% male. The mean age of them was 25.6±8.5 years (rang: 13-65. The plain radiography revealed the eight (12.5 % cases of pneumothorax and one (1.6% hemothorax. The findings of primary ultrasonography also showed the same number of hemo-pneumothorax. Sensitivity and specificity of primary ultrasound in diagnosis of pneumothorax were 100% (95% Cl: 60.7- 100 and 100.0% (95% Cl, 92.0% to 100.0% and in detection of hemothorax were 100% (95% Cl: 50.5-100 and 100% (95% Cl: 92.8-100, respectively. Sensitivity and specificity of ultrasound in the third hour were 100% (95% Cl: 31.3-100 and 100% (95% Cl: 91.4-100, respectively. Conclusion: Findings of the present study have shown that ultrasonography has an acceptable diagnostic accuracy in the initial assessment of patients with penetrating chest trauma. However, because of its dependency on operator

  17. The Efficacy of Magnetic Resonance Imaging and Color Doppler Ultrasonography in Diagnosis of Salivary Gland Tumors

    Directory of Open Access Journals (Sweden)

    Behrooz Davachi

    2014-12-01

    Full Text Available Background and aims. Although salivary gland tumors are not very common, early diagnosis and treatment is crucial because of their proximity to vital organs, and therefore, determining the efficacy of new imaging procedures becomes important. This study aimed to evaluate the efficacy of magnetic resonance imaging (MRI and color doppler ultrasonography parameters in the diagnosis and differentiation of benign and malignant salivary gland tumors. Materials and methods. In this cross-sectional study, color doppler ultrasonography and MRI were performed for 22 patients with salivary gland tumor. Demographic data as well as MRI, color doppler ultrasonography, and surgical parameters including tumor site, signal in MRI images, ultrasound echo, tumor border, lymphadenopathy, invasion, perfusion, vascular resistance index (RI, vascular pulse index (PI were analyzed using Chi-square test, Fisher’s exact test, and independent ttest. Results. The mean age of patients was 46.59±13.97 years (8 males and 14 females. Patients with malignant tumors were older (P < 0.01. The most common tumors were pleomorphic adenoma (36.4%, metastasis (36.4%, and mucoepidermoid carcinoma (9%. Nine tumors (40.9% were benign and 13 (59.1% were malignant. The overall accuracy of MRI and color doppler ultrasonography in determining tumor site was 100% and 95%, respectively. No significant difference observed between RI and PI and the diagnosis of tumor. Conclusion. Both MRI and ultrasonography have high accuracy in the localization of tumors. Well-identified border was a sign of benign tumors. Also, invasion to adjacent structures was a predictive factor for malignancy.

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

    Directory of Open Access Journals (Sweden)

    Mahmoud Yousefifard

    2016-01-01

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

  19. Anatomical features of plantar aponeurosis: cadaveric study using ultrasonography and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Moraes do Carmo, Clarissa Canella; Fonseca de Almeida Melao, Lina Isabel; Valle de Lemos Weber, Marcio Freitas; Trudell, Debra; Resnick, Donald [UCSD, Department of Radiology, San Diego, CA (United States); VA Healthcare System San Diego, La Jolla, CA (United States)

    2008-10-15

    Abnormalities of the plantar aponeurosis are commonly encountered in patients with subcalcaneal heel pain. Understanding normal anatomy is required to accurately diagnose some disorders of the foot. The purpose of our study was to describe the normal anatomy of the plantar aponeurosis, using ultrasonography and MRI with close anatomic correlation in cadavers. After MRI and ultrasonography of 10 cadaveric foot specimens, the thickness of the central and lateral portions of the plantar aponeurosis displayed by imaging studies was measured by three radiologists. One specimen was sectioned in the transverse plane, one in the coronal plane, one in the sagittal plane, and two in a sagittal oblique plane. Normal anatomy was identified and similar measurements of the plantar aponeurosis were also made. An average value was determined and a statistical analysis was accomplished. The calcaneal insertions of the plantar aponeurosis were better visualized than its distal portions with both MRI and ultrasonography. The measurements of the plantar aponeurosis made by three different radiologists were different, but without statistical significance. The average measurements for the central and lateral portions of the plantar aponeurosis with both imaging methods were different from each other because of differences in the morphology of these structures. The values obtained with ultrasonography and MRI, were also different from each other for both the central and lateral portions of the plantar aponeurosis, but with no statistical significance. We have described the detailed anatomy of the plantar aponeurosis with emphasis on the more distal structures that can be visualized with MRI. There was no statistically significant difference between the accuracy of ultrasonography and MRI regarding the measurements of the thickness of the central and lateral portions of the plantar aponeurosis. Knowledge of the normal anatomy of these structures enables the radiologist to identify early

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

    Science.gov (United States)

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

    2017-08-01

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