WorldWideScience

Sample records for intravascular ultrasound assessment

  1. Harmonic Intravascular Ultrasound

    NARCIS (Netherlands)

    M.E. Frijlink (Martijn)

    2006-01-01

    textabstractMedical ultrasound is a popular imaging modality in cardiology. Harmonic Imaging is a technique that has been shown to increase the image quality of diagnostic ultrasound at frequencies below 10 MHz. However, Intravascular Ultrasound, which is a technique to acoustically investigate

  2. Intravascular ultrasound assessment of remodelling and reference segment plaque burden in type-2 diabetic patients

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Mintz, Gary S

    2007-01-01

    AIMS: Intravascular ultrasound (IVUS) assesses arterial remodelling by comparing the lesion external elastic membrane (EEM) with the reference segments; however, reference segments are rarely disease-free. The aim was to assess lesion and reference segment remodelling and plaque burden in patients...... with type-2 diabetes mellitus. METHODS AND RESULTS: We used pre-intervention IVUS to study 62 de novo lesions in 43 patients with type-2 diabetes mellitus. The lesion site was the image slice with the smallest lumen cross-sectional area (CSA). The proximal and distal reference segments were the most normal...... IVUS lumen and quantitative coronary angiographic artery...

  3. Mapping intravascular ultrasound controversies in interventional cardiology practice.

    Directory of Open Access Journals (Sweden)

    David Maresca

    Full Text Available Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound innovation has been relatively limited. Intravascular ultrasound remains a niche technology; its clinical practice did not vastly expand, except in Japan, where intravascular ultrasound is an appraised tool for guiding percutaneous coronary interventions. In this qualitative research study, we follow scholarship on the sociology of innovation in exploring both the current adoption practices and perspectives on the future of intravascular ultrasound. We conducted a survey of biomedical experts with experience in the technology, the practice, and the commercialization of intravascular ultrasound. The collected information enabled us to map intravascular ultrasound controversies as well as to outline the dynamics of the international network of experts that generates intravascular ultrasound innovations and uses intravascular ultrasound technologies. While the technology is praised for its capacity to measure coronary atherosclerotic plaque morphology and is steadily used in clinical research, the lack of demonstrated benefits of intravascular ultrasound guided coronary interventions emerges as the strongest factor that prevents its expansion. Furthermore, most of the controversies identified were external to intravascular ultrasound technology itself, meaning that decision making at the industrial, financial and regulatory levels are likely to determine the future of intravascular ultrasound. In light of opinions from the responding experts', a wider adoption of intravascular ultrasound as a stand-alone imaging modality seems rather uncertain, but the appeal for this technology may be renewed by improving image quality and through combination with

  4. Intravascular ultrasound assessed incomplete stent apposition and stent fracture in stent thrombosis after bare metal versus drug-eluting stent treatment the Nordic Intravascular Ultrasound Study (NIVUS)

    DEFF Research Database (Denmark)

    Kosonen, Petteri; Vikman, Saila; Jensen, Lisette Okkels

    2013-01-01

    This prospective multicenter registry used intravascular ultrasound (IVUS) in patients with definite stent thrombosis (ST) to compare rates of incomplete stent apposition (ISA), stent fracture and stent expansion in patients treated with drug-eluting (DES) versus bare metal (BMS) stents. ST...

  5. The use of intravascular ultrasound for intraoperative assessment during semiclosed thromboendarterectomy

    DEFF Research Database (Denmark)

    Vogt, K C; Sillesen, H; Schroeder, T V

    1998-01-01

    To evaluate the application of intravascular ultrasound (IVUS) for intraoperative assessment of semiclosed thromboendarterectomy (TEA), IVUS images of the iliofemoral segment in 20 patients were obtained. The configuration and size of residual atherosclerotic material were evaluated. Stenoses...... was detected in the artery by IVUS. The material was removed in five cases. The part of the iliac artery proximal to the endarterectomized segment was visualized in 14 cases and showed minor stenoses in 10 cases. After follow-up at a median of 8 months (range 1-24), occlusion had occurred in one of 20 patients...... and restenosis (> 50%) had developed in two (10%). At this point, patency cannot be related to IVUS findings. We conclude that IVUS is a feasible method for intraoperative assessment of semiclosed TEA. The rate of early failures due to residual material might be reduced by this new application of IVUS....

  6. Multicenter assessment of the reproducibility of volumetric radiofrequency-based intravascular ultrasound measurements in coronary lesions that were consecutively stented

    DEFF Research Database (Denmark)

    Huisman, Jennifer; Egede, Rasmus; Rdzanek, Adam

    2012-01-01

    To assess in a multicenter design the between-center reproducibility of volumetric virtual histology intravascular ultrasound (VH-IVUS) measurements with a semi-automated, computer-assisted contour detection system in coronary lesions that were consecutively stented. To evaluate the reproducibility...

  7. Mapping Intravascular Ultrasound Controversies in Interventional Cardiology Practice

    NARCIS (Netherlands)

    Maresca, D.; Adams, S.; Maresca, B.; Van der Steen, A.F.W.

    2014-01-01

    Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound

  8. Mapping intravascular ultrasound controversies in interventional cardiology practice

    NARCIS (Netherlands)

    Maresca, David; Adams, Samantha; Maresca, Bruno; van der Steen, Antonius F W

    2014-01-01

    Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound

  9. Serial intravascular ultrasound assessment of changes in coronary atherosclerotic plaque dimensions and composition: an update

    DEFF Research Database (Denmark)

    Hartmann, Marc; Huisman, Jennifer; Böse, Dirk

    2011-01-01

    This manuscript reviews the use of serial intravascular ultrasound (IVUS) examination of coronary atherosclerosis in recent observational studies and randomized trials that revealed the effects of cholesterol-lowering and lipid-modifying therapies and offered novel insight into plaque progression....... Finally, we report on the evaluation of true vessel remodelling in recent serial IVUS trials and discuss the future perspective of serial invasive imaging of coronary atherosclerosis....

  10. Correlation between dual-axis rotational coronary angiography and intravascular ultrasound in a coronary lesion assessment.

    Science.gov (United States)

    Jin, Zhi-Geng; Zhang, Zhuo-Qi; Jing, Li-Min; Wei, Yu-Jie; Zhang, Jiao; Luo, Jian-Ping; Yang, Sheng-Li; Ma, Dong-Xing; Liu, Ying; Han, Wei; Yang, Yong; Liu, Hui-Liang

    2017-02-01

    The purpose of this study was to evaluate the accuracy of dual-axis rotational coronary angiography (DARCA) for coronary lesion assessment by directly comparing with intravascular ultrasound (IVUS). From October 2014 to December 2015, 40 patients (58 lesions) who had undergone both DARCA and IVUS were included in the image analysis. The minimum lumen diameter (MLD), lesion length, reference vessel diameter (RVD) and percent diameter stenosis at the same lesion, were identified and assessed. Significant correlation with IVUS was found for DARCA in either lesion length (r = 0.90, P < 0.001) or RVD (r = 0.81, P < 0.001) comparison. DARCA had fair correlation with IVUS for both MLD (r = 0.65, P < 0.001) and diameter stenosis (r = 0.48, P < 0.001). From the Bland-Altman plots, there was a good agreement between DARCA and IVUS regarding MLD (mean difference: -0.23 mm, 95 % limits of agreement: -0.96 to 0.50 mm) and RVD (mean difference: -0.15 mm, 95 % limits of agreement: -0.85 to 0.55 mm), while lesser agreement was found on lesion length (mean difference: -3.39 mm, 95 % limits of agreement: -12.63 to 5.85 mm) and diameter stenosis (mean difference: 4.82 %, 95 % limits of agreement: -17.05 to 26.68 %). There is an adequate correlation and agreement between DARCA and IVUS in coronary lesion assessment.

  11. Intravascular Ultrasound and its Use in Vascular Interventional Radiology

    International Nuclear Information System (INIS)

    Klepanec, A.; Vulev, I.; Vozar, M.; Balazs, T.; Madaric, J.; Holoman, M.

    2009-01-01

    Intravascular ultrasound has become in invasive vascular radiology in the last decade the important part of diagnostic and also therapeutic procedures in management of vascular diseases. The basic possibilities for the use of IVUS include diagnostic procedures in vascular pathology assessment and therapeutic indications in the field of peripheral vascular interventions (PVI). Unlike other image modalities (CT, MRI, ultrasound) IVUS enables gather unique image in r eal time r ight from the vessel lumen, what helps to add important information regarding vessel wall, plate morphology, thrombi and cross-sectional vessel area. After initial use of intravascular ultrasound in coronary circulation, using IVUS is nowadays widely extended especially in aortic diseases, carotid and renal arteries and arteries of the lower extremities. This review article summarizes possibilities of intravascular ultrasound utilization in diagnostic process and therapy from peripheral vascular diseases up to thoracoabdominal aorta diseases and our experience with this new diagnostic modality. (author)

  12. Comparison of intravascular ultrasound and angiographic assessement of coronary reference segment size in patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Mintz, Gary S

    2008-01-01

    During percutaneous coronary intervention, the reference segment is assessed angiographically. This report described the discrepancy between angiographic and intravascular ultrasound (IVUS) assessment of reference segment size in patients with type 2 diabetes mellitus. Preintervention IVUS was used...... was measured as plaque CSA/external elastic membrane (EEM) CSA. Using IVUS, the reference lumen diameter was 2.80 +/- 0.42 mm and the reference EEM diameter was 4.17 +/- 0.56 mm. The angiographic reference diameter was 2.63 +/- 0.36 mm. Mean difference between the IVUS EEM diameter and angiographic reference...... diameter was 1.56 +/- 0.55 mm. The mean difference between the IVUS reference lumen diameter and angiographic reference lumen diameter was 0.18 +/- 0.44 mm. Plaque burden in the reference segment correlated inversely with the difference between IVUS and quantitative coronary angiographic reference lumen...

  13. Intravascular ultrasound assessment of minimumlumen area and intimal hyperplasia in in-stent restenosis after drug-eluting or bare-metal stent implantation. The Nordic Intravascular Ultrasound Study (NIVUS)

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Vikman, Saila; Antonsen, Lisbeth

    2017-01-01

    Introduction: Drug-eluting stents (DES) reduce the risk of restenosis after percutaneous coronary intervention. The aim of the study was to evaluate, by intravascular ultrasound (IVUS), the minimum lumen area site in the stented segment and the distribution of intimal hyperplasia in patients...

  14. Use of Intravascular Ultrasound Imaging in Percutaneous Coronary Intervention to Treat Left Main Coronary Artery Disease.

    Science.gov (United States)

    De Maria, Giovanni Luigi; Banning, Adrian P

    2017-05-01

    Due to its potential prognostic implications and technical complexity, revascularisation of left main coronary artery (LMCA) disease requires careful consideration. Since publication of the results of the SYNTAX study, and more recently the EXCEL and NOBLE trials, there has been particular interest in percutaneous revascularisation of the LMCA. It is becoming clear that percutaneous revascularisation of LMCA disease requires appropriate lesion preparation and carefully optimised stenting in order to offer patients a treatment option as effective as coronary artery bypass grafting. For this reason intravascular imaging, and especially intravascular ultrasound, is becoming a key procedural step in LMCA percutaneous coronary intervention. In the current review paper we analyse the role of intravascular imaging with intravascular ultrasound in LMCA percutaneous coronary intervention, focusing on the main applications in this context from lesion assessment to stent sizing and optimisation.

  15. Discrimination of intravascular lumen and dissections in single intravascular ultrasound images using subtraction, conventional averaging and saline flush

    NARCIS (Netherlands)

    G. Pasterkamp (Gerard); M.S. van der Heiden (M.); M.J. Post (Mark); C. Borst (Cornelius); E.J. Gussenhoven (Elma); H. Pieterman; H. van Urk (Hero); N. Bom (Klaas)

    1995-01-01

    textabstractWith current 30-MHz intravascular ultrasound systems, flowing blood may cause considerable backscatter which in real-time images is characterized by dynamic speckle. However, in a single intravascular ultrasound image (still-frame) the discrimination between arterial lumen and wall may

  16. Mechanical scanning in intravascular ultrasound imaging: Artifacts and driving mechanisms

    NARCIS (Netherlands)

    H. ten Hoff (H.); E.J. Gussenhoven (Elma); C.M. Korbijn (Carin); F. Mastik (Frits); C.T. Lancée (Charles); N. Bom (Klaas)

    1995-01-01

    textabstractObjective: Currently, intravascular ultrasound (US) imaging catheters are developed and produced to provide a complementary diagnostic method in the treatment of blood vessel obstructive disease. Typical catheter dimensions are a diameter of 1–2.5 mm and a length of 1–1.5 m. A real-time

  17. An Axial Array for Volumetric Intravascular Ultrasound Imaging

    NARCIS (Netherlands)

    Alles, E.J.

    2012-01-01

    Intravascular ultrasound (IVUS) is a medical imaging modality aimed at imaging blood vessel walls from within the vessel. Current commercial IVUS catheters are designed to yield two-dimensional cross-sectional images perpendicular to the vessel wall. By pulling the catheter back through the artery

  18. Renal denervation by intravascular ultrasound: Preliminary in vivo study

    Science.gov (United States)

    Sinelnikov, Yegor; McClain, Steve; Zou, Yong; Smith, David; Warnking, Reinhard

    2012-10-01

    Ultrasound denervation has recently become a subject of intense research in connection with the treatment of complex medical conditions including neurological conditions, development of pain management, reproduction of skin sensation, neuropathic pain and spasticity. The objective of this study is to investigate the use of intravascular ultrasound to produce nerve damage in renal sympathetic nerves without significant injury to the renal artery. This technique may potentially be used to treat various medical conditions, such as hypertension. The study was approved by the Institutional Animal Care and Use Committee. Ultrasound was applied to renal nerves of the swine model for histopathological evaluation. Therapeutic ultrasound energy was delivered circumferentially by an intravascular catheter maneuvered into the renal arteries. Fluoroscopic imaging was conducted pre-and post-ultrasound treatment. Animals were recovered and euthanized up to 30 hours post procedure, followed by necropsy and tissue sample collection. Histopathological examination showed evidence of extensive damage to renal nerves, characterized by nuclear pyknosis, hyalinization of stroma and multifocal hemorrhages, with little or no damage to renal arteries. This study demonstrates the feasibility of intravascular ultrasound as a minimally invasive renal denervation technique. Further studies are necessary to evaluate the long-term safety and efficacy of this technique and its related clinical significance.

  19. Assessment of carotid plaque composition using fast-kV switching dual-energy CT with gemstone detector: comparison with extracorporeal and virtual histology-intravascular ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Shinohara, Yuki; Kuya, Keita; Ohta, Yasutoshi; Fujii, Shinya; Ogawa, Toshihide [Tottori University, Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Yonago (Japan); Sakamoto, Makoto; Watanabe, Takashi [Tottori University, Division of Neurosurgery, Department of Neurological Sciences, Faculty of Medicine, Yonago (Japan); Kishimoto, Junichi; Iwata, Naoki [Tottori University Hospital, Division of Clinical Radiology, Yonago (Japan)

    2015-09-15

    The present study compares the applicability of CT carotid plaque imaging using effective Z maps using gemstone spectral imaging (GSI) with that of conventional extracorporeal carotid ultrasound (US) and virtual histology-intravascular ultrasound (VH-IVUS). We assessed stenosis in 31 carotid arteries of 30 patients. All patients underwent carotid CTA using GSI (Discovery CT750 HD, GE Healthcare). US and IVUS were examined with 25 and 8 vessels, respectively. We compared the effective Z values at noncalcified carotid plaque with the plaque components identified by US. We defined the plaque with low or low to iso intensity on US as vulnerable plaque and the plaque with iso, iso to high, and high intensity on US as stable plaque. We also performed visual assessment of color-coded effective Z maps in comparison with VH-IVUS and compared effective Z values with plaque components generated by VH-IVUS. The effective Z values at noncalcified carotid plaque were significantly lower for a group with vulnerable plaque, than with stable plaque on US (p < 0.05). Receiver operating curve analysis showed that AUC of effective Z values was 0.882 concerning the differentiation of these two groups on US. The interpretation of color-coded effective Z maps was essentially compatible with that of VH-IVUS for carotid plaque in all vessels. Effective Z values at noncalcified plaque showed significant negative correlation with the areas of fibro-fatty components generated by VH-IVUS (ρ = -0.874, p < 0.05). Effective Z maps generated by GSI can detect vulnerable carotid plaque materials. (orig.)

  20. Assessment of carotid plaque composition using fast-kV switching dual-energy CT with gemstone detector: comparison with extracorporeal and virtual histology-intravascular ultrasound

    International Nuclear Information System (INIS)

    Shinohara, Yuki; Kuya, Keita; Ohta, Yasutoshi; Fujii, Shinya; Ogawa, Toshihide; Sakamoto, Makoto; Watanabe, Takashi; Kishimoto, Junichi; Iwata, Naoki

    2015-01-01

    The present study compares the applicability of CT carotid plaque imaging using effective Z maps using gemstone spectral imaging (GSI) with that of conventional extracorporeal carotid ultrasound (US) and virtual histology-intravascular ultrasound (VH-IVUS). We assessed stenosis in 31 carotid arteries of 30 patients. All patients underwent carotid CTA using GSI (Discovery CT750 HD, GE Healthcare). US and IVUS were examined with 25 and 8 vessels, respectively. We compared the effective Z values at noncalcified carotid plaque with the plaque components identified by US. We defined the plaque with low or low to iso intensity on US as vulnerable plaque and the plaque with iso, iso to high, and high intensity on US as stable plaque. We also performed visual assessment of color-coded effective Z maps in comparison with VH-IVUS and compared effective Z values with plaque components generated by VH-IVUS. The effective Z values at noncalcified carotid plaque were significantly lower for a group with vulnerable plaque, than with stable plaque on US (p < 0.05). Receiver operating curve analysis showed that AUC of effective Z values was 0.882 concerning the differentiation of these two groups on US. The interpretation of color-coded effective Z maps was essentially compatible with that of VH-IVUS for carotid plaque in all vessels. Effective Z values at noncalcified plaque showed significant negative correlation with the areas of fibro-fatty components generated by VH-IVUS (ρ = -0.874, p < 0.05). Effective Z maps generated by GSI can detect vulnerable carotid plaque materials. (orig.)

  1. Front-end IC design for intravascular ultrasound imaging

    OpenAIRE

    Yamaner, Yalçın Feysel; Yamaner, Yalcin Feysel; Cenkeramaddi, Linga Reddy; Bozkurt, Ayhan

    2008-01-01

    Capacitive micromachined ultrasonic transducers(cMUT) technology is a new trend for intravascular ultrasound (IVUS) imaging. Large bandwidth, high sensitivity and compatibility to CMOS processes makes the cMUT a better choice compared to the conventional piezoelectric transducer. To exploit the merits of cMUT technology, an accurately designed front end circuit is required. The circuit functions as an output pulse driver for the generation of the acoustic signal and buffers the return echo. F...

  2. PCA-based polling strategy in machine learning framework for coronary artery disease risk assessment in intravascular ultrasound: A link between carotid and coronary grayscale plaque morphology.

    Science.gov (United States)

    Araki, Tadashi; Ikeda, Nobutaka; Shukla, Devarshi; Jain, Pankaj K; Londhe, Narendra D; Shrivastava, Vimal K; Banchhor, Sumit K; Saba, Luca; Nicolaides, Andrew; Shafique, Shoaib; Laird, John R; Suri, Jasjit S

    2016-05-01

    Percutaneous coronary interventional procedures need advance planning prior to stenting or an endarterectomy. Cardiologists use intravascular ultrasound (IVUS) for screening, risk assessment and stratification of coronary artery disease (CAD). We hypothesize that plaque components are vulnerable to rupture due to plaque progression. Currently, there are no standard grayscale IVUS tools for risk assessment of plaque rupture. This paper presents a novel strategy for risk stratification based on plaque morphology embedded with principal component analysis (PCA) for plaque feature dimensionality reduction and dominant feature selection technique. The risk assessment utilizes 56 grayscale coronary features in a machine learning framework while linking information from carotid and coronary plaque burdens due to their common genetic makeup. This system consists of a machine learning paradigm which uses a support vector machine (SVM) combined with PCA for optimal and dominant coronary artery morphological feature extraction. Carotid artery proven intima-media thickness (cIMT) biomarker is adapted as a gold standard during the training phase of the machine learning system. For the performance evaluation, K-fold cross validation protocol is adapted with 20 trials per fold. For choosing the dominant features out of the 56 grayscale features, a polling strategy of PCA is adapted where the original value of the features is unaltered. Different protocols are designed for establishing the stability and reliability criteria of the coronary risk assessment system (cRAS). Using the PCA-based machine learning paradigm and cross-validation protocol, a classification accuracy of 98.43% (AUC 0.98) with K=10 folds using an SVM radial basis function (RBF) kernel was achieved. A reliability index of 97.32% and machine learning stability criteria of 5% were met for the cRAS. This is the first Computer aided design (CADx) system of its kind that is able to demonstrate the ability of coronary

  3. Rotational multispectral fluorescence lifetime imaging and intravascular ultrasound: bimodal system for intravascular applications

    Science.gov (United States)

    Ma, Dinglong; Bec, Julien; Yankelevich, Diego R.; Gorpas, Dimitris; Fatakdawala, Hussain; Marcu, Laura

    2014-06-01

    We report the development and validation of a hybrid intravascular diagnostic system combining multispectral fluorescence lifetime imaging (FLIm) and intravascular ultrasound (IVUS) for cardiovascular imaging applications. A prototype FLIm system based on fluorescence pulse sampling technique providing information on artery biochemical composition was integrated with a commercial IVUS system providing information on artery morphology. A customized 3-Fr bimodal catheter combining a rotational side-view fiberoptic and a 40-MHz IVUS transducer was constructed for sequential helical scanning (rotation and pullback) of tubular structures. Validation of this bimodal approach was conducted in pig heart coronary arteries. Spatial resolution, fluorescence detection efficiency, pulse broadening effect, and lifetime measurement variability of the FLIm system were systematically evaluated. Current results show that this system is capable of temporarily resolving the fluorescence emission simultaneously in multiple spectral channels in a single pullback sequence. Accurate measurements of fluorescence decay characteristics from arterial segments can be obtained rapidly (e.g., 20 mm in 5 s), and accurate co-registration of fluorescence and ultrasound features can be achieved. The current finding demonstrates the compatibility of FLIm instrumentation with in vivo clinical investigations and its potential to complement conventional IVUS during catheterization procedures.

  4. Association of insulin resistance and coronary artery remodeling: an intravascular ultrasound study

    OpenAIRE

    Kim, Sang-Hoon; Moon, Jae-Youn; Lim, Yeong Min; Kim, Kyung Ho; Yang, Woo-In; Sung, Jung-Hoon; Yoo, Seung Min; Kim, In Jai; Lim, Sang-Wook; Cha, Dong-Hun; Cho, Seung-Yun

    2015-01-01

    Background There are few studies that investigated the correlation between insulin resistance (IR) and the coronary artery remodeling. The aim of the study is to investigate the association of IR measured by homeostasis model assessment of insulin resistance (HOMA-IR) and coronary artery remodeling evaluated by intravascular ultrasound (IVUS). Methods A total of 298 consecutive patients who received percutaneous coronary interventions under IVUS guidance were retrospectively enrolled. The val...

  5. Recurring extracranial internal carotid artery vasospasm detected by intravascular ultrasound.

    Science.gov (United States)

    Dembo, Tomohisa; Tanahashi, Norio

    2012-01-01

    A 24-year-old woman presented with headache and left-sided focal signs following multiple episodes of right monocular visual impairment. Magnetic resonance angiography revealed a decreased vascular image intensity due to a suspicious stenosis in the right internal carotid artery (ICA). The stenosis was not demonstrated on duplex sonography as it was beyond the field of view of the investigation. Intravascular ultrasound (IVUS) revealed that the outer vessel diameter was significantly reduced during stenosis, supporting the presence of vasospasm. Idiopathic recurrent extracranial ICA vasospasm was diagnosed. Recurrent vasospasms of extracranial ICA may be a distinct entity that can cause ischemic stroke.

  6. Accuracy of electrocardiographic-gated versus nongated volumetric intravascular ultrasound measurements of coronary arterial narrowing

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per

    2007-01-01

    Intravascular ultrasound (IVUS) allows precise measurements of plaque plus media (P+M) volume and neointimal hyperplasia after coronary artery stenting. Conventional IVUS volumetric analysis is performed mostly without electrocardiographically gated acquisition, and the IVUS images are selected...

  7. Circulating Microparticles and Coronary Plaque Components Assessed by Virtual Histology Intravascular Ultrasound of the Target Lesion in Patients with Stable Angina.

    Directory of Open Access Journals (Sweden)

    Pil-Ki Min

    Full Text Available High levels of microparticles (MPs circulate in the blood of patients with atherosclerotic diseases where they can serve as potential biomarkers of vascular injury and cardiovascular outcome. We used virtual histology intravascular ultrasound (VH-IVUS to evaluate the relationship between the levels of circulating MPs and the coronary plaque composition in patients with stable angina. We included 35 patients with stable angina (22 men, age 64 ± 9 years and a de novo target lesion. Preintervention gray-scale and VH-IVUS analysis was performed across the target lesion. Volumetric analysis was performed over a 10-mm-long segment centered at the minimum luminal site. Blood samples were obtained from the femoral artery before coronary angioplasty. MPs were measured using a solid-phase capture assay from a commercial kit. We divided participants into either a low MPs group or high MPs group based on the median value of MPs. There was no significant difference in baseline characteristics between the groups. The plaque burden and remodeling index were similar between the groups. The presence of VH-IVUS-derived thin-cap fibroatheroma was not different between the groups. The percentage of the necrotic core (NC was significantly higher in the high MPs group than in the low MPs group, both in planar (17.0 ± 8.8% vs. 24.1 ± 6.9%, p = 0.012 and volumetric analyses (17.0 ± 4.8% vs. 22.1 ± 4.3%, p = 0.002. Circulating MPs were positively correlated with the percentage of the NC area at the minimal luminal site (r = 0.491, p = 0.003 and the percentage of the NC volume (r = 0.496, p = 0.002. Elevated levels of circulating MPs were associated with the amount of NC in the target lesion in those with stable angina, suggesting a potential role of circulating MPs as a biomarker for detecting unstable plaque in patients with stable angina.

  8. Perspectives on Imaging the Left Main Coronary Artery Using Intravascular Ultrasound and Optical Coherence Tomography

    Directory of Open Access Journals (Sweden)

    Harry C Lowe

    2015-01-01

    Full Text Available Percutaneous Coronary Intervention (PCI for significant left main coronary artery (LMCA stenosis is increasingly being viewed as a viable alternative to Coronary Artery Bypass Grafting (CABG (1. This is leading to an expectation of increasing numbers of such procedures, with a consequent focus on both the ability to image both lesion severity, and assess more accurately the results of PCI. While there have been advances in physiologic assessment of left main severity using fractional flow reserve (FFR, imaging of the LMCA using Intravascular Ultrasound (IVUS and more recently Optical Coherence Tomography (OCT has the specific advantage of being able to provide detailed anatomical information both pre and post PCI, such that it is timely to review briefly the current status of these two imaging technologies in the context of LMCA intervention.

  9. Relationship between intravascular ultrasound parameters and fractional flow reserve in intermediate coronary artery stenosis of left anterior descending artery: intravascular ultrasound volumetric analysis.

    Science.gov (United States)

    Yang, Hyoung-Mo; Tahk, Seung-Jea; Lim, Hong-Seok; Yoon, Myeong-Ho; Choi, So-Yeon; Choi, Byoung-Joo; Jin, Xiong Jie; Hwang, Gyo-Seung; Park, Jin-Sun; Shin, Joon-Han

    2014-02-15

    The objective of this study was to assess the relationship between intravascular ultrasound (IVUS) parameters, including volumetric analysis, and fractional flow reserve (FFR). Although it is known that coronary atherosclerosis burden measured by IVUS volumetric analysis is related with clinical outcomes, its relationship with functional significance remains unknown. Both IVUS and FFR were performed in 206 cases of intermediate stenosis of the left anterior descending artery (LAD). Myocardial ischemia was assessed by FFR and maximal hyperemia was induced by continuous intracoronary adenosine infusion. FFR  0.80 were associated with larger plaque volume (181.8 ± 82.3 vs. 125.9 ± 77.9 mm3, P < 0.001) and PAV (58.9 ± 5.6 vs. 53.8 ± 7.9%, P < 0.001). IVUS parameters representing severity and extent of atheromatous plaque correlated with functional significance in LAD lesions with intermediate stenosis.

  10. Reproducibility of intravascular ultrasound radiofrequency data analysis (virtual histology) with a 45-MHz rotational imaging catheter in ex vivo human coronary arteries

    NARCIS (Netherlands)

    T. Muramatsu (Takashi); H.M. Garcia-Garcia (Hector); S. Brugaletta (Salvatore); J.H. Heo (Jungho); Y. Onuma (Yoshinobu); R.J. Fedewa (Russell J.); A. Nair (Anuja); Y. Ozaki (Yukio); P.W.J.C. Serruys (Patrick)

    2015-01-01

    textabstractBackground: Despite the frequent use of spectral analysis of intravascular ultrasound radiofrequency data (VH® IVUS) in clinical studies, the assessment for reproducibility using this with high frequency IVUS remains unexplored. Purpose: The aim of this study was to examine the

  11. Design of low noise transimpedance amplifier for intravascular ultrasound

    KAUST Repository

    Reda, Dina

    2009-11-01

    In this paper, we study transimpedance amplifiers for capacitive sensing applications with a focus on Intravascular Ultra Sound (IVUS). We employ RF noise cancellation technique on capacitive feedback based transimpedance amplifiers. This technique eliminates the input-referred noise of TIAs completely and enhances the dynamic range of front-end electronics. Simulation results verify the proposed technique used in two different TIA topologies employing shunt-shunt feedback. ©2009 IEEE.

  12. Low variation and high reproducibility in plaque volume with intravascular ultrasound

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Pedersen, Knud Erik

    2004-01-01

    BACKGROUND: Intravascular ultrasound (IVUS) has several advantages compared to angiography when evaluating coronary atherosclerosis in the vessel wall. METHODS: The accuracy, reproducibility, and short-time spontaneous variation in volume of vessel, plaque and lumen were studied by electrocardiog......BACKGROUND: Intravascular ultrasound (IVUS) has several advantages compared to angiography when evaluating coronary atherosclerosis in the vessel wall. METHODS: The accuracy, reproducibility, and short-time spontaneous variation in volume of vessel, plaque and lumen were studied...... by electrocardiographic-gated three-dimensional (3D) IVUS in 20 male patients with ischaemic heart disease (IHD). RESULTS: The study lesions were angiographically insignificant, with a length of the analysed segment on 11.4+/-5.9 mm. At baseline the mean minimal lumen diameter was 2.41+/-0.59 mm, minimal lumen area 4......=0.804; pIVUS is a highly reproducible method when applied on coronary artery...

  13. Multimodality Intracoronary Imaging With Near-Infrared Spectroscopy and Intravascular Ultrasound in Asymptomatic Individuals With High Calcium Scores.

    Science.gov (United States)

    Madder, Ryan D; VanOosterhout, Stacie; Klungle, David; Mulder, Abbey; Elmore, Matthew; Decker, Jeffrey M; Langholz, David; Boyden, Thomas F; Parker, Jessica; Muller, James E

    2017-10-01

    This study sought to determine the frequency of large lipid-rich plaques (LRP) in the coronary arteries of individuals with high coronary artery calcium scores (CACS) and to determine whether the CACS correlates with coronary lipid burden. Combined near-infrared spectroscopy and intravascular ultrasound was performed in 57 vessels in 20 asymptomatic individuals (90% on statins) with no prior history of coronary artery disease who had a screening CACS ≥300 Agatston units. Among 268 10-mm coronary segments, near-infrared spectroscopy images were analyzed for LRP, defined as a bright yellow block on the near-infrared spectroscopy block chemogram. Lipid burden was assessed as the lipid core burden index (LCBI), and large LRP were defined as a maximum LCBI in 4 mm ≥400. Vessel plaque volume was measured by quantitative intravascular ultrasound. Vessel-level CACS significantly correlated with plaque volume by intravascular ultrasound ( r =0.69; P infrared spectroscopy ( r =0.24; P =0.07). Despite a high CACS, no LRP was detected in 8 (40.0%) subjects. Large LRP having a maximum LCBI in 4 mm ≥400 were infrequent, found in only 5 (25.0%) of 20 subjects and in only 5 (1.9%) of 268 10-mm coronary segments analyzed. Among individuals with a CACS ≥300 Agatston units mostly on statins, CACS correlated with total plaque volume but not LCBI. This observation may have implications on coronary risk among individuals with a high CACS considering that it is coronary LRP, rather than calcification, that underlies the majority of acute coronary events. © 2017 American Heart Association, Inc.

  14. Monolithic CMUT on CMOS Integration for Intravascular Ultrasound Applications

    Science.gov (United States)

    Zahorian, Jaime; Hochman, Michael; Xu, Toby; Satir, Sarp; Gurun, Gokce; Karaman, Mustafa; Degertekin, F. Levent

    2012-01-01

    One of the most important promises of capacitive micromachined ultrasonic transducer (CMUT) technology is integration with electronics. This approach is required to minimize the parasitic capacitances in the receive mode, especially in catheter based volumetric imaging arrays where the elements need to be small. Furthermore, optimization of the available silicon area and minimized number of connections occurs when the CMUTs are fabricated directly above the associated electronics. Here, we describe successful fabrication and performance evaluation of CMUT arrays for intravascular imaging on custom designed CMOS receiver electronics from a commercial IC foundry. The CMUT on CMOS process starts with surface isolation and mechanical planarization of the CMOS electronics to reduce topography. The rest of the CMUT fabrication is achieved by modifying a low temperature micromachining process through the addition of a single mask and developing a dry etching step to produce sloped sidewalls for simple and reliable CMUT to CMOS interconnection. This CMUT to CMOS interconnect method reduced the parasitic capacitance by a factor of 200 when compared with a standard wire bonding method. Characterization experiments indicate that the CMUT on CMOS elements are uniform in frequency response and are similar to CMUTs simultaneously fabricated on standard silicon wafers without electronics integration. Experiments on a 1.6 mm diameter dual-ring CMUT array with a 15 MHz center frequency show that both the CMUTs and the integrated CMOS electronics are fully functional. The SNR measurements indicate that the performance is adequate for imaging CTOs located 1 cm away from the CMUT array. PMID:23443701

  15. Visualization of plaque distribution in a curved artery: three-dimensional intravascular ultrasound imaging.

    Science.gov (United States)

    Choi, Ahnryul; McPherson, David D; Kim, Hyunggun

    2017-12-01

    Intravascular ultrasound (IVUS) imaging provides an excellent tool for evaluation of the type, morphology, extent, and severity of an atheromatous plaque. 3 D IVUS imaging offers additive information pertaining to morphology of the arterial structures and volumetric plaque distributions. A new 3 D IVUS visualization technique was developed to provide 3 D structural information of a curved artery. A virtual 3 D curved arterial phantom consisting of varying cross-sectional shapes, wall thicknesses, and acoustic intensity information was utilized to validate the nonlinear interpolation technique to create intermediary 2 D IVUS images. IVUS imaging was performed for the iliofemoral arterial segment of an atherosclerotic Yucatan miniswine model. These in-vivo IVUS data were utilized for intermediary IVUS image generation and volumetric 3 D IVUS visualization. Smooth transitional changes of cross-sectional shape, wall thickness and grayscale intensity were found between the intermediary images and the original arterial phantom slices. The 3 D IVUS imaging of the unfolded curved iliofemoral artery provided realistic 3 D luminal surface images of the arteries with physiologic grayscale intensity information. This unique 3 D IVUS imaging technique may help with assessment of 3 D plaque distribution across the curved arterial structure, and improve 3 D visualization of atheromatous components.

  16. Monolithic CMUT-on-CMOS integration for intravascular ultrasound applications.

    Science.gov (United States)

    Zahorian, Jaime; Hochman, Michael; Xu, Toby; Satir, Sarp; Gurun, Gokce; Karaman, Mustafa; Degertekin, F Levent

    2011-12-01

    One of the most important promises of capacitive micromachined ultrasonic transducer (CMUT) technology is integration with electronics. This approach is required to minimize the parasitic capacitances in the receive mode, especially in catheter-based volumetric imaging arrays, for which the elements must be small. Furthermore, optimization of the available silicon area and minimized number of connections occurs when the CMUTs are fabricated directly above the associated electronics. Here, we describe successful fabrication and performance evaluation of CMUT arrays for intravascular imaging on custom-designed CMOS receiver electronics from a commercial IC foundry. The CMUT-on-CMOS process starts with surface isolation and mechanical planarization of the CMOS electronics to reduce topography. The rest of the CMUT fabrication is achieved by modifying a low-temperature micromachining process through the addition of a single mask and developing a dry etching step to produce sloped sidewalls for simple and reliable CMUT-to-CMOS interconnection. This CMUT-to-CMOS interconnect method reduced the parasitic capacitance by a factor of 200 when compared with a standard wire-bonding method. Characterization experiments indicate that the CMUT-on-CMOS elements are uniform in frequency response and are similar to CMUTs simultaneously fabricated on standard silicon wafers without electronics integration. Ex- periments on a 1.6-mm-diameter dual-ring CMUT array with a center frequency of 15 MHz show that both the CMUTs and the integrated CMOS electronics are fully functional. The SNR measurements indicate that the performance is adequate for imaging chronic total occlusions located 1 cm from the CMUT array.

  17. Intravascular ultrasound-guided optimized stent deployment. Immediate and 6 months clinical and angiographic results from the Multicenter Ultrasound Stenting in Coronaries Study (MUSIC Study)

    Science.gov (United States)

    de Jaegere, P; Mudra, H; Figulla, H; Almagor, Y; Doucet, S; Penn, I; Colombo, A; Hamm, C; Bartorelli, A; Rothman, M; Nobuyoshi, M; Yamaguchi, T; Voudris, V; DiMario, C; Makovski, S; Hausmann, D; Rowe, S; Rabinovich, S; Sunamura, M; van Es, G A

    1998-08-01

    A study was set up to validate the safety and feasibility of intravascular ultrasound-guided stenting without subsequent anticoagulation, and its impact on the 6 months restenosis rate. The study was designed to be multicentred, prospective, and observational. One hundred and sixty-one patients with stable angina and a de novo coronary artery lesion were enrolled. In four patients, the implantation of a Palmaz-Schatz (with spiral bridge) stent had failed. One of these four patients died 3 days following bypass surgery. In two other patients, intravascular ultrasound assessment was not performed. One hundred and twenty-five of the remaining 155 patients (81%) were treated with aspirin (100 mg x day(-1)), because all three criteria for optimized stent expansion were met. Twenty-two of the remaining 38 patients (25%), in whom at least one criterion was not met were treated with aspirin and acenocoumarol (3 months, INR 2.5-3.5), while 16 patients only received aspirin. Stent thrombosis was documented in two patients (1.3%) for which repeat angioplasty was performed. During the hospital stay, there were no deaths or Q-wave myocardial infarctions. Five patients (3.2%) sustained a non-Q-wave myocardial infarction. During the follow-up period (198+/-38 days, complete for all patients, except one), one patient (0.6%) sustained a Q-wave myocardial infarction, one (0.6%) underwent bypass surgery, and repeat angioplasty was performed in nine patients (5.7%). In two of the nine patients, repeat angioplasty involved another lesion. Therefore, the target lesion revascularization rate during follow-up was 4.5% (seven patients). At quantitative coronary angiography, the minimal lumen diameter (mean+/-SD) increased from 1.12+/-0.34 mm before to 2.89+/-0.35 mm after stenting. Repeat angiography at 6 months was performed in 144 patients (92%). The minimal lumen diameter at follow-up was 2.12+/-0.67 mm. Restenosis (diameter stenosis of 50% or more) was documented in 12 patients or 8

  18. Successful Intravascular Ultrasound-Guided Transradial Coronary Intervention with a 4Fr Guiding Catheter.

    Science.gov (United States)

    Nakano, Yasuhiro; Sadamatsu, Kenji

    2016-01-01

    Minimizing the catheter size can reduce vascular access complications and contrast dye usage in coronary angiography. The small diameter of the 4Fr guiding catheter has limited the use of several angioplasty devices such as intravascular ultrasound (IVUS) in the past. However, the combination of a novel IVUS catheter and a 0.010 guidewire makes it possible to perform IVUS-guided percutaneous coronary intervention (PCI) with a 4Fr guiding catheter. We herein report the case of a 51-year-old man with silent myocardial ischemia who underwent IVUS-guided transradial PCI with a 4Fr guiding catheter.

  19. Offline fusion of co-registered intravascular ultrasound and frequency domain optical coherence tomography images for the analysis of human atherosclerotic plaques

    DEFF Research Database (Denmark)

    Räber, Lorenz; Heo, Jung Ho; Radu, Maria D

    2012-01-01

    To demonstrate the feasibility and potential usefulness of an offline fusion of matched optical coherence tomography (OCT) and intravascular ultrasound (IVUS)/virtual histology (IVUS-VH) images.......To demonstrate the feasibility and potential usefulness of an offline fusion of matched optical coherence tomography (OCT) and intravascular ultrasound (IVUS)/virtual histology (IVUS-VH) images....

  20. Angioplasty Guided by Intravascular Ultrasound: Meta-Analysis of Randomized Clinical Trials

    Energy Technology Data Exchange (ETDEWEB)

    Figueiredo, José Albuquerque Neto de, E-mail: jafneto@cardiol.br; Nogueira, Iara Antonia Lustosa [Universidade Federal do Maranhão, São Luiz, MA (Brazil); Figueiro, Mabel Fernandes; Buehler, Anna Maria; Berwanger, Otavio [Instituto de Ensino e Pesquisa do Hospital do Coração, São Paulo, SP (Brazil)

    2013-08-15

    The impact of intravascular ultrasound (IVUS) use on stenting has shown inconclusive results. Systematic review and meta-analysis of the impact of IVUS on stenting regarding the clinical and angiographic evolution. A search was performed in Medline/Pubmed, CENTRAL, Embase, Lilacs, Scopus and Web of Science databases. It included randomized clinical trials (RCTs) that evaluated the implantation of stents guided by IVUS, compared with those using angiography alone (ANGIO). The minimum follow-up duration was six months and the following outcomes were assessed: thrombosis, mortality, myocardial infarction, percutaneous and surgical revascularization, major adverse cardiovascular events (MACE) and restenosis. The binary outcomes were presented considering the number of events in each group; the estimates were generated by a random effects model, considering Mantel-Haenszel statistics as weighting agent and magnitude of effect for the relative risk (RR) with its respective 95% confidence interval (95%CI). Higgins I{sup 2} test was used to quantify the consistency between the results of each study. A total of 2,689 articles were evaluated, including 8 RCTs. There was a 27% reduction in angiographic restenosis (RR: 0.73, 95% CI: 0.54-0.97, I{sup 2} = 51%) and statistically significant reduction in the rates of percutaneous revascularization and overall (RR: 0.88; 95% CI: 0.51 to 1.53, I{sup 2} = 61%, RR: 0.73, 95% CI: 0.54 to 0.99, I{sup 2} = 55%), with no statistical difference in surgical revascularization (RR: 0.95, 95% CI: 0.52-1.74, I{sup 2} = 0%) in favor of IVUS vs. ANGIO. There were no differences regarding the other outcomes in the comparison between the two strategies. Angioplasty with stenting guided by IVUS decreases the rates of restenosis and revascularization, with no impact on MACE, acute myocardial infarction, mortality or thrombosis outcomes.

  1. Angioplasty Guided by Intravascular Ultrasound: Meta-Analysis of Randomized Clinical Trials

    International Nuclear Information System (INIS)

    Figueiredo, José Albuquerque Neto de; Nogueira, Iara Antonia Lustosa; Figueiro, Mabel Fernandes; Buehler, Anna Maria; Berwanger, Otavio

    2013-01-01

    The impact of intravascular ultrasound (IVUS) use on stenting has shown inconclusive results. Systematic review and meta-analysis of the impact of IVUS on stenting regarding the clinical and angiographic evolution. A search was performed in Medline/Pubmed, CENTRAL, Embase, Lilacs, Scopus and Web of Science databases. It included randomized clinical trials (RCTs) that evaluated the implantation of stents guided by IVUS, compared with those using angiography alone (ANGIO). The minimum follow-up duration was six months and the following outcomes were assessed: thrombosis, mortality, myocardial infarction, percutaneous and surgical revascularization, major adverse cardiovascular events (MACE) and restenosis. The binary outcomes were presented considering the number of events in each group; the estimates were generated by a random effects model, considering Mantel-Haenszel statistics as weighting agent and magnitude of effect for the relative risk (RR) with its respective 95% confidence interval (95%CI). Higgins I 2 test was used to quantify the consistency between the results of each study. A total of 2,689 articles were evaluated, including 8 RCTs. There was a 27% reduction in angiographic restenosis (RR: 0.73, 95% CI: 0.54-0.97, I 2 = 51%) and statistically significant reduction in the rates of percutaneous revascularization and overall (RR: 0.88; 95% CI: 0.51 to 1.53, I 2 = 61%, RR: 0.73, 95% CI: 0.54 to 0.99, I 2 = 55%), with no statistical difference in surgical revascularization (RR: 0.95, 95% CI: 0.52-1.74, I 2 = 0%) in favor of IVUS vs. ANGIO. There were no differences regarding the other outcomes in the comparison between the two strategies. Angioplasty with stenting guided by IVUS decreases the rates of restenosis and revascularization, with no impact on MACE, acute myocardial infarction, mortality or thrombosis outcomes

  2. Abnormal pulmonary artery stiffness in pulmonary arterial hypertension: in vivo study with intravascular ultrasound.

    Directory of Open Access Journals (Sweden)

    Edmund M T Lau

    Full Text Available BACKGROUND: There is increasing recognition that pulmonary artery stiffness is an important determinant of right ventricular (RV afterload in pulmonary arterial hypertension (PAH. We used intravascular ultrasound (IVUS to evaluate the mechanical properties of the elastic pulmonary arteries (PA in subjects with PAH, and assessed the effects of PAH-specific therapy on indices of arterial stiffness. METHOD: Using IVUS and simultaneous right heart catheterisation, 20 pulmonary segments in 8 PAH subjects and 12 pulmonary segments in 8 controls were studied to determine their compliance, distensibility, elastic modulus and stiffness index β. PAH subjects underwent repeat IVUS examinations after 6-months of bosentan therapy. RESULTS: AT BASELINE, PAH SUBJECTS DEMONSTRATED GREATER STIFFNESS IN ALL MEASURED INDICES COMPARED TO CONTROLS: compliance (1.50±0.11×10(-2 mm(2/mmHg vs 4.49±0.43×10(-2 mm(2/mmHg, p<0.0001, distensibility (0.32±0.03%/mmHg vs 1.18±0.13%/mmHg, p<0.0001, elastic modulus (720±64 mmHg vs 198±19 mmHg, p<0.0001, and stiffness index β (15.0±1.4 vs 11.0±0.7, p = 0.046. Strong inverse exponential associations existed between mean pulmonary artery pressure and compliance (r(2 = 0.82, p<0.0001, and also between mean PAP and distensibility (r(2 = 0.79, p = 0.002. Bosentan therapy, for 6-months, was not associated with any significant changes in all indices of PA stiffness. CONCLUSION: Increased stiffness occurs in the proximal elastic PA in patients with PAH and contributes to the pathogenesis RV failure. Bosentan therapy may not be effective at improving PA stiffness.

  3. Imminent Cardiac Risk Assessment via Optical Intravascular Biochemical Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wetzel, D.; Wetzel, L; Wetzel, M; Lodder, R

    2009-01-01

    still the first line of defense. However, with the fidelity of 64-slice CT imaging, this technique has recently become an option when the patient presents with symptoms of reduced arterial flow. Single photon emission computerized tomography (SPECT) treadmill exercise testing is a standard non-invasive test for decreased perfusion of heart muscle, but is time consuming and not suited for emergent evaluation. Once the invasive clinical option of catherization is chosen, this provides the opportunity for intravascular ultrasound (IVUS) imaging. As the probe is pulled through the artery, the diameter at different parts is measurable, and monochrome contrast in the constricted area reveals the presence of tissue with a different ultrasonic response. Also, via an optical catheter with a fiber-optic conductor, the possibly of spectroscopic analysis of arterial walls is now a reality. In this case, the optical transducer is coupled to a near-infrared spectrometer. Revealing the arterial chemical health means that plaque vulnerability and imminent risk could be assessed by the physician. The classical emergency use of catherization involves a contrast agent and dynamic X-ray imaging to locate the constriction, determine its severity, and possibly perform angioplasty, and stent placement.

  4. Reliability of mechanical and phased-array designs for serial intravascular ultrasound examinations--animal and clinical studies in stented and non-stented coronary arteries.

    Science.gov (United States)

    Tardif, J C; Bertrand, O F; Mongrain, R; Lespérance, J; Grégoire, J; Paiement, P; Bonan, R

    2000-10-01

    Both mechanical and multi-element intravascular ultrasound designs have potential advantages and limitations that may impact on their value for clinical and research purposes. Determination of the reproducibility of measurements is critical before a given system can be used in studies such as regression of atherosclerosis trials. We performed serial intravascular ultrasound imaging with catheters using mechanical and phased-array designs in stented and non-stented coronary arteries in dogs and in patients. Both systems correlated well for areas (r > or = 0.90, p or = 0.84. p mechanical designs for measurements of area (mean difference in dogs and in patients: -0.24 and 0.96 mm2, p mechanical system (r > or = 0.96 for all measurements). The differences in absolute and relative variability between the mechanical and phased-array designs, both for reanalysis of same frames and serial pullbacks, were very small. Although multi-element and mechanical intravascular ultrasound designs are not strictly interchangeable, their similar reproducibility and the small differences in measurements demonstrate that both designs are acceptable alternatives for trials of regression of atherosclerosis. Determination of the variability for serial pullbacks of both designs was also important to assess the statistical power of such trials.

  5. Natural history of intravascular ultrasound-detected edge dissections from coronary stent deployment.

    Science.gov (United States)

    Sheris, S J; Canos, M R; Weissman, N J

    2000-01-01

    High-resolution intravascular ultrasound (IVUS) performed immediately after stent deployment often reveals dissection at the stent margin that may not be appreciated by angiography. However, the natural history of these edge dissections is unknown. These intimal disruptions at the stent margins have been previously reported to occur in 5% to 23% of stent implantations. The short-term prognosis of these lesions appears to be good; however, the longer-term effect on restenosis and/or vessel remodeling is not known. We therefore studied a cohort of patients with the use of IVUS immediately after stent implantation and at 6 months to assess the incidence and prognosis of coronary edge dissections. One hundred fifty patients undergoing Palmaz-Shatz stent implantation were imaged with IVUS with the use of a motorized pullback, and the incidence of edge dissections was determined and graded according to depth and circumferential extent. Arterial and lesional morphometric parameters were assessed by digital planimetry. Six-month IVUS images were aligned with the poststent IVUS to determine the natural history of these lesions. Sixteen (10.7%) of 150 had edge tears. All were angiographically silent. Most lesions (n = 9) were superficial intimal tears. Vessel, lumen, and plaque area were similar in the nondissection and dissection groups in both the proximal and distal reference segments. Plaque eccentricity was likewise similar in both groups. At 6 months, lesions (n = 12) healed without a change in plaque burden, undergoing a "tacking down" process. Vessel area (19. 1 +/- 6.4 vs 18.4 +/- 7.1 mm(2), P = not significant), lumen area (8. 2 +/- 4.1 vs 9.2 +/- 4.0 mm(2), P = not significant), and plaque area (10.0 +/- 3.3 vs 9.8 +/- 3.3 mm(2), P = not significant) were unchanged when compared with the lesion site taken at stent deployment. Edge dissections as detected by IVUS do not necessarily proscribe an adverse prognosis at 6 months. This finding may provide reassurance to

  6. Characterization of a saphenous vein graft aneurysm by intravascular ultrasound and computerized three-dimensional reconstruction.

    Science.gov (United States)

    Ennis, B M; Zientek, D M; Ruggie, N T; Billhardt, R A; Klein, L W

    1993-04-01

    Aneurysmal dilatations in saphenous vein grafts are rare complications of coronary artery bypass surgery that mostly represent thin-wall pseudoaneurysms at anastomotic sites. We describe a case of an enlarging distal saphenous vein graft aneurysm in which intravascular ultrasound (IVUS) and computerized three-dimensional reconstruction (3DR) of the IVUS images was performed to conclusively demonstrate true aneurysm morphology. Although both atherosclerotic and nonatherosclerotic mechanisms for vein graft aneurysm formation have been previously suggested, IVUS images and 3DR of the aneurysm in this case did not reveal any of the features typical for atherosclerotic lesions. Further, the IVUS images and 3DR suggest that progressive atherosclerosis is not the likely cause of aneurysm formation in this case. This application of IVUS and 3DR provides detailed information about saphenous vein graft aneurysm structure, clues to aneurysm formation, and suggests a natural history that may differ from that of pseudoaneurysms.

  7. Quantification of iliac artery stenoses: a methodological comparative study between intravascular ultrasound, arteriography and duplex scanning

    DEFF Research Database (Denmark)

    Vogt, K C; Rasmussen, John Bøje Grønvall; Skovgaard, Lene T

    1998-01-01

    Two morphological methods for quantifying the degree of stenoses in the iliac arteries, intravascular ultrasound (IVUS) and arteriography, were compared with duplex scanning, a method of evaluating the haemodynamic importance of the stenosis. A total of 38 patients, 20 women and 18 men, median age...... 66 y, admitted for either PTA (n=18) or femoro-femoral crossover bypass surgery (n=20), were examined by IVUS, single plane arteriography and duplex scanning. The predictive value, sensitivity, specificity and kappa value of IVUS were higher than the corresponding values for arteriography. Logistic...... regression analysis found that IVUS had a predictive value (p=0.0003) for diagnosing significant stenosis as defined by duplex scanning, but arteriography did not (p=0.1). However, this difference in usefulness as predictors did not reach significance. The agreement between arteriography and IVUS...

  8. The role of Intravascular Ultrasound in the management of spontaneous coronary artery dissection

    Directory of Open Access Journals (Sweden)

    Karamitsos Theodoros D

    2008-05-01

    Full Text Available Abstract Primary or spontaneous coronary artery dissection (SCAD is an unusual but increasingly recognized cause of acute myocardial ischemia and sudden cardiac death. Typically, SCAD presents in younger patients without conventional risk factors for coronary artery disease. It occurs more commonly in women than in men, and frequently during pregnancy or the postpartum period. Its pathophysiology is poorly understood, and there is considerable controversy regarding the optimal management of patients with SCAD-related myocardial ischemia. Therapeutic approaches include conservative medical therapy, coronary artery bypass graft surgery and percutaneous coronary intervention (PCI. We present four cases of SCAD to illustrate specific aspects of the presentation and management of this condition, with particular reference to the importance of intravascular ultrasound (IVUS to aid diagnosis and guide subsequent PCI.

  9. Comparison of angiography and intravascular ultrasound before and after balloon angioplasty of the femoropopliteal artery

    International Nuclear Information System (INIS)

    Lankeren, Winnifred van; Gussenhoven, Elma J.; Pieterman, Herman; Sambeek, Marc R. H. M. van; Lugt, Aad van der

    1998-01-01

    Purpose: To compare angiographic and intravascular ultrasound (IVUS) data before and after balloon angioplasty (PTA) of the femoropopliteal artery.Methods: Qualitative and quantitative analyses were performed on corresponding angiographic and IVUS levels obtained from 135 patients.Results: IVUS detected more lesions, calcified lesions, and vascular damage than angiography. Sensitivity of angiography was good for the presence of a lesion (84%), moderate for eccentric lesions (53%) and for vascular damage (52%), and poor for calcified lesions (30%). The increase in angiographic diameter stenosis was associated with a decrease in lumen area and increase in percentage area stenosis on IVUS.Conclusions: Angiography is less sensitive than IVUS for detecting lesion eccentricity, calcified lesions, and vascular damage. Presence of a lesion and amount of plaque were underestimated angiographically. Only before PTA was good agreement found between angiographic diameter stenosis and lumen size on IVUS.

  10. The Imaging Modulography Technique Revisited for High-Definition Intravascular Ultrasound: Theoretical Framework.

    Science.gov (United States)

    Tacheau, Antoine; Le Floc'h, Simon; Finet, Gérard; Doyley, Marvin M; Pettigrew, Roderic I; Cloutier, Guy; Ohayon, Jacques

    2016-03-01

    Mechanical characterization of atherosclerotic lesions remains an essential step for the detection of vulnerable plaques (VPs). Recently, an intravascular ultrasound (IVUS) elasticity reconstruction method (iMOD) has been tested in vivo by our group. The major limitation of iMOD is the need to estimate the strain field in the entire VP despite attenuated depth penetration signals when using high-definition (HD) IVUS systems. Therefore, an extended iMOD approach (E-iMOD) was designed and applied to coronary lesions of patients imaged in vivo with IVUS. The E-iMOD method (i) quantified necrotic core areas with a mean absolute relative error of 3.5 ± 3.5% and (ii) identified Young's moduli of the necrotic cores and fibrous regions with mean values of 5.7 ± 0.8 kPa and 794.5 ± 22.0 kPa instead of 5 kPa and 800 kPa, respectively. This study demonstrates the potential of the improved HD-IVUS modulography technique E-iMOD to characterize coronary VPs. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. All rights reserved.

  11. Angiographically borderline left main coronary artery lesions: correlation of transthoracic doppler echocardiography and intravascular ultrasound: a pilot study

    Directory of Open Access Journals (Sweden)

    Varga Albert

    2011-06-01

    Full Text Available Abstract Background the clinical decision making could be difficult in patients with borderline lesions (visually assessed stenosis severity of 30 to 50% of the left main coronary artery (LM. The aim of the study was to evaluate the relationship between transthoracic Doppler (TTDE peak diastolic flow velocity (PDV and intravascular ultrasound (IVUS measurements in the assessment of angiographically borderline LM lesions. Methods 27 patients (mean age 64 ± 8 years, 21 males with borderline LM stenosis referred for IVUS examination were included in the study. We performed standard IVUS with minimal lumen area (MLA and plaque burden (PB measurement and routine quantitative coronary angiography (QCA with diameter stenosis (%DS and area stenosis (%AS assessment in all. During TTDE, resting PDV was measured in the LM. Results interpretable Doppler signal could be obtained in 24 patients (88% feasibility; therefore these patients entered the final analysis. MLA was 7.1 ± 2.7 mm2. TTDE measured PDV correlated significantly with IVUS-derived MLA (r = -0.46, p 2 LM stenosis. Conclusion In angiographically borderline LM disease, resting PDV from transthoracic echocardiography is increased in presence of increased plaque burden by IVUS. TTDE evaluation might be a useful adjunct to other invasive and non-invasive methods in the assessment of borderline LM lesions. Further, large scale studies are needed to establish the exact cut-off value of PDV for routine clinical application.

  12. Resolution of spontaneous coronary artery dissection within 3 weeks detected by computed tomography angiography and intravascular ultrasound.

    Science.gov (United States)

    Tsutsui, Hiroshi; Chino, Chiharu; Komatsu, Miho; Sakai, Takahiro; Aizawa, Kazunori; Owa, Mafumi

    2017-01-01

    A 62-year-old woman was admitted with chest pain lasting about 3 h. Spontaneous coronary artery dissection (SCAD) was detected in the left anterior descending artery (LAD) by intravascular ultrasound (IVUS). Sixteen days after onset, follow-up computed tomography angiography was performed and revealed shrinkage of the false lumen of the SCAD. On hospital day 22, IVUS image confirmed that the SCAD in the LAD was completely healed. This case shows the possibility of rapid healing of SCAD.

  13. Angled-focused 45 MHz PMN-PT single element transducer for intravascular ultrasound imaging.

    Science.gov (United States)

    Yoon, Sangpil; Williams, Jay; Kang, Bong Jin; Yoon, Changhan; Cabrera-Munoz, Nestor; Jeong, Jong Seob; Lee, Sang Goo; Shung, K Kirk; Kim, Hyung Ham

    2015-06-01

    A transducer with an angled and focused aperture for intravascular ultrasound imaging has been developed. The acoustic stack for the angled-focused transducer was made of PMN-PT single crystal with one matching layer, one protective coating layer, and a highly damped backing layer. It was then press-focused to a desired focal length and inserted into a thin needle housing with an angled tip. A transducer with an angled and unfocused aperture was also made, following the same fabrication procedure, to compare the performance of the two transducers. The focused and unfocused transducers were tested to measure their center frequencies, bandwidths, and spatial resolutions. Lateral resolution of the angled-focused transducer (AFT) improved more than two times compared to that of the angled-unfocused transducer (AUT). A tissue-mimicking phantom in water and a rabbit aorta tissue sample in rabbit blood were scanned using AFT and AUT. Imaging with AFT offered improved contrast, over imaging with AUT, of the tissue-mimicking phantom and the rabbit aorta tissue sample by 23 dB and 8 dB, respectively. The results show that AFT has strong potential to provide morphological and pathological information of coronary arteries with high resolution and high contrast.

  14. Expansion in calcific lesions and overall clinical outcomes following bioresorbable scaffold implantation optimized with intravascular ultrasound.

    Science.gov (United States)

    Kawamoto, Hiroyoshi; Ruparelia, Neil; Latib, Azeem; Miyazaki, Tadashi; Sato, Katsumasa; Tanaka, Akihito; Naganuma, Toru; Sticchi, Alessandro; Chieffo, Alaide; Carlino, Mauro; Montorfano, Matteo; Colombo, Antonio

    2017-04-01

    This study aimed to investigate clinical outcomes following bioresorbable scaffold (BRS) optimized with intravascular ultrasound (IVUS), and furthermore expansion of BRS in calcific lesions. Although IVUS use has contributed to improved clinical outcomes with metallic stent implantation, it is unclear if this is also true with regards to BRS, especially in calcified lesions. Between May 2012 and April 2015, 291 lesions in 198 patients were treated with BRS with IVUS use. We evaluated overall clinical outcomes at 1-year and investigated the expansion and eccentricity index of BRS amongst quadrants categorized by calcium arc (CA) every 90-degrees. The rates of major adverse cardiac events were 5.4% (at 6 months) and 10.7% (at 12 months). TLR was observed in 3.1% at 6-month and 7.5% at 12-month follow up. Although there was a significant difference among quadrants regarding to eccentricity of calcium (0°≦CA BRS expansion index [minimal scaffold area (MSA) divided by BRS area expanded at a nominal pressure] was comparable between quadrants. The use of IVUS to optimize BRS implantation results in favorable clinical outcomes even for complex lesions. Although eccentric calcium distribution resulted in asymmetric expansion of BRS, the final MSA was comparable irrespective of calcium distribution. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  15. Determinants of slow flow following stent implantation in intravascular ultrasound-guided primary percutaneous coronary intervention.

    Science.gov (United States)

    Watanabe, Yusuke; Sakakura, Kenichi; Taniguchi, Yousuke; Yamamoto, Kei; Wada, Hiroshi; Fujita, Hideo; Momomura, Shin-Ichi

    2018-03-01

    Slow flow is a serious complication in primary percutaneous coronary intervention (PCI) and is associated with poor clinical outcomes. Intravascular ultrasound (IVUS)-guided PCI may improve clinical outcomes after drug-eluting stent implantation. The purpose of this study was to seek the factors of slow flow following stent implantation, including factors related to IVUS-guided primary PCI. The study population consisted of 339 ST-elevation myocardial infarction patients, who underwent stent deployment with IVUS. During PCI, 56 patients (16.5%) had transient or permanent slow flow. Multivariate logistic regression analysis showed age (OR 1.04, 95% CI 1.01-1.07, P = 0.01), low attenuation plaque on IVUS (OR 3.38, 95% CI 1.70-6.72, P = 0.001), initial Thrombolysis In Myocardial Infarction (TIMI) flow grade 2 (vs. TIMI 0: OR 0.44, 95% CI 0.20-0.99, P = 0.046), and the ratio of stent diameter to vessel diameter (per 0.1 increase: OR 2.63, 95% CI 1.84-3.77, P flow. A ratio of stent diameter to vessel diameter of 0.71 had an 80.4% sensitivity and 56.9% specificity to predict slow flow. There was no significant difference in ischemic-driven target vessel revascularization between the modest stent expansion (ratio of stent diameter to vessel diameter flow following stent implantation in IVUS-guided primary PCI.

  16. Impact of statins on progression of atherosclerosis: rationale and design of SATURN (Study of Coronary Atheroma by InTravascular Ultrasound: effect of Rosuvastatin versus AtorvastatiN).

    Science.gov (United States)

    Nicholls, Stephen J; Borgman, Marilyn; Nissen, Steven E; Raichlen, Joel S; Ballantyne, Christie; Barter, Philip; Chapman, M John; Erbel, Raimund; Libby, Peter

    2011-06-01

    Previous imaging studies have demonstrated that the beneficial impact of high-dose statins on the progression of coronary atherosclerosis associates with their ability to lower levels of low-density lipoprotein cholesterol (LDL-C) and C-reactive protein (CRP) and to raise high-density lipoprotein cholesterol (HDL-C). The Study of Coronary Atheroma by InTravascular Ultrasound: Effect of Rosuvastatin versus AtorvastatiN (SATURN, NCT00620542) aims to compare the effects of high-dose atorvastatin and rosuvastatin on disease progression. A total of 1385 subjects with established coronary artery disease (CAD) on angiography were randomized to receive rosuvastatin 40 mg or atorvastatin 80 mg for 24 months. The primary efficacy parameter will be the nominal change in percent atheroma volume (PAV), determined by analysis of intravascular ultrasound (IVUS) images of matched coronary artery segments acquired at baseline and at 24-month follow-up. The effect of statin therapy on plasma lipids and inflammatory markers, and the incidence of clinical cardiovascular events will also be assessed. The study does not have the statistical power to directly compare the treatment groups with regard to clinical events. Serial IVUS has emerged as a sensitive imaging modality to assess the impact of treatments on arterial structure. In this study, IVUS will be used to determine whether high-dose statins have different effects on plaque progression.

  17. Joint learning of ultrasonic backscattering statistical physics and signal confidence primal for characterizing atherosclerotic plaques using intravascular ultrasound.

    Science.gov (United States)

    Sheet, Debdoot; Karamalis, Athanasios; Eslami, Abouzar; Noël, Peter; Chatterjee, Jyotirmoy; Ray, Ajoy K; Laine, Andrew F; Carlier, Stephane G; Navab, Nassir; Katouzian, Amin

    2014-01-01

    Intravascular Ultrasound (IVUS) is a predominant imaging modality in interventional cardiology. It provides real-time cross-sectional images of arteries and assists clinicians to infer about atherosclerotic plaques composition. These plaques are heterogeneous in nature and constitute fibrous tissue, lipid deposits and calcifications. Each of these tissues backscatter ultrasonic pulses and are associated with a characteristic intensity in B-mode IVUS image. However, clinicians are challenged when colocated heterogeneous tissue backscatter mixed signals appearing as non-unique intensity patterns in B-mode IVUS image. Tissue characterization algorithms have been developed to assist clinicians to identify such heterogeneous tissues and assess plaque vulnerability. In this paper, we propose a novel technique coined as Stochastic Driven Histology (SDH) that is able to provide information about co-located heterogeneous tissues. It employs learning of tissue specific ultrasonic backscattering statistical physics and signal confidence primal from labeled data for predicting heterogeneous tissue composition in plaques. We employ a random forest for the purpose of learning such a primal using sparsely labeled and noisy samples. In clinical deployment, the posterior prediction of different lesions constituting the plaque is estimated. Folded cross-validation experiments have been performed with 53 plaques indicating high concurrence with traditional tissue histology. On the wider horizon, this framework enables learning of tissue-energy interaction statistical physics and can be leveraged for promising clinical applications requiring tissue characterization beyond the application demonstrated in this paper. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Towards a Reduced-Wire Interface for CMUT-Based Intravascular Ultrasound Imaging Systems.

    Science.gov (United States)

    Lim, Jaemyung; Tekes, Coskun; Degertekin, F Levent; Ghovanloo, Maysam

    2017-04-01

    Having intravascular ultrasound (IVUS) imaging capability on guide wires used in cardiovascular interventions may eliminate the need for separate IVUS catheters and expand the use of IVUS in a larger portion of the vasculature. High frequency capacitive micro machined ultrasonic transducer (CMUT) arrays should be integrated with interface electronics and placed on the guide wire for this purpose. Besides small size, this system-on-a-chip (SoC) front-end should connect to the back-end imaging system with a minimum number of wires to preserve the critical mechanical properties of the guide wire. We present a 40 MHz CMUT array interface SoC, which will eventually use only two wires for power delivery and transmits image data using a combination of analog-to-time conversion (ATC) and an impulse radio ultra-wideband (IR-UWB) wireless link. The proof-of-concept prototype ASIC consumes only 52.8 mW and occupies 4.07 [Formula: see text] in a 0.35- [Formula: see text] standard CMOS process. A rectifier and regulator power the rest of the SoC at 3.3 V from a 10 MHz power carrier that is supplied through a 2.4 m micro-coax cable with an overall efficiency of 49.1%. Echo signals from an 8-element CMUT array are amplified by a transimpedance amplifier (TIA) array and down-converted to baseband by quadrature sampling using a 40 MHz clock, derived from the power carrier. The ATC generates pulse-width-modulated (PWM) samples at 2 × 10 MS/s with 6 bit resolution, while the entire system achieved 5.1 ENOB. Preliminary images from the prototype system are presented, and alternative data transmission and possible future directions towards practical implementation are discussed.

  19. Optical Coherence Tomography Analysis of Attenuated Plaques Detected by Intravascular Ultrasound in Patients with Acute Coronary Syndromes

    Directory of Open Access Journals (Sweden)

    Takashi Kubo

    2011-01-01

    Full Text Available Background. Recent intravascular ultrasound (IVUS studies have demonstrated that hypoechoic plaque with deep ultrasound attenuation despite absence of bright calcium is common in acute coronary syndrome. Such “attenuated plaque” may be an IVUS characteristic of unstable lesion. Methods. We used optical coherence tomography (OCT in 104 patients with unstable angina to compare lesion characteristics between IVUS-detected attenuated plaque and nonattenuated plaque. Results. IVUS-detected attenuated plaque was observed in 41 (39% patients. OCT-detected lipidic plaque (88% versus 49%, <0.001, thin-cap fibroatheroma (48% versus 16%, <0.001, plaque rupture (44% versus 11%, <0.001, and intracoronary thrombus (54% versus 17%, <0.001 were more often seen in IVUS-detected attenuated plaques compared with nonattenuated plaques. Conclusions. IVUS-detected attenuated plaque has many characteristics of unstable coronary lesion. The presence of attended plaque might be an important marker of lesion instability.

  20. Intravascular Ultrasound Catheter Evaluation of the Left Ventricle in Mice: A Feasibility Study.

    Science.gov (United States)

    Gardin, Julius M.; Siri, Francis; Kitsis, Richard N.; Leinwand, Leslie

    1996-11-01

    With the advent of transgenic technology, it has become increasingly important to find a method for evaluating left ventricular (LV) anatomy and function in intact wild type, intervened, and transgenic mice. Mice are 1/10th the size of rats, and have body masses of 10-60 g, LV masses of 40-150 mg, LV wall thicknesses of 0.5-2 mm, and LV internal dimensions of 1-3 mm. Although the murine LV has been imaged by transthoracic (TTE) two-dimensional directed M-mode echocardiography, we explored the use of intravascular ultrasound (IVUS) catheters, with imaging from various positions, to see if better two-dimensional images of the LV could be obtained by IVUS than TTE. Eight normal mice were anesthetized using pentobarbital or avertin. The mice were studied using a commercially available IVUS system (Endosonics, Inc.). Two IVUS catheters (3.5 and 5.0 Fr) with 20-MHz multielement array transducers were used. Each catheter had a 4.0-mm imaging depth of field in all directions (360 degrees ) from the mid-point of the catheter core. Multiple imaging approaches were attempted: transesophageal (TEE); transjugular (TJ); transperitoneal (TP); and open chest, from both epicardial surface (Ep) and via direct LV puncture. TEE and TJ approaches afforded insufficient depth of field to image the entire LV in cross section. TP and Ep approaches resulted in poor images, related both to inadequate depth of field and to relatively small sector angles subtended by imaging elements. LVP (intracavitary imaging) was capable of satisfactorily imaging the LV epicardium, but was unable to image the endocardium, probably because the latter was within the 1.9-mm "ringdown" catheter artifact. All IVUS approach studies lacked sufficient temporal resolution (10 frames/sec) to reliably display systolic and diastolic frames necessary for evaluation of LV function. In contrast, as previously reported, transthoracic two-dimensionally directed M-mode echocardiograms have sufficient temporal and spatial

  1. Segmentation of arterial walls in intravascular ultrasound cross-sectional images using extremal region selection.

    Science.gov (United States)

    Faraji, Mehdi; Cheng, Irene; Naudin, Iris; Basu, Anup

    2018-03-01

    Intravascular Ultrasound (IVUS) is an intra-operative imaging modality that facilitates observing and appraising the vessel wall structure of the human coronary arteries. Segmentation of arterial wall boundaries from the IVUS images is not only crucial for quantitative analysis of the vessel walls and plaque characteristics, but is also necessary for generating 3D reconstructed models of the artery. The aim of this study is twofold. Firstly, we investigate the feasibility of using a recently proposed region detector, namely Extremal Region of Extremum Level (EREL) to delineate the luminal and media-adventitia borders in IVUS frames acquired by 20 MHz probes. Secondly, we propose a region selection strategy to label two ERELs as lumen and media based on the stability of their textural information. We extensively evaluated our selection strategy on the test set of a standard publicly available dataset containing 326 IVUS B-mode images. We showed that in the best case, the average Hausdorff Distances (HD) between the extracted ERELs and the actual lumen and media were 0.22  mm and 0.45 mm, respectively. The results of our experiments revealed that our selection strategy was able to segment the lumen with ⩽0.3 mm HD to the gold standard even though the images contained major artifacts such as bifurcations, shadows, and side branches. Moreover, when there was no artifact, our proposed method was able to delineate media-adventitia boundaries with 0.31 mm HD to the gold standard. Furthermore, our proposed segmentation method runs in time that is linear in the number of pixels in each frame. Based on the results of this work, by using a 20 MHz IVUS probe with controlled pullback, not only can we now analyze the internal structure of human arteries more accurately, but also segment each frame during the pullback procedure because of the low run time of our proposed segmentation method. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Regression and shift in composition of coronary atherosclerotic plaques by pioglitazone: insight from an intravascular ultrasound analysis.

    Science.gov (United States)

    Clementi, Fabrizio; Di Luozzo, Marco; Mango, Ruggiero; Luciani, Giulio; Trivisonno, Antonio; Pizzuto, Francesco; Martuscelli, Eugenio; Mehta, Jawahar L; Romeo, Francesco

    2009-03-01

    Plaque reduction with the use of pioglitazone and statin combination therapy has been observed in carotid plaque. We sought to investigate the effect of combination therapy with statins and pioglitazone on coronary plaque regression and composition with the use of intravascular ultrasound (IVUS) and intravascular ultrasound-virtual histology (IVUS-VH). We analysed 29 plaques in 25 diabetic patients with angiographic evidence of nonsignificant coronary lesions with IVUS-VH. Patients were treated with 80 mg of atorvastatin and 30 mg of pioglitazone daily for 6 months. After 6 months of therapy, IVUS-VH of each lesion was reacquired. Mean elastic external membrane volume was significantly reduced between baseline and follow-up (343.9 vs. 320.5 mm; P < 0.05) as was mean total atheroma volume (179.3 vs. 166.6 mm; P < 0.05). Change in total atheroma volume showed a 6.3% mean reduction. Areas of fibrous tissue, fibrolipidic tissue and calcium decreased over the 6 months of follow-up, although not significantly. On the other hand, the necrotic core increased from 9 to 14% (P < 0.05). Our data demonstrated that atorvastatin/pioglitazone association is able to induce significant regression of coronary atherosclerosis, acting on plaque composition. Our findings are preliminary results and will be confirmed in an ongoing randomized placebo-controlled multicenter trial (PIPER; Pioglitazone for Prevention of Restenosis in Diabetics with Complex Lesion; trial registration: clinical trials.gov. Identifier: NCT 00376870).

  3. 3-D ultrasound imaging using a forward-looking CMUT ring array for intravascular/intracardiac applications.

    Science.gov (United States)

    Yeh, David T; Oralkan, Omer; Wygant, Ira O; O'Donnell, Matthew; Khuri-Yakub, Butrus T

    2006-06-01

    Forward-viewing ring arrays can enable new applications in intravascular and intracardiac ultrasound. This work presents compelling, full-synthetic, phased-array volumetric images from a forward-viewing capacitive micromachined ultrasonic transducer (CMUT) ring array wire bonded to a custom integrated circuit front end. The CMUT ring array has a diameter of 2 mm and 64 elements each 100 microm x 100 microm in size. In conventional mode, echo signals received from a plane reflector at 5 mm had 70% fractional bandwidth around a center frequency of 8.3 MHz. In collapse mode, 69% fractional bandwidth is measured around 19 MHz. Measured signal-to-noise ratio (SNR) of the echo averaged 16 times was 29 dB for conventional operation and 35 dB for collapse mode. B-scans were generated of a target consisting of steel wires 0.3 mm in diameter to determine resolution performance. The 6 dB axial and lateral resolutions for the B-scan of the wire target are 189 microm and 0.112 radians for 8 MHz, and 78 microm and 0.051 radians for 19 MHz. A reduced firing set suitable for real-time, intravascular applications was generated and shown to produce acceptable images. Rendered three-dimensional (3-D) images of a Palmaz-Schatz stent also are shown, demonstrating that the imaging quality is sufficient for practical applications.

  4. Cardiac allograft vasculopathy compared by intravascular ultrasound sonography: everolimus to mycophenolate mofetil--one single-center experience.

    Science.gov (United States)

    Chou, N-K; Jan, C-F; Chi, N-H; Lee, C-M; Wu, I-H; Huang, S-C; Chen, Y-S; Yu, H-Y; Tsao, C-I; Ko, W-J; Chu, S-H; Wang, S-S

    2012-05-01

    Cardiac allograft vasculopathy (CAV) remains one of the leading causes of late graft failure and death. Cyclosporine microemulsion Neoral (CsA) had been used in heart transplantation (HTx) recipients. Meanwhile, Everolimus (EVL; Certican, Norvatis Pharmaceuticals; Basel, Switzerland) or mycophenolate mofetil (MMF) have been combined with CsA for maintenance treatment. We compared atherosclerosis in HTx patients showing CAV by intravascular ultrasound (IVUS) in two groups: the CE who received CsA, EVL, and steroid versus the CM group, who received CsA, MMF, and steroid. We explored IVUS parameters such as plaque thickness (PT), lumen circumference (LC), media adventitial circumference, lumen diameter (LD), and media adventitial diameter to characterize the atherosclerosis among CE versus CM groups. In this study, both the CE and CM groups showed increased plaque thickening in the first year posttransplantation (P data. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Intravascular ultrasound as a novel tool for the diagnosis and targeted treatment of functional popliteal artery entrapment syndrome

    Directory of Open Access Journals (Sweden)

    Anna E. Boniakowski, MD

    2017-06-01

    Full Text Available Functional popliteal artery entrapment syndrome can be difficult to diagnose, as the imaging modalities presently employed are designed to detect anatomic entrapment. We describe a novel imaging technique to aid in diagnosis in this cohort. A 22-year-old cyclist presented with exercise-limiting claudication. Magnetic resonance angiography with provocative maneuvers was nondiagnostic. Digital subtraction angiography revealed long-segment occlusion of the popliteal artery with plantar flexion; however, the specific site of compression remained unclear. Intravascular ultrasound allowed specific localization of compression and further confirmed the diagnosis. Thus, we report this as an adjunctive imaging modality to definitively diagnose functional popliteal artery entrapment syndrome and to assist in operative planning.

  6. Assessing mechanical properties with intravascular or endoscopic optical coherence tomography

    Science.gov (United States)

    Lamouche, G.; Azarnoush, H.; Vergnole, S.; Pazos, V.; Bisaillon, C.-E.; Debergue, P.; Boulet, B.; Diraddo, R.

    2011-03-01

    We explore the potential of intravascular or endoscopic optical coherence tomography (OCT) to extract relevant mechanical properties of a tissue deformed by an inflating balloon. Tubular OCT phantoms with different mechanical properties are fabricated. The phantoms are deformed by an inflating balloon, and the deformation is monitored with OCT. A quantitative description of the phantom deformation is obtained by segmenting the OCT images. Two strategies to extract the mechanical properties from this quantitative data are presented: by comparing to a finite-element simulation and by performing a mechanical analysis.

  7. Influence of high-dose lipid lowering treatment compared to low-dose lipid lowering treatment on plaque composition assessed by intravascular ultrasound virtual histology in patients with ST-segment elevation acute myocardial infarction

    DEFF Research Database (Denmark)

    Egede, Rasmus; Jensen, Lisette Okkels; Hansen, Henrik Steen

    2013-01-01

    -naive patients with ST-segment elevation myocardial infarction (STEMI) were randomised to 5 mg or 40 mg rosuvastatin. The volume of each plaque component (necrotic core, fibrous tissue, fibro-fatty, and dense calcium) was assessed at baseline and after 12 months of follow-up. Baseline low-density lipoprotein...... (LDL) cholesterol level was reduced by 31.8% in the low-dose group (from 3.1±0.7 mmol/l to 2.0±0.4 mmol/l, p...

  8. The clinical importance and prediction of steal following femoro-femoral cross-over bypass: study of the donor iliac artery by intravascular ultrasound, arteriography, duplex scanning and pressure measurements

    DEFF Research Database (Denmark)

    Vogt, K C; Rasmussen, J G; Schroeder, T V

    2000-01-01

    to evaluate the clinical significance of the steal phenomenon following femoro-femoral bypass, and whether the addition of intravascular ultrasound (IVUS) to the established examinations of the donor iliac artery can improve the prediction of patients who will develop steal.......to evaluate the clinical significance of the steal phenomenon following femoro-femoral bypass, and whether the addition of intravascular ultrasound (IVUS) to the established examinations of the donor iliac artery can improve the prediction of patients who will develop steal....

  9. Early characterization of atherosclerotic coronary plaques with multidetector computed tomography in patients with acute coronary syndrome. A comparative study with intravascular ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Iriart, Xavier; Dos-Santos, Pierre [Universite Bordeaux 2, Inserm U. 441 Atherosclerose, Bordeaux (France); Brunot, Sebastien [CHU de Bordeaux, Hopital du Haut-Leveque, Unite d' Imagerie Thoracique et Cardiovasculaire, Pessac (France); Unite de Soins Intensifs Cardiologiques, Pessac (France); Unite d' Imagerie Thoracique et Cardiovasculaire, Hopital Cardiologique, Pessac (France); Coste, Pierre; Leroux, Lionel [Universite Bordeaux 2, Inserm U. 441 Atherosclerose, Bordeaux (France); Unite de Soins Intensifs Cardiologiques, Pessac (France); Montaudon, Michel [Universite Bordeaux 2, Inserm U. 885 F 33076, Bordeaux (France); CHU de Bordeaux, Hopital du Haut-Leveque, Unite d' Imagerie Thoracique et Cardiovasculaire, Pessac (France); Labeque, Jean-Noel; Jais, Catherine [Unite de Soins Intensifs Cardiologiques, Pessac (France); Laurent, Francois [Universite Bordeaux 2, Inserm U. 885 F 33076, Bordeaux (France); CHU de Bordeaux, Hopital du Haut-Leveque, Unite d' Imagerie Thoracique et Cardiovasculaire, Pessac (France); Unite d' Imagerie Thoracique et Cardiovasculaire, Hopital Cardiologique, Pessac (France)

    2007-10-15

    We compared 16-slice computed tomography (CT) with intravascular ultrasound (IVUS) in their ability to identify the culprit lesion, and to assess plaque characterization and vascular remodelling in acute coronary syndrome (ACS). Twenty patients were prospectively studied. Coronary plaque identification and characterization were compared using 16-slice CT and 40-MHz catheter-based IVUS. Minimum lumen area (MLA), cross-sectional vessel area (CVA) and vessel remodelling were determined for each comparable lesion. One hundred and sixty-nine segments were compared and 84 plaques analysed. Sixteen-slice CT detected 95% of culprit lesions (19/20). No feature suggestive of plaque rupture was detected by 16-slice CT. Attenuation measurements within all lesions revealed different values for hypoechoic (38 {+-} 33 HU), hyperechoic (94 {+-} 44 HU), and calcified plaques (561 {+-} 216 HU), (P < 0.001). Agreement between 16-slice CT and IVUS on measuring MLA and CVA was evaluated using Bland-Altman analysis. Pearson and intra-class coefficient (ICC) were 0.81 and 0.70 for MLA, and 0.81 and 0.36 for CVA, for 16-slice CT and IVUS, respectively. Agreement between both techniques for vessel positive remodelling was moderate (kappa = 0.54, P < 0.001). Sixteen-slice CT has shown moderate accuracy in quantifying and characterizing coronary plaques compared with IVUS. Spatial resolution of 16-slice CT remains a major limitation, however, to accurately assess the complex lesions involved in ACS. (orig.)

  10. Clinical feasibility of 3D automated coronary atherosclerotic plaque quantification algorithm on coronary computed tomography angiography: Comparison with intravascular ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hyung-Bok [Yonsei University Health System, Yonsei-Cedar Sinai Integrative Cardiovascular Imaging Research Center, Seoul (Korea, Republic of); Myongji Hospital, Division of Cardiology, Cardiovascular Center, Goyang (Korea, Republic of); Lee, Byoung Kwon [Yonsei University College of Medicine, Division of Cardiology, Gangnam Severance Hospital, Seoul (Korea, Republic of); Shin, Sanghoon [Yonsei University Health System, Yonsei-Cedar Sinai Integrative Cardiovascular Imaging Research Center, Seoul (Korea, Republic of); National Health Insurance Corporation Ilsan Hospital, Division of Cardiology, Goyang (Korea, Republic of); Heo, Ran; Chang, Hyuk-Jae; Chung, Namsik [Yonsei University Health System, Yonsei-Cedar Sinai Integrative Cardiovascular Imaging Research Center, Seoul (Korea, Republic of); Yonsei University Health System, Division of Cardiology, Severance Cardiovascular Hospital, Seoul (Korea, Republic of); Arsanjani, Reza [Cedars-Sinai Medical Center, Departments of Imaging and Medicine, Cedars-Sinai Heart Institute, Los Angeles, CA (United States); Kitslaar, Pieter H. [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Medis medical Imaging Systems B.V., Leiden (Netherlands); Broersen, Alexander; Dijkstra, Jouke [Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden (Netherlands); Ahn, Sung Gyun [Yonsei University Wonju Severance Christian Hospital, Division of Cardiology, Wonju (Korea, Republic of); Min, James K. [New York-Presbyterian Hospital, Institute for Cardiovascular Imaging, Weill-Cornell Medical College, New York, NY (United States); Hong, Myeong-Ki; Jang, Yangsoo [Yonsei University Health System, Division of Cardiology, Severance Cardiovascular Hospital, Seoul (Korea, Republic of)

    2015-10-15

    To evaluate the diagnostic performance of automated coronary atherosclerotic plaque quantification (QCT) by different users (expert/non-expert/automatic). One hundred fifty coronary artery segments from 142 patients who underwent coronary computed tomography angiography (CCTA) and intravascular ultrasound (IVUS) were analyzed. Minimal lumen area (MLA), maximal lumen area stenosis percentage (%AS), mean plaque burden percentage (%PB), and plaque volume were measured semi-automatically by expert, non-expert, and fully automatic QCT analyses, and then compared to IVUS. Between IVUS and expert QCT analysis, the correlation coefficients (r) for the MLA, %AS, %PB, and plaque volume were excellent: 0.89 (p < 0.001), 0.84 (p < 0.001), 0.91 (p < 0.001), and 0.94 (p < 0.001), respectively. There were no significant differences in the mean parameters (all p values >0.05) except %AS (p = 0.01). The automatic QCT analysis showed comparable performance to non-expert QCT analysis, showing correlation coefficients (r) of the MLA (0.80 vs. 0.82), %AS (0.82 vs. 0.80), %PB (0.84 vs. 0.73), and plaque volume (0.84 vs. 0.79) when they were compared to IVUS, respectively. Fully automatic QCT analysis showed clinical utility compared with IVUS, as well as a compelling performance when compared with semiautomatic analyses. (orig.)

  11. Monitoring of allograft vasculopathy by intravascular ultrasound one month and one year after heart transplantation: A single center study.

    Science.gov (United States)

    Bedanova, Helena; Orban, Marek; Tretina, Martin; Fila, Petr; Horvath, Vladimir; Krejci, Jan; Nemec, Petr

    2016-03-01

    The aim of this trial was to use intravascular ultrasound (IVUS) to determine whether cardiac allograft vasculopathy (CAV) starts progressing during the first year after heart transplantation (HTx). We retrospectively analyzed 51 patients (11 women) who received heart transplants in our center between January 2010 and September 2013 and underwent coronary angiography as well as IVUS examination one month and one year after HTx. Patients with proven calcification and fibrotic plates in the IVUS examination one month after HTx constituted a group with defined donor-transmitted atherosclerosis (DTA). In patients without DTA, measurements of maximal intimal thickening (MIT) were made in two predetermined locations. Eight of the 51 patients had DTA, while 43 did not. These were divided based on maximal intimal thickness (MIT) into a group with MIT first year after HTx significantly more frequently in patients with DTA and MIT ≥ 0.5 mm. It is essential in these patients to implement an IVUS control examination one year after transplantation. The results can lead to a change in treatment strategy to prevent further progress of the disease.

  12. Accuracy of multidetector row computed tomography for the detection of transplant vasculopathy: comparison with invasive coronary angiography and intravascular ultrasound

    International Nuclear Information System (INIS)

    Carrascosa, P.; Capunay, C.; Carrascosa, J.; Perrone, S.; Deviggiano, A.; Lopez, E.M.; Lev, G.; Garcia, M.J.

    2009-01-01

    Objective: To evaluate the diagnostic accuracy of multidetector computed tomography (MDCT) for detection of luminal stenosis and cardiac allograft vasculopathy in comparison with coronary angiography (CA) and intravascular ultrasound (IVUS) respectively. Material and methods: Nineteen cardiac transplant patients scheduled for follow-up CA were included. MDCT coronary angiography was performed using a 16-row CT scanner within 7-14 days after CA and IVUS. Studies were analyzed by independent readers; two observers evaluated the CT datasets for the presence of coronary artery stenosis > 50% and allograft vasculopathy. Results: The sensitivity for detecting > 50% luminal stenosis was 80-88% and specificity, 98-99% and for detection of cardiac allograft vasculopathy, the sensitivity was 91-96% and specificity, 88-91%. Conclusion: In this preliminary series, our results indicate that MDCT coronary angiography was capable of detecting both significant coronary stenosis as well as diffuse intimal proliferation. This non-invasive procedure could be an alternative to CA and IVUS in the surveillance of heart transplant patients. (authors) [es

  13. Diagnostic accuracy of integrated intravascular ultrasound and optical coherence tomography (IVUS-OCT) system for coronary plaque characterization

    Science.gov (United States)

    Li, Jiawen; Ma, Teng; Mohar, Dilbahar; Correa, Adrian; Minami, Hataka; Jing, Joseph; Zhou, Qifa; Patel, Pranav M.; Chen, Zhongping

    2014-03-01

    Intravascular ultrasound (IVUS) imaging and optical coherence tomography (OCT), two commonly used intracoronary imaging modalities, play important roles in plaque evaluation. The combined use of IVUS (to visualize the entire plaque volume) and OCT (to quantify the thickness of the plaque cap, if any) is hypothesized to increase plaque diagnostic accuracy. Our group has developed a fully-integrated dual-modality IVUS-OCT imaging system and 3.6F catheter for simultaneous IVUS-OCT imaging with a high resolution and deep penetration depth. However, the diagnostic accuracy of an integrated IVUS-OCT system has not been investigated. In this study, we imaged 175 coronary artery sites (241 regions of interest) from 20 cadavers using our previous reported integrated IVUS-OCT system. IVUS-OCT images were read by two skilled interventional cardiologists. Each region of interest was classified as either calcification, lipid pool or fibrosis. Comparing the diagnosis by cardiologists using IVUSOCT images with the diagnosis by the pathologist, we calculated the sensitivity and specificity for characterization of calcification, lipid pool or fibrosis with this integrated system. In vitro imaging of cadaver coronary specimens demonstrated the complementary nature of these two modalities for plaques classification. A higher accuracy was shown than using a single modality alone.

  14. Safety and efficacy of intravascular ultrasound-guided inferior vena cava filter in super obese bariatric patients.

    Science.gov (United States)

    Kardys, Clark M; Stoner, Michael C; Manwaring, Mark L; Barker, Michael; Macdonald, Kenneth G; Pender, John R; Chapman, William H

    2008-01-01

    The morbidly obese (body mass index >40 kg/m(2)) are at significant risk of postoperative venous thromboembolism (VTE). Pulmonary embolism is the leading cause of death after Roux-en-Y gastric bypass, approximating .5%. Because of the technical limitations with fluoroscopy and table weight limits, it has been our practice at our university-based bariatric center to offer intravascular ultrasound (IVUS)-guided inferior vena cava filter (IVCF) placement at Roux-en-Y gastric bypass to patients with a history of VTE, hypercoagulable state, or profound immobility. The hospital and outpatient records of all 594 patients who underwent Roux-en-Y gastric bypass from January 1, 2004 to October 31, 2006 were reviewed. The patients who had undergone concurrent IVUS-guided IVCF placement were selected. The co-morbidities, outcomes, and complications were recorded. Of the 594 patients, 31 (mean body mass index 71.2 +/- 2.96 kg/m(2)) had undergone concurrent IVUS-guided IVCF placement. The indications included a history of VTE (n = 5), a known hypercoagulable state (n = 2), and profound immobility (n = 25). The technical success rate was 96.8%. One filter was malpositioned in the iliac vein. No catheter site complications occurred. A ventilation/perfusion scan and computed tomography scan each detected pulmonary embolism in 2 surviving patients within 2 months postoperatively. Two patients died, 1 on postoperative day 8 and 1 on postoperative day 15 (6.4%). The mean follow-up time was 262.8 +/- 37.3 days. Autopsy excluded VTE or IVCF-related issues as the cause of death in both patients. These results suggest the efficacy of IVUS-guided IVCF placement in preventing mortality from pulmonary embolism in high-risk bariatric patients. IVUS-guided IVCF placement can be safely performed with an excellent success rate in high-risk patients who would not otherwise be candidates for intervention because of the technical limitations of fluoroscopy.

  15. A new method for real-time co-registration of 3D coronary angiography and intravascular ultrasound or optical coherence tomography

    International Nuclear Information System (INIS)

    Carlier, Stéphane; Didday, Rich; Slots, Tristan; Kayaert, Peter; Sonck, Jeroen; El-Mourad, Mike; Preumont, Nicolas; Schoors, Dany; Van Camp, Guy

    2014-01-01

    We present a new clinically practical method for online co-registration of 3D quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) or optical coherence tomography (OCT). The workflow is based on two modified commercially available software packages. Reconstruction steps are explained and compared to previously available methods. The feasibility for different clinical scenarios is illustrated. The co-registration appears accurate, robust and induced a minimal delay on the normal cath lab activities. This new method is based on the 3D angiographic reconstruction of the catheter path and does not require operator’s identification of landmarks to establish the image synchronization

  16. Intravascular ultrasound findings in the multicenter, randomized, double-blind RAVEL (RAndomized study with the sirolimus-eluting VElocity balloon- expandable stent in the treatment of patients with de novo native coronary artery Lesions) trial

    NARCIS (Netherlands)

    J.M.R. Ligthart (Jürgen); M-C. Morice (Marie-Claude); P.J. de Feyter (Pim); M. Degertekin (Muzaffer); K. Tanabe (Kengo); J.E. Sousa (Eduardo); A. Colombo (Antonio); G. Guagliumi (Giulio); W. Wijns (William); W.K. Lindeboom (Wietze); P.W.J.C. Serruys (Patrick); A.C. Abizaid (Alexandre)

    2002-01-01

    textabstractBACKGROUND: The goal of this intravascular ultrasound investigation was to provide a more detailed morphological analysis of the local biological effects of the implantation of a sirolimus-eluting stent compared with an uncoated stent. METHODS AND RESULTS: In the RAVEL trial, 238

  17. Late lumen loss and intima hyperplasia after sirolimus-eluting and zotarolimus-eluting stent implantation in diabetic patients: the diabetes and drug-eluting stent (DiabeDES III) angiography and intravascular ultrasound trial

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Maeng, Michael; Thayssen, Per

    2011-01-01

    Patients with diabetes mellitus have increased risk of in-stent restenosis after coronary stent implantation due to neointimal hyperplasia (NIH). The aim of this study was to use quantitative coronary angiography (QCA) and volumetric intravascular ultrasound (IVUS) to evaluate the effects...

  18. Comparison of intravascular ultrasound versus angiography-guided drug-eluting stent implantation: A meta-analysis of one randomised trial and ten observational studies involving 19,619 patients

    NARCIS (Netherlands)

    Y. Zhang (Yaojun); V. Farooq (Vasim); H.M. Garcia-Garcia (Hector); C.V. Bourantas (Christos); N.-L. Tian (Nai-Liang); S.-J. Dong (Sheng-Jie); M. Li (Minghui); S. Yang (Shengyun); P.W.J.C. Serruys (Patrick); S.-L. Chen (Shao-Liang)

    2012-01-01

    textabstractAims: The impact of intravascular ultrasound (IVUS) guided coronary drug-eluting stent (DES) implantation on clinical outcomes remains controversial. A meta-analysis of the currently available clinical trials investi-gating IVUS-guided DES implantation was undertaken. Methods and

  19. Severe thrombocytopenia induced by iodinated contrast after coronary angiography: The use of gadolinium contrast and intravascular ultrasound as an alternative to guide percutaneous coronary intervention.

    Science.gov (United States)

    Cubero-Gómez, José María; Guerrero Márquez, Francisco J; Diaz-de la-Llera, Luis; Fernández-Quero, Mónica; Guisado-Rasco, Agustín; Villa-Gil-Ortega, Manuel

    2017-01-01

    Acute contrast-induced thrombocytopenia is a rare event with the use of modern low osmolarity iodinated contrast media. The pathophysiological mechanism that causes platelet counts to drop has not been identified, but an immunological mechanism is suspected due to cytotoxicity after previous exposure to contrast. We report the case of a 47-year-old male patient with acute severe thrombocytopenia due to iodinated contrast media exposure. His platelet count after the procedure with the highest amount of contrast was zero, which is the lowest reported platelet count to date. Percutaneous coronary revascularization under both intravascular ultrasound and gadolinium contrast guidance was performed without complications. The most feared complication after the use of gadolinium is nephrogenic systemic fibrosis, especially in patients on hemodialysis. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Controlled antegrade intimal tracking with subintimal balloon inflation as a novel bailout technique for chronic total occlusion after failed intravascular ultrasound-guided parallel wire technique.

    Science.gov (United States)

    Imai, Yuta; Yajima, Junji; Hosaka, Fumitaka

    Failure to cross with a guidewire is the most common reason for failure of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). In cases of CTO PCI with no interventional collaterals, an intravascular ultrasound (IVUS)-guided parallel wire technique is usually the last-resort procedure. Failure of this technique sometimes causes enlarged subintimal space, resulting in procedure failure. We present a successful second attempt at left anterior descending artery CTO PCI with no interventional collaterals. After IVUS-guided parallel wire technique failed with an enlarged subintimal space, successful antegrade wire crossing was achieved using controlled antegrade intimal tracking with balloon inflation in the subintimal space to deflect a second wire. This technique may be useful as a bailout strategy in otherwise-failed CTO PCI with an enlarged subintimal space. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Intravascular ultrasound guidance improves clinical outcomes during implantation of both first- and second-generation drug-eluting stents: a meta-analysis.

    Science.gov (United States)

    Nerlekar, Nitesh; Cheshire, Caitlin J; Verma, Kunal P; Ihdayhid, Abdul-Rahman; McCormick, Liam M; Cameron, James D; Bennett, Martin R; Malaiapan, Yuvaraj; Meredith, Ian T; Brown, Adam J

    2017-01-20

    Our aim was to assess whether intravascular ultrasound (IVUS) improves clinical outcomes during implantation of first- and second-generation drug-eluting stents (DES). IVUS guidance is associated with improved clinical outcomes during DES implantation, but it is unknown whether this benefit is limited to either first- or second-generation devices. MEDLINE, EMBASE and PubMed were searched for studies comparing outcomes between IVUS- and angiography-guided PCI. Among 909 potentially relevant studies, 15 trials met the inclusion criteria. The primary endpoint was MACE, defined as death, myocardial infarction, target vessel/lesion revascularisation (TVR/TLR) or stent thrombosis (ST). Summary estimates were obtained using Peto modelling. In total, 9,313 patients from six randomised trials and nine observational studies were included. First-generation DES were implanted in 6,156 patients (3,064 IVUS-guided and 3,092 angiography-guided) and second-generation in 3,157 patients (1,528 IVUS-guided and 1,629 angiography-guided). IVUS guidance was associated with a significant reduction in MACE (odds ratio [OR] 0.73, 95% CI: 0.64-0.85, pDES (0.57, 95% CI: 0.43-0.77, pDES, IVUS guidance was associated with significantly lower rates of cardiac death (OR 0.33, 95% CI: 0.14-0.78, p=0.02), TVR (OR 0.47, 95% CI: 0.28-0.79, p=0.006), TLR (OR 0.61, 95% CI: 0.42-0.90, p=0.01) and ST (OR 0.31, 95% CI: 0.12-0.78, p=0.02). Cumulative meta-analysis highlighted progressive temporal benefit towards IVUS-guided PCI to reduce MACE (OR 0.60, 95% CI: 0.48-0.75, pDES platforms. These data support the use of IVUS guidance in contemporary revascularisation procedures using second-generation DES.

  2. Dynamic contrast enhanced ultrasound assessment of the vascular effects of novel therapeutics in early stage trials.

    Science.gov (United States)

    Leen, Edward; Averkiou, Michalakis; Arditi, Marcel; Burns, Peter; Bokor, Daniela; Gauthier, Thomas; Kono, Yuko; Lucidarme, Olivier

    2012-07-01

    Imaging is key in the accurate monitoring of response to cancer therapies targeting tumour vascularity to inhibit its growth and dissemination. Dynamic contrast enhanced ultrasound (DCE ultrasound) is a quantitative method with the advantage of being non-invasive, widely available, portable, cost effective, highly sensitive and reproducible using agents that are truly intravascular. Under the auspices of the initiative of the Experimental Cancer Medicine Centre Imaging Network, bringing together experts from the UK, Europe and North America for a 2-day workshop in May 2010, this consensus paper aims to provide guidance on the use of DCE ultrasound in the measurement of tumour vascular support in clinical trials. Key Points • DCE ultrasound can quantify and extract specific blood flow parameters, such as flow velocity, relative vascular volume and relative blood flow rate. • DCE ultrasound can be performed repeatedly and is therefore ideally suited for pharmacokinetic and pharmacodynamic studies evaluating vascular-targeted drugs. • DCE ultrasound provides a reproducible method of assessing the vascular effects of therapy in pre-clinical and early clinical trials, which is easily translatable into routine clinical practice.

  3. Antiatherosclerotic effects of long-term maximally intensive statin therapy after acute coronary syndrome: insights from Study of Coronary Atheroma by Intravascular Ultrasound: Effect of Rosuvastatin Versus Atorvastatin.

    Science.gov (United States)

    Puri, Rishi; Nissen, Steven E; Shao, Mingyuan; Ballantyne, Christie M; Barter, Philip J; Chapman, M John; Erbel, Raimund; Libby, Peter; Raichlen, Joel S; Uno, Kiyoko; Kataoka, Yu; Nicholls, Stephen J

    2014-11-01

    Patients with acute coronary syndromes (ACS) display diffuse coronary atheroma instability and heightened risk of early and late recurrent coronary events. We compared the long-term antiatherosclerotic efficacy of high-intensity statins in patients with ACS when compared with stable disease. Study of Coronary Atheroma by Intravascular Ultrasound: Effect of Rosuvastatin Versus Atorvastatin (SATURN) used serial intravascular ultrasound measures of coronary atheroma volume in patients treated with rosuvastatin 40 mg or atorvastatin 80 mg for 24 months. The overall effect of high-intensity statins on the change in coronary percent atheroma volume and major adverse cardiovascular events (death/nonfatal myocardial infarction/coronary revascularization) were evaluated in this post hoc analysis. When compared with non-ACS patients (n=678), patients with ACS (n=361) were younger, actively smoking, and have had a previous myocardial infarction (all P<0.001). At baseline, patients with ACS exhibited lower high-density lipoprotein cholesterol (43.5±11 versus 45.8±11 mg/dL; P=0.002), a higher apolipoprotein B: apolipoprotein A-1 ratio (0.90±0.24 versus 0.83±0.24; P<0.001) and greater percent atheroma volume (37.3±8.5% versus 35.9±8.1%; P=0.01) when compared with non-ACS patients. Despite similar achieved levels of lipid and inflammatory markers after high-intensity statin therapy, patients with ACS demonstrated greater percent atheroma volume regression than non-ACS patients (-1.46±0.14 versus -0.89±0.13; P=0.003). After propensity-weighted multivariable adjustment, baseline percent atheroma volume (P<0.001) and an ACS clinical presentation (P=0.02) independently associated with plaque regression. The 24-month major adverse cardiovascular events-free survival was similar between patients with ACS and non-ACS (90.6 versus 92.9%; P=0.25). Long-term high-intensity statin therapy caused greater plaque regression and comparable major adverse cardiovascular events rates in

  4. Acute myocardial infarction due to spontaneous, localized, acute dissection of the sinus of Valsalva detected by intravascular ultrasound and electrocardiogram-gated computed tomography.

    Science.gov (United States)

    Ichihashi, Taku; Ito, Tsuyoshi; Murai, Shunsuke; Ikehara, Noriyuki; Fujita, Hiroshi; Suda, Hisao; Ohte, Nobuyuki

    2016-09-01

    A 58-year-old man was referred to our hospital because of chest pain. The 12-lead electrocardiogram (ECG) revealed ST-segment elevation in II, III, and a Vf with advanced heart block. Transthoracic echocardiography demonstrated aortic root dilatation at the sinus of Valsalva, moderate aortic regurgitation, and decreased wall motion in the inferior part of the left ventricle. Non-ECG-gated enhanced computed tomography (CT) did not reveal an aortic dissection. The patient underwent emergent coronary angiography, which revealed a severely narrowed ostium of the right coronary artery (RCA). Percutaneous coronary intervention (PCI) was performed under intravascular ultrasound (IVUS) guidance. IVUS images demonstrated an intimal flap extending from the aortic wall to the proximal RCA, suggesting that a periaortic hematoma in the false lumen compressed the ostium of the RCA, leading to acute myocardial infarction. To recover hemodynamic stability, the RCA ostium was stented. Subsequent ECG-gated enhanced CT clearly depicted the entry point and extension of the dissection localized within the sinus of Valsalva. The dissection likely involved the left main coronary artery and an emergent Bentall procedure was performed. Intraoperative findings confirmed an intimal tear and extension of the dissection. Thus, ECG-gated CT can clearly depict the entry site and extension of a dissection occurring in the localized area that cannot be detected by conventional CT.

  5. Comprehensive analysis of intravascular ultrasound and angiographic morphology of culprit lesions between ST-segment elevation myocardial infarction and non-ST-segment elevation acute coronary syndrome.

    Science.gov (United States)

    Takaoka, Naoko; Tsujita, Kenichi; Kaikita, Koichi; Hokimoto, Seiji; Mizobe, Michio; Nagano, Masahide; Horio, Eiji; Sato, Koji; Nakayama, Naoki; Yoshimura, Hiromi; Yamanaga, Kenshi; Komura, Naohiro; Kojima, Sunao; Tayama, Shinji; Nakamura, Sunao; Ogawa, Hisao

    2014-02-15

    Some plaques lead to ST-segment elevation myocardial infarction (STEMI), whereas others cause non-ST-segment elevation acute coronary syndrome (NSTEACS). We used angiography and intravascular ultrasound (IVUS) to investigate the difference of culprit lesion morphologies in ACS. Consecutive 158 ACS patients whose culprit lesions were imaged by preintervention IVUS were enrolled (STEMI=81; NSTEACS=77). IVUS and angiographic findings of the culprit lesions, and clinical characteristics were compared between the groups. There were no significant differences in patients' characteristics except for lower rate of statin use in patients with STEMI (20% vs 44%, p=0.001). Although angiographic complex culprit morphology (Ambrose classification) and thrombus were more common in STEMI than in NSTEACS (84% vs 62%, p=0.002; 51% vs 5%, pSYNTAX score was lower in STEMI (8.6 ± 5.4 vs 11.5 ± 7.1, p=0.01). In patients with STEMI, culprit echogenicity was more hypoechoic (64% vs 40%, p=0.01), and the incidence of plaque rupture, attenuation and "microcalcification" were significantly higher (56% vs 17%, pMorphological feature (outward vessel remodeling, plaque buildup and IVUS vulnerability of culprit lesions) might relate to clinical presentation in patients with ACS. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Intravascular ultrasound-guided drug-eluting stent implantation: An updated meta-analysis of randomized control trials and observational studies.

    Science.gov (United States)

    Steinvil, Arie; Zhang, Yao-Jun; Lee, Sang Yeub; Pang, Si; Waksman, Ron; Chen, Shao-Liang; Garcia-Garcia, Hector M

    2016-08-01

    The use of intravascular ultrasound (IVUS) guidance for drug-eluting stent (DES) optimization is limited by the number of adequately powered randomized control trials (RCTs). We performed an updated meta-analysis, including data from recently published RCTs and observational studies, by reviewing the literature in Medline and the Cochrane Library to identify studies that compared clinical outcomes between IVUS-guided and angiography-guided DES implantation from January 1995 to January 2016. This meta-analysis included 25 eligible studies, including 31,283 patients, of whom 3192 patients were enrolled in 7 RCTs. In an analysis of all 25 studies, the summary results for all the events analyzed were significantly in favor of IVUS-guided DES implantation [major adverse cardiac events (MACE, odds ratio [OR] 0.76, 95% confidence intervals [CI]: 0.70-0.82, PDES implantation was found only for MACE (OR 0.66, 95% CI: 0.52-0.84, P=0.001), TLR (OR 0.61, 95% CI: 0.43-0.87, P=0.006), and TVR (OR 0.61, 95% CI: 0.41-0.90, P=0.013). IVUS-guided percutaneous coronary intervention was associated with better overall clinical outcomes than angiography-guided DES implantation. However, in a solely RCT meta-analysis, this benefit was mainly driven by reduced rates of revascularizations. Copyright © 2016. Published by Elsevier Ireland Ltd.

  7. Assessing intravascular volume by difference in pulse pressure in pigs submitted to graded hemorrhage.

    Science.gov (United States)

    Pestel, Gunther J; Hiltebrand, Luzius B; Fukui, Kimiko; Cohen, Delphine; Hager, Helmut; Kurz, Andrea M

    2006-10-01

    We assessed changes in intravascular volume monitored by difference in pulse pressure (dPP%) after stepwise hemorrhage in an experimental pig model. Six pigs (23-25 kg) were anesthetized (isoflurane 1.5 vol%) and mechanically ventilated to keep end-tidal CO2 (etCO2) at 35 mmHg. A PA-catheter and an arterial catheter were placed via femoral access. During and after surgery, animals received lactated Ringer's solution as long as they were considered volume responders (dPP>13%). Then animals were allowed to stabilize from the induction of anesthesia and insertion of catheters for 30 min. After stabilization, baseline measurements were taken. Five percent of blood volume was withdrawn, followed by another 5%, and then in 10%-increments until death from exsanguination occurred. After withdrawal of 5% of blood volume, all pigs were considered volume responders (dPP>13%); dPP rose significantly from 6.1+/-3.3% to 19.4+/-4.2%. The regression analysis of stepwise hemorrhage revealed a linear relation between blood loss (hemorrhage in %) and dPP (y=0.99*x+14; R2=0.7764; P<.0001). In addition, dPP was the only parameter that changed significantly between baseline and a blood loss of 5% (P<0.01), whereas cardiac output, stroke volume, heart rate, MAP, central venous pressure, pulmonary artery occlusion pressure, and systemic vascular resistance, respectively, remained unchanged. We conclude that in an experimental hypovolemic pig model, dPP correlates well with blood loss.

  8. Intravascular ultrasound-guided vs angiography-guided drug-eluting stent implantation in complex coronary lesions: Meta-analysis of randomized trials.

    Science.gov (United States)

    Bavishi, Chirag; Sardar, Partha; Chatterjee, Saurav; Khan, Abdur Rahman; Shah, Arpit; Ather, Sameer; Lemos, Pedro A; Moreno, Pedro; Stone, Gregg W

    2017-03-01

    The relative outcomes of intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) compared with angiography-guided PCI with drug-eluting stent (DES) in complex lesions have not been established. We sought to compare the efficacy and safety of IVUS-guided PCI with angiography-guided PCI in patients with complex coronary lesions treated with DES. Electronic databases were searched to identify all randomized trials comparing IVUS-guided vs angiography-guided DES implantation. We evaluated major adverse cardiac events (MACE), all-cause and cardiovascular death, myocardial infarction, target lesion revascularization (TLR), target vessel revascularization (TVR), and stent thrombosis outcomes at the longest reported follow-up. Random-effects modeling was used to calculate pooled relative risk (RR) and 95% CIs. Eight trials comprising 3,276 patients (1,635 IVUS-guided and 1,641 angiography-guided) enrolling only patients with complex lesions were included. Mean follow-up was 1.4±0.5years. Compared with angiography-guided PCI, patients undergoing IVUS-guided PCI had significantly lower MACE (RR 0.64, 95% CI 0.51-0.80, P=.0001), TLR (RR 0.62, 95% CI 0.45-0.86, P=.004), and TVR (RR 0.60, 95% CI 0.42-0.87, P=.007). There were no significant differences for stent thrombosis, cardiovascular death, or all-cause death. In meta-regression analysis, IVUS-guided PCI was of greatest benefit in reducing MACE in patients with acute coronary syndromes, diabetes, and long lesions. The present meta-analysis demonstrates a significant reduction in MACE, TVR, and TLR with IVUS-guided DES implantation in complex coronary lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Does intravascular ultrasound provide clinical benefits for percutaneous coronary intervention with bare-metal stent implantation? A meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Lodi-Junqueira Lucas

    2012-09-01

    Full Text Available Abstract Background The role of intravascular ultrasound (IVUS in percutaneous coronary interventions (PCI is still controversial despite several previously published meta-analyses. A meta-analysis to evaluate the controversial role of IVUS-guided PCI with bare-metal stenting was performed and a previous published meta-analysis was re-evaluated in order to clarify the discrepancy between results of these studies. Methods A systematic review was performed by an electronic search of the PubMed, Embase and Web of Knowledge databases and by a manual search of reference lists for randomized controlled trials published until April 2011, with clinical outcomes and, at least, six months of clinical follow-up. A meta-analysis based on the intention to treat was performed with the selected studies. Results Five studies and 1,754 patients were included. There were no differences in death (OR = 1.86; 95% CI = 0.88-3.95; p = 0.10, non-fatal myocardial infarction (OR = 0.65; 95% CI = 0.27-1.58; p = 0.35 and major adverse cardiac events (OR = 0.74; 95% CI = 0.49-1.13; p = 0.16. An analysis of the previous published meta-analysis strongly suggested the presence of publication bias. Conclusions There is no evidence to recommend routine IVUS-guided PCI with bare-metal stent implantation. This may be explained by the paucity and heterogeneity of the studies published so far.

  10. Neointimal hyperplasia after sirolimus-eluting and paclitaxel-eluting stent implantation in diabetic patients: the Randomized Diabetes and Drug-Eluting Stent (DiabeDES) Intravascular Ultrasound Trial

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Maeng, Michael; Thayssen, Per

    2008-01-01

    AIMS: Patients with diabetes have increased risk of in-stent restenosis after coronary stent implantation owing to neointimal hyperplasia (NIH). The aim of the study was to evaluate the extent and distribution of NIH with intravascular ultrasound (IVUS) after coronary artery stenting with sirolimus......-eluting (Cypher) or paclitaxel-eluting (Taxus) stents in diabetic patients. METHODS AND RESULTS: One hundred and thirty diabetic patients were randomized to Cypher or Taxus stent implantation. IVUS was performed at 8 month follow-up. NIH volume was significantly reduced in the Cypher group when compared...

  11. Ultrasound assessment of great saphenous vein insufficiency

    Directory of Open Access Journals (Sweden)

    Chander RK

    2015-06-01

    Full Text Available Rajiv K Chander,1 Thomas S Monahan1,2 1Section of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, 2Department of Surgery, Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA Abstract: Duplex ultrasonography is the ideal modality to assess great saphenous vein insufficiency. Duplex ultrasonography incorporates both gray scale images to delineate anatomy and color-Doppler imaging that visualizes the flow of blood in a structure. Assessment of great saphenous vein requires definition of the anatomy, augmentation of flow, evaluation for both superficial and deep vein thrombosis, and determining the presence of reflux. Currently, evolution in the treatment of reflux also relies on ultrasound for the treatment of the disease. Understanding the utilization of the ultrasound for the diagnosis and treatment of greater saphenous vein reflux is important for practitioners treating reflux disease. Keywords: duplex ultrasonography, small saphenous vein 

  12. The use of intravascular ultrasound imaging to improve use of inferior vena cava filters in a high-risk bariatric population.

    Science.gov (United States)

    Kardys, Clark M; Stoner, Michael C; Manwaring, Mark L; Bogey, William M; Parker, Frank M; Powell, Steve

    2007-12-01

    Pulmonary embolism is the leading cause of death after gastric bypass procedures for obesity, approximating 0.5% to 4%. All bariatric patients, but especially the super-obese, which have a body mass index (BMI) >50 kg/m(2), are at significant risk for postoperative venous thromboembolism (VTE). Visualization and weight limitations of fluoroscopy tables exclude most bariatric and all super-obese patients from inferior vena cava (IVC) filter placement using fluoroscopy. Intravascular ultrasound (IVUS)-guided IVC filter placement is the only modality that allows these high-risk patients to have an IVC filter placed. Hospital and outpatient records of the 494 patients who underwent gastric bypass procedures from January 1, 2004, to May 31, 2006, were reviewed. All patients who had concurrent IVC filter placement with the use of IVUS guidance were selected. Comorbidities, outcomes, and complications were recorded. We identified 27 patients with mean BMI of 70 +/- 3 kg/m(2); of these, 25 were super-obese (BMI >50 kg/m(2)). Procedures included five laparoscopic and 22 open gastric bypass operations. All patients underwent concurrent IVC filter placement using IVUS guidance. In addition to super-obesity, indications for IVC filter placement included history of VTE (n = 4), known hypercoagulable state (n = 2), and profound immobility (n = 21). Mean follow up was 293 +/- 40 days. Technical success rate was 96.3%. There were no catheter site complications. In one surviving patient, a nonfatal pulmonary embolism was detected by computed tomography 2 months postoperatively. Two patients died, and autopsy excluded VTE as the cause of death in both. This study suggests efficacy of IVUS-guided IVC filter placement in preventing mortality from pulmonary embolism in high-risk bariatric patients, including the super-obese. IVUS-guided IVC filter placement can be safely performed with an excellent success rate in all bariatric patients, including the super-obese, who otherwise would

  13. Transcatheter Arterial Embolization for Postpartum Hemorrhage with Disseminated Intravascular Coagulation: Outcome Assessment

    Energy Technology Data Exchange (ETDEWEB)

    An, Eun Jung; Kim, Young Hwan; Kwon, Bo Ra; Kim, See Hyung [Dept. of Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2011-12-15

    We evaluated the efficacy and predictors of clinical outcome after transcatheter arterial embolization (TAE) for treatment of postpartum hemorrhage with disseminated intravascular coagulation (DIC). Of 127 patients who underwent TAE for postpartum hemorrhage, 46 progressed to DIC (group 1), 81 showed normal range hematological parameters (group 2). We retrospectively evaluated etiology, embolization methods and the efficacy of TAE for intergroup comparison Pearson Chi-Square test and logistic regression model. Overall TAE failed to control bleeding in 9 patients in spite of technical success. Lower bleeding control rate was found in group 2 (82.6%) relative to group 1 (98.8%, p = 0.001). And embolization methods were not statistically different between two groups no statistically significant predictors associated with failed hemostasis except the amount of transfusion in group 1. Although bleeding control rate is lower in postpartum hemorrhage with DIC than without DIC, we believe that TAE with correction of DIC is an effective method for postpartum hemorrhage with DIC.

  14. A new method to quantify coronary calcification by intravascular ultrasound - the different patterns of calcification of acute myocardial infarction, unstable angina pectoris and stable angina pectoris.

    Science.gov (United States)

    Wang, Xiaofei; Lu, Chengzhi; Chen, Xin; Zhao, Xiangdong; Xia, Dasheng

    2008-11-01

    Intravascular ultrasound (IVUS) enables the identification of calcification with more details and quantification of calcification, but there is not a proper method to quantify the calcification with IVUS. Previous IVUS studies used arc or length of calcium, respectively, to quantify calcification, but calcium is determined by a combination of arc and length. We devised a new method to quantify calcium as arc area (AA) in the present study, and AA is two-dimensional and irrelevant to vessel size. We selected 201 patients with stable angina pectoris (SAP), unstable angina pectoris (UAP), or acute myocardial infarction (AMI) who underwent IVUS imaging of a de novo native atherosclerotic lesion considered to be the culprit lesion before percutaneous coronary intervention between December 2001 and December 2007. The culprit lesion site for analysis was the 10 mm-long segment including the smallest lumen cross-sectional area. The arc of each calcium deposit in each image was measured with a protractor centered on the lumen and the length of each calcium deposit was calculated with the number of images containing the calcium deposit minus 1, then multiplying 0.5 mm (the images were 0.5 mm apart). Finally, the AA was calculated by arc (degree) multiplying length (mm). The average number of calcium deposits in the culprit lesions of patients with acute myocardial infarction (AMI) was significantly larger than patients with SAP or UAP, and the number of calcium deposits of patients with SAP or UAP was almost the same (mean +/- SD, AMI 2.21 +/- 1.98, SAP 1.15 +/- 1.01, UAP 1.20 +/- 1.15, AMI versus SAP or UAP; p < 0.0005). The average AA per calcium deposit was significantly different in culprit lesions of patients with SAP and UAP or AMI, the calcium deposits were bigger in SAP than in UAP or AMI, and there were no differences between UAP and AMI (mean +/- SD, SAP 788.6 +/- 767.0 degree x mm, UAP 136.6 +/- 189.3 degree x mm, AMI 148.4 +/- 217.1 degree x mm, SAP versus UAP or

  15. Three-dimensional assessment of scoliosis based on ultrasound data

    Science.gov (United States)

    Zhang, Junhua; Li, Hongjian; Yu, Bo

    2015-12-01

    In this study, an approach was proposed to assess the 3D scoliotic deformity based on ultrasound data. The 3D spine model was reconstructed by using a freehand 3D ultrasound imaging system. The geometric torsion was then calculated from the reconstructed spine model. A thoracic spine phantom set at a given pose was used in the experiment. The geometric torsion of the spine phantom calculated from the freehand ultrasound imaging system was 0.041 mm-1 which was close to that calculated from the biplanar radiographs (0.025 mm-1). Therefore, ultrasound is a promising technique for the 3D assessment of scoliosis.

  16. Absence of accelerated atherosclerotic disease progression after intracoronary infusion of bone marrow derived mononuclear cells in patients with acute myocardial infarction--angiographic and intravascular ultrasound--results from the TErapia Celular Aplicada al Miocardio Pilot study.

    Science.gov (United States)

    Arnold, Roman; Villa, Adolfo; Gutiérrez, Hipólito; Sánchez, Pedro L; Gimeno, Federico; Fernández, Maria E; Gutiérrez, Oliver; Mota, Pedro; Sánchez, Ana; García-Frade, Javier; Fernández-Avilés, Francisco; San Román, Jose A

    2010-06-01

    We tried to evaluate a putative negative effect on coronary atherosclerosis in patients receiving intracoronary infusion of unfractionated bone marrow mononuclear cells (BMMC) following an acute ST-elevation myocardial infarction. Peripheral blood mononuclear cells or enriched CD133(+) BMMC have been associated with accelerated atherosclerosis of the distal segment of the infarct related artery (IRA). Thirty-seven patients with ST-elevation myocardial infarction from the TECAM pilot study underwent intracoronary infusion of autologous BMMC 9 +/- 3.1 days after onset of symptoms. We compared angiographic changes from baseline to 9 months of follow-up in the distal non-stented segment of the IRA, as well as in the contralateral coronary artery, with a matched control group. A subgroup of 15 treated patients underwent additional IVUS within the distal segment of the IRA. No difference between stem cell and control group were found regarding changes in minimum lumen diameter (0.006 +/- 0.42 vs 0.06 +/- 0.41 mm, P = ns) and the percentage of stenosis (-2.68 +/- 12.33% vs -1.78 +/- 8.75%, P = ns) at follow-up. Likewise, no differences were seen regarding changes in the contralateral artery (minimum lumen diameter -0.004 +/- 0.54 mm vs -0.06 +/- 0.35 mm, P = ns). In the intravascular ultrasound substudy, no changes were demonstrated comparing baseline versus follow-up in maximum area stenosis and plaque volume. In this pilot study, analysis of a subgroup of patients found that intracoronary injection of unfractionated BMMC in patients with acute ST-elevation myocardial infarction was not associated with accelerated atherosclerosis progression at mid term. Prospective, randomised studies in large cohorts with long-term angiographic and intravascular ultrasound follow-up are necessary to determine the safety of this therapy. Copyright 2010 Mosby, Inc. All rights reserved.

  17. Comparison of change in coronary atherosclerosis in patients with stable versus unstable angina pectoris receiving statin therapy (from the Treatment With Statin on Atheroma Regression Evaluated by Intravascular Ultrasound With Virtual Histology [TRUTH] study).

    Science.gov (United States)

    Nozue, Tsuyoshi; Yamamoto, Shingo; Tohyama, Shinichi; Fukui, Kazuki; Umezawa, Shigeo; Onishi, Yuko; Kunishima, Tomoyuki; Sato, Akira; Nozato, Toshihiro; Miyake, Shogo; Takeyama, Youichi; Morino, Yoshihiro; Yamauchi, Takao; Muramatsu, Toshiya; Hibi, Kiyoshi; Terashima, Mitsuyasu; Michishita, Ichiro

    2013-04-01

    Although statin-induced regression in coronary atherosclerosis seems to be greater in patients with acute coronary syndrome than in those with stable coronary artery disease, no reports have examined this. The purpose of the present study was to compare the changes in coronary atherosclerosis in patients with stable versus unstable angina pectoris (AP). The effects of 8-month statin therapy on coronary atherosclerosis were evaluated using virtual histology intravascular ultrasound, and analyzable intravascular ultrasound data were obtained from 119 patients (83 patients with stable AP and 36 with unstable AP). A significant decrease in plaque volume was observed in patients with unstable AP (-2.2%, p = 0.02) but not in patients with stable AP. A significant increase in the necrotic-core component (0.30 mm(3)/mm, p = 0.009) was observed only in patients with unstable AP. Significant positive correlations were observed between the percentage of change in platelet-activating factor acetylhydrolase and the percentage of change in plaque volume (r = 0.346, p = 0.05) in patients with unstable AP. No significant correlations were observed in patients with stable AP. Multivariate regression analyses showed that a reduction in platelet-activating factor acetylhydrolase was associated with regression in coronary atherosclerosis, particularly of the fibrous component (β = 0.443, p = 0.003), in patients with unstable AP. In conclusion, regression of the coronary artery plaque volume was greater, although statin therapy did not halt the increases in plaque vulnerability, in patients with unstable AP compared to those with stable AP. A reduction in the serum platelet-activating factor acetylhydrolase level was associated with regression in coronary atherosclerosis, particularly the fibrous plaque volume, in patients with unstable AP. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Long-term safety and feasibility of three-vessel multimodality intravascular imaging in patients with ST-elevation myocardial infarction

    DEFF Research Database (Denmark)

    Taniwaki, Masanori; Radu, Maria D; Garcia-Garcia, Hector M

    2015-01-01

    We assessed the feasibility and the procedural and long-term safety of intracoronary (i.c) imaging for documentary purposes with optical coherence tomography (OCT) and intravascular ultrasound (IVUS) in patients with acute ST-elevation myocardial infarction (STEMI) undergoing primary PCI in the s...

  19. Assessment of microcirculation by contrast-enhanced ultrasound: a new approach in vascular medicine.

    Science.gov (United States)

    Kaspar, Mathias; Partovi, Sasan; Aschwanden, Markus; Imfeld, Stephan; Baldi, Thomas; Uthoff, Heiko; Staub, Daniel

    2015-01-01

    Contrast-enhanced ultrasound (CEUS) has emerged as a valuable imaging modality that complements and enhances standard vascular ultrasound imaging. Ultrasound contrast agents are gas-filled microbubbles that are injected intravenously and serve as intravascular tracers. Based on the properties to enhance and to quantify the macro- and microcirculation down to the capillary perfusion level in different vascular territories and organs, CEUS imaging has the potential to improve the diagnostic performance in the detection and characterisation of various vascular disorders reviewed in this article. In carotid atherosclerotic disease, CEUS imaging provides additional information on plaque vulnerability by illustrating the presence and extent of intraplaque neovascularisation. This new imaging modality may be helpful for further risk stratification of arteriosclerotic lesions and for detecting patients at risk for vascular events, eventually leading to more specific individually tailored therapeutic recommendations. CEUS imaging is also a helpful tool for the diagnosis and for monitoring of inflammatory vascular diseases. It increases the diagnostic performance of ultrasound in detecting inflammatory changes of the vessel wall such as hypervascularisation and hyperaemia. Changes in vessel wall enhancement may also reflect the response to anti-inflammatory therapy. Moreover, CEUS imaging is also a valuable tool for the assessment of the microcirculation and the tissue perfusion in solid organs including native and transplanted kidneys. The technique provides more accurate information on perfusion deficits of the parenchyma in patients with kidney infarction, necrosis or graft dysfunction. CEUS also has great potential in the assessment of the microcirculation of the skeletal muscle, particularly in patients with peripheral artery disease or diabetic microangiopathy. In the future, the use of targeted on site microbubbles could further enhance and expand the diagnostic

  20. Objective and structured assessment of lung ultrasound competence

    DEFF Research Database (Denmark)

    Skaarup, Søren Helbo; Laursen, Christian B.; Bjerrum, Anne Sofie

    2017-01-01

    RATIONALE: Point-of-care lung ultrasound imaging has substantial diagnostic value and is widely used in respiratory, emergency and critical care medicine. Like other ultrasound examinations, lung ultrasound is operator-dependent. The current recommendations for competence in lung ultrasound sets....... 5 elements were excluded. 2 new elements were proposed, 1 gained consensus. 2 elements were rephrased. We found that the lung ultrasound competence evaluation tool could differentiate between different levels of competence (p... and intermediate operators (p=0.005) but not between novices and intermediate (p=0.06). The assessment tool had a good inter-rater agreement; Pearson's R=0.85 (pevaluate operator competence in point-of-care lung ultrasound...

  1. Feasibility of using intravascular ultrasonography for assessment of giant cavernous aneurysm after endovascular treatment: a technical report.

    Science.gov (United States)

    Majidi, Shahram; Grigoryan, Mikayel; Tekle, Wondwossen G; Watanabe, Masaki; Qureshi, Adnan I

    2012-06-01

    Intravascular ultrasonography (IVUS) has been shown as a valuable adjunct imaging tool during endovascular procedures but its value in detection of any recurrence during follow up after endovascular coil embolization of large and giant intracranial aneurysms is not reported. A 41 years old man who had been treated using stent assisted coil embolization for cavernous segment aneurysm of the left internal carotid artery underwent 60 month angiographic follow up. Concurrently, IVUS catheter was advanced under fluoroscopic guidance inside the cavernous portion of the left internal carotid artery. Then IVUS images were used to visualize the stent, coil loops, and aneurysm neck. The angiographic images were limited because of superimposition of the aneurysm on the parent vessel in all projections. IVUS images demonstrated that the stent was patent along its whole length and there was no sign of stent deformity or in-stent thrombosis. Loops of the coil were visualized as hyperechoic signals inside the aneurysm and there was no sign of herniated loops of coil inside the stent. In this case report, we observed that adjunct use of IVUS can provide valuable information not ascertained by angiography during follow up assessment of coil embolized aneurysm.

  2. Ultrasound in the Assessment of Myopathic Disorders

    NARCIS (Netherlands)

    Zaidman, C.M.; Alfen, N. van

    2016-01-01

    Neuromuscular ultrasound (US) augments a careful physical examination and electrodiagnostic evaluation in the evaluation of suspected myopathy. Ultrasound evaluation of muscle can identify abnormal echo intensity, size, and movement. Because it is painless and noninvasive, US can be used to evaluate

  3. Reliable and valid assessment of ultrasound operator competence in obstetrics and gynecology

    DEFF Research Database (Denmark)

    Tolsgaard, M G; Ringsted, C; Dreisler, E

    2014-01-01

    OBJECTIVES: To explore the reliability and validity of a recently developed instrument for assessment of ultrasound operator competence, the Objective Structured Assessment of Ultrasound Skills (OSAUS). METHODS: Three groups of 10 doctors with different levels of ultrasound experience in obstetrics...

  4. Reproducibility of abdominal fat assessment by ultrasound and computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Mauad, Fernando Marum; Chagas-Neto, Francisco Abaete; Benedeti, Augusto Cesar Garcia Saab; Nogueira-Barbosa, Marcello Henrique; Muglia, Valdair Francisco; Carneiro, Antonio Adilton Oliveira; Muller, Enrico Mattana; Elias Junior, Jorge, E-mail: fernando@fatesa.edu.br [Faculdade de Tecnologia em Saude (FATESA), Ribeirao Preto, SP (Brazil); Universidade de Fortaleza (UNIFOR), Fortaleza, CE (Brazil). Departmento de Radiologia; Universidade de Sao Paulo (FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Departmento de Medicina Clinica; Universidade de Sao Paulo (FFCLRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Filosofia, Ciencias e Letras; Hospital Mae de Deus, Porto Alegre, RS (Brazil)

    2017-05-15

    Objective: To test the accuracy and reproducibility of ultrasound and computed tomography (CT) for the quantification of abdominal fat in correlation with the anthropometric, clinical, and biochemical assessments. Materials and Methods: Using ultrasound and CT, we determined the thickness of subcutaneous and intra-abdominal fat in 101 subjects-of whom 39 (38.6%) were men and 62 (61.4%) were women-with a mean age of 66.3 years (60-80 years). The ultrasound data were correlated with the anthropometric, clinical, and biochemical parameters, as well as with the areas measured by abdominal CT. Results: Intra-abdominal thickness was the variable for which the correlation with the areas of abdominal fat was strongest (i.e., the correlation coefficient was highest). We also tested the reproducibility of ultrasound and CT for the assessment of abdominal fat and found that CT measurements of abdominal fat showed greater reproducibility, having higher intraobserver and interobserver reliability than had the ultrasound measurements. There was a significant correlation between ultrasound and CT, with a correlation coefficient of 0.71. Conclusion: In the assessment of abdominal fat, the intraobserver and interobserver reliability were greater for CT than for ultrasound, although both methods showed high accuracy and good reproducibility. (author)

  5. Developing an Undergraduate Ultrasound Curriculum: A Needs Assessment.

    Science.gov (United States)

    Stone-McLean, Jordan; Metcalfe, Brian; Sheppard, Gillian; Murphy, Justin; Black, Holly; McCarthy, Heather; Dubrowski, Adam

    2017-09-28

    Background The introduction of ultrasound into the undergraduate medical school curriculum is gaining momentum in North America. At present, many institutions are teaching ultrasound to undergraduate medical students using a traditional framework designed to instruct practicing clinicians, or have modeled the curriculum on other universities. This approach is not based on educational needs or supported by evidence. Methods Using a descriptive, cross-sectional survey of stakeholder groups, we assessed the perceived relevance of various ultrasound skills and the attitude towards implementing an undergraduate ultrasound curriculum at our university. Results One hundred and fifty survey respondents representing all major stakeholder groups participated. All medical students, 97% of residents and 82% of educators agreed that the introduction of an ultrasound curriculum would enhance medical students' understanding of anatomy and physiology. All clinical medical students and residents, 92% of preclinical medical students, and 82% of educators agreed that the curriculum should also include clinical applications of ultrasound. Participants also indicated their preferences for specific curriculum content based on their perceived needs. Conclusion An integrated undergraduate ultrasound curriculum composed of specific preclinical and clinical applications was deemed appropriate for our university following a comprehensive needs assessment. Other universities planning such curricula should consider employing a needs assessment to provide direction for curriculum need and content.

  6. Reproducibility of abdominal fat assessment by ultrasound and computed tomography

    Directory of Open Access Journals (Sweden)

    Fernando Marum Mauad

    Full Text Available Abstract Objective: To test the accuracy and reproducibility of ultrasound and computed tomography (CT for the quantification of abdominal fat in correlation with the anthropometric, clinical, and biochemical assessments. Materials and Methods: Using ultrasound and CT, we determined the thickness of subcutaneous and intra-abdominal fat in 101 subjects-of whom 39 (38.6% were men and 62 (61.4% were women-with a mean age of 66.3 years (60-80 years. The ultrasound data were correlated with the anthropometric, clinical, and biochemical parameters, as well as with the areas measured by abdominal CT. Results: Intra-abdominal thickness was the variable for which the correlation with the areas of abdominal fat was strongest (i.e., the correlation coefficient was highest. We also tested the reproducibility of ultrasound and CT for the assessment of abdominal fat and found that CT measurements of abdominal fat showed greater reproducibility, having higher intraobserver and interobserver reliability than had the ultrasound measurements. There was a significant correlation between ultrasound and CT, with a correlation coefficient of 0.71. Conclusion: In the assessment of abdominal fat, the intraobserver and interobserver reliability were greater for CT than for ultrasound, although both methods showed high accuracy and good reproducibility.

  7. Summative clinical competency assessment: A survey of ultrasound practitioners' views.

    Science.gov (United States)

    Harrison, Gill

    2015-02-01

    Clinical competency and the assessment of core skills is a crucial element of any programme leading to an award with a clinical skills component. This has become a more prominent feature of current reports on quality health care provision. This project aimed to determine ultrasound practitioners' opinions about how best to assess clinical competency. An on-line questionnaire was sent to contacts from the Consortium for the Accreditation of Sonographic Education and details distributed at the British Medical Ultrasound Society conference in 2011. One hundred and sixteen responses were received from a range of clinical staff with an interest in ultrasound assessment. The majority of respondents suggested that competency assessments should take place in the clinical departments with or without an element of assessment at the education centre. Moderation was an important area highlighted by respondents, with 84% of respondents suggesting that two assessors were required and 66% of those stating some element of external moderation should be included. The findings suggest that respondents' preference is for some clinical competency assessments to take place on routine lists within the clinical department, assessed by two people one of which would be an external assessor. In view of recent reports relating to training and assessment of health care professionals, the ultrasound profession needs to begin the debate about how best to assess clinical competence and ensure appropriate first post-competency of anyone undertaking ultrasound examinations.

  8. Assessing Elementary Lesions in Gout by Ultrasound

    DEFF Research Database (Denmark)

    Terslev, Lene; Gutierrez, Marwin; Christensen, Robin

    2015-01-01

    OBJECTIVE: To test the reliability of the consensus-based ultrasound (US) definitions of elementary gout lesions in patients. METHODS: Eight patients with microscopically proven gout were evaluated by 16 sonographers for signs of double contour (DC), aggregates, erosions, and tophi in the first m...

  9. Impact of kissing balloon inflation on the main vessel stent volume, area, and symmetry after side-branch dilation in patients with coronary bifurcation lesions: a serial volumetric intravascular ultrasound study.

    Science.gov (United States)

    Rahman, Shahid; Leesar, Tara; Cilingiroglu, Mehmet; Effat, Mohamed; Arif, Imran; Helmy, Tarek; Leesar, Massoud A

    2013-09-01

    Intravascular ultrasound (IVUS) was performed to investigate the impact of kissing balloon inflation (KBI) on the main vessel (MV) stent volume, area, and symmetry after side-branch (SB) dilation in patients with coronary bifurcation lesions (CBL). It remains controversial whether KBI would restore the MV stent area and symmetry loss after SB dilation. A total of 88 serial IVUS examinations of the MV were performed after MV angioplasty, MV stenting, SB dilation, and KBI in 22 patients with CBL. The MV stent was divided into proximal, bifurcation, and distal segments; the stent volume index (SVI), minimal stent area (MSA), stent symmetry index (SSI), and external elastic membrane (EEM) volume index were measured in 198 stent segments and compared after MV stenting, SB dilation, and KBI. In the bifurcation segment, SVI, MSA, and SSI were significantly smaller after SB dilation than after MV stenting and KBI (SVI was 6.10 ± 1.50 mm(3)/mm vs. 6.68 ± 1.60 mm(3)/mm and 6.57 ± 1.60 mm(3)/mm, respectively, p impact on the MV stent volume or symmetry. This is the first comprehensive volumetric IVUS analysis of CBL, to our knowledge, demonstrating that KBI restores the MV stent volume, area, and symmetry loss after SB dilation in the bifurcation segment, and induces asymmetric stent expansion in the proximal segment. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. Serial intravascular ultrasound analysis of peri-stent remodeling and proximal and distal edge effects after sirolimus-eluting or paclitaxel-eluting stent implantation in patients with diabetes mellitus

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Maeng, Michael; Mintz, Gary S

    2009-01-01

    Patients with diabetes have an increased risk of in-stent restenosis after coronary stent implantation. Serial intravascular ultrasound was used to study chronic arterial responses and edge effects after implantation of Cypher (Cordis, Johnson & Johnson, Miami Lakes, Florida) or Taxus (Boston......-up. The increase in peri-stent external elastic membrane (EEM) volume was more pronounced in the Taxus group (292.4 +/- 132.6 to 309.5 +/- 146.8 mm(3)) than in the Cypher group (274.4 +/- 137.2 to 275.4 +/- 140.1 mm(3); p = 0.005). Peri-stent plaque volume increased in the Taxus group (152.5 +/- 73.7 to 166.......1 +/- 85.1 mm(3)), but was unchanged in the Cypher group (153.5 +/- 75.5 to 151.5 +/- 75.8 mm(3); p = 0.002). In proximal and distal reference segments, mean lumen area decreased within the entire 5-mm edge segment (proximal and distal) because of plaque progression (distal, 5.5 +/- 3.6 to 5.8 +/- 3.7 mm(2...

  11. Characterization and morphology of atherosclerotic plaque of coronary arteries: utility of electron-beam tomography to detect non-calcified plaque: a comparison with conventional coronary angiography and intravascular ultrasound.

    Science.gov (United States)

    Funabashi, Nobusada; Misumi, Kazuo; Ohnishi, Hiroyuki; Asano, Miki; Komuro, Issei

    2007-01-31

    Electron-beam tomography (EBT) may provide useful information about characterization and morphology of atherosclerotic plaque of coronary arteries. Twenty-six subjects (20 male, 6 female) with suspected coronary heart disease had two routine (r) and one enhanced (e) EBT scans to detect non-calcified plaque (NCP) in the coronary arterial lumen, and were compared with conventional coronary angiograms (CAG) and intravascular ultrasound (IVUS). Three had the sites, which did not have high CT values suggesting calcification in rEBT, nor which was not enhanced by contrast material in eEBT. One had the site with positive CT values that were supposed to be the proliferation intima or organized thrombus and at the corresponding site mixed plaque was observed in the IVUS image. The other two had the site with negative CT values that were supposed to be fat tissue with significant stenosis in CAG. We also made the cross-sectional images of the vessel and the morphology of the NCP, which projected into the lumen, could be evaluated. We could detect the NCP, differentiate fat tissue from soft tissue and evaluate the morphology of the plaque in EBT.

  12. Intravascular ultrasound guidance to minimize the use of iodine contrast in percutaneous coronary intervention: the MOZART (Minimizing cOntrast utiliZation With IVUS Guidance in coRonary angioplasTy) randomized controlled trial.

    Science.gov (United States)

    Mariani, José; Guedes, Cristiano; Soares, Paulo; Zalc, Silvio; Campos, Carlos M; Lopes, Augusto C; Spadaro, André G; Perin, Marco A; Filho, Antonio Esteves; Takimura, Celso K; Ribeiro, Expedito; Kalil-Filho, Roberto; Edelman, Elazer R; Serruys, Patrick W; Lemos, Pedro A

    2014-11-01

    The aim of this study was to evaluate the impact of intravascular ultrasound (IVUS) guidance on the final volume of contrast agent used in patients undergoing percutaneous coronary intervention (PCI). To date, few approaches have been described to reduce the final dose of contrast agent in PCIs. We hypothesized that IVUS might serve as an alternative imaging tool to angiography in many steps during PCI, thereby reducing the use of iodine contrast. A total of 83 patients were randomized to angiography-guided PCI or IVUS-guided PCI; both groups were treated according to a pre-defined meticulous procedural strategy. The primary endpoint was the total volume contrast agent used during PCI. Patients were followed clinically for an average of 4 months. The median total volume of contrast was 64.5 ml (interquartile range [IQR]: 42.8 to 97.0 ml; minimum, 19 ml; maximum, 170 ml) in the angiography-guided group versus 20.0 ml (IQR: 12.5 to 30.0 ml; minimum, 3 ml; maximum, 54 ml) in the IVUS-guided group (p MOZART]; NCT01947335). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. Multiparametric Quantitative Ultrasound Imaging in Assessment of Chronic Kidney Disease.

    Science.gov (United States)

    Gao, Jing; Perlman, Alan; Kalache, Safa; Berman, Nathaniel; Seshan, Surya; Salvatore, Steven; Smith, Lindsey; Wehrli, Natasha; Waldron, Levi; Kodali, Hanish; Chevalier, James

    2017-11-01

    To evaluate the value of multiparametric quantitative ultrasound imaging in assessing chronic kidney disease (CKD) using kidney biopsy pathologic findings as reference standards. We prospectively measured multiparametric quantitative ultrasound markers with grayscale, spectral Doppler, and acoustic radiation force impulse imaging in 25 patients with CKD before kidney biopsy and 10 healthy volunteers. Based on all pathologic (glomerulosclerosis, interstitial fibrosis/tubular atrophy, arteriosclerosis, and edema) scores, the patients with CKD were classified into mild (no grade 3 and quantitative ultrasound parameters included kidney length, cortical thickness, pixel intensity, parenchymal shear wave velocity, intrarenal artery peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index. We tested the difference in quantitative ultrasound parameters among mild CKD, moderate to severe CKD, and healthy controls using analysis of variance, analyzed correlations of quantitative ultrasound parameters with pathologic scores and the estimated glomerular filtration rate (GFR) using Pearson correlation coefficients, and examined the diagnostic performance of quantitative ultrasound parameters in determining moderate CKD and an estimated GFR of less than 60 mL/min/1.73 m 2 using receiver operating characteristic curve analysis. There were significant differences in cortical thickness, pixel intensity, PSV, and EDV among the 3 groups (all P quantitative ultrasound parameters, the top areas under the receiver operating characteristic curves for PSV and EDV were 0.88 and 0.97, respectively, for determining pathologic moderate to severe CKD, and 0.76 and 0.86 for estimated GFR of less than 60 mL/min/1.73 m 2 . Moderate to good correlations were found for PSV, EDV, and pixel intensity with pathologic scores and estimated GFR. The PSV, EDV, and pixel intensity are valuable in determining moderate to severe CKD. The value of shear wave velocity in

  14. Assessing intravascular fluid status

    African Journals Online (AJOL)

    perfusion such as urine output. or titration of fluid therapy with the goal of optimising haemodynamic status. Most practitioners agree that an underlying theme is ... their work is the understanding that at steady state venous return and cardiac output are equal, and that factors increasing venous return would enable a greater.

  15. Ultrasound

    Science.gov (United States)

    Ultrasound is a useful procedure for monitoring the baby's development in the uterus. Ultrasound uses inaudible sound waves to produce a two-dimensional image of the baby while inside the mother's ...

  16. A Methodology for Anatomic Ultrasound Image Diagnostic Quality Assessment

    DEFF Research Database (Denmark)

    Hemmsen, Martin Christian; Lange, Theis; Brandt, Andreas Hjelm

    2017-01-01

    This paper discusses methods for assessment of ultrasound image quality based on our experiences with evaluating new methods for anatomic imaging. It presents a methodology to ensure a fair assessment between competing imaging methods using clinically relevant evaluations. The methodology...... to properly reveal the clinical value. The paper exemplifies the methodology using recent studies of Synthetic Aperture Sequential Beamforming tissue harmonic imaging....

  17. Automatic assessment of ultrasound image usability

    Science.gov (United States)

    Valente, Luca; Funka-Lea, Gareth; Stoll, Jeffrey

    2011-03-01

    We present a novel and efficient approach for evaluating the quality of ultrasound images. Image acquisition is sensitive to skin contact and transducer orientation and requires both time and technical skill to be done properly. Images commonly suffer degradation due to acoustic shadows and signal attenuation, which present as regions of low signal intensity masking anatomical details and making the images partly or totally unusable. As ultrasound image acquisition and analysis becomes increasingly automated, it is beneficial to also automate the estimation of image quality. Towards this end, we present an algorithm that classifies regions of an image as usable or un-usable. Example applications of this algorithm include improved compounding of free-hand 3D ultrasound volumes by eliminating unusable data and improved automatic feature detection by limiting detection to only usable areas. The algorithm operates in two steps. First, it classifies the image into bright areas, likely to have image content, and dark areas, likely to have no content. Second, it classifies the dark areas into unusable (i.e. due to shadowing and/or signal loss) and usable (i.e. anatomically accurate dark regions, such as with a blood vessel) sub-areas. The classification considers several factors, including statistical information, gradient intensity and geometric properties such as shape and relative position. Relative weighting of factors was obtained through the training of a Support Vector Machine. Classification results for both human and phantom images are presented and compared to manual classifications. This method achieves 91% sensitivity and 91% specificity for usable regions of human scans.

  18. Ultrasound Assessment of Cervical Length in Pregnancy

    Directory of Open Access Journals (Sweden)

    An-Shine Chao

    2008-09-01

    Full Text Available Cervical length in high-risk women for preterm birth has to be identified before early second trimester. Sequential evaluations lead to high predictive significance. The mean cervical length at 24 weeks is about 35 mm when measured by transvaginal ultrasound. A short cervix is defined as a cervix that is less than 25 mm and funneling, i.e. ballooning of the membranes into a dilated internal os, but with a closed external os. Factors such as short cervical length, uterine anomaly, previous cervical surgery, multiple gestation and positive fetal fibronectin results are associated with preterm delivery. Serial transvaginal ultrasound examinations during the early second trimester would provide longitudinal changes in the cervical length. The use of 17α-hydroxyprogesterone caproate and cerclage has shown to be beneficial in preventing preterm delivery. When combined with other predictors such as occiput position, parity, maternal age and body mass index, cervical length is a useful parameter for predicting the feasibility of labor induction and successful delivery.

  19. Ultrasound Vascular Elastography as a Tool for Assessing Atherosclerotic Plaques

    DEFF Research Database (Denmark)

    Mahmood, Badar; Ewertsen, C; Carlsen, Jørn

    2016-01-01

    compared to B-mode ultrasound alone. Most studies reported higher strain values for vulnerable plaques. Ultrasound elastography has potential as a clinical tool in the assessment of atherosclerotic plaques. Elastography is able to distinguish between different plaque types, but there is considerable...... Library and Web of Science databases. A standardized template was used to extract relevant data following the PRISMA 2009 checklist. 20 articles were included in this paper. The studies were heterogeneous. All studies reported that elastography was a feasible technique and provided additional information...

  20. Intravascular pulmonary metastases

    International Nuclear Information System (INIS)

    Shepard, J.A.O.; Moore, E.H.; Templeton, P.A.; McLoud, T.C.

    1988-01-01

    The diagnosis of intravascular metastatic tumor emboli to the lungs is rarely made. The authors present a characteristic radiographic finding of intravascular lung metastases that they observed in four patients with diagnoses or right atrial myoxoma, invasive renal cell carcinoma, invasive pelvic osteosarcoma, and recurrent pelvic chondrosarcoma. Substantiation of intravascular pulmonary metastases was achieved by means of autopsy, pulmonary artery biopsy, and surgical documentation of tumor invasion of the inferior vena cava or pelvic veins. In all four cases, chest computed tomography (CT) demonstrated branching, beaded opacities extending from the hila into the periphery of the lung in the distribution of pulmonary arteries. In one case, similar findings were observed in magnetic resonance (MR) images of the chest. Follow-up studies in three cases showed progressive enlargement and varicosity of the abnormal pulmonary artery consistent with proliferation of intravascular tumor. In the case of metastatic osteosarcoma, intraluminal ossification was also observed at CT. In three of four cases, pulmonary infarction was demonstrated in the distribution of the abnormal pulmonary arteries seen at CT as small, peripheral, wedge-shaped opacities. The demonstration of progressively dilated and beaded pulmonary arteries in patients with extrathoracic malignancies is suggestive of intravascular lung metastases, particularly when accompanied by peripheral infarction

  1. Intravascular photoacoustic imaging of human coronary atherosclerosis

    Science.gov (United States)

    Jansen, Krista; van der Steen, Antonius F. W.; Springeling, Geert; van Beusekom, Heleen M. M.; Oosterhuis, J. Wolter; van Soest, Gijs

    2011-03-01

    We demonstrate intravascular photoacoustic imaging of human coronary atherosclerotic plaque. We specifically imaged lipid content, a key factor in vulnerable plaques that may lead to myocardial infarction. An integrated intravascular photoacoustics (IVPA) and ultrasound (IVUS) catheter with an outer diameter of 1.25 mm was developed. The catheter comprises an angle-polished optical fiber adjacent to a 30 MHz single-element transducer. The ultrasonic transducer was optically isolated to eliminate artifacts in the PA image. We performed measurements on a cylindrical vessel phantom and isolated point targets to demonstrate its imaging performance. Axial and lateral point spread function widths were 110 μm and 550 μm, respectively, for PA and 89 μm and 420 μm for US. We imaged two fresh human coronary arteries, showing different stages of disease, ex vivo. Specific photoacoustic imaging of lipid content, is achieved by spectroscopic imaging at different wavelengths between 1180 and 1230 nm.

  2. Summative clinical competency assessment: A survey of ultrasound practitioners’ views

    OpenAIRE

    Harrison, Gill

    2014-01-01

    Clinical competency and the assessment of core skills is a crucial element of any programme leading to an award with a clinical skills component. This has become a more prominent feature of current reports on quality health care provision. This project aimed to determine ultrasound practitioners’ opinions about how best to assess clinical competency. An on-line questionnaire was sent to contacts from the Consortium for the Accreditation of Sonographic Education and details distributed at the ...

  3. Comprehensive ultrasound assessment of complications post-liver transplantation.

    LENUS (Irish Health Repository)

    O'Brien, J

    2010-04-01

    Human liver transplantation for end-stage liver disease was first performed in 1963. Refinements in surgical technique and new immunosuppressive regimens have improved outcomes. Today, transplant patients have a 5-year survival rate of approximately 75%. Nevertheless, significant complications still occur. Ultrasonography (US), is the initial imaging modality of choice allowing bedside assessment for detection and follow-up of early and delayed graft complications, and facilitating interventional procedures. This review outlines the role of ultrasound in post-transplantation assessment.

  4. Dosimetric model for intravascular brachytherapy

    International Nuclear Information System (INIS)

    Flower, E.E.; Stroud, D.B.

    2000-01-01

    Full text: Intravascular brachytherapy has been shown to be a prophylaxis for restenosis. Adventitial macrophages, which are extremely radiosensitive, initiate neointima formation. A model of the dose levels of the treatment range is developed, assuming that the adventitia is the target tissue. If the adventitia receives a dose of less than 10 Gy, it is assumed the treatment will be ineffective. If the dose to any part of the wall is above 30 Gy, it is assumed that the treatment could be detrimental. Hence the treatment range is between 10 and 30 Gy, with 20 Gy being the optimum dosage to the adventitia. An algorithm using numerical integration of published dose kernels calculates the dose at any point surrounding a beta ( 32 P) line source of finite length. Dose profiles were obtained to demonstrate edge effects. For long lesions, the source is often stepped along the artery. Dose changes due to separation or overlapping of sources during source stepping procedures were also determined. Isodose curves were superimposed on intravascular ultrasound images to demonstrate dose levels. For an exposure time of 60 seconds with a 200mCi source, the optimum dose of 20 Gy occurs at a distance 1.94mm from the centre of the source. The upper limit of the treatment dose range (30 Gy) occurs at 1.59mm. The lower limit of the treatment dose range (10 Gy) occurs at 2.7mm. Significant perturbations to the treatment dose range can be caused by non-centering of the source, edge effects and separation or overlapping of sources in stepping procedures. Despite these concerns, many successful procedures have been reported and this implies that the model is over simplified and requires modifications. Copyright (2000) Australasian College of Physical Scientists and Engineers in Medicine

  5. The role of contrast-enhanced ultrasound in risk assessment of carotid atheroma

    OpenAIRE

    Silviu Stanciu; Cristina Enciu; Ioana Răduţă; Dan Stoicescu; Adrian Anghel; Daniela Anghel; B. Olan; Lucian Ciobîcă

    2016-01-01

    Background and objective: Contrast-enhanced ultrasound, used to assess atherosclerotic carotid plaques, improves visualization of vessel wall irregularities and depicts intraplaque neovascularization. This article illustrates the use of contrast-enhanced ultrasound in the risk assessment of carotid atherosclerotic lesions, especially in challenging plaques evaluation. Materials and methods: For 23 patients with difficult duplex ultrasound examination due to carotid tortuosity o...

  6. Ultrasound

    Science.gov (United States)

    ... chap 66. Cosgrove DO, Eckersley RJ, Harvey CJ, Lim A. Ultrasound. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. ... by: Jason Levy, MD, Northside Radiology Associates, Atlanta, GA. Also ...

  7. [Intravascular endothelioma (author's transl)].

    Science.gov (United States)

    Vanĕk, J

    1978-01-01

    A 76-year-old woman developed a slowly growing lesion over the right index and the adjacent part of the metacarpus. A cell proliferation filling up the skin veins was classified as intravascular endothelioma. This rather rare oncological entity with a good prognosis should be differentiated from peculiar pattern occasionally seen in organisation of thrombi as well as malignant endothelial tumours.

  8. Obstetric and Gynecologic Ultrasound Curriculum and Competency Assessment in Residency Training Programs

    DEFF Research Database (Denmark)

    Abuhamad, Alfred; Minton, Katherine K; Benson, Carol B

    2018-01-01

    Ultrasound imaging has become integral to the practice of obstetrics and gynecology. With increasing educational demands and limited hours in residency programs, dedicated time for training and achieving competency in ultrasound has diminished substantially. The American Institute of Ultrasound...... in Medicine assembled a multisociety task force to develop a consensus-based, standardized curriculum and competency assessment tools for obstetric and gynecologic ultrasound training in residency programs. The curriculum and competency assessment tools were developed based on existing national...

  9. Obstetric and gynecologic ultrasound curriculum and competency assessment in residency training programs

    DEFF Research Database (Denmark)

    Abuhamad, Alfred; Minton, Katherine K; Benson, Carol B

    2018-01-01

    Ultrasound imaging has become integral to the practice of obstetrics and gynecology. With increasing educational demands and limited hours in residency programs, dedicated time for training and achieving competency in ultrasound has diminished substantially. The American Institute of Ultrasound...... in Medicine assembled a multisociety task force to develop a consensus-based, standardized curriculum and competency assessment tools for obstetric and gynecologic ultrasound training in residency programs. The curriculum and competency assessment tools were developed based on existing national...

  10. Normative pelvic floor parameters in children assessed by transabdominal ultrasound.

    Science.gov (United States)

    Bower, W F; Chase, J W; Stillman, B C

    2006-07-01

    Successful management of dysfunctional voiding in children hinges on retraining inappropriate pelvic floor muscle recruitment. Recently dynamic pelvic floor muscle activity was visualized in adults using transabdominal ultrasound. We evaluated transabdominal ultrasound for visualizing and measuring pelvic floor muscle activity in normative children. A total of 21 volunteers, including 10 boys and 11 girls 7 to 16 years old (mean age 11.6) who were free of bladder disorders consented to participate in the study. Subjects were screened and demonstrated normative bladder emptying before being imaged while supine and standing using a sagittal curved linear array 2 to 5 MHz transducer over the suprapubic region. After pelvic floor muscle contraction was explained 4 parameters were measured 3 times each, including the direction of movement/displacement from freeze-frame ultrasound images, and endurance and coordination from ultrasound movie loops. The methodology for digitizing movie data were developed, tested and found to be reliable. New variables of endurance as a percent of maximum coordination amplitude and coordination as the amplitude between maximum and minimum effort were created. Overall 66% and 71% of subjects demonstrated anterior displacement of the pelvic floor during voluntary contraction while lying and standing, respectively, with no significant difference in lying vs standing. However, coordination displacement was greater while lying than standing. During 20-second contractions pelvic floor muscle activity attained peak amplitude at 5.5 seconds, followed by a marked decay with 1 or more cycles of muscular re-recruitment. It was observed that fatigue led to repeat recruitment of the rectus and oblique abdominal muscles. In children free of voiding dysfunction pelvic floor displacement and coordination are highly variable. Noninvasive ultrasound of the pelvic floor provided visual assessment of muscular activity, a biofeedback component for the patient

  11. FD-OCT and IVUS intravascular imaging modalities in peripheral vasculature.

    Science.gov (United States)

    Spiliopoulos, S; Kitrou, P; Katsanos, K; Karnabatidis, D

    2017-02-01

    Intra-Vascular Ultra-Sound (IVUS) and Frequency Domain-Optical Coherence Tomography (FD-OCT), in vivo, intra-vascular, imaging modalities, widely used in the field of coronary disease, have been recently implemented in peripheral endovascular procedures, for procedural assessment, plaque characterization and determination of predictors of treatment outcomes. Their unique characteristics have also been used in order to provide additional features and improve the performance of re-entry devices and atherotomes. Areas covered: Present review focuses on available literature regarding these two promising imaging technologies in the peripheral vasculature, highlighting the added value produced by their use in endovascular therapy, their limitations and their utilization in new endovascular devices. Authors also provide their future perspective and the possible benefits in understanding vascular behavior and lesion characterization in peripheral endovascular interventions. Expert commentary: By providing both quantitative but also qualitative data on vessel and lesion morphology, intravascular imaging modalities offer a valid solution for endovascular treatment evaluation and outcome presentation homogeneity.

  12. Effects of Intravascular Ultrasound-Guided Versus Angiography-Guided New-Generation Drug-Eluting Stent Implantation: Meta-Analysis With Individual Patient-Level Data From 2,345 Randomized Patients.

    Science.gov (United States)

    Shin, Dong-Ho; Hong, Sung-Jin; Mintz, Gary S; Kim, Jung-Sun; Kim, Byeong-Keuk; Ko, Young-Guk; Choi, Donghoon; Jang, Yangsoo; Hong, Myeong-Ki

    2016-11-14

    The aim of this study was to evaluate the clinical usefulness of intravascular ultrasound (IVUS)-guided new-generation drug-eluting stent (DES) implantation using a meta-analysis of individual patient-level data from randomized trials. Published randomized trials that compare IVUS-guided versus angiography-guided new-generation DES implantation are scarce. Searches of the MEDLINE, Embase, and Cochrane databases were performed to find randomized trials that compared IVUS-guided versus angiography-guided new-generation DES implantation. A total of 2,345 patients from 3 randomized trials were identified, and all patients were treated for long lesions or chronic total occlusions. Individual patient-level data were obtained. The primary endpoint was a major adverse cardiac event, a composite of cardiac death, myocardial infarction, or stent thrombosis. An intention-to-treat analysis and per protocol analysis were performed. By 1 year post-procedure, major adverse cardiac events had occurred in 0.4% of the patients who underwent IVUS-guided DES implantation versus 1.2% of those who underwent angiography-guided DES implantation (hazard ratio [HR]: 0.36; 95% confidence interval [CI]: 0.13 to 0.99; p = 0.040). For the IVUS-guided group, favorable clinical outcomes were observed for myocardial infarction (0% vs. 0.4%; HR: 0.09; p = 0.026). In addition, the clinical benefit of IVUS guidance was stronger in the per protocol analysis (HR: 0.32; 95% CI: 0.12 to 0.89; p = 0.021). Compared with angiographic guidance, IVUS-guided new-generation DES implantation was associated with favorable outcomes in terms of major adverse cardiac events, the composite of cardiac death, myocardial infarction, or stent thrombosis. These findings must be interpreted only for complex lesions, because all identified patients had long lesions or chronic total occlusions. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. Assessment of ultrasound-guided procedures in preclinical years.

    Science.gov (United States)

    Amini, Richard; Stolz, Lori Ann; Breshears, Elliot; Patanwala, Asad E; Stea, Nicholas; Hawbaker, Nicolaus; Thompson, Matthew; Sanders, Arthur Barry; Adhikari, Srikar

    2017-10-01

    Medical graduates entering residency often lack confidence and competence in procedural skills. Implementation of ultrasound (US)-guided procedures into undergraduate medical education is a logical step to addressing medical student procedural competency. The objective of our study was to determine the impact of an US teaching workshop geared toward training medical students in how to perform three distinct US-guided procedures. Cross-sectional study at an urban academic medical center. Following a 1-h didactic session, a sample of 11 students out of 105 (10.5 %) were asked to perform three procedures each (total 33 procedures) to establish a baseline of procedural proficiency. Following a 1-h didactic session, students were asked to perform 33 procedures using needle guidance with ultrasound to establish a baseline of student proficiency. Also, a baseline survey regarding student opinions, self-assessment of skills, and US procedure knowledge was administered before and after the educational intervention. After the educational workshop, students' procedural competency was assessed by trained ultrasound clinicians. One-hundred-and-five third-year medical students participated in this study. The average score for the knowledge-based test improved from 46 % (SD 16 %) to 74 % (SD 14 %) (p technical skill at performing US-guided procedures.

  14. Ability of combined Near-Infrared Spectroscopy-Intravascular Ultrasound (NIRS-IVUS) imaging to detect lipid core plaques and estimate cap thickness in human autopsy coronary arteries

    Science.gov (United States)

    Grainger, S. J.; Su, J. L.; Greiner, C. A.; Saybolt, M. D.; Wilensky, R. L.; Raichlen, J. S.; Madden, S. P.; Muller, J. E.

    2016-03-01

    The ability to determine plaque cap thickness during catheterization is thought to be of clinical importance for plaque vulnerability assessment. While methods to compositionally assess cap integrity are in development, a method utilizing currently available tools to measure cap thickness is highly desirable. NIRS-IVUS is a commercially available dual imaging method in current clinical use that may provide cap thickness information to the skilled reader; however, this is as yet unproven. Ten autopsy hearts (n=15 arterial segments) were scanned with the multimodality NIRS-IVUS catheter (TVC Imaging System, Infraredx, Inc.) to identify lipid core plaques (LCPs). Skilled readers made predictions of cap thickness over regions of chemogram LCP, using NIRS-IVUS. Artery segments were perfusion fixed and cut into 2 mm serial blocks. Thin sections stained with Movat's pentachrome were analyzed for cap thickness at LCP regions. Block level predictions were compared to histology, as classified by a blinded pathologist. Within 15 arterial segments, 117 chemogram blocks were found by NIRS to contain LCP. Utilizing NIRSIVUS, chemogram blocks were divided into 4 categories: thin capped fibroatheromas (TCFA), thick capped fibroatheromas (ThCFA), pathological intimal thickening (PIT)/lipid pool (no defined cap), and calcified/unable to determine cap thickness. Sensitivities/specificities for thin cap fibroatheromas, thick cap fibroatheromas, and PIT/lipid pools were 0.54/0.99, 0.68/0.88, and 0.80/0.97, respectively. The overall accuracy rate was 70.1% (including 22 blocks unable to predict, p = 0.075). In the absence of calcium, NIRS-IVUS imaging provided predictions of cap thickness over LCP with moderate accuracy. The ability of this multimodality imaging method to identify vulnerable coronary plaques requires further assessment in both larger autopsy studies, and clinical studies in patients undergoing NIRS-IVUS imaging.

  15. Intravascular (catheter) MR imaging

    International Nuclear Information System (INIS)

    Cohen, A.M.; Hurst, G.C.; Katz, D.E.; Dverk, J.L.; Wiesen, E.J.; Czerski, L.W.; Malaya, R.; Bellon, E.M.

    1989-01-01

    Intravascular MR probes allow excellent spatial resolution and have the potential to detect arterial wall microstructure. Ultrasonic intravascular probes suggest that detailed morphologic information can assist clinical decision making. Catheter MR probes of 2--7 mm outside diameter (OD) were built of copper wire, Teflon, and parts from standard commercial catheters. The probes were connected to the surface coil receiver input of our Picker VISTA 2055HP 1.5-T imaging system. The extant (linear) body coil was used for transmit. Phantoms were constructed of coaxial glass MR tubes, filled with doped water. Watanabe rabbit aorta and human autopsy iliac artery specimens were examined within 4 hours of excision or stored by freezing. In vivo iliac arteries in dogs under general anesthesia were imaged, with percutaneous placement of the probe. Results are presented

  16. Hepatic Steatosis Assessment with Ultrasound Small-Window Entropy Imaging.

    Science.gov (United States)

    Zhou, Zhuhuang; Tai, Dar-In; Wan, Yung-Liang; Tseng, Jeng-Hwei; Lin, Yi-Ru; Wu, Shuicai; Yang, Kuen-Cheh; Liao, Yin-Yin; Yeh, Chih-Kuang; Tsui, Po-Hsiang

    2018-04-02

    Nonalcoholic fatty liver disease is a type of hepatic steatosis that is not only associated with critical metabolic risk factors but can also result in advanced liver diseases. Ultrasound parametric imaging, which is based on statistical models, assesses fatty liver changes, using quantitative visualization of hepatic-steatosis-caused variations in the statistical properties of backscattered signals. One constraint with using statistical models in ultrasound imaging is that ultrasound data must conform to the distribution employed. Small-window entropy imaging was recently proposed as a non-model-based parametric imaging technique with physical meanings of backscattered statistics. In this study, we explored the feasibility of using small-window entropy imaging in the assessment of fatty liver disease and evaluated its performance through comparisons with parametric imaging based on the Nakagami distribution model (currently the most frequently used statistical model). Liver donors (n = 53) and patients (n = 142) were recruited to evaluate hepatic fat fractions (HFFs), using magnetic resonance spectroscopy and to evaluate the stages of fatty liver disease (normal, mild, moderate and severe), using liver biopsy with histopathology. Livers were scanned using a 3-MHz ultrasound to construct B-mode, small-window entropy and Nakagami images to correlate with HFF analyses and fatty liver stages. The diagnostic values of the imaging methods were evaluated using receiver operating characteristic curves. The results demonstrated that the entropy value obtained using small-window entropy imaging correlated well with log 10 (HFF), with a correlation coefficient r = 0.74, which was higher than those obtained for the B-scan and Nakagami images. Moreover, small-window entropy imaging also resulted in the highest area under the receiver operating characteristic curve (0.80 for stages equal to or more severe than mild; 0.90 for equal to or more severe than moderate; 0

  17. Usability of ultrasound assessment of gastric content. Case reports.

    Science.gov (United States)

    Stach, Orest; Starczewska, Małgorzata H; Kański, Andrzej

    2014-12-01

    The paper presents the use of ultrasound assessment of gastric content in anesthesiological practice. Factors influencing pulmonary aspiration of gastric content and the risk of a complication in the form of aspiration pneumonia are discussed. The examination was performed on two patients hospitalized in a state of emergency who required surgical intervention. The first patient, a 46-year-old male with a phlegmon of the foot, treated for type 2 diabetes, ischemic heart disease and renal insufficiency, required urgent incision of the phlegmon. The second patient, a 36-year-old male with a post-traumatic pericerebral hematoma, qualified for an urgent trepanation. Interviews with the patients and their medical documentation indicated that they had been fasting for the recommended six hours before the surgery. However, during a gastric ultrasound examination it was found that food was still present in the stomach, which caused a change in the anesthesiological procedure chosen. The authors present a method of performing gastric ultrasound examination, determining the nature of the food content present and estimating its volume.

  18. Intravascular "mulberry-like" bodies

    DEFF Research Database (Denmark)

    Sørensen, Flemming Brandt; Klebe, J G; Henriques, U V

    1988-01-01

    Intravascular "mulberry-like" bodies in a stillborn female infant with moderate maceration are reported. The histogenesis of these structures is discussed based on light-microscopic, immunohistochemical and ultrastructural findings. No demonstrable causal relation between the intravascular lesion...... and fetal death was found, the cause of death being attributed to intrauterine asphyxia. It is concluded, that intravascular "mulberry-bodies" most likely represent artifacts due to red blood cell autolysis....

  19. Pelvic floor muscle contractility: digital assessment vs transperineal ultrasound.

    Science.gov (United States)

    van Delft, K; Thakar, R; Sultan, A H

    2015-02-01

    A significant reduction in hiatal area and anteroposterior diameter can be induced by pelvic floor muscle contraction, and this has been demonstrated using three-dimensional/four-dimensional (3D/4D) transperineal ultrasound (TPS) in a small group of women. Our objective was to correlate pelvic floor muscle contractility using digital assessment with the change in TPS hiatus measurements during maximum pelvic floor muscle contraction. Nulliparous pregnant women were recruited from the antenatal clinic. Pelvic floor muscle contractility was assessed by digital palpation using the validated Modified Oxford Scale (MOS). Subsequently, women underwent 3D/4D TPS. Measurements of the hiatal area and anteroposterior diameter were taken from the rendered ultrasound images at rest and at maximum contraction, and differences in measurements were expressed as percentages. Spearman's rank (ρ) was used to assess the correlation. Four hundred and fifty-nine assessments were performed, of which 268 were from women at around 36 weeks' gestation, and 191 were from women following delivery at 3 months postpartum. The overall correlation between MOS and TPS was found to be ρ = 0.47 for hiatal area (P biofeedback when training patients in pelvic floor muscle exercises. As TPS is non-intrusive, it may be the method of choice for some women. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

  20. Contrast enhanced ultrasound in the assessment of urogenital pathology

    Directory of Open Access Journals (Sweden)

    Libero Barozzi

    2014-12-01

    Full Text Available Contrast enhanced ultrasound (CEUS is an innovative technique that employs microbubble contrast agents to demonstrate parenchymal perfusion. Although initial clinical application was focused on the liver pathology, a wide variety of clinical conditions can be assessed now with CEUS. CEUS is a well-tolerated technique and is acquiring an increasing role in the assessment of renal pathology because contrast agents are not excreted by the kidney and do not affect the renal function. CEUS demonstrated an accuracy similar to contrast enhanced multi-detector computed tomography (CEMDCT in detecting focal lesions, with the advantage of the real-time assessment of microvascular perfusion by using time-intensity curves. The aim of this paper is to review the main indications of CEUS in the assessment of renal and urogenital pathology. Imaging examples are presented and described. Advantages and limitations of CEUS with reference to conventional US and CE-MDCT are discussed.

  1. Role of ultrasound in assessment of early rheumatoid arthritis

    International Nuclear Information System (INIS)

    Hyzy, M.D.; Slavotinek, J.; Smith, M.D.

    2007-01-01

    This report reviews imaging methods used for diagnosis and monitoring of rheumatoid arthritis, with emphasis on the role of ultrasonography. Traditionally, conventional radiography has been useful in detecting and monitoring the extent of joint destruction in rheumatic disease. However, it is particularly difficult to detect pathological joint changes in the early stages. Magnetic resonance imaging is able to detect inflammation of the synovial membrane and erosions but is limited by cost and availability. Ultrasound has recently emerged as a useful and potentially reliable method for assessing the degree of joint inflammation and erosion in patients with early rheumatoid arthritis

  2. Intravascular ultrasound: validation and clinical application

    NARCIS (Netherlands)

    A. van der Lugt (Aad)

    1996-01-01

    textabstractAtherogenesis is a process with an insidious onset and course. Once clinical signs and symptoms have become manifest, the obstructive lesion is usually at an advanced stage. Arteriography is the standard method for evaluation of atherosclerotic disease and has been useful in

  3. Basic ultrasound training assessment in the initial abdominal trauma screening

    Directory of Open Access Journals (Sweden)

    LUAN GERALDO OCAÑA OLIVEIRA

    2018-02-01

    Full Text Available ABSTRACT Objective: to verify the efficiency and usefulness of basic ultrasound training in trauma (FAST - Focused Assessment with Sonography in Trauma for emergency physicians in the primary evaluation of abdominal trauma. Methods: a longitudinal and observational study was carried out from 2015 to 2017, with 11 emergency physicians from Hospital Universitário do Oeste do Paraná, submitted to ultrasound training in emergency and trauma (USET® - SBAIT. FAST results started to be collected two months after the course. These were compared with a composite score of complementary exams and surgical findings. Information was stored in a Microsoft Excel program database and submitted to statistical analysis. Results: FAST was performed in 120 patients. In the study, 38.4% of the assessed patients had a shock index ≥0.9. The composite score detected 40 patients with free peritoneal fluid, whereas FAST detected 27 cases. The method sensitivity was 67.5%, specificity was 98.7%, the positive predictive value was 96.4%, the negative predictive value was 85.39% and accuracy was 88%. All those with a positive FAST had a shock index ≥0.9. Fifteen patients with positive FAST and signs of instability were immediately submitted to surgery. Conclusions: the basic training of emergency physicians in FAST showed efficiency and usefulness in abdominal trauma assessment. Due to its low cost and easy implementation, this modality should be considered as a screening strategy for patients with abdominal trauma in health systems.

  4. Nonlinear viscoelastic properties of tissue assessed by ultrasound.

    Science.gov (United States)

    Sinkus, Ralph; Bercoff, Jeremy; Tanter, Mickaël; Gennisson, Jean-Luc; El-Khoury, Carl; Servois, Vincent; Tardivon, Anne; Fink, Mathias

    2006-11-01

    A technique to assess qualitatively the presence of higher-order viscoelastic parameters is presented. Low-frequency, monochromatic elastic waves are emitted into the material via an external vibrator. The resulting steady-state motion is detected in real time via an ultra fast ultrasound system using classical, one-dimensional (1-D) ultrasound speckle correlation for motion estimation. Total data acquisition lasts only for about 250 ms. The spectrum of the temporal displacement data at each image point is used for analysis. The presence of nonlinear effects is detected by inspection of the ratio of the second harmonics amplitude with respect to the total amplitude summed up to the second harmonic. Results from a polyacrylamide-based phantom indicate a linear response (i.e., the absence of higher harmonics) for this type of material at 65 Hz mechanical vibration frequency and about 100 microm amplitude. A lesion, artificially created by injection of glutaraldehyde into a beef specimen, shows the development of higher harmonics at the location of injection as a function of time. The presence of upper harmonics is clearly evident at the location of a malignant lesion within a mastectomy.

  5. Assessment of performance measures and learning curves for use of a virtual-reality ultrasound simulator in transvaginal ultrasound examination

    DEFF Research Database (Denmark)

    Madsen, M E; Konge, L; Nørgaard, L N

    2014-01-01

    -6), corresponding to an average of 219 min (range, 150-251 min) of training. The test/retest reliability was high, with an intraclass correlation coefficient of 0.93. CONCLUSIONS: Competence in the performance of gynecological ultrasound examination can be assessed in a valid and reliable way using virtual-reality......OBJECTIVE: To assess the validity and reliability of performance measures, develop credible performance standards and explore learning curves for a virtual-reality simulator designed for transvaginal gynecological ultrasound examination. METHODS: A group of 16 ultrasound novices, along with a group...... simulation. The novices' performance improved with practice and their learning curves plateaued at the level of expert performance, following between 3 and 4 h of simulator training....

  6. Functional assessment of the diaphragm by speckle tracking ultrasound during inspiratory loading

    NARCIS (Netherlands)

    Mos-Oppersma, Eline; Hatam, Nima; Doorduin, Jonne; van der Hoeven, Johannes G.; Marx, Gernot; Goetzenich, Andreas; Fritsch, Sebastian; Heunks, Leo M.A.; Bruells, Christian S.

    2017-01-01

    Assessment of diaphragmatic effort is challenging, especially in critically ill patients in the phase of weaning. Fractional thickening during inspiration assessed by ultrasound has been used to estimate diaphragm effort. It is unknown whether more sophisticated ultrasound techniques such as speckle

  7. Use of ultrasound to assess Cheddar cheese characteristics.

    Science.gov (United States)

    Benedito, J; Carcel, J A; Sanjuan, N; Mulet, A

    2000-03-01

    Blocks of Cheddar cheese were matured in temperature-controlled chambers at 5 and 12 degrees C. The ultrasonic velocity increased during maturation ranging from 1657 to 1677 ms-1 at 12 degrees C and from 1684 to 1693 ms-1 at 5 degrees C. The ultrasonic velocity was related to the square root of the deformability modulus and the slope in puncture. The increase of velocity during maturation shows the feasibility of using an ultrasonic device to non-destructively monitor Cheddar cheese maturity. Ultrasound velocity was measured at different temperatures. The velocity decreased with increasing temperature, and from the slope of the first part of the temperature-velocity curves it was possible to non-destructively assess the moisture content of different types of cheese.

  8. Quantitative Assessment of First Annular Pulley and Adjacent Tissues Using High-Frequency Ultrasound

    OpenAIRE

    Lin, Yi-Hsun; Yang, Tai-Hua; Wang, Shyh-Hau; Su, Fong-Chin

    2017-01-01

    Due to a lack of appropriate image resolution, most ultrasound scanners are unable to sensitively discern the pulley tissues. To extensively investigate the properties of the A1 pulley system and the surrounding tissues for assessing trigger finger, a 30 MHz ultrasound system was implemented to perform in vitro experiments using the hypodermis, A1 pulley, and superficial digital flexor tendon (SDFT) dissected from cadavers. Ultrasound signals were acquired from both the transverse and sagitta...

  9. In-Vivo Assessment of Coronary Atherosclerosis

    NARCIS (Netherlands)

    G.A. Rodriguez-Granillo

    2006-01-01

    textabstractIntravascular ultrasound (IVUS) has emerged as a highly accurate tool for the serial assessment of the natural history of coronary atherosclerosis and to evaluate the effect of different conventional and emerging drug therapies on the progression of atherosclerosis. The

  10. Intrapartum assessment of caput succedaneum by transperineal ultrasound: a two-centre pilot study.

    Science.gov (United States)

    Hassan, Wassim A; Eggebo, Torbjorn M; Salvesen, Kjell A; Lindtjorn, Elsa; Lees, Christoph

    2015-08-01

    Digital assessments of caput succedaneum are subjective; however, caput succedaneum can also be expressed as ultrasound measured skin-skull distance (SSD). In this study, we aimed to compare the clinical and ultrasound assessment of caput succedaneum (caput) in nulliparous women in the first stage of labour. Furthermore, we aimed to investigate the repeatability of ultrasound measurements. We observed a significant but low correlation between clinical and ultrasound assessments (Kappa value 0.29; P caput measurements was -0.4 mm (95% CI, -0.85 to 0.05), and limits of agreement were -3.44 to 2.64 mm. We conclude that ultrasound measured SSD is an objective expression of caput with significant correlation with clinical assessment. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  11. 3-D Ultrasound Vascularity Assessment for Breast Cancer Diagnosis

    National Research Council Canada - National Science Library

    Carson, Paul

    1997-01-01

    This project is to improve the diagnosis and management of patients with breast cancer through development and evaluation of 3D ultrasound imaging and quantification techniques emphasizing vascularity...

  12. Disseminated intravascular coagulation in sepsis

    NARCIS (Netherlands)

    Zeerleder, Sacha; Hack, C. Erik; Wuillemin, Walter A.

    2005-01-01

    Disseminated intravascular coagulation is a frequent complication of sepsis. Coagulation activation, inhibition of fibrinolysis, and consumption of coagulation inhibitors lead to a procoagulant state resulting in inadequate fibrin removal and fibrin deposition in the microvasculature. As a

  13. Intracranial translucency assessment at first trimester nuchal translucency ultrasound.

    Science.gov (United States)

    Lane, Annah; Lee, Ling; Traves, Donna; Lee, Andreas

    2017-04-01

    The antenatal diagnosis of open spina bifida (OSB), a neural tube defect, is predominantly made at the second trimester morphology scan by ultrasound detection of structural abnormalities resulting from the associated Chiari II malformation. Evidence has emerged suggesting that these structural abnormalities can be detected earlier, by examination of the posterior fossa as part of the first trimester nuchal translucency scan. In particular, absence of the intra-cranial translucency (IT) of the fourth ventricle has shown promise as a diagnostic marker of OSB, although the sensitivity and specificity of this finding varies widely in the literature. The aim of this study is to assess the feasibility of obtaining the image of the IT at our institution as part of the routine first trimester scan. This is a prospective study of 900 obstetric patients who presented to a tertiary women's imaging centre for routine first trimester nuchal translucency screening ultrasound for the year 2014. Their risk status was that of the general population (low risk) prior to presentation. A total of 158 patients were excluded, leaving a study group of 742. Sonographers obtained a mid-sagittal view of the fetal face with particular focus on optimum viewing of the IT. All images were examined by a Radiology Registrar for presence or absence of IT. Duration of each scan was documented. The IT image was successfully acquired in 94.9% of scans. Maternal pre-pregnancy BMI and fetal lie were shown to have a statistically significant effect on success of acquisition of the IT image. No cases of OSB were diagnosed during the study. Scan times were not lengthened by the addition of the image. We consider that acquisition of an image of the IT as part of the routine first trimester nuchal translucency scan is feasible, without lengthening appointment times. © 2016 The Royal Australian and New Zealand College of Radiologists.

  14. Quantitative ultrasound and photoacoustic imaging for the assessment of vascular parameters

    CERN Document Server

    Meiburger, Kristen M

    2017-01-01

    This book describes the development of quantitative techniques for ultrasound and photoacoustic imaging in the assessment of architectural and vascular parameters. It presents morphological vascular research based on the development of quantitative imaging techniques for the use of clinical B-mode ultrasound images, and preclinical architectural vascular investigations on quantitative imaging techniques for ultrasounds and photoacoustics. The book is divided into two main parts, the first of which focuses on the development and validation of quantitative techniques for the assessment of vascular morphological parameters that can be extracted from B-mode ultrasound longitudinal images of the common carotid artery. In turn, the second part highlights quantitative imaging techniques for assessing the architectural parameters of vasculature that can be extracted from 3D volumes, using both contrast-enhanced ultrasound (CEUS) imaging and photoacoustic imaging without the addition of any contrast agent. Sharing and...

  15. Transvaginal ultrasound assessment of myometrial and cervical stroma invasion in women with endometrial cancer -interobserver reproducibility among ultrasound experts and gynaecologists

    DEFF Research Database (Denmark)

    Eriksson, LS; Lindqvist, PG; Flöter Rådestad, A

    2014-01-01

    OBJECTIVES: To assess interobserver reproducibility among ultrasound experts and gynaecologists in the prediction of deep myometrial- and cervical stroma invasion by transvaginal ultrasound in women with endometrial cancer. METHODS: Video-clips of the corpus- and cervix uteri of 53 women...... with endometrial cancer, examined preoperatively by the same ultrasound expert, were integrated in a digitalized survey. Nine ultrasound experts and 9 gynaecologists evaluated presence or absence of deep myometrial- and cervical stroma invasion. Histopathology from hysterectomy specimen was used as gold standard.......001). CONCLUSION: Preoperative ultrasound assessment of deep myometrial- and cervical stroma invasion in endometrial cancer is best performed by ultrasound experts, as they show a higher degree of agreement to histopathology and higher interobserver reproducibility in the assessment of cervical stromal invasion....

  16. Freehand three-dimensional ultrasound to assess semitendinosus muscle morphology.

    Science.gov (United States)

    Haberfehlner, Helga; Maas, Huub; Harlaar, Jaap; Becher, Jules G; Buizer, Annemieke I; Jaspers, Richard T

    2016-10-01

    In several neurological disorders and muscle injuries, morphological changes of the m. semitendinosus (ST) are presumed to contribute to movement limitations around the knee. Freehand three-dimensional (3D) ultrasound (US), using position tracking of two-dimensional US images to reconstruct a 3D voxel array, can be used to assess muscle morphology in vivo. The aims of this study were: (i) to introduce a newly developed 3D US protocol for ST; and (ii) provide a first comparison of morphological characteristics determined by 3D US with those measured on dissected cadaveric muscles. Morphological characteristics of ST (e.g. muscle belly length, tendon length, fascicle length and whole muscle volume, and volumes of both compartments) were assessed in six cadavers using a 3D US protocol. Subsequently, ST muscles were removed from the body to measure the same morphological characteristics. Mean differences between morphological characteristics measured by 3D US and after dissection were smaller than 10%. Intra-class correlation coefficients (ICCs) were higher than 0.75 for all variables except for the lengths of proximal fascicles (ICC = 0.58). Measurement of the volume of proximal compartment by 3D US was not feasible, due to low US image quality proximally. We conclude that the presented 3D US protocol allows for reasonably accurate measurements of key morphological characteristics of ST muscle. © 2016 The Authors. Journal of Anatomy published by John Wiley & Sons Ltd on behalf of Anatomical Society.

  17. Collecting Validity Evidence for Simulation-Based Assessment of Point-of-Care Ultrasound Skills

    DEFF Research Database (Denmark)

    Jensen, Jesper Kørup; Dyre, Liv; Jørgensen, Mattis Enggaard

    2017-01-01

    skills assessed using a virtual reality ultrasound simulator. Procedural performance on the 4 FAST windows was assessed by automated simulator metrics, which received a passing or failing score. The validity evidence for these simulator metrics was examined by a stepwise approach according......OBJECTIVES: The aim of this study was to examine the validity of a simulator test designed to evaluate focused assessment with sonography for trauma (FAST) skills. METHODS: Participants included a group of ultrasound novices (n = 25) and ultrasound experts (n = 10). All participants had their FAST...

  18. An easily made, low-cost phantom for ultrasound airway exam training and assessment

    Directory of Open Access Journals (Sweden)

    Kristopher M Schroeder

    2013-01-01

    Full Text Available Background: Recent manuscripts have described the use of ultrasound imaging to evaluate airway structures. Ultrasound training tools are necessary for practitioners to become proficient at obtaining and interpreting images. Few training tools exist and those that do can often times be expensive and rendered useless with repeated needle passes. Methods: We utilised inexpensive and easy to obtain materials to create a gel phantom model for ultrasound-guided airway examination training. Results: Following creation of the gel phantom model, images were successfully obtained of the thyroid and cricoid cartilages, cricothyroid membrane and tracheal rings in both the sagittal transverse planes. Conclusion: The gel phantom model mimics human airway anatomy and may be used for ultrasound-guided airway assessment and intervention training. This may have important safety implications as ultrasound imaging is increasingly used for airway assessment.

  19. Ultrasound thrombolysis in stent thrombosis.

    Science.gov (United States)

    Rassin, T; Desmet, W; Piessens, J; Rosenschein, U

    2000-11-01

    Recent refinement in stent implantation technique and peri-procedural pharmacological treatment has lowered the incidence of stent thrombosis significantly. Still, all stent thromboses are associated with major adverse events. In previous studies it has been suggested that intravascular ultrasound fibrinolysis is safe and effective. In this report, ultrasound successfully reperfused thrombotically occluded stents. These observations suggest that ultrasound may dissolve occlusive platelet-rich thrombus effectively and safely. Cathet. Cardiovasc. Intervent. 51:332-334, 2000. Copyright 2000 Wiley-Liss, Inc.

  20. Assessment of performance measures and learning curves for use of a virtual-reality ultrasound simulator in transvaginal ultrasound examination.

    Science.gov (United States)

    Madsen, M E; Konge, L; Nørgaard, L N; Tabor, A; Ringsted, C; Klemmensen, A K; Ottesen, B; Tolsgaard, M G

    2014-12-01

    To assess the validity and reliability of performance measures, develop credible performance standards and explore learning curves for a virtual-reality simulator designed for transvaginal gynecological ultrasound examination. A group of 16 ultrasound novices, along with a group of 12 obstetrics/gynecology (Ob/Gyn) consultants, were included in this experimental study. The first two performances of the two groups on seven selected modules on a high-fidelity ultrasound simulator were used to identify valid and reliable metrics. Performance standards were determined and novices were instructed to continue practicing until they attained the performance level of an expert subgroup (n = 4). All 28 participants completed the selected modules twice and all novices reached the expert performance level. Of 153 metrics, 48 were able to be used to discriminate between the two groups' performance. The ultrasound novices scored a median of 43.8% (range, 17.9-68.9%) and the Ob/Gyn consultants scored a median of 82.8% (range, 60.4-91.7%) of the maximum sum score (P virtual-reality simulation. The novices' performance improved with practice and their learning curves plateaued at the level of expert performance, following between 3 and 4 h of simulator training. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

  1. Assessment of Bone Health in Men and Women Comparing DXA to Calcaneal Ultrasound

    National Research Council Canada - National Science Library

    Murphy, M

    2002-01-01

    ...) were assessed for bone mineral density (BMD, g/sq cm) and broadband ultrasound attenuation (BUA, db/MHz). BMD of the total body, regional and lumbar spine was measured via dual-energy X-ray absorptiometry...

  2. Dosimetry in intravascular brachytherapy

    International Nuclear Information System (INIS)

    Campos, Laelia Pumilla Botelho

    2000-03-01

    Among the cardiovascular diseases responsible for deaths in the adult population in almost all countries of the world, the most common is acute myocardial infarction, which generally occurs because of the occlusion of one or more coronary arteries. Several diagnostic techniques and therapies are being tested for the treatment of coronary artery disease. Balloon angioplasty has been a popular treatment which is less invasive than traditional surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment).Recently, the idea of delivering high radiation doses to coronary arteries to avoid or delay restenosis has been suggested. Known as intravascular brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis in some patient populations. In order to study the radiation dosimetry in the patient and radiological protection for the attending staff for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, o,30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several candidate radionuclides as well. Two s tent sources (metallic prosthesis that put inside of patient's artery through angioplasty) employing 32 P are also simulated. Advantages and disadvantages of the various radionuclides and source geometries are discussed. The dosimetry developed here will aid in the realization of the benefits obtained in patients for this promising new technology. (author)

  3. Assessment of Hemophilic Arthropathy by Ultrasound: Where Do We Stand?

    Science.gov (United States)

    Di Minno, Matteo Nicola Dario; Ambrosino, Pasquale; Quintavalle, Gabriele; Coppola, Antonio; Tagliaferri, Annarita; Martinoli, Carlo; Rivolta, Gianna Franca

    2016-07-01

    Joint hemorrhages represent the most common type of bleeding episode in persons with hemophilia, and recurrent hemarthrosis triggers chronic arthropathy, which is the most frequent chronic complication in these patients. In recent years, in the frame of a comprehensive care approach, a growing attention has been given to the periodic assessment of the joint status in hemophilia patients with the aim to identify early arthropathic changes and to prevent the development of a clinically overt arthropathy. Besides clinical examination, X-ray and magnetic resonance imaging (MRI) are currently used to evaluate joint status and to monitor the disease progression in hemophilia. Considering the limitations of X-ray and MRI, growing interest has been given to ultrasound (US) as a possible tool to assess joint status and identify early arthropathic changes in hemophilia patients. In the present review, we summarize major literature evidence on the use of joint US for the evaluation of markers of disease activity (joint effusion and synovial hypertrophy) and of degenerative damages (osteochondral changes) in patients with hemophilia. On the whole, being able to identify the presence of intra- or extra-articular fluid, US examination is the fastest and most reliable technique to identify acute conditions, such as hemarthrosis. In addition, the information on joint involvement provided by US in the patient follow-up may influence treatment decisions on a personalized basis. The use of US as part of a routine clinical examination by hemophilia experts may optimize the diagnostic workflow, avoiding additional costs and long waiting lists for patients referred to imaging departments. In the frame of a comprehensive care approach, US might represent a strategy to early detect and monitor synovial hypertrophy and osteochondral changes in hemophilia, thus extending the clinical examination and helping identify joints to be studied with a second-level examination such as MRI. Thieme

  4. Correlation of Digital Palpation and Transabdominal Ultrasound for Assessment of Pelvic Floor Muscle Contraction

    OpenAIRE

    Arab, Amir Massoud; Behbahani, Roxana Bazaz; Lorestani, Leila; Azari, Afsaneh

    2009-01-01

    Pelvic floor muscle (PFM) dysfunction has been commonly associated with urinary disorders and lumbo-pelvic pain. Transabdominal (TA) ultrasound is currently used by physical therapists to assess PFM function. Controversy exists regarding the correlation between TA ultrasound measurement and vaginal palpation for assessment of PFM contraction, and this relationship has not yet been examined concurrently during the same contraction. The purpose of this study was to determine the correlation of ...

  5. Intravascular photoacoustic tomography for characterization of atherosclerotic lipid and inflammation

    Science.gov (United States)

    Zhang, Jian; Qin, Huan; Shi, Yujiao; Yang, Sihua; Xing, Da

    2014-09-01

    Photoacoustic imaging is a fast growing imaging technology depending on its high optical resolution of optics while taking the advantage of the high penetration depth of ultrasound. In this paper, we demonstrate the new progress in the photoacoustic imaging. Atherosclerosis is characterized by a progressive build-up of lipid in the arterial wall, which is known as plaque. Histological studies demonstrate that the primary cause of acute cardiovascular events is the rupture of atherosclerotic plaques. Lipid and inflammation within the plaque are related to influence the propensity of plaques to disrupt. Photoacoustic intravascular tomography (IVPAT) holds a great advantage in providing comprehensive morphological and functional information of plaques. Lipid relative concentration maps of atherosclerotic aorta were obtained and compared with histology. Furthermore, by selectively targeting the intravascular inflammatory cytokines, IVPAT is also capable of mapping the inflamed area and determining the degree of inflammation.

  6. Fetal ultrasound examination and assessment of genetic soft markers in Sweden: are ethical principles respected?

    Science.gov (United States)

    Hayat Roshanai, Afsaneh; Ingvoldstad, Charlotta; Lindgren, Peter

    2015-02-01

    To explore procedures for providing information, assessment and documentation about ultrasound soft markers in Sweden. Descriptive, quantitative, cross-sectional survey. Eighty-two percent of all obstetric ultrasound clinics in Sweden (covering >90% of routine fetal ultrasound examinations). Postal questionnaire survey between December 2010 and January 2011. Items about provision of information, risk estimation, and follow-up strategies in relation to observed ultrasound soft markers. More than 96% of all fetal routine ultrasound examinations were performed at 15-21 gestational weeks, primarily by midwives. Half of the clinics replying wanted prospective parents to be provided with information, but 38 (78%) of the clinics did not routinely inform about assessment of soft markers before the examination. Follow up and decisions on whether to give information when soft markers were found were based on the number and type of the observed markers, whether other structural deviations existed, and on the woman's age and anxiety level. Only at eight clinics (17%) were parents informed about all soft marker findings. At 13 clinics (28%) observed markers were documented/recorded, even though the women were not informed. Information regarding the assessment and importance of observed soft markers seems to be inconsistent and insufficient. Provision of information and documentation of findings appear to be handled differently at obstetric ultrasound clinics. This suggests that Swedish ethical principles relating to healthcare and ultrasound examinations are incompletely followed and national guidelines appear to be necessary. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

  7. The role of contrast-enhanced ultrasound in risk assessment of carotid atheroma

    Directory of Open Access Journals (Sweden)

    Silviu Stanciu

    2016-07-01

    Full Text Available Background and objective: Contrast-enhanced ultrasound, used to assess atherosclerotic carotid plaques, improves visualization of vessel wall irregularities and depicts intraplaque neovascularization. This article illustrates the use of contrast-enhanced ultrasound in the risk assessment of carotid atherosclerotic lesions, especially in challenging plaques evaluation. Materials and methods: For 23 patients with difficult duplex ultrasound examination due to carotid tortuosity or calcifications we assessed plaque morphology (contour, echogenicity and stenosis degree using contrast substance (Sonovue, Braco with dedicated vascular low mechanical index CPC software. Conclusion: Contrast-enhanced ultrasound is a new, noninvasive, and safe procedure for imaging carotid atherosclerotic lesions. It is a valuable tool for evaluating the vulnerable plaque at risk for rupture and for the diagnostic of the development and severity of systemic atherosclerotic disease

  8. Collecting Validity Evidence for the Assessment of Mastery Learning in Simulation-Based Ultrasound Training

    DEFF Research Database (Denmark)

    Dyre, L; Nørgaard, L N; Tabor, A

    2016-01-01

    Purpose: To collect validity evidence for the assessment of mastery learning on a virtual reality transabdominal ultrasound simulator. Materials and Methods: We assessed the validity evidence using Messick's framework for validity. The study included 20 novices and 9 ultrasound experts who all...... completed 10 obstetric training modules on a transabdominal ultrasound simulator that provided automated measures of performance for each completed module (i. e., simulator metrics). Differences in the performance of the two groups were used to identify simulator metrics with validity evidence...... learning level within a median of 4 attempts (range 3 - 8) corresponding to a median of 252 minutes of simulator training (range 211 - 394 minutes). Conclusion: This study found that validity evidence for the assessment of mastery learning in simulation-based ultrasound training can be demonstrated...

  9. Intravascular blood coagulation after irradiation

    International Nuclear Information System (INIS)

    Sushkevich, G.N.

    1981-01-01

    The problems of activation of intravascular blood coagulation (JVBC) at different stages after irradiation, are considered. JVBC peculiarities (disseminated intravascular syndrome (DIV) or thrombo hemorrhagic syndrome) are investigated. Literature on alterations which take place in the organism under effect of ionizing irradiation is analyzed. This analysis proves the characteristic features of thrombinogenesis activation and development of DIV syndrome not only in the early post-radiation period, but in the middle of radiation disease, as well. It is also shown that ionizing radiation activizes the hemocoagulation process and causes IVBC in the case of both local and general irradiation [ru

  10. Prediction of postpercutaneous coronary intervention myocardial infarction: insights from intravascular imaging, coronary flow, and biomarker evaluation.

    Science.gov (United States)

    Hoole, Stephen P; Hernández-Sánchez, Jules; Brown, Adam J; Giblett, Joel P; Bennett, Martin R; West, Nick E J

    2018-05-01

    Percutaneous coronary intervention-induced myocardial infarction (PMI) has prognostic significance. Identifying patients at high risk for PMI is desirable as it may alter strategy and facilitate early preventative therapy. We therefore sought to establish whether preprocedural demographic, interventional (plaque characteristics and coronary microcirculatory function), and inflammatory, endothelial damage, and platelet-derived biomarker data could predict the risk of PMI. We performed target vessel pressure wire to assess fractional flow reserve, index of microcirculatory resistance (IMR) and coronary flow reserve, plaque characterization by virtual histology intravascular ultrasound, and assayed peripheral biomarkers before uncomplicated PCI in 88 patients. We then analyzed post-PCI cardiac troponin level to adjudicate PMI based on the third universal definition of myocardial infarction. Overall incidence of PMI was 27%. Women [10/15 (66%) vs. 14/73 (19%), PPMI. Preprocedural coronary flow reserve was lower in individuals with a subsequent PMI (1.8±1.2 vs. 2.1±1.3. P=0.03), and patients with higher pre-PCI IMR were more likely to sustain PMI [IMR>22: 10/23 (44%) vs. ≤22: 14/65 (22%), P=0.04], although neither was predictive after multivariate analysis. Plaque characterization by virtual histology intravascular ultrasound did not discriminate those at risk of PMI. However, peripheral venous interleukin (IL)-18 and IL-8 levels were independently negatively and positively associated with PMI, respectively. Women and those with low BMI, particularly when associated with high IL-8 and low IL-18 levels, appear to be at increased risk of PMI.

  11. Freehand three-dimensional ultrasound to assess semitendinosus muscle morphology

    NARCIS (Netherlands)

    Haberfehlner, H.; Maas, H.; Harlaar, J.; Becher, J.G.; Buizer, A.I.; Jaspers, R.T.

    2016-01-01

    In several neurological disorders and muscle injuries, morphological changes of the m. semitendinosus (ST) are presumed to contribute to movement limitations around the knee. Freehand three-dimensional (3D) ultrasound (US), using position tracking of two-dimensional US images to reconstruct a 3D

  12. Intravascular Stenting in Microvascular Anastomoses

    DEFF Research Database (Denmark)

    Assersen, Kristine; Sørensen, Jens

    2015-01-01

    Background The effect of intravascular stenting (IVaS) on microvascular anastomoses has given adverse results. For experienced microsurgeons the benefit of IVaS is doubtful. We have investigated the potential benefit of the IVaS technique for two groups of inexperienced microsurgeons with differe...

  13. Intravascular bronchio-alveolar tumor

    International Nuclear Information System (INIS)

    Mata, J.M.; Caceres, J.; Prat, J.; Lopez, J.I.; Velilla, O.

    1991-01-01

    In 1975 Dail and Liebow described the clinical and pathological characteristics of a pulmonary tumor which they dominated intravascular bronchio-alveolar tumor (IVBAT). Our aim is to acquaint radiologists with the existence of this tumor by describing the radiologic findings in 2 patients with IVBAT, 1 with hepatic involvement ant the other with pulmonary osteoarthropathy. (author). 7 refs.; 2 figs

  14. Comparison of dynamic ultrasound and stress radiology for assessment of inferior glenohumeral laxity in asymptomatic shoulders

    International Nuclear Information System (INIS)

    Cheng, S.C.; Wallace, W.A.; Hulse, D.; Fairbairn, K.J.; Clarke, M.

    2008-01-01

    To determine the level of agreement between dynamic ultrasound imaging and stress radiography used for the measurement of inferior glenohumeral laxity in asymptomatic shoulders, and to determine the repeatability of the dynamic ultrasound technique. Using a custom-made stress device to apply an inferior displacement force of 90 N, we assessed 20 asymptomatic male subjects for inferior glenohumeral laxity, using stress radiography and dynamic ultrasound. Paired differences between the two methods were evaluated by the 95% limits of agreement method. At a separate session, 19 subjects had inferior glenohumeral laxity assessed by two observers, using dynamic ultrasound. Inter- and intra-observer repeatability was determined for the ultrasound technique. The mean [± standard deviation (SD)] inferior translation was 4.7 ± 4.1 mm by stress radiography and 4.4 ± 2.3 mm by dynamic ultrasound. The 95% limits of agreement showed good agreement between the two methods. The paired difference between the two measurement methods varied with the magnitude of the measurement (P < 0.001). Intra-observer repeatability of dynamic ultrasound was determined by the use of intra-class correlation coefficients and was 0.94 and 0.89 for the two investigators. Inter-observer repeatability was 0.85. The standard error of the measurement was 0.60 mm and 0.66 mm, for repeated measurements by the two investigators, and 0.85 mm between investigators. Repeatability coefficients demonstrated excellent consistency of measurement between sessions and good consistency between observers. Dynamic ultrasound is a valid and reproducible method for the assessment and quantification of inferior glenohumeral laxity. (orig.)

  15. Brachytherapy optimal planning with application to intravascular radiation therapy

    DEFF Research Database (Denmark)

    Sadegh, Payman; Mourtada, Firas A.; Taylor, Russell H.

    1999-01-01

    . Dose rate calculations are based on the sosimetry formulation of the American Association of Physicists in Medicine, Task Group 43. We apply the technique to optimal planning for intravascular brachytherapy of intimal hyperplasia using ultrasound data and 192Ir seeds. The planning includes...... determination of an optimal dwell-time sequence for a train of seeds that deliver ratiation while stepping through the vessel lesion. The results illustrate the advantage of this strategy over the common approach of delivering radiation by positioning a single train of seeds along the whole lesion....

  16. Assessment of pelvic floor muscle contractility: digital palpation versus 2D and 3D perineal ultrasound.

    Science.gov (United States)

    Albrich, Stefan; Steetskamp, Joscha; Knoechel, Sophie-Luise; Porta, Saskia; Hoffmann, Gerald; Skala, Christine

    2016-04-01

    The aim of our study was to investigate 2D and 3D ultrasound assessment of pelvic floor muscle contractility as an objective non-invasive diagnostic tool in urogynecologic patients. Patients from our urogynecological outpatient clinic were examined clinically by a single investigator including digital palpation as well as 2D and 3D perineal ultrasound. Muscle contractility was graded according to the modified Oxford Score and ultrasound images were saved for later analysis. Stored images were evaluated offline by another investigator blinded to all clinical data at a later stage. Bladder neck distance from pubic symphysis and symphysis-levator distance were measured in 2D at rest and during maximal pelvic floor muscle contraction. Hiatal area at the level of minimal hiatal dimensions as a 3D ultrasound parameter was measured at rest and during maximal pelvic floor muscle contraction, too. Spearman's rho was used to calculate statistical correlation between ultrasound parameters and digital assessment. A total of 114 patients were examined in our study. We found a significant correlation between modified Oxford Score and 2D ultrasound parameters of elongation of bladder neck length (Spearman's rho 0.292, p = 0.002) and reduction of symphysis-levator distance (Spearman's rho 0.0.301, p = 0.001), respectively. In addition, we detected a statistical significant correlation of modified Oxford Score and reduction of hiatal area in 3D ultrasound (Spearman's rho 0.458, p pelvic floor muscle strength with 2D and 3D ultrasound parameters as an objective diagnostic tool.

  17. Three-dimensional ultrasound assessment of endometrial receptivity: a review

    Directory of Open Access Journals (Sweden)

    Alcázar Juan

    2006-11-01

    Full Text Available Abstract Three-dimensional ultrasound (3D US is a new imaging modality, which is being introduced into clinical practice. Although this technique will not probably replace two-dimensional ultrasound, it is being increasingly used. It has been reported that 3D US is a very high reproducible technique. The endometrium has been paid special attention when using this technique. The aim of this paper is to address some technical aspects of 3D US and to review critically its current status in evaluating endometrial function with special focus in its role in predicting pregnancy in assisted reproductive techniques. In spontaneous cycles endometrial volume grows during follicular phase remaining constant through the luteal phase. Endometrial vascularization increases during follicular phase peaking 2–3 days before ovulation, decreasing thereafter and increasing again during mid and late luteal phase. Data from studies analysing the role of 3D US for predicting IVF outcome are controversial. An explanation for these controversial findings might be different design of reported studies, specially the timing of ultrasound evaluation.

  18. Extramedullary Hematopoiesis in Uterine Leiomyoma Associated with Numerous Intravascular Thrombi

    Directory of Open Access Journals (Sweden)

    Xiaoyan Cui

    2014-01-01

    Full Text Available We report a case of extramedullary hematopoiesis (EMH in uterine leiomyoma and associated numerous intravascular thrombi. A 29-year-old nulliparous female presented with heavy vaginal bleeding and a hematocrit of 22%. No bone marrow biopsy has been performed. She had a history of uterine leiomyomata and menorrhagia for a year. A transvaginal ultrasound confirmed the presence of a uterine leiomyoma. The patient was treated conservatively with oral contraceptive pills due to desire for fertility. However, she continued to have heavy vaginal bleeding and developed bilateral upper extremity deep vein thrombosis and multiple superficial vein thromboses after two months. An exploratory laparotomy with uterine myomectomy was performed. Gross examination of the specimen revealed a single nodular mass measuring 10.0×9.5×7.5 cm with a white-tan swirling cut surface. Microscopic examination revealed benign smooth muscle consistent with leiomyoma and numerous intravascular thrombi both with areas of EMH. Immunohistochemical stains confirmed the presence of all three benign lineages of hematopoietic cells. Occurrence of EMH in uterine leiomyoma and intravascular thrombi is very rare. It may be related to systemic hematopoietic stimulation due to severe chronic anemia and local presence of hematopoietic growth factors and/or cytokines.

  19. Development of a model based scoring system for diagnosis of canine disseminated intravascular coagulation with independent assessment of sensitivity and specificity

    DEFF Research Database (Denmark)

    Wiinberg, Bo; Jensen, Asger Lundorff; Johansson, Per Ingemar

    2010-01-01

    coagulation tests for the diagnosis of DIC in dogs. To develop the scoring system, 100 dogs consecutively admitted to an intensive care unit (ICU) with diseases predisposing for DIC were enrolled prospectively (group A). The validation involved 50 dogs consecutively diagnosed with diseases predisposing......A template for a scoring system for disseminated intravascular coagulation (DIC) in humans has been proposed by the International Society on Thrombosis and Haemostasis (ISTH). The objective of this study was to develop and validate a similar objective scoring system based on generally available...... of the model was sustained by prospective evaluation in group B (sensitivity 83.3%, specificity 77.3%). Based on commonly used, plasma-based coagulation assays, it was possible to design an objective diagnostic scoring system for canine DIC with a high sensitivity and specificity....

  20. A clinical assessment tool for ultrasound-guided axillary brachial plexus block.

    LENUS (Irish Health Repository)

    Sultan, S F

    2012-05-01

    Competency in anesthesia traditionally has been determined subjectively in practice. Optimal training in procedural skills requires valid and reliable forms of assessment. The objective was to examine a procedure-specific clinical assessment tool for ultrasound-guided axillary brachial plexus block for inter-rater reliability and construct validity in a clinical setting.

  1. Ultrasound Images of the Tongue: A Tutorial for Assessment and Remediation of Speech Sound Errors

    Science.gov (United States)

    Preston, Jonathan L.; McAllister Byun, Tara; Boyce, Suzanne E.; Hamilton, Sarah; Tiede, Mark; Phillips, Emily; Rivera-Campos, Ahmed; Whalen, Douglas H.

    2017-01-01

    Diagnostic ultrasound imaging has been a common tool in medical practice for several decades. It provides a safe and effective method for imaging structures internal to the body. There has been a recent increase in the use of ultrasound technology to visualize the shape and movements of the tongue during speech, both in typical speakers and in clinical populations. Ultrasound imaging of speech has greatly expanded our understanding of how sounds articulated with the tongue (lingual sounds) are produced. Such information can be particularly valuable for speech-language pathologists. Among other advantages, ultrasound images can be used during speech therapy to provide (1) illustrative models of typical (i.e. "correct") tongue configurations for speech sounds, and (2) a source of insight into the articulatory nature of deviant productions. The images can also be used as an additional source of feedback for clinical populations learning to distinguish their better productions from their incorrect productions, en route to establishing more effective articulatory habits. Ultrasound feedback is increasingly used by scientists and clinicians as both the expertise of the users increases and as the expense of the equipment declines. In this tutorial, procedures are presented for collecting ultrasound images of the tongue in a clinical context. We illustrate these procedures in an extended example featuring one common error sound, American English /r/. Images of correct and distorted /r/ are used to demonstrate (1) how to interpret ultrasound images, (2) how to assess tongue shape during production of speech sounds, (3), how to categorize tongue shape errors, and (4), how to provide visual feedback to elicit a more appropriate and functional tongue shape. We present a sample protocol for using real-time ultrasound images of the tongue for visual feedback to remediate speech sound errors. Additionally, example data are shown to illustrate outcomes with the procedure. PMID

  2. Fracture status in men assessed by quantitative ultrasound measurements at the calcaneus.

    Science.gov (United States)

    Pluskiewicz, Wojciech; Wilk, Robert; Wielgórecki, Artur; Golba, Krzysztof S; Drozdzowska, Bogna

    2011-07-01

    The aim of the study was to assess fracture status in men by quantitative ultrasound measurements at the calcaneus. The diagnostic accuracy of quantitative ultrasound measurements was evaluated at baseline and follow-up. We observed 165 men (baseline age ± SD, 59.84 ± 10.6 years) recruited from an outpatient osteoporosis clinic. The mean follow-up duration was approximately 101.3 ± 35 months. There was no difference in either age or body mass index at baseline between the patients with a fracture history (n = 30) and the others (n = 135). The following fractures were identified at baseline: ankle, 15; wrist, 10; rib, 9; foot, 5; and hip, 1. The speed of sound (meters per second), broadband ultrasound attenuation (decibels per megahertz), and stiffness index (percent) were measured with a quantitative ultrasound device. The date of fracture occurrence at follow-up was defined as the final point. In the patients with a fracture history, the ultrasound variables were significantly lower than those in the rest of the group (P fractures occurred in 21 patients (wrist, 11; ankle, 5; rib, 3; hip, 1; and humerus, 1), and the ultrasound outcomes were nonsignificantly lower in the fractured men. The risk of fracture was estimated by the Cox regression analysis. A prior fracture was the only factor that significantly (4 times) increased the risk of a subsequent fracture (hazard ratio, 4.21; 95% confidence interval, 1.81-9.86; P Calcaneus ultrasound measurements can distinguish between patients with fractures and those without. In follow-up, ultrasound measurements did not indicate an increased fracture risk; a prior osteoporotic fracture was the major prognostic factor.

  3. Ultrasound assessment of tension-free vaginal tape (TVT).

    Science.gov (United States)

    Flock, F; Kohorst, F; Kreienberg, R; Reich, A

    2011-01-01

    To date, no standardization for the visualization of tension-free vaginal tape (TVT) has been established in clinical practice. The aim of this prospective observational study was to evaluate the shape and position of the tape using ultrasound and to compare this data with clinical postoperative results. In a three-year period, 296 patients with clinically and urodynamically proven stress urinary incontinence (SUI) were treated with TVT and received follow-up in our department. An additional 12 patients, who were initially treated in other hospitals and had postoperative problems, were included in this study. Depending on the outcome after 3 months, the patients were divided into groups with and without specific disorders. The TVT was evaluated by introital ultrasound. The position of the tape was established by its location in relation to the urethral length and the distance to the hypoechoic center of the urethra (HCU). A suitable TVT position was determined in patients without any postoperative disorders. The mean value for the TVT position at rest in relation to the urethral length was 61 %. The distance to the HCU was 4.6 ± 1.5 mm. In patients with persistent SUI, the tape was more often located under the inner (3 % vs. 0 %) or outer quarter (29 % vs. 13 %, p = 0.004). In patients with residual volume, the distance to the urethra was significantly lower (2.7 vs. 4.6, p TVT may be regularly investigated using ultrasound. In combination with the clinical outcome, it represents an important method of evaluating the tape and assists in the planning of a future therapeutic course of action in cases of postoperative problems. © Georg Thieme Verlag KG Stuttgart · New York.

  4. The ultrasound assessment of the psoriatic arthritis: from joint to skin

    Directory of Open Access Journals (Sweden)

    A. Ariani

    2011-06-01

    Full Text Available There is a growing number of papers investigating the diagnostic potential of ultrasonography in the assessment of patients with psoriatic arthritis and supporting its higher sensitivity over clinical examination in the diagnosis of synovitis, enthesitis and tenosynovitis. Less attention has been paid on both skin and nail, frequently involved in this condition. The aim of this paper is to show the potential of ultrasound in a multi-target assessment (joints, tendons, entesis, skin and nails in patients with psoriatic arthritis, using the last generation ultrasound equipment.

  5. Uncertainty assessment in measurement of myotube thickness in cells culture treated with and without therapeutic ultrasound

    International Nuclear Information System (INIS)

    Abrunhosa, V M; Alvarenga, A V; Costa-Félix, R P B; Costa, M L; Mermelstein, C

    2015-01-01

    Effectiveness of an ultrasound treatment shall be assessed by experiments. A reliable cell culture protocol is available and spatial discrepancies could arise. To assure if the spatial difference are relevant or not, and how they should be dealt with, an uncertainty model for the treatment result is a metrological reliable solution. The present work reports a metrological approach to assess myotube thickness and to validate a primary cell culture of muscle after a therapeutic ultrasound treatment, comparing it with a control group. The results reinforced the importance of such approach and show an efficacy of treatment on myotube differentiation

  6. Multiple imputation as a means to assess Mammographic vs. Ultrasound technology in Determine Breast Cancer Recurrence

    Science.gov (United States)

    Helenowski, Irene B.; Demirtas, Hakan; Khan, Seema; Eladoumikdachi, Firas; Shidfar, Ali

    2014-03-01

    Tumor size based on mammographic and ultrasound data are two methods used in predicting recurrence in breast cancer patients. Which technology offers better determination of diagnosis is an ongoing debate among radiologists, biophysicists, and other clinicians, however. Further complications in assessing the performance of each technology arise from missing data. One approach to remedy this problem may involve multiple imputation. Here, we therefore examine how imputation affects our assessment of the relationship between recurrence and tumor size determined either by mammography of ultrasound technology. We specifically employ the semi-parametric approach for imputing mixed continuous and binary data as presented in Helenowski and Demirtas (2013).

  7. How reassuring is a normal breast ultrasound in assessment of a screen-detected mammographic abnormality? A review of interval cancers after assessment that included ultrasound evaluation

    International Nuclear Information System (INIS)

    Bennett, M.L.; Welman, C.J.; Celliers, L.M.

    2011-01-01

    Aim: To review factors resulting in a false-negative outcome or delayed cancer diagnosis in women recalled for further evaluation, including ultrasound, after an abnormal screening mammogram. Materials and methods: Of 646,692 screening mammograms performed between 1 January 1995 and 31 December 2004, 34,533 women were recalled for further assessment. Nine hundred and sixty-four interval cancers were reported in this period. Forty-six of these women had been recalled for further assessment, which specifically included ultrasound evaluation in the preceding 24 months, and therefore, met the inclusion criteria for this study. Screening mammograms, further mammographic views, ultrasound scans, clinical findings, and histopathology results were retrospectively reviewed by two consultant breast radiologists. Results: The interval cancer developed in the contralateral breast (n = 9), ipsilateral breast, but different site (n = 6), and ipsilateral breast at the same site (n = 31) as the abnormality for which they had recently been recalled. In the latter group, 10 were retrospectively classified as a false-negative outcome, nine had a delay in obtaining a biopsy, and 12 had a delay due to a non-diagnostic initial biopsy. Various factors relating to these outcomes are discussed. Conclusion: Out of 34,533 women who attended for an assessment visit and the 46 women who subsequently developed an interval breast cancer, 15 were true interval cancers, 10 had a false-negative assessment outcome, and 21 had a delay to cancer diagnosis on the basis of a number of factors. When there is discrepancy between the imaging and histopathology results, a repeat biopsy rather than early follow-up would have avoided a delay in some cases. A normal ultrasound examination should not deter the radiologist from proceeding to stereotactic biopsy, if the index mammographic lesion is suspicious of malignancy.

  8. Evaluation of in-stent restenosis in the APPROACH trial (assessment on the prevention of progression by Rosiglitazone on atherosclerosis in diabetes patients with cardiovascular history)

    NARCIS (Netherlands)

    H.M. Garcia-Garcia (Hector); S.A. Garg (Scot); S. Brugaletta (Salvatore); G. Morocutti (Giorgio); R.E. Ratner (Robert); N.S. Kolatkar (Nikheel); B.G. Kravitz (Barbara); D.M. Miller (Diane); C. Huang (Chunmei); R.W. Nesto (Richard); P.W.J.C. Serruys (Patrick); R.P. Aftring (R.); N.S. Kolatkar (Nikheel); B.G. Kravitz (Barbara); J. Wolstenholme (Jane); J. Saarinen (Jari); R. Fowler (R.); J. Hoffman (Jonathan); D. Steele-Norwood (D.); R. Russell (Robert); S. Young (S.); Y.F. Chou; S. McMorn (Steve); C. Kirsch (Courtney); B. Louridas (Bonnie); T. Olivieria (Teresa); D. Mattioli (Debra); D. Miller (D.); C. Huang (Chunmei); C. Nguyen (C.); K. Jahnke (Kristoph); G.S. Mintz (Gary); J. Lachin (J.); M. Abrahamson (M.); P. Carson (P.); P. Jones

    2012-01-01

    textabstractTo determine (1) the medium-term effect of rosiglitazone and glipizide on intra-stent neointima hyperplasia, (2) restenosis pattern as assessed by intravascular ultrasound (IVUS) and quantitative coronary angiography (QCA) in patients with T2DM and coronary artery disease. A total of 462

  9. Volume of preclinical xenograft tumors is more accurately assessed by ultrasound imaging than manual caliper measurements.

    Science.gov (United States)

    Ayers, Gregory D; McKinley, Eliot T; Zhao, Ping; Fritz, Jordan M; Metry, Rebecca E; Deal, Brenton C; Adlerz, Katrina M; Coffey, Robert J; Manning, H Charles

    2010-06-01

    The volume of subcutaneous xenograft tumors is an important metric of disease progression and response to therapy in preclinical drug development. Noninvasive imaging technologies suitable for measuring xenograft volume are increasingly available, yet manual calipers, which are susceptible to inaccuracy and bias, are routinely used. The goal of this study was to quantify and compare the accuracy, precision, and inter-rater variability of xenograft tumor volume assessment by caliper measurements and ultrasound imaging. Subcutaneous xenograft tumors derived from human colorectal cancer cell lines (DLD1 and SW620) were generated in athymic nude mice. Experienced independent reviewers segmented 3-dimensional ultrasound data sets and collected manual caliper measurements resulting in tumor volumes. Imaging- and caliper-derived volumes were compared with the tumor mass, the reference standard, determined after resection. Bias, precision, and inter-rater differences were estimated for each mouse among reviewers. Bootstrapping was used to estimate mean and confidence intervals of variance components, intraclass correlation coefficients (ICCs), and confidence intervals for each source of variation. The average deviation from the true volume and inter-rater differences were significantly lower for ultrasound volumes compared with caliper volumes (P = .0005 and .001, respectively). Reviewer ICCs for ultrasound and caliper measurements were similarly low (1%), yet caliper volume variance was 1.3-fold higher than for ultrasound. Ultrasound imaging more accurately, precisely, and reproducibly reflects xenograft tumor volume than caliper measurements. These data suggest that preclinical studies using the xenograft burden as a surrogate end point measured by ultrasound imaging require up to 30% fewer animals to reach statistical significance compared with analogous studies using caliper measurements.

  10. Quantitative Ultrasound Assessment of Cartilage Degeneration in Ovariectomized Rats with Low Estrogen Levels.

    Science.gov (United States)

    Wang, Qing; Liu, Zhiwei; Wang, Yinong; Pan, Qingya; Feng, Qianjin; Huang, Qinghua; Chen, Wufan

    2016-01-01

    The aim of this study was to assess quantitatively the site-specific degeneration of articular cartilage in ovariectomized rats with low estrogen levels using a high-frequency ultrasound system. Fourteen female Sprague-Dawley rats were randomly divided into two groups (n = 7 per group): a sham group in which only the peri-ovarian fatty tissue was exteriorized and an ovariectomized group that underwent bilateral ovariectomy to create a menopause model with low estrogen levels. All animals were sacrificed at the end of the third week after ovariectomy. Hindlimbs were harvested. The articular cartilage from five anatomic sites (i.e., femoral caput [FC], medial femoral condyle [MFC], lateral femoral condyle [LFC], medial tibial plateau [MTP] and lateral tibial plateau [LTP]) was examined with ultrasound. Four parameters were extracted from the ultrasound radiofrequency data: reflection coefficient of the cartilage surface (RC1), reflection coefficient of the cartilage-bone interface (RC2), ultrasound roughness index (URI) and thickness of the cartilage tissue. The results indicated significant (p reduction induces morphologic and acoustic alterations in the articular cartilage of the hip and knee joints in ovariectomized rats. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  11. Quantitative Assessment of First Annular Pulley and Adjacent Tissues Using High-Frequency Ultrasound

    Directory of Open Access Journals (Sweden)

    Yi-Hsun Lin

    2017-01-01

    Full Text Available Due to a lack of appropriate image resolution, most ultrasound scanners are unable to sensitively discern the pulley tissues. To extensively investigate the properties of the A1 pulley system and the surrounding tissues for assessing trigger finger, a 30 MHz ultrasound system was implemented to perform in vitro experiments using the hypodermis, A1 pulley, and superficial digital flexor tendon (SDFT dissected from cadavers. Ultrasound signals were acquired from both the transverse and sagittal planes of each tissue sample. The quantitative ultrasonic parameters, including sound speed, attenuation coefficient, integrated backscatter (IB and Nakagami parameter (m, were subsequently estimated to characterize the tissue properties. The results demonstrated that the acquired ultrasound images have high resolution and are able to sufficiently differentiate the variations of tissue textures. Moreover, the attenuation slope of the hypodermis is larger than those of the A1 pulley and SDFT. The IB of A1 pulley is about the same as that of the hypodermis, and is very different from SDFT. The m parameter of the A1 pulley is also very different from those of hypodermis and SDFT. This study demonstrated that high-frequency ultrasound images in conjunction with ultrasonic parameters are capable of characterizing the A1 pulley system and surrounding tissues.

  12. Collecting Validity Evidence for Simulation-Based Assessment of Point-of-Care Ultrasound Skills.

    Science.gov (United States)

    Jensen, Jesper Kørup; Dyre, Liv; Jørgensen, Mattis Enggaard; Andreasen, Lisbeth Anita; Tolsgaard, Martin Grønnebaek

    2017-12-01

    The aim of this study was to examine the validity of a simulator test designed to evaluate focused assessment with sonography for trauma (FAST) skills. Participants included a group of ultrasound novices (n = 25) and ultrasound experts (n = 10). All participants had their FAST skills assessed using a virtual reality ultrasound simulator. Procedural performance on the 4 FAST windows was assessed by automated simulator metrics, which received a passing or failing score. The validity evidence for these simulator metrics was examined by a stepwise approach according to the Standards for Educational and Psychological Testing. Metrics with validity evidence were included in a simulator test, and the reliability of test scores was determined. Finally, a pass/fail level for procedural performance was established. Of the initial 55 metrics, 34 (61.8%) had validity evidence (P validity evidence, and test scores were calculated as percentages of the maximum score. The median simulator test scores were 14.7% (range, 0%-47.1%) and 94.1% (range, 94.1%-100%) for novices and experts, respectively (P validity. © 2017 by the American Institute of Ultrasound in Medicine.

  13. Plantar fibromatosis. Ultrasound assessment; La fibromatosi plantare: risultati ecografici

    Energy Technology Data Exchange (ETDEWEB)

    Solivetti, F.R.; Luzi, F.; Bucher, S.; Thorel, M.F.; Muscardin, L. [Rome Ospedale Santa Maria e San Gallicano, Rome (Italy)

    1999-05-01

    In 1998-99, six patients with plantar fibromatosis were submitted to US (ultrasound) with plantar fibromatosis were submitted to US with 13 MHz linear array and 20 MHz mechanical annular array probes. All patients were examined in prone recumbency with the probe positioned on the sole of the foot. Only some of them were subsequently submitted to surgery. Plantar fibromatosis exhibited an almost pathognomonic pattern and US proved to be a quick, noninvasive and cost-effective technique to confirm clinical diagnosis. The nodule is typically single and iso echoic, with maximum diameter of about 1 cm, inhomogeneous internal structure and few thin hyperechoic septa. The nodular fibrous proliferation adheres with the major axis along the plantar fascia; it exhibits clear-cut margins and US beam transmission is good. No calcifications or fluid collections are seen within the nodule. Color and power Doppler show no flow inside. It is demonstrated that US is an adequate tool for the study of plantar fibromatosis. [Italian] Negli anni 1998-99 sono stati osservati ben sei casi di fibromatosi plantare, solo in parte trattati chirurgicamente. Tutti sono stati studiati con ecografia, con apparecchiatura in tempo reale e sonde lineari da 13 MHz e anulari da 20 MHz. Si puo' descrivere un quadro tipico della malattia diagnosticabile con l'ecografia, specie in associazione con sintomi clinici caratteristici.

  14. Real-time ultrasound elastography: an assessment of enlarged cervical lymph nodes.

    Science.gov (United States)

    Lo, Wu-Chia; Cheng, Po-Wen; Wang, Chi-Te; Liao, Li-Jen

    2013-09-01

    To determine the efficacy of real-time elastography (RTE), compared with our previously proposed prediction model, in the detection of malignancy in cervical lymph nodes (LNs). One hundred and thirty-one patients underwent ultrasound-guided fine needle aspiration biopsy (ultrasound FNAB) after ultrasound and RTE evaluation. The formula of the RTE scoring system was a four-point visual scale, based on a previously determined model. The formula of the prediction model was: [Formula: see text]. An extended model was constructed with four previous predictors and elasticity scores, using a logistic regression model. Final histology revealed 77 benign and 54 malignant LNs. In the elasticity score system, sensitivity was 66.7 %, specificity was 57.1 %, the positive predictive value (PPV) was 52.2 % and the negative predictive value (NPV) was 71.0 %. In the prediction model system, sensitivity was 79.6 %, specificity was 92.2 %, the PPV was 87.8 % and the NPV was 86.6 %. When the extended and the original model were compared, the areas under the receiver operating characteristic curve (c-statistic) was 0.94 and 0.95, respectively (P > 0.05). Qualitative RTE offers no additional value over conventional ultrasound in predicting malignancy in cervical LNs. • An ultrasound system can help in the assessment of cervical lymph nodes. • Grey-scale and power Doppler ultrasound remain fundamental for neck nodal evaluation. • Qualitative real-time elastography provided no additional value compared with current prediction models.

  15. Use of Ultrasound Elastography in the Assessment of the Musculoskeletal System

    International Nuclear Information System (INIS)

    Paluch, Łukasz; Nawrocka-Laskus, Ewa; Wieczorek, Janusz; Mruk, Bartosz; Frel, Małgorzata; Walecki, Jerzy

    2016-01-01

    This article presents possible applications of ultrasound elastography in musculoskeletal imaging based on the available literature, as well as the possibility of extending indications for the use of elastography in the future. Ultrasound elastography (EUS) is a new method that shows structural changes in tissues following application of physical stress. Elastography techniques have been widely used to assess muscles and tendons in vitro since the early parts of the twentieth century. Only recently with the advent of new technology and creation of highly specialized ultrasound devices, has elastography gained widespread use in numerous applications. The authors performed a search of the Medline/PubMed databases for original research and reviewed publications on the application of ultrasound elastography for musculoskeletal imaging. All publications demonstrate possible uses of ultrasound elastography in examinations of the musculoskeletal system. The most widely studied areas include the muscles, tendons and rheumatic diseases. There are also reports on the employment in vessel imaging. The main limitation of elastography as a technique is above all the variability of applied pressure during imaging, which is operator-dependent. It would therefore be reasonable to provide clear guidelines on the technique applied, as well as clear indications for performing the test. It is important to develop methods for creating artifact-free, closed-loop, compression-decompression cycles. The main advantages include cost-effectiveness, short duration of the study, non-invasive nature of the procedure, as well as a potentially broader clinical availability. There are no clear guidelines with regard to indications as well as examination techniques. Ultrasound elastography is a new and still poorly researched method. We conclude, however, that it can be widely used in the examinations of musculoskeletal system. Therefore, it is necessary to conduct large, multi-center studies to

  16. Interobserver agreement of multicompartment ultrasound in the assessment of pelvic floor anatomy.

    Science.gov (United States)

    Lone, Farah; Sultan, Abdul H; Stankiewicz, Aleksandra; Thakar, Ranee

    2016-01-01

    To assess the interobserver agreement of pelvic floor anatomical measurements using multicompartment pelvic floor ultrasound. Females were recruited from the urogynaecology/gynaecology clinics between July and October 2009 and underwent multicompartment pelvic floor ultrasonography (PFUS) using two-dimensional (2D) transperineal ultrasound (TPUS), high-frequency 2D/three-dimensional (3D) endovaginal ultrasound (EVUS) using a biplane probe with linear and transverse arrays and a 360° rotational 3D-EVUS. PFUS measurements were independently analysed by two clinicians. 158 females had PFUS assessment. Good-to-excellent interobserver agreement was observed for bladder-symphysis distance at rest and valsalva, urethral thickness, urethral length, urethral volume, levator hiatus area and width, anteroposterior diameter and anorectal angle. Lins Correlation was used to calculate the interobserver agreement and Bland-Altman plots were created to demonstrate the agreement between the researchers. There was also a good-to-excellent agreement between the two clinicians for the assessment of pelvic organ prolapse (POP) in the anterior, middle and posterior compartment. Multicompartment PFUS is a reliable tool in the anatomical assessment of pelvic floor measurements and POP. We found a good-to-excellent agreement between the two assessors in the assessment of pelvic floor measurements for all three pelvic floor compartments and suggest that multicompartment PFUS could be considered as a systematic integrated approach to assess the pelvic floor.

  17. Multicenter assessment of venous reflux by duplex ultrasound.

    Science.gov (United States)

    Lurie, Fedor; Comerota, Anthony; Eklof, Bo; Kistner, Robert L; Labropoulos, Nicos; Lohr, Joann; Marston, William; Meissner, Mark; Moneta, Gregory; Neglén, Peter; Neuhardt, Diana; Padberg, Frank; Welsh, Harold J

    2012-02-01

    This prospective multicenter investigation was conducted to define the repeatability of duplex-based identification of venous reflux and the relative effect of key parameters on the reproducibility of the test. Repeatability was studied by having the same technologist perform duplicate tests, at the same time of the day, using the same reflux-provoking maneuver and with the patient in the same position. Reproducibility was examined by having two different technologists perform the test at the same time of the day, using the same reflux-provoking maneuver and with the patient in the same position. Facilitated reproducibility was studied by having two different technologists examine the same patients immediately after an educational intervention. Limits of agreement between two duplex scans were studied by changing three elements of the test: time of the day (morning vs afternoon), patient's position (standing vs supine), and reflux initiation (manual vs automatic compression-decompression). The study enrolled 17 healthy volunteers and 57 patients with primary chronic venous disease. Repeatability of reflux time measurements in deep veins did not significantly differ with the time of day, the patient's position, or the reflux-provoking maneuver. Reflux measurements in the superficial veins were more repeatable (P ultrasound detection of venous reflux. Reports should include information on the time of the test, the patient's position, and the provoking maneuver used. Adopting a uniform cut point of 0.5 second for pathologic reflux can significantly improve the reliability of reflux detection. Implementation of a standard protocol should elevate the minimal standard for agreement between repeated tests from the current 70% to at least 80% and with more rigid standardization, to 90%. Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  18. Bone status in rheumatoid arthritis assessed at peripheral sites by three different quantitative ultrasound devices

    DEFF Research Database (Denmark)

    Madsen, O R; Suetta, C; Egsmose, C

    2004-01-01

    Rheumatoid arthritis (RA) is characterized by periarticular and generalized loss of bone mass. Quantitative ultrasound (QUS) has been introduced as a method for the assessment of bone status and fracture risk. In this cross-sectional study bone status was assessed by QUS at different peripheral...... sites in 27 women with RA (mean disease duration 15 years) and in 36 healthy women matched for age, height and weight. Speed of sound (SOS, m/s), broadband ultrasound attenuation (BUA, dB/MHz) and stiffness of the calcaneus were assessed by a Lunar Achilles device. Amplitude-dependent SOS (Ad-SOS, m...... reduced in RA at most sites ( pcalcaneus and distal radius ( p

  19. Ultrasound Assessment of Normal Portal Vein Diameter in ...

    African Journals Online (AJOL)

    Even if the additional use of color and spectral Doppler improves the assessment of patients suspected of having portal hypertension, gray scale assessment of portal vein diameter is corner stone in the initial evaluation. Knowing the normal portal venous dimension in a specified population is so crucial. Methods: This is a ...

  20. Intravascular ultrasound assessment of expansion of the sirolimus-eluting (Cypher Select) and paclitaxel-eluting (Taxus Express-2) stent in patients with diabetes mellitus

    DEFF Research Database (Denmark)

    Jensen, L.O.; Maeng, M.; Mintz, G.S.

    2008-01-01

    Patients with diabetes have a higher risk for in-stent restenosis after coronary stent implantation. Drug-eluting stents (DES) are highly effective in reducing in-stent restenosis. Once neointimal hyperplasia is suppressed with DES, the impact of stent underexpansion becomes magnified. The aim of...

  1. Assessment of a New E-Learning System on Thorax, Trachea, and Lung Ultrasound

    Directory of Open Access Journals (Sweden)

    Colleen Cuca

    2013-01-01

    Full Text Available Background. Lung ultrasound has become an emerging tool in acute and critical care medicine. Combined theoretical and hands-on training has been required to teach ultrasound diagnostics. Current computer technology allows for display, explanation, and animation of information in a remote-learning environment. Objective. Development and assessment of an e-learning program for lung ultrasound. Methods. An interactive online tutorial was created. A prospective learning success study was conducted with medical students using a multiple-choice test (Trial A. This e-learning program was used as preparation for a certified course followed by an evaluation of trained doctors (Trial B by linear analogue scales. Pretests were compared with postcourse tests and sustainability tests as well as a posttest of a one-day custom classroom training. Results. In Trial A, during the learning success study (n=29, the increase of correct answers was 11.7 to 17/20 in the post-test and to 16.6/20 in the sustainability test (relative change 45.1%, P<0.0001. E-learning almost equalled scores of classroom-based training regarding gain and retention of factual knowledge. In Trial B, nineteen participating doctors found a 79.5% increase of knowledge (median, 95% CI: 69%; 88%. Conclusion. The basics of lung ultrasound can be taught in a highly effective manner using e-learning.

  2. Assessment of a new e-learning system on thorax, trachea, and lung ultrasound.

    Science.gov (United States)

    Cuca, Colleen; Scheiermann, Patrick; Hempel, Dorothea; Via, Gabriele; Seibel, Armin; Barth, Magnus; Hirche, Tim O; Walcher, Felix; Breitkreutz, Raoul

    2013-01-01

    Background. Lung ultrasound has become an emerging tool in acute and critical care medicine. Combined theoretical and hands-on training has been required to teach ultrasound diagnostics. Current computer technology allows for display, explanation, and animation of information in a remote-learning environment. Objective. Development and assessment of an e-learning program for lung ultrasound. Methods. An interactive online tutorial was created. A prospective learning success study was conducted with medical students using a multiple-choice test (Trial A). This e-learning program was used as preparation for a certified course followed by an evaluation of trained doctors (Trial B) by linear analogue scales. Pretests were compared with postcourse tests and sustainability tests as well as a posttest of a one-day custom classroom training. Results. In Trial A, during the learning success study (n = 29), the increase of correct answers was 11.7 to 17/20 in the post-test and to 16.6/20 in the sustainability test (relative change 45.1%, P learning almost equalled scores of classroom-based training regarding gain and retention of factual knowledge. In Trial B, nineteen participating doctors found a 79.5% increase of knowledge (median, 95% CI: 69%; 88%). Conclusion. The basics of lung ultrasound can be taught in a highly effective manner using e-learning.

  3. The Design and Evaluation of the Comprehensive Hospitalist Assessment and Mentorship with Portfolios (CHAMP) Ultrasound Program.

    Science.gov (United States)

    Mathews, Benji K; Reierson, Kreegan; Vuong, Khuong; Mehta, Ankit; Miller, Paula; Koenig, Seth; Narasimhan, Mangala

    2018-02-28

    Literature supports the use of point-ofcare ultrasound performed by the treating hospitalist in the diagnosis of common diseases. There is no consensus on the training paradigm or the evaluation of skill retention for hospitalists. To evaluate the effectiveness of a comprehensive bedside ultrasound training program with postcourse competency assessments for hospitalists. A retrospective report of a training program with 53 hospitalists. The program consisted of online modules, a 3-day in-person course, portfolios, 1-day refresher training, monthly scanning, and assessments. Hospitalists were rated by using similar pre- and postcourse competency assessments and self-rating parameters during the 3-day and refresher courses. A large tertiary-care center. Skills increased after the 3-day course from a median preassessment score of 15% correct (interquartile range [IQR] 10%-25%) to a median postassessment score of 90% (IQR 80%-95%; P < .0001). At the time of the refresher course, the median precourse skills score had decreased to 65% correct (IQR 35%-90%), which improved to 100% postcourse (IQR 85%-100%; P < .0001). Skills scores decreased significantly less between the post 3-day course assessment and pre 1-day refresher course for hospitalists who completed portfolios (mean decrease 13.6% correct; P < .0001) and/or monthly scanning sessions (mean decrease 7.3% correct; P < .0001) compared with hospitalists who did not complete these items. A comprehensive longitudinal ultrasound training program including competency assessments improved ultrasound acquisition skills with hospitalists. Skill retention remained high in those who completed portfolios and/or monthly scanning sessions along with a 1-day in-person refresher course.

  4. CNS Intravascular Lymphoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Amer Awad

    2011-01-01

    Full Text Available Intravascular lymphoma is a rare but well-described entity. The clinical manifestations are heterogeneous. We report a case of a 59-year-old woman who presented initially with syncope followed by subacute cognitive decline that progressed to minimally conscious state. Shortly after the transfer to our tertiary center the patient died. Brain autopsy disclosed the diagnosis of B-cell intravascular lymphoma. We speculate that syncope could be the first manifestation of central nervous system intravascular lymphoma and should be considered in the differential diagnosis of unexplained syncope. In addition, we stress the importance of early brain biopsy in unexplained white matter disease.

  5. Ultrasound imaging for the rheumatologist XXX. Sonographic assessment of the painful knee.

    Science.gov (United States)

    Meenagh, G; Filippucci, E; Delle Sedie, A; Iagnocco, A; Scirè, C A; Riente, L; Montecucco, C; Valesini, G; Bombardieri, S; Grassi, W

    2010-01-01

    The knee joint is a frequent focus of attention for rheumatologists when assessing patients presenting to a clinic and may represent underlying intra-articular inflammatory pathology or involvement of the surrounding soft tissues. This study describes the correlation between clinical and ultrasound findings in patients presenting with a variety of rheumatic disorders and knee pain. US imaging provides for a sensitive and detailed identification of different intra- and peri-articular pathology responsible for knee pain.

  6. High speed intravascular photoacoustic imaging of atherosclerotic arteries (Conference Presentation)

    Science.gov (United States)

    Piao, Zhonglie; Ma, Teng; Qu, Yueqiao; Li, Jiawen; Yu, Mingyue; He, Youmin; Shung, K. Kirk; Zhou, Qifa; Kim, Chang-Seok; Chen, Zhongping

    2016-02-01

    Cardiovascular disease is the leading cause of death in the industrialized nations. Accurate quantification of both the morphology and composition of lipid-rich vulnerable atherosclerotic plaque are essential for early detection and optimal treatment in clinics. In previous works, intravascular photoacoustic (IVPA) imaging for detection of lipid-rich plaque within coronary artery walls has been demonstrated in ex vivo, but the imaging speed is still limited. In order to increase the imaging speed, a high repetition rate laser is needed. In this work, we present a high speed integrated IVPA/US imaging system with a 500 Hz optical parametric oscillator laser at 1725 nm. A miniature catheter with 1.0 mm outer diameter was designed with a 200 μm multimode fiber and an ultrasound transducer with 45 MHz center frequency. The fiber was polished at 38 degree and enclosed in a glass capillary for total internal reflection. An optical/electrical rotary junction and pull-back mechanism was applied for rotating and linearly scanning the catheter to obtain three-dimensional imaging. Atherosclerotic rabbit abdominal aorta was imaged as two frame/second at 1725 nm. Furthermore, by wide tuning range of the laser wavelength from 1680 nm to 1770 nm, spectroscopic photoacoustic analysis of lipid-mimicking phantom and an human atherosclerotic artery was performed ex vivo. The results demonstrated that the developed IVPA/US imaging system is capable for high speed intravascular imaging for plaque detection.

  7. Qualitative and quantitative ultrasound assessment of gastric content.

    Science.gov (United States)

    Bisinotto, Flora Margarida Barra; Pansani, Patrícia Luísa; Silveira, Luciano Alves Matias da; Naves, Aline de Araújo; Peixoto, Ana Cristina Abdu; Lima, Hellen Moreira de; Martins, Laura Bisinotto

    2017-02-01

    Pulmonary aspiration of the gastric contents is one of the most feared complications in anesthesia. Its prevention depends on preoperative fasting as well as identification of risky patients. A reliable diagnostic tool to assess gastric volume is currently lacking. The aim of this study performed on volunteers was to evaluate the feasibility of ultrasonography to identify qualitative and quantitative gastric content. A standardized gastric scanning protocol was applied on 67 healthy volunteers to assess the gastric antrum in four different situations: fasting, after ingesting clear fluid, milk and a solid meal. A qualitative and quantitative assessment of the gastric content in the antrum was performed by a blinded sonographer. The antrum was considered either as empty, or containing clear or thick fluid, or solids. Total gastric volume was predicted based on a cross-sectional area of the antrum. A p-value less than 0.05 was considered statistically significant. For each type of gastric content, the sonographic characteristics of the antrum and its content were described and illustrated. Sonographic qualitative assessment allowed to distinguish between an empty stomach and one with different kinds of meal. The predicted gastric volume was significantly larger after the consumption of any food source compared to fasting. Bedside sonography can determine the nature of gastric content. It is also possible to estimate the difference between an empty gastric antrum and one that has some food in it. Such information may be useful to estimate the risk of aspiration, particularly in situations when prandial status is unknown or uncertain.

  8. Variables associated with lung congestion as assessed by chest ultrasound in diabetics undergoing hemodialysis

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Santos

    Full Text Available Abstract Introduction: Ultrasound is an emerging method for assessing lung congestion but is still seldom used. Lung congestion is an important risk of cardiac events and death in end-stage renal disease (ESRD patients on hemodialysis (HD. Objective: We investigated possible variables associated with lung congestion among diabetics with ESRD on HD, using chest ultrasound to detect extracellular lung water. Methods: We studied 73 patients with diabetes as the primary cause of ESRD, undergoing regular HD. Lung congestion was assessed by counting the number of B lines detected by chest ultrasound. Hydration status was assessed by bioimpedance analysis and cardiac function by echocardiography. The collapse index of the inferior vena cava (IVC was measured by ultrasonography. All patients were classified according to NYHA score. Correlations of the number of B lines with continuous variables and comparisons regarding the number of B lines according to categorical variables were performed. Multivariate linear regression was used to test the variables as independent predictors of the number of B lines. Results: None of the variables related to hydration status and cardiac function were associated with the number of B lines. In the multivariate analysis, only the IVC collapse index (b = 45.038; p < 0.001 and NYHA classes (b = 13.995; p = 0.006 were independent predictors of the number of B lines. Conclusion: Clinical evaluation based on NYHA score and measurement of the collapsed IVC index were found to be more reliable than bioimpedance analysis to predict lung congestion.

  9. Qualitative and quantitative ultrasound assessment of gastric content

    Directory of Open Access Journals (Sweden)

    Flora Margarida Barra Bisinotto

    Full Text Available Summary Objective: Pulmonary aspiration of the gastric contents is one of the most feared complications in anesthesia. Its prevention depends on preoperative fasting as well as identification of risky patients. A reliable diagnostic tool to assess gastric volume is currently lacking. The aim of this study performed on volunteers was to evaluate the feasibility of ultrasonography to identify qualitative and quantitative gastric content. Method: A standardized gastric scanning protocol was applied on 67 healthy volunteers to assess the gastric antrum in four different situations: fasting, after ingesting clear fluid, milk and a solid meal. A qualitative and quantitative assessment of the gastric content in the antrum was performed by a blinded sonographer. The antrum was considered either as empty, or containing clear or thick fluid, or solids. Total gastric volume was predicted based on a cross-sectional area of the antrum. A p-value less than 0.05 was considered statistically significant. Results: For each type of gastric content, the sonographic characteristics of the antrum and its content were described and illustrated. Sonographic qualitative assessment allowed to distinguish between an empty stomach and one with different kinds of meal. The predicted gastric volume was significantly larger after the consumption of any food source compared to fasting. Conclusion: Bedside sonography can determine the nature of gastric content. It is also possible to estimate the difference between an empty gastric antrum and one that has some food in it. Such information may be useful to estimate the risk of aspiration, particularly in situations when prandial status is unknown or uncertain.

  10. Model based assessment of vestibular jawbone thickness using high frequency 3D ultrasound micro-scanning

    Science.gov (United States)

    Habor, Daniel; Neuhaus, Sarah; Vollborn, Thorsten; Wolfart, Stefan; Radermacher, Klaus; Heger, Stefan

    2013-03-01

    Endosseous implants are well-established in modern dentistry. However, without appropriate therapeutic intervention, progressive peri-implant bone loss may lead to failing implants. Conventionally, the particularly relevant vestibular jawbone thickness is monitored using radiographic 3D imaging methods. Ionizing radiation, as well as imaging artifacts caused by metallic implants and superstructures are major drawbacks of these imaging modalities. In this study, a high frequency ultrasound (HFUS) based approach to assess the vestibular jawbone thickness is being introduced. It should be emphasized that the presented method does not require ultrasound penetration of the jawbone. An in-vitro study using two porcine specimens with inserted endosseous implants has been carried out to assess the accuracy of our approach. The implant of the first specimen was equipped with a gingiva former while a polymer superstructure was mounted onto the implant of the second specimen. Ultrasound data has been acquired using a 4 degree of freedom (DOF) high frequency (gingiva, gingiva former (first specimen) and superstructure (second specimen). The meshes are matched with a-priori acquired 3D models of the implant, the superstructure and the gingiva former using a best-fit algorithm. Finally, the vestibular peri-implant bone thickness has been assessed in the resulting 3D models. The accuracy of this approach has been evaluated by comparing the ultrasound based thickness measurement with a reference measurement acquired with an optical extra-oral 3D scanner prior to covering the specimens with gingiva. As a final result, the bone thicknesses of the two specimens were measured yielding an error of -46+/-89μm (first specimen) and 70+/-93μm (second specimen).

  11. Intravascular lipoma of the renal vein

    Directory of Open Access Journals (Sweden)

    Z Doyle

    2015-06-01

    Full Text Available Lipomas are benign neoplasms composed of adipocytes encased in a fibrous capsule. Intravascular lipomas are rare and almost always incidental findings. In the published literature, the majority are described within the inferior vena cava (IVC and less frequently reported in the superior vena cava, brachiocephalic vein, subclavian vein, internal jugular vein, external iliac vein and common femoral vein. We present the case of a 59-year-old male who presented with a symptomatic ureteral calculus and was found to have an intravascular lipoma of the right renal vein with extension into the IVC. To our knowledge, this is the first ever report of an intravascular lipoma in the renal vein. We discuss the imaging characteristics of intravascular lipomas and the differential diagnosis that should be considered.

  12. Intravascular Myopericytoma in the Heel: Case Report and Literature Review

    Science.gov (United States)

    Valero, José; Salcini, José L.; Gordillo, Luis; Gallart, José; González, David; Deus, Javier; Lahoz, Manuel

    2015-01-01

    Abstract Intravascular myopericytoma (IVMP), regarded as a variant of myopericytoma, is a rare tumor. Very few cases have been described, none in the foot. The first case of IVMP located in the heel of the foot is described in this article. A literature review is reported of all cases of IVMP published in the English literature. A 48-year-old man possessed an IVMP on the heel of the right foot. The physical examination and histopathological and ultrasound studies are described. The literature review yielded 5 cases of IVMP, 2 of which were in the thigh and 1 each in the oral mucosa, the periorbital region, and the leg. The possibility that these lesions may be malignant suggests that the histopathological study of vascular tumors should include immunohistochemical tests. PMID:25789958

  13. Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis

    OpenAIRE

    Kensuke Tashiro, MD; Shuji Yamashita, MD; Mitsunaga Narushima, MD; Isao Koshima, MD; Shimpei Miyamoto, MD

    2017-01-01

    Background:. Although supermicrosurgical anastomosis is a widely known reconstructive microsurgical technique, it is difficult to perform. To expand the clinical use of supermicrosurgery, we used hemi-intravascular stenting (hemi-IVaS), which is performed by inserting an intravascular stent into one side of the vessel. We conducted lymphaticovenular anastomosis, free perforator flap transfer, and fingertip replantation with supermicrosurgical anastomosis using hemi-IVaS technique and examined...

  14. Ultrasound -a useful complementary tool to mammography in assessment of symptomatic breast diseases

    International Nuclear Information System (INIS)

    Fatima, S.T.; Zahur, Z.; Jeilani, A.; Hussain, S.J.A.

    2015-01-01

    Breast cancer is the most common female malignancy worldwide. Pakistan has the highest incidence rate of breast cancer than any other Asian population. The purpose of the study was to evaluate the worth of sono-mammography in diagnosis of symptomatic breast diseases by comparing it with mammogram. Methods: In this cross-sectional validation study, 45 subjects with mean age of 45+-12.07 were included. Majority of the patients presented with complaint of breast lump. After complete history and clinical examination, all the patients had high resolution ultrasound of bilateral breasts and axilla followed by bilateral mammography. Histopathology was taken as gold standard in this study. The exclusion criteria were pregnancy and patients having direct clinical signs of breast malignancy. Results: Based on histopathology, out of 45 patients with breast symptoms, 12 patients had benign lesions, whereas 32 patients were diagnosed as the cases of breast cancers. Finally one patient did not have biopsy proven final diagnosis. Sensitivity and specificity of ultrasound were calculated to be 100% and 67% as compared to sensitivity and specificity of 90.6% and 91.7% for that of mammography. Conclusions: Ultrasound is a useful complementary tool to mammography in assessment of symptomatic breast diseases since it helps in characterization and localization of breast lesions seen on mammogram and it is not limited by dense breasts. Also it should be the considered as initial imaging technique for assessment of palpable breast lumps. (author)

  15. Assessment of ultrasound imaging and physical examination findings in greater trochanteric pain syndrome

    Directory of Open Access Journals (Sweden)

    Fulya Bakılan

    2015-03-01

    Full Text Available Objective: The aim of this study was to investigate the prevalence of greater trochanteric bursitis and gluteus medius tendinopathy using ultrasound in patients with greater trochanteric pain and assess the value of the pain on resisted hip abduction and pain on resisted hip internal rotation in predicting the presence of gluteus medius tendinopathy. Methods: The study was a retrospective analysis of 75 patients with greater trochanteric pain. The physical examination records were identified as pain on resisted hip abduction and hip internal rotation. After observing physical examination records, presence of greater trochanteric bursitis or gluteus medius tendinopathy were assessed in documented ultrasound findings. Results: Of the 75 patients with greater trochanteric pain, trochanteric bursitis was found in 41.4% of patients, gluteus medius tendinopathy was found in 20% of patients. A significant difference was found in both presence of pain on resisted hip abduction and internal rotation between patients with gluteus medius tendinopathy and patients with other abnormalities in favor of gluteus medius tendinopathy. Conclusion: In order to determine the etiology of greater trochanteric pain, physical examination and ultrasound imaging is important, especially examination of pain on resisted hip abduction and hip internal rotation is essential to detect gluteus medius tendinopathy.

  16. Scatterer size estimation using the center frequency assessed from ultrasound time domain data.

    Science.gov (United States)

    Erlöv, Tobias; Jansson, Tomas; Persson, Hans W; Cinthio, Magnus

    2016-10-01

    Scatterer size estimation is useful when characterizing tissue using ultrasound. In all previous studies on scatterer size, the estimations are performed in the frequency domain and are thus subjected to a trade off in time-frequency resolution. This study focused on the feasibility of estimating scatterer size in the time domain using only the ultrasound center frequency, assuming a Gaussian-shaped pulse. A model for frequency normalization was derived and the frequency-dependent attenuation was compensated. Five phantoms with well-defined sizes of spherical glass beads were made and scanned with two different linear array transducers with variable center frequencies. A strong correlation (r = 0.99, p estimation of scatterer size is possible using only the center frequency assessed in the time domain.

  17. Dosimetric calculus in intravascular brachytherapy; Calculos dosimetricos em braquiterapia intravascular

    Energy Technology Data Exchange (ETDEWEB)

    Campos, Laelia Pumilla Botelho; Stabin, Michael Gregory [Pernambuco Univ., Recife, PE (Brazil). Dept. de Energia Nuclear

    2000-07-01

    Among the cardiovascular diseases, the most common is acute myocardial infarction, which occurs because of the occlusion of one or more coronary arteries. Balloon angioplasty has been a popular treatment which is less invasive than surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment). Known as Intravascular Brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis. In order to study the radiation dosimetry in the patient and radiological protection for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, 0.30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several radionuclides. Two stent sources employing {sup 32}P are also simulated. Advantages and disadvantages of the radionuclides and source geometries are discussed and the dosimetry developed here will aid in the realization of the benefits obtained in patients. (author)

  18. Ultrasound assessment of gastric volume in children after drinking carbohydrate-containing fluids.

    Science.gov (United States)

    Song, I-K; Kim, H-J; Lee, J-H; Kim, E-H; Kim, J-T; Kim, H-S

    2016-04-01

    Gastric ultrasound is a valid tool for non-invasive assessment of the nature and volume of gastric contents in adults and children. Perioperative fasting guidelines recommend oral carbohydrates up to 2 h before elective surgery. We evaluated gastric volume in children using ultrasound before and after drinking carbohydrate fluids before surgery. Paediatric patients younger than 18 yr old undergoing elective surgery were enrolled. Initial ultrasound assessment of gastric volume was performed after fasting for 8 h. Two hours before surgery, patients were given carbohydrate drinks: 15 ml kg(-1) for patients younger than 3 yr old and 10 ml kg(-1) for those more than 3 yr old. Before induction of general anaesthesia, the gastric volume was reassessed. Parental satisfaction scores (0=totally satisfied, 10=totally dissatisfied) and complications were recorded. Of the 86 enrolled patients, 79 completed the study; three refused to ingest the requested volume, and surgery was delayed for more than 2 h in four patients. The mean (sd) of the initial and second ultrasound measurements were 2.09 (0.97) and 1.85 (0.94) cm(2), respectively (P=0.01; mean difference 0.24 cm(2), 95% confidence interval 0.06-0.43). The median (interquartile range) satisfaction score was 2.4 (0-6). Two instances of postoperative vomiting and one instance of postoperative nausea occurred. Carbohydrate fluids ingested 2 h before surgery reduced the gastric volume and did not cause serious complications in paediatric patients. Parents were satisfied with the preoperative carbohydrate drink. Children may benefit from drinking carbohydrate fluids up to 2 h before elective surgery. cris.nih.go.kr (KCT0001546). © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Does MRI add to ultrasound in the assessment of disorders of sex development?

    International Nuclear Information System (INIS)

    Mansour, S.M.; Hamed, S.T.; Adel, L.; Kamal, R.M.; Ahmed, D.M.

    2012-01-01

    Objective: The objective of the study was to evaluate the need of magnetic resonance imaging and using different approaches (transabdominal, endoluminal and transperineal) in the proper assessment of disorders of sex development regarding gonadal detection and gender differentiation. Subjects and methods: Twenty five patients with abnormalities of sex disorders were included. They were classified into two groups according to the time of clinical presentation: Group 1 (early onset) included eight cases. Their age ranged from one month to 12 years (mean age = 3.0). They presented with overt genital ambiguity of clitoral hypertrophy in a phenotypic female, non palpable testes or micropenis in a phenotypic male. Group 2 (late onset) included 17 cases. Their age ranged from 16 to 33 years (mean age 18.1). This group presented by distressing puberty symptoms of primary amenorrhea in a female phenotype or undescended testis and behaving as a male. Cases were subjected to Ultrasound and MR imaging examinations. Imaging results were correlated results of chromosomal and hormonal assays as well as laparoscopy findings. Results: The study included: 10/25 cases (40%) of female pseudo-hermaphroditism, 13/25 cases (52%) of male pseudo-hermaphroditism, one case (4%) of true hermaphroditism and one case (4%) of pure gonadal dysgenesis. The accuracy of multi approach ultrasound was 89.8% compared to 85.7% in MR imaging. Conclusion: Ultrasound should be considered the initial screening modality in the assessment of developmental sex disorders. MRI examination could be reserved for gonad identification when ultrasound examination fails to do so and for corrective surgery guidance

  20. Does MRI add to ultrasound in the assessment of disorders of sex development?

    Energy Technology Data Exchange (ETDEWEB)

    Mansour, S.M., E-mail: sahar_mnsr@yahoo.com [Radiology Department (Women' s imaging unit), Faculty of Medicine, Cairo University,Egypt (Egypt); Hamed, S.T., E-mail: sohathamed@yahoo.com [Radiology Department (Women' s imaging unit), Faculty of Medicine, Cairo University,Egypt (Egypt); Adel, L., E-mail: lamiaadel73@yahoo.com [Radiology Department (Women' s imaging unit), Faculty of Medicine, Cairo University,Egypt (Egypt); Kamal, R.M., E-mail: rashaakamal@hotmail.com [Radiology Department (Women' s imaging unit), Faculty of Medicine, Cairo University,Egypt (Egypt); Ahmed, D.M., E-mail: sahar_mnsr@yahoo.com [National Research Center, Cairo (Egypt)

    2012-09-15

    Objective: The objective of the study was to evaluate the need of magnetic resonance imaging and using different approaches (transabdominal, endoluminal and transperineal) in the proper assessment of disorders of sex development regarding gonadal detection and gender differentiation. Subjects and methods: Twenty five patients with abnormalities of sex disorders were included. They were classified into two groups according to the time of clinical presentation: Group 1 (early onset) included eight cases. Their age ranged from one month to 12 years (mean age = 3.0). They presented with overt genital ambiguity of clitoral hypertrophy in a phenotypic female, non palpable testes or micropenis in a phenotypic male. Group 2 (late onset) included 17 cases. Their age ranged from 16 to 33 years (mean age 18.1). This group presented by distressing puberty symptoms of primary amenorrhea in a female phenotype or undescended testis and behaving as a male. Cases were subjected to Ultrasound and MR imaging examinations. Imaging results were correlated results of chromosomal and hormonal assays as well as laparoscopy findings. Results: The study included: 10/25 cases (40%) of female pseudo-hermaphroditism, 13/25 cases (52%) of male pseudo-hermaphroditism, one case (4%) of true hermaphroditism and one case (4%) of pure gonadal dysgenesis. The accuracy of multi approach ultrasound was 89.8% compared to 85.7% in MR imaging. Conclusion: Ultrasound should be considered the initial screening modality in the assessment of developmental sex disorders. MRI examination could be reserved for gonad identification when ultrasound examination fails to do so and for corrective surgery guidance.

  1. Quantitative assessment of oral orbicular muscle deformation after cleft lip reconstruction: an ultrasound elastography study.

    Science.gov (United States)

    de Korte, Chris L; van Hees, Nancy; Lopata, Richard G P; Weijers, Gert; Katsaros, Christos; Thijssen, Johan M

    2009-08-01

    Reconstruction of a cleft lip leads inevitably to scar tissue formation. Scar tissue within the restored oral orbicular muscle might be assessed by quantification of the local contractility of this muscle. Furthermore, information about the contraction capability of the oral orbicular muscle is crucial for planning the revision surgery of an individual patient. We used ultrasound elastography to determine the local deformation (strain) of the upper lip and to differentiate contracting muscle from passive scar tissue. Raw ultrasound data (radio-frequency format; rf-) were acquired, while the lips were brought from normal state into a pout condition and back in normal state, in three patients and three normal individuals. During this movement, the oral orbicular muscle contracts and, consequently, thickens in contrast to scar tissue that will not contract, or even expand. An iterative coarse-to-fine strain estimation method was used to calculate the local tissue strain. Analysis of the raw ultrasound data allows estimation of tissue strain with a high precision. The minimum strain that can be assessed reproducibly is 0.1%. In normal individuals, strain of the orbicular oral muscle was in the order of 20%. Also, a uniform strain distribution in the oral orbicular muscle was found. However, in patients deviating values were found in the region of the reconstruction and the muscle tissue surrounding that. In two patients with a successful reconstruction, strain was reduced by 6% in the reconstructed region with respect to the normal parts of the muscle (from 22% to 16% and from 25% to 19%). In a patient with severe aesthetical and functional disability, strain decreased from 30% in the normal region to 5% in the reconstructed region. With ultrasound elastography, the strain of the oral orbicular muscle can be quantified. In healthy subjects, the strain profiles and maximum strain values in all parts of the muscle were similar. The maximum strain of the muscle during

  2. Ultrasound assessment of selected peripheral nerve pathologies. Part III: Injuries and postoperative evaluation

    Directory of Open Access Journals (Sweden)

    Berta Kowalska

    2013-03-01

    Full Text Available The previous articles of the series devoted to ultrasound diagnostics of peripheral nerves concerned the most common nerve pathologies, i.e. entrapment neuropathies. The aim of the last part of the series is to present ultrasound possibilities in the postoperative control of the peripheral nerves as well as in the diagnostics of the second most common neuropathies of peripheral nerves, i.e. posttraumatic lesions. Early diagnostics of posttraumatic changes is of fundamental importance for the course of treatment and its long-term effects. It aids surgeons in making treatment decisions (whether surgical or conservative. When surgical treatment is necessary, the surgeon, based on US findings, is able to plan a given type of operative method. In certain cases, may even abandon the corrective or reconstructive surgery of the nerve trunk (when there are extensive defects of the nerve trunks and instead, proceed with muscle transfers. Medical literature proposes a range of divisions of the kinds of peripheral nerve injuries depending on, among others, the mechanism or degree of damage. However, the most important issue in the surgeon-diagnostician communication is a detailed description of stumps of the nerve trunks, their distance and location. In the postoperative period, ultrasound is used for monitoring the operative or conservative treatment effects including the determination of the causes of a persistent or recurrent neuropathy. It facilitates decision-making concerning a repeated surgical procedure or assuming a wait-and-see attitude. It is a difficult task for a diagnostician and it requires experience, close cooperation with a clinician and knowledge concerning surgical techniques. Apart from a static assessment, a dynamic assessment of possible adhesions constitutes a crucial element of postoperative examination. This feature distinguishes ultrasound scanning from other methods used in the diagnostics of peripheral neuropathies.

  3. Ultrasound evaluation of liver disease in cystic fibrosis as part of an annual assessment clinic: A 9-year review

    International Nuclear Information System (INIS)

    Williams, Stuart M.; Goodman, Robin; Thomson, Anne; McHugh, Kieran; Lindsell, David R.M.

    2002-01-01

    AIM: To review 9 years of annual assessment data in cystic fibrosis (CF) and evaluate the frequency of hepatobiliary abnormalities and the correlation between ultrasound and biochemical findings. MATERIALS AND METHODS: Over a 9-year period (1990-99), 168 children (age range 1-18 years) with CF have undergone an annual assessment which has included clinical, biochemical and ultrasonographic evaluation of the hepatobiliary system. We have retrospectively reviewed the sequential ultrasound reports and correlated them with the contemporaneous biochemical results. RESULTS: A total of 725 ultrasound examinations were performed over the review period. Sixty patients had at least one examination showing an abnormality of liver echo texture and in 39 patients this was a persisting finding. Seven patients (4.2%) developed frank cirrhotic change on ultrasound criteria, while 15 patients (8.9%) had evidence of persistent splenomegaly. Gall-bladder calculi were present in 4.8%. In 176 examinations (24%) there was disparity between the ultrasound findings and aspartate aminotransferase (AST) levels. In 3.0% of cases (five patients) there were persisting abnormalities of liver echo texure and persisting splenomegaly with a normal range AST value. CONCLUSION: No perfect method of assessing hepatobiliary involvement in CF is currently available. Ultrasonographic and biochemical assessment may reflect different aspects of disease progression. Routine use of ultrasound in annual assessment allows identification of a minority of patients with liver changes but with normal biochemistry. Williams, S.M. et al. (2002)

  4. General Ultrasound Imaging

    Medline Plus

    Full Text Available ... diagnose heart conditions, and assess damage after a heart attack. Ultrasound is safe, noninvasive, and does not use ... heart failure, and to assess damage after a heart attack. Ultrasound of the heart is commonly called an “ ...

  5. High-frequency ultrasound in carpal tunnel syndrome: assessment of patient eligibility for surgical treatment

    Directory of Open Access Journals (Sweden)

    Katarzyna Kapuścińska

    2015-09-01

    Full Text Available Carpal tunnel syndrome (CTS is the most common entrapment neuropathy and a frequent cause of sick leaves because of work-related hand overload. That is why an early diagnosis and adequate treatment (conservative or surgical are essential for optimal patient management. Aim: The aim of the study is to assess the usefulness of high-frequency ultrasound in CTS for the assessment of patient eligibility for surgical treatment. Material and methods: The study involved 62 patients (50 women and 12 men, aged 28–70, mean age 55.2 with scheduled surgeries of CTS on the basis of clinical symptoms, physical examination performed by a neurosurgeon and a positive result of EMG testing. The ultrasound examinations of the wrist were performed in all these patients. On the basis of the collected data, the author has performed multiple analyses to confi rm the usefulness of ultrasound imaging in assessing patient eligibility for surgical treatment of CTS. Results: US examinations showed evidence of median nerve compression at the level of the carpal tunnel in all of the examined patients. This was further confi rmed during surgical procedures. The mean value of the cross-sectional area at the proximal part of the pisiform bone was 17.45 mm2 (min. 12 mm2 , max. 31 mm2 . Nerve hypoechogenicity proximal to the nerve compression site was visible in all 62 patients (100%. Increased nerve vascularity on the transverse section was present in 50 patients (80.65%. Conclusions: Ultrasonography with the use of high-frequency transducers is a valuable diagnostic tool both for assessing patient eligibility for surgical treatment of CTS, and in postoperative assessment of the treatment efficacy.

  6. Ultrasound of the elbow with emphasis on detailed assessment of ligaments, tendons, and nerves

    Energy Technology Data Exchange (ETDEWEB)

    De Maeseneer, Michel, E-mail: Michel.demaeseneer@uzbrussel.be [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium); Brigido, Monica Kalume, E-mail: Mbrigido@med.umich.edu [Department of Radiology, University of Michigan, Ann Arbor, MI (United States); Antic, Marijana, E-mail: Misscroa@gmail.com [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium); Lenchik, Leon, E-mail: Llenchik@wakehealth.edu [Department of Radiology, Wake Forest University, Winston-Salem, NC (United States); Milants, Annemieke, E-mail: Annemieke.Milants@gmail.com [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium); Vereecke, Evie, E-mail: Evie.Vereecke@kuleuven-kulak.be [Department of Anatomy, KULAK, Katholieke Universiteit Leuven, Campus Kortrijk, Kortrijk (Belgium); Jager, Tjeerd [Aalsters Stedelijk Ziekenhuis, Aalst (Belgium); Shahabpour, Maryam, E-mail: Maryam.Shahabpour@uzbrussel.be [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium)

    2015-04-15

    Highlights: •Medial and lateral tendons: the different muscles forming these tendons can be followed up to the insertion. The imaging anatomy is reviewed. •Medial and lateral ligaments: the anatomy is complex and specialized imaging planes and arm positions are necessary for accurate assessment. •Biceps tendon: the anatomy of the distal biceps and lacertus fibrosus are discussed and illustrated with cadaveric correlation. •US imaging of the nerves about the elbow and visualization of the possible compression points is discussed. -- Abstract: The high resolution and dynamic capability of ultrasound make it an excellent tool for assessment of superficial structures. The ligaments, tendons, and nerves about the elbow can be fully evaluated with ultrasound. The medial collateral ligament consists of an anterior and posterior band that can easily be identified. The lateral ligament complex consists of the radial collateral ligament, ulnar insertion of the annular ligament, and lateral ulnar collateral ligament, easily identified with specialized probe positioning. The lateral ulnar collateral ligament can best be seen in the cobra position. On ultrasound medial elbow tendons can be followed nearly up to their common insertion. The pronator teres, flexor carpi radialis, palmaris longus, and flexor digitorum superficialis can be identified. The laterally located brachioradialis and extensor carpi radialis longus insert on the supracondylar ridge. The other lateral tendons can be followed up to their common insertion on the lateral epicondyle. The extensor digitorum, extensor carpi radialis brevis, extensor digiti minimi, and extensor carpi ulnaris can be differentiated. The distal biceps tendon is commonly bifid. For a complete assessment of the distal biceps tendon specialized views are necessary. These include an anterior axial approach, medial and lateral approach, and cobra position. In the cubital tunnel the ulnar nerve is covered by the ligament of Osborne

  7. Ultrasound of the elbow with emphasis on detailed assessment of ligaments, tendons, and nerves

    International Nuclear Information System (INIS)

    De Maeseneer, Michel; Brigido, Monica Kalume; Antic, Marijana; Lenchik, Leon; Milants, Annemieke; Vereecke, Evie; Jager, Tjeerd; Shahabpour, Maryam

    2015-01-01

    Highlights: •Medial and lateral tendons: the different muscles forming these tendons can be followed up to the insertion. The imaging anatomy is reviewed. •Medial and lateral ligaments: the anatomy is complex and specialized imaging planes and arm positions are necessary for accurate assessment. •Biceps tendon: the anatomy of the distal biceps and lacertus fibrosus are discussed and illustrated with cadaveric correlation. •US imaging of the nerves about the elbow and visualization of the possible compression points is discussed. -- Abstract: The high resolution and dynamic capability of ultrasound make it an excellent tool for assessment of superficial structures. The ligaments, tendons, and nerves about the elbow can be fully evaluated with ultrasound. The medial collateral ligament consists of an anterior and posterior band that can easily be identified. The lateral ligament complex consists of the radial collateral ligament, ulnar insertion of the annular ligament, and lateral ulnar collateral ligament, easily identified with specialized probe positioning. The lateral ulnar collateral ligament can best be seen in the cobra position. On ultrasound medial elbow tendons can be followed nearly up to their common insertion. The pronator teres, flexor carpi radialis, palmaris longus, and flexor digitorum superficialis can be identified. The laterally located brachioradialis and extensor carpi radialis longus insert on the supracondylar ridge. The other lateral tendons can be followed up to their common insertion on the lateral epicondyle. The extensor digitorum, extensor carpi radialis brevis, extensor digiti minimi, and extensor carpi ulnaris can be differentiated. The distal biceps tendon is commonly bifid. For a complete assessment of the distal biceps tendon specialized views are necessary. These include an anterior axial approach, medial and lateral approach, and cobra position. In the cubital tunnel the ulnar nerve is covered by the ligament of Osborne

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

    Science.gov (United States)

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

    2016-06-01

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

  9. Ultrasound as a Noninvasive Method to Assess Changes of Intracranial Volume and Pressure During Simulated Microgravity

    Science.gov (United States)

    Murthy, G.; Yost, W. T.; Ballard, R. E.; Watenpaugh, D. E.; Kawai, Y.; Hargens, A. R.

    1994-01-01

    Headaches are commonly experienced by astronauts in microgravity and by subjects undergoing head-down tilt (simulated microgravity on Earth). Exposure to microgravity probably elevates blood pressure and flow in the head which may increase intracranial volume (ICV) and pressure (ICP) and in turn cause headache. Due to the slightly compliant nature of the cranial vault and the encasement of brain and its vasculature within this vault, any increase of ICV will increase ICP and slightly distend the cranium. Previous studies document perivascular edema and increased ICP in rhesus monkeys during head-down tilt. Elevated ICP has also been reported in humans during head-down tilt. ICP measurements in healthy humans are rare because of the invasiveness of currently-available measurement techniques. Therefore, we proposed a noninvasive ultrasound technique to assess changes of ICV and JCP. The ultrasound principle is based on compliance of the cranial vault. A 450 kHz ultrasound stimulus is transmitted through the cranium by a transducer every 7.5-10 msec. The ultrasound wave enters the brain tissue, reflects off the opposite side of the cranium and is received by the same transducer. The detected wave is compared for phase quadrature (90 deg.to transmitted wave). Because the electronic circuitry of the device maintains a 90 deg. phase (phi), any alterations in the detected wave caused by an increase of ICV and ICP will be reflected as a change in the wave frequency. Phase shift is directly proportional to path length of the wave, DELTA x, which is expressed as DELTA x = phi lambda/2 pi where lambda is wavelength. Elevated ICV and ICP expand the cranial vault and increase path length of the wave (a measure of intracranial distance). Increased path length equals reduced frequency of the detected wave. Reduced frequency is then related to elevated ICP. This technique has potential uses for ICP studies of astronauts in space and head trauma patients on Earth.

  10. Ultrasound assessment of lower limb muscle mass in response to resistance training in COPD

    Directory of Open Access Journals (Sweden)

    Menon Manoj K

    2012-12-01

    Full Text Available Abstract Background Quantifying the improvements in lower limb or quadriceps muscle mass following resistance training (RT, is an important outcome measure in COPD. Ultrasound is a portable, radiation free imaging technique that can measure the size of superficial muscles belonging to the quadriceps group such as the rectus femoris, but has not been previously used in COPD patients following RT. We compared the responsiveness of ultrasound derived measures of quadriceps mass against dual energy x-ray absorptiometry (DEXA, in patients with COPD and healthy controls following a programme of high intensity knee extensor RT. Methods Portable ultrasound was used to assess the size of the dominant quadriceps in 45 COPD patients and 19 healthy controls-before, during, and after 8 weeks of bilateral high intensity isokinetic knee extensor RT. Scanning was performed at the mid-thigh region, and 2 indices of quadriceps mass were measured-rectus femoris cross-sectional area (RFcsa and quadriceps muscle thickness (Qt. Thigh lean mass (Tdexa was determined by DEXA. Results Training resulted in a significant increase in Tdexa, RFcsa and Qt in COPD patients [5.7%, 21.8%, 12.1% respectively] and healthy controls [5.4%, 19.5%, 10.9 respectively]. The effect size for the changes in RFcsa (COPD= 0.77; Healthy=0.83 and Qt (COPD=0.36; Healthy=0.78 were greater than the changes in Tdexa (COPD=0.19; Healthy=0.26 following RT. Conclusions Serial ultrasound measurements of the quadriceps can detect changes in muscle mass in response to RT in COPD. The technique has good reproducibility, and may be more sensitive to changes in muscle mass when compared to DEXA. Trial registration http://www.controlled-trials.com (Identifier: ISRCTN22764439

  11. State of the art of ultrasound in the assessment of psoriasis and psoriatic arthritis.

    Science.gov (United States)

    Gutierrez, Marwin; Kaeley, Gurjit S; Bertolazzi, Chiara; Pineda, Carlos

    2017-05-01

    Ultrasound (US) is a rapidly evolving technique that is gaining increasing success in the assessment of psoriatic arthritis (PsA). Recently, new research avenues have been opened, and these are focused on the potential of US for the assessment of extra musculoskeletal areas such as skin and nails. This permits work on the concept of 'holistic US assessment of PsA'. Areas covered: Here, we analyze the potential role of US in the global assessment of PsA. Additionally, we provide the current evidence supporting its application in routine clinical practice. Literature was obtained from medical databases including PubMed and Embase. Expert commentary: US can detect not only structural abnormalities but also minimal blood flow changes at the superficial soft tissue level. This makes it a great tool for the global assessment of disease activity in PsA, in which persistently active disease plays a major role in causing anatomical damage and physical functional disability.

  12. Dynamic contrast-enhanced ultrasound and elastography assess deltoid muscle integrity after reverse shoulder arthroplasty.

    Science.gov (United States)

    Fischer, Christian; Krammer, Daniel; Hug, Andreas; Weber, Marc-André; Kauczor, Hans-Ulrich; Krix, Martin; Bruckner, Thomas; Kunz, Pierre; Schmidmaier, Gerhard; Zeifang, Felix

    2017-01-01

    The outcome after reverse shoulder arthroplasty (RSA) depends on the condition of the deltoid muscle, which we assessed with new ultrasound modalities and electromyography (EMG). Contrast-enhanced ultrasound (CEUS) and acoustic radiation force impulse (ARFI) were applied to assess perfusion and elasticity of the deltoid muscle compared with the clinical and functional outcome. The study recruited 64 patients (mean age, 72.9 years) treated with RSA between 2004 and 2013. The deltoid muscle was examined with EMG and ultrasound imaging. Functional scores such as Constant score and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form score were assessed. Among other CEUS parameters, the wash-in perfusion index, time to peak, and rise time were compared between the operated-on and contralateral shoulders as well as between patients with above-average and below-average outcome. The stiffness of the deltoid muscle was analyzed with ARFI. After RSA, deltoid perfusion (wash-in perfusion index, Δ = -12% ± 22%, P = .0001) and shoulder function (Constant score, Δ = -14 ± 24, P Deltoid perfusion was higher in patients with above-average outcome (rise time, Δ = 33% ± 13%, P = .038). The operated-on deltoid muscles showed higher stiffness than the contralateral muscles (ARFI, Δ = 0.2 ± 0.9 m/s, P = .0545). EMG excluded functionally relevant axillary nerve injuries in the study population. CEUS revealed reduced mean perfusion of the deltoid muscle after RSA. Reduced perfusion was associated with limited range of motion and below-average outcome. Functional shoulder impairment after RSA might be predicted by noninvasive CEUS as a surrogate parameter for the integrity of the deltoid muscle. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  13. Coagulación intravascular diseminada = Disseminated intravascular coagulation

    Directory of Open Access Journals (Sweden)

    Arango Barrientos, Marcos

    2010-12-01

    Full Text Available La coagulación intravascular diseminada (CID es una entidad clínica frecuente que se presenta como fenómeno secundario a diversas enfermedades entre las cuales se destacan las infecciones graves, las neoplasias y las catástrofes obstétricas. Se caracteriza por una activación difusa y simultánea de los sistemas endógenos de la coagulación y la fibrinólisis. El depósito de pequeños trombos en la circulación conduce finalmente a disfunción orgánica múltiple y en algunos casos a la muerte. Las manifestaciones clínicas pueden incluir fenómenos trombóticos y hemorrágicos. Se ha propuesto un puntaje de fácil aplicación para simplificar el diagnóstico de la entidad. El tratamiento incluye el control específico de la causa subyacente que favorece la aparición de la CID, el soporte con hemoderivados en pacientes con manifestaciones de sangrado y la anticoagulación terapéutica en pacientes con trombosis mayores. El desarrollo de CID es un factor pronóstico adverso que aumenta significativamente la tasa de mortalidad. En este artículo de revisión se incluyen los siguientes aspectos de la CID: historia, epidemiología, clasificación, entidades asociadas, fisiopatología, clínica, diagnóstico, tratamiento y pronóstico.

  14. Dosimetry in intravascular brachytherapy; Calculos dosimetricos em braquiterapia intravascular

    Energy Technology Data Exchange (ETDEWEB)

    Campos, Laelia Pumilla Botelho

    2000-03-01

    Among the cardiovascular diseases responsible for deaths in the adult population in almost all countries of the world, the most common is acute myocardial infarction, which generally occurs because of the occlusion of one or more coronary arteries. Several diagnostic techniques and therapies are being tested for the treatment of coronary artery disease. Balloon angioplasty has been a popular treatment which is less invasive than traditional surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment).Recently, the idea of delivering high radiation doses to coronary arteries to avoid or delay restenosis has been suggested. Known as intravascular brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis in some patient populations. In order to study the radiation dosimetry in the patient and radiological protection for the attending staff for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, o,30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several candidate radionuclides as well. Two s tent sources (metallic prosthesis that put inside of patient's artery through angioplasty) employing {sup 32} P are also simulated. Advantages and disadvantages of the various radionuclides and source geometries are discussed. The dosimetry developed here will aid in the realization of the benefits obtained in patients for this promising new technology. (author)

  15. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... Children's (Pediatric) Ultrasound - Abdomen Obstetric Ultrasound Ultrasound - Prostate Kidney and Bladder Stones Abnormal Vaginal Bleeding Ovarian Cancer Images related to Ultrasound - Pelvis Sponsored by Please ...

  16. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... Ultrasound - Abdomen Obstetric Ultrasound Ultrasound - Prostate Kidney and Bladder Stones Abnormal Vaginal Bleeding Ovarian Cancer Images related to Ultrasound - Pelvis Sponsored by Please ...

  17. Home pregnancy test compared to standard-of-care ultrasound dating in the assessment of pregnancy duration.

    Science.gov (United States)

    Johnson, S; Shaw, R; Parkinson, P; Ellis, J; Buchanan, P; Zinaman, M

    2011-02-01

    To determine the level of agreement between the Clearblue Digital Pregnancy Test with Conception Indicator home pregnancy test and standard-of-care ultrasound in assessing pregnancy duration in a real-life, observational setting encompassing routine, clinical care. This was a prospective observational study of non-pregnant women seeking conception. Women collected daily urine samples from day 1 of their next menstrual cycle. If any volunteer became pregnant, daily urine samples continued to be collected for 43 days after the LH surge. Samples from day -7 to day +28 relative to the expected period (LH surge + 15 days) were tested using the home pregnancy test. This categorised any resulting pregnancies into one of three groups: 1-2 weeks, 2-3 weeks, and 3+ weeks since conception. Information from the standard UK ultrasound dating scan was also recorded by the midwife, including the expected delivery date according to ultrasound and the expected delivery date according to LMP. Full data were available from 52 pregnant women who had conceived naturally. During the study analysis, 4786 urine samples were cross-compared with 52 routine 12-week NHS ultrasound assessments and the level of agreement between home pregnancy testing and standard-of-care ultrasound in determining pregnancy duration was calculated. The agreement between the gestational age as calculated by the home pregnancy test result and the exact midwife-recorded gestational age using ultrasound was 82.3%. However, when a ± 5-day range was applied to the ultrasound reading (as per routine UK clinical practice), the level of agreement was 98%. The home pregnancy test provides a significantly high (98%) level of agreement with standard-of-care ultrasound when assessing pregnancy duration in a real-life, observational setting which closely mirrors daily clinical practice.

  18. Assessment of ultrasound equipment as a possible source of nosocomial infection in Lagos state hospitals and radio-diagnostic centres

    International Nuclear Information System (INIS)

    Akpochafor, M.O.; Eze, C.U.; Adeneye, S.O.; Ajekigbe, A.T.

    2015-01-01

    Aim: To assess the role of ultrasound equipment as a possible source of nosocomial infection in Lagos metropolis, Nigeria. Methods: Microbiological cultures were carried out on samples obtained from ultrasound probes, gel and couch before and after scanning period. Cultures were incubated in a culture plate (Chocolate and MacConkey agar) for 48 h at a temperature of 37 ° in order to grow microorganism, after which the culture plate was examined microscopically against a bright light in order to identify the isolated organisms based on their colonial characteristics. Results: Transabdominal ultrasound probes, transvaginal probe, ultrasound couch and ultrasound gel all were contaminated with microorganisms. Staphylococcus aureus was the most frequent and most common organisms found (33.8%). Other organisms such as Staphylococcus epidermidis (15.4%), Candida albicans (6.2%), aerobic spore formers (26.2%), Klebsiella pneumonia (6.2%), Pseudomonas aeruginosa (3.1%), among others were also identified. Conclusion: The ultrasound equipment posed a significant risk for infection transmission. Patients who underwent ultrasonography within the period of the study had significant chances of being infected with Staphylococcus aureus, S. epidermidis and Aerobic spore formers. - Highlights: • Ultrasound equipment has been shown to be a possible source of nosocomial infection for patient undergoing ultrasonography. • The study showed that Staphylococcus aureus was the most commonly isolated organism. • Transabdominal probe was the most commonly contaminated ultrasound equipment in the finding. • The ultrasound gel was also contaminated with organisms like S. aureus, etc. • There was a statistical significant difference between site of collection of sample and growth density of microorganisms (p = 0.03)

  19. Ultrasound Image Quality Assessment: A framework for evaluation of clinical image quality

    DEFF Research Database (Denmark)

    Hemmsen, Martin Christian; Pedersen, Mads Møller; Nikolov, Svetoslav Ivanov

    2010-01-01

    Improvement of ultrasound images should be guided by their diagnostic value. Evaluation of clinical image quality is generally performed subjectively, because objective criteria have not yet been fully developed and accepted for the evaluation of clinical image quality. Based on recommendation 500...... from the International Telecommunication Union - Radiocommunication (ITU-R) for such subjective quality assessment, this work presents equipment and a methodology for clinical image quality evaluation for guiding the development of new and improved imaging. The system is based on a BK-Medical 2202 Pro...... information, which is fast enough to get sufficient number of scans under realistic operating conditions, so that statistical evaluation is valid and reliable....

  20. Prediction of outcome after femoropopliteal balloon angioplasty by intravascular ultrasound

    DEFF Research Database (Denmark)

    Vogt, K C; Just, S; Rasmussen, John Bøje Grønvall

    1997-01-01

    limbs) undergoing PTA of the superficial femoral or popliteal artery. The degree of stenosis, the diameter and area of the lumen and the morphological changes in the plaque were related to the short-term patency of the intervention, as evaluated by duplex scan and ankle branchial index. RESULTS: Fifteen...... arteries remained patent. Two occlusions and two stenoses developed during the first 3 months after the intervention and one occlusion occurred after 1 year. The following IVUS parameters were related to a favourable patency: presence of calcification; dissection or plaque rupture and residual stenosis...

  1. Intravascular ultrasound for iliac artery imaging. Clinical review

    DEFF Research Database (Denmark)

    Vogt, K G; Schroeder, T V

    2001-01-01

    IVUS is able to produce trans-sectional images of the iliac arteries at a high resolution. The three layered appearance of the arterial wall can be visualized. In the atherosclerotic diseased artery calcified plaques can be discerned from non-calcified plaques, and the distribution of the plaque......-eccentric or concentric-can be determined. IVUS seems to be superior to arteriography in quantifying the degree of stenosis, being able to relate the luminal area to the mediabounded area at the same site of the artery. The discrepancy between IVUS and arteriography is even greater when evaluating residualstenosis after...

  2. Trauma Ultrasound.

    Science.gov (United States)

    Wongwaisayawan, Sirote; Suwannanon, Ruedeekorn; Prachanukool, Thidathit; Sricharoen, Pungkava; Saksobhavivat, Nitima; Kaewlai, Rathachai

    2015-10-01

    Ultrasound plays a pivotal role in the evaluation of acute trauma patients through the use of multi-site scanning encompassing abdominal, cardiothoracic, vascular and skeletal scans. In a high-speed polytrauma setting, because exsanguinations are the primary cause of trauma morbidity and mortality, ultrasound is used for quick and accurate detection of hemorrhages in the pericardial, pleural, and peritoneal cavities during the primary Advanced Trauma Life Support (ATLS) survey. Volume status can be assessed non-invasively with ultrasound of the inferior vena cava (IVC), which is a useful tool in the initial phase and follow-up evaluations. Pneumothorax can also be quickly detected with ultrasound. During the secondary survey and in patients sustaining low-speed or localized trauma, ultrasound can be used to help detect abdominal organ injuries. This is particularly helpful in patients in whom hemoperitoneum is not identified on an initial scan because findings of organ injuries will expedite the next test, often computed tomography (CT). Moreover, ultrasound can assist in detection of fractures easily obscured on radiography, such as rib and sternal fractures. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  3. Cost savings and clinical acceptability of an intravascular line tip culture triage policy.

    Science.gov (United States)

    Colston, J; Batchelor, B; Bowler, I C J W

    2013-05-01

    Culture of intravascular line tips is useful for the diagnosis of intravascular line-related phlebitis and bacteraemia. However, the test lacks specificity, with a low predictive value for intravascular line bacteraemia. A recent randomised study showed that predictive value could be increased and costs reduced by refrigerating intravascular lines and retrieving them for culture only if there was a bacteraemia in the seven days before or after the intravascular line was received. We studied whether a similar triage policy could be introduced into our 1400-bed National Health Service (NHS) teaching hospital in the UK. We assessed cost reduction in the laboratory and clinical acceptability. Data regarding the number of intravascular lines received, stored and cultured and blood cultures received was retrieved from the microbiology computer, for five-month periods before and after the introduction of the new triage policy. Of the 134 intravascular line tips received in the five months after the policy had been introduced, 101 (75%) were stored without retrieval and 33 were cultured. Of these, 7/134 (5%) were culture positive and three matched a concurrent blood culture. Audit showed that compliance with the policy was >98%. The estimated annual cost reduction following the introduction of the policy was £3,166.96. The policy was acceptable to clinicians. The policy was both cost saving and clinically acceptable. If the policy were adopted throughout the NHS in the UK, the annual cost saving to the service might be in the order of £300,000. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  4. No change in impedance upon intravascular injection of D5W.

    Science.gov (United States)

    Chin, James; Tsui, Ban C H

    2010-06-01

    Electrical impedance increases following test injections of non-conducting solutions around nerves; however, this increase should diminish rapidly with intravascular needle placement, wherein the systemic circulation will dissipate the solution. For this observational study, we hypothesized that the impedance increases significantly at the perineural space after an injection of 5% dextrose in water (D5W), but that it does not increase correspondingly at the intravascular location After Ethics Research Board approval, electrical impedance was measured by a nerve stimulator displaying resistance, Stimuplex HNS 12, before and during (30 sec) an injection of D5W 3 mL: 1) during intravenous cannula placement using an insulated stimulating needle sheathed in its plastic cannula, MultiSet NanoLine with 18G needle; and 2) during needle placement (Pajunk 22G insulated) for an ultrasound-guided supraclavicular block in patients undergoing hand surgery. The impedance changes at each location were analyzed and compared. Data were collected from 16 patients. Baseline impedance was lower intravascularly (mean 16.5 +/- standard deviation 7.2 kOmega) compared with perineurally (23.5 +/- 8.3 kOmega) (P = 0.037). Peak impedance after intravascular D5W injection was 20.1 +/- 6.8 kOmega, which was not a significant change (P = 0.15). In contrast, peak impedance after perineural D5W injection was 58.6 +/- 29.1 kOmega, an increase of 35.1 +/- 26.4 kOmega (155 +/- 117%), and then it reached a plateau of 36.7 +/- 19.6 kOmega. The increase in impedance was significantly greater at the perineural location (P < 0.0001). The absence of a significant increase in impedance upon injection of D5W prior to injection of local anesthetic may provide useful information to warn of intravascular injection.

  5. General Ultrasound Imaging

    Medline Plus

    Full Text Available ... procedure? Ultrasound examinations can help to diagnose a variety of conditions and to assess organ damage following ... the Ultrasound-Guided Breast Biopsy page . diagnose a variety of heart conditions, including valve problems and congestive ...

  6. Fluorescent Method for Observing Intravascular Bonghan Duct

    Directory of Open Access Journals (Sweden)

    Byung-Cheon Lee

    2005-12-01

    Full Text Available Observation of intra-vascular threadlike structures in the blood vessels of rats is reported with the images by differential interference contrast microscope, and fluorescence inverted microscope of the acridine-orange stained samples. The confocal microscope image and the hematoxylin-eosin staining revealed the distinctive pattern of nuclei distribution that clearly discerned the threadlike structure from fibrin, capillary, small venule, arteriole, or lymph vessel. Physiological function of the intra-vascular thread in connection with acupuncture is discussed. Especially, this threadlike duct can be a circulation path for herb-liquid flow, which may provide the scientific mechanism for therapeutic effect of herbal acupuncture.

  7. A Simplified Ultrasound Comet Tail Grading Scoring to Assess Pulmonary Congestion in Patients with Heart Failure

    Directory of Open Access Journals (Sweden)

    Hong Li

    2018-01-01

    Full Text Available Ultrasound lung comets (ULCs are a nonionizing bedside approach to assess extravascular lung water. We evaluated a protocol for grading ULC score to estimate pulmonary congestion in heart failure patients and investigated clinical and echocardiographic correlates of the ULC score. Ninety-three patients with congestive heart failure, admitted to the emergency department, underwent pulmonary ultrasound and echocardiography. A ULC score was obtained by summing the ULC scores of 7 zones of anterolateral chest scans. The results of ULC score were compared with echocardiographic results, the New York Heart Association (NYHA functional classification, radiologic score, and N-terminal pro-b-type natriuretic peptide (NT-proBNP. Positive linear correlations were found between the 7-zone ULC score and the following: E/e′, systolic pulmonary artery pressure, severity of mitral regurgitation, left ventricular global longitudinal strain, NYHA functional classification, radiologic score, and NT-proBNP. However, there was no significant correlation between ULC score and left ventricular ejection fraction, left ventricle diameter, left ventricular volume, or left atrial volume. A multivariate analysis identified the E/e′, systolic pulmonary artery pressure, and radiologic score as the only independent variables associated with ULC score increase. The simplified 7-zone ULC score is a rapid and noninvasive method to assess lung congestion. Diastolic rather than systolic performance may be the most important determinant of the degree of lung congestion in patients with heart failure.

  8. Ultrasound subclinical markers in assessing vascular changes in cognitive decline and dementia.

    Science.gov (United States)

    Demarin, Vida; Morovic, Sandra

    2014-01-01

    Aging is often associated with some cognitive impairment. Greater population life expectancy is one explanation for increased incidence of cognitive impairment cases. Large numbers of people with cognitive impairment and dementia is becoming one of the most important medical and social problems worldwide. Therefore, prevention of cognitive impairment is an imperative. Dementia includes a heterogeneous group of disorders, the most common being Alzheimer's disease and vascular dementia. Most cardiovascular risk factors, such as hypertension, diabetes mellitus, hypercholesterolemia, atrial fibrillation, and smoking, are not exclusively risk factors for vascular dementia, but also for Alzheimer's disease. Early changes in the blood vessel wall can be detected by early ultrasound screening methods which allow us to detect changes before the disease becomes clinically evident. Intracranial hemodynamics can be assessed by transcranial Doppler sonography (TCD), functional TCD with various functional tests, and TCD detection of cerebral emboli. Extracranial circulation (carotid and vertebral arteries) can be assessed by means of color Doppler flow imaging. Novel ultrasound technology enables non-invasive, portable, bedside detection of early vascular changes such as arterial stiffness, measurement of the intima-media thickness, pulse-wave velocity, flow-mediated dilation, or endothelial dysfunction in order to obtain information necessary to determine more closely the relation between vascular status and disease development, so that the evolution of cardiovascular disease can be prevented or at least postponed. Early disease detection enables in-time management, and studies have shown that careful control of vascular risk factors can postpone or even reverse disease progression.

  9. Assessment of Ultrasound Field Properties and the Potential Effects on Cells

    OpenAIRE

    Chen, Zhongze

    2013-01-01

    Ultrasound is regarded a convenient and safe tool to acquire diagnostic information that we need for clinical use. For a long time ultrasound has been counted as a harmless method, but after all, there is a heating and a me-chanical impact by ultrasound exposure. This influence can reveal both positive (e.g., cell plant growth) and negative (e.g. cell death) effects. Acoustic exposure pattern changed drastically in recent years due to the rapid, technological developments in ultrasound imagin...

  10. Using ultrasound to assess the thickness of the transversus abdominis in a sling exercise.

    Science.gov (United States)

    Lükens, Jörn; Boström, Kim J; Puta, Christian; Schulte, Tobias L; Wagner, Heiko

    2015-08-19

    Activation of the deep stabilizing trunk muscle transversus abdominis (TrA) is important for trunk stabilization and spine stability. Sling exercises are used for the activation of trunk muscles, therefore we determined the thickness of the TrA in a standardized sling exercise in comparison to rest and abdominal press. Furthermore we propose a standardized measurement method, which can be used to compare relative muscle thickness levels in different exercises. The main objective of the study was to assess and to compare the thickness of the TrA during different conditions; resting condition, sling exercise condition (non-voluntary contraction), and abdominal press condition (voluntary contraction) using a non-invasive ultrasound-based measurement method. Ultrasound measurement (USM; 8.9 MHz, B-mode) was employed to measure the thickness of the TrA in twenty healthy volunteers (13 m, 7 f), each one measured three times with breaks of 48 h. On each measurement day, the subjects were measured on three different conditions: resting condition (RC), sling condition (SC), and abdominal press condition (APC). The USM images were analyzed using a custom-made MatLab script, to determine the thickness of the TrA. A two-way repeated-measurements ANOVA was performed with a significant effect of the factor condition [F(2,38) = 47.82, p exercise can be used to significantly increase the TrA thickness, and that the TrA thickness was significantly different on the three conditions (RC, SC, APC) using the ultrasound-based method.

  11. Non-invasive assessment of bone quantity and quality in human trabeculae using scanning ultrasound imaging

    Science.gov (United States)

    Xia, Yi

    Fractures and associated bone fragility induced by osteoporosis and osteopenia are widespread health threat to current society. Early detection of fracture risk associated with bone quantity and quality is important for both the prevention and treatment of osteoporosis and consequent complications. Quantitative ultrasound (QUS) is an engineering technology for monitoring bone quantity and quality of humans on earth and astronauts subjected to long duration microgravity. Factors currently limiting the acceptance of QUS technology involve precision, accuracy, single index and standardization. The objective of this study was to improve the accuracy and precision of an image-based QUS technique for non-invasive evaluation of trabecular bone quantity and quality by developing new techniques and understanding ultrasound/tissue interaction. Several new techniques have been developed in this dissertation study, including the automatic identification of irregular region of interest (iROI) in bone, surface topology mapping (STM) and mean scattering spacing (MSS) estimation for evaluating trabecular bone structure. In vitro results have shown that (1) the inter- and intra-observer errors in QUS measurement were reduced two to five fold by iROI compared to previous results; (2) the accuracy of QUS parameter, e.g., ultrasound velocity (UV) through bone, was improved 16% by STM; and (3) the averaged trabecular spacing can be estimated by MSS technique (r2=0.72, pcurrent gold-standard method, i.e., DXA, while additional information are obtained by the QUS for predicting fracture risk by monitoring of bone's quality. The developed QUS imaging technique can be used to assess bone's quantity and quality with improved accuracy and precision.

  12. Assessment of DNA double-strand breaks induced by intravascular iodinated contrast media following in vitro irradiation and in vivo, during paediatric cardiac catheterization.

    Science.gov (United States)

    Gould, Richard; McFadden, Sonyia L; Horn, Simon; Prise, Kevin M; Doyle, Philip; Hughes, Ciara M

    2016-01-01

    Paediatric cardiac catheterizations may result in the administration of substantial amounts of iodinated contrast media and ionizing radiation. The aim of this work was to investigate the effect of iodinated contrast media in combination with in vitro and in vivo X-ray radiation on lymphocyte DNA. Six concentrations of iodine (15, 17.5, 30, 35, 45, and 52.5 mg of iodine per mL blood) represented volumes of iodinated contrast media used in the clinical setting. Blood obtained from healthy volunteers was mixed with iodinated contrast media and exposed to radiation doses commonly used in paediatric cardiac catheterizations (0 mGy, 70 mGy, 140 mGy, 250 mGy and 450 mGy). Control samples contained no iodine. For in vivo experimentation, pre and post blood samples were collected from children undergoing cardiac catheterization, receiving iodine concentrations of up to 51 mg of iodine per mL blood and radiation doses of up to 400 mGy. Fluorescence microscopy was performed to assess γH2AX-foci induction, which corresponded to the number of DNA double-strand breaks. The presence of iodine in vitro resulted in significant increases of DNA double-strand breaks beyond that induced by radiation for ≥ 17.5 mg/mL iodine to blood. The in vivo effects of contrast media on children undergoing cardiac catheterization resulted in a 19% increase in DNA double-strand breaks in children receiving an average concentration of 19 mg/mL iodine to blood. A larger investigation is required to provide further information of the potential benefit of lowering the amount of iodinated contrast media received during X-ray radiation investigations. Copyright © 2015 John Wiley & Sons, Ltd.

  13. Intravascular leiomyomatosis: an exceptional entity.

    Science.gov (United States)

    Brunel, I; Iacoponi, S; Hernandez, A; Diestro, M D; De Santiago, J; Zapardiel, I

    2016-01-01

    Intravenous leiomyomatosis (IVL) is a rare benign condition characterized by the proliferation of smooth muscle cells originating from either the uterine venous wall or a uterine myoma. This leiomyomatosis extends most frequently to pelvic vessels, but also occasionally into the inferior vena cava and right cardiac chambers. Preoperative diagnosis is difficult and it should be suspected in the presence of cardiac or pelvic masses in women who have undergone hysterectomy or myomectomy previously. The treatment is hysterectomy, normally associated with a bilateral oophorectomy and removing the mass or metastasis if any. The post-surgical follow-up should be performed at long-term and include exploration and imaging, either ultrasound or MRI. The association of antiestrogenic drugs can be useful for disease control, especially in cases where oophorectomy is not performed and the tumor cannot be removed completely.

  14. Temperature dependence of the shear modulus of soft tissues assessed by ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Sapin-de Brosses, E; Gennisson, J-L; Pernot, M; Fink, M; Tanter, M [Langevin Institute (CNRS UMR 7587), INSERM ERL U979, ESPCI ParisTech, 10 rue Vauquelin, 75 005 Paris (France)], E-mail: emilie.sapin@espci.fr

    2010-03-21

    Soft tissue stiffness was shown to significantly change after thermal ablation. To better understand this phenomenon, the study aims (1) to quantify and explain the temperature dependence of soft tissue stiffness for different organs, (2) to investigate the potential relationship between stiffness changes and thermal dose and (3) to study the reversibility or irreversibility of stiffness changes. Ex vivo bovine liver and muscle samples (N = 3 and N = 20, respectively) were slowly heated and cooled down into a thermally controlled saline bath. Temperatures were assessed by thermocouples. Sample stiffness (shear modulus) was provided by the quantitative supersonic shear imaging technique. Changes in liver stiffness are observed only after 45 deg. C. In contrast, between 25 deg. C and 65 deg. C, muscle stiffness varies in four successive steps that are consistent with the thermally induced proteins denaturation reported in the literature. After a 6 h long heating and cooling process, the final muscle stiffness can be either smaller or bigger than the initial one, depending on the stiffness at the end of the heating. Another important result is that stiffness changes are linked to thermal dose. Given the high sensitivity of ultrasound to protein denaturation, this study gives promising prospects for the development of ultrasound-guided HIFU systems.

  15. Added value of Virtual Touch IQ shear wave elastography in the ultrasound assessment of breast lesions.

    Science.gov (United States)

    Ianculescu, Victor; Ciolovan, Laura Maria; Dunant, Ariane; Vielh, Philippe; Mazouni, Chafika; Delaloge, Suzette; Dromain, Clarisse; Blidaru, Alexandru; Balleyguier, Corinne

    2014-05-01

    To determine the diagnostic performance of Acoustic Radiation Force Impulse (ARFI) Virtual Touch IQ shear wave elastography in the discrimination of benign and malignant breast lesions. Conventional B-mode and elasticity imaging were used to evaluate 110 breast lesions. Elastographic assessment of breast tissue abnormalities was done using a shear wave based technique, Virtual Touch IQ (VTIQ), implemented on a Siemens Acuson S3000 ultrasound machine. Tissue mechanical properties were interpreted as two-dimensional qualitative and quantitative colour maps displaying relative shear wave velocity. Wave speed measurements in m/s were possible at operator defined regions of interest. The pathologic diagnosis was established on samples obtained by ultrasound guided core biopsy or fine needle aspiration. BIRADS based B-mode evaluation of the 48 benign and 62 malignant lesions achieved 92% sensitivity and 62.5% specificity. Subsequently performed VTIQ elastography relying on visual interpretation of the colour overlay displaying relative shear wave velocities managed similar standalone diagnostic performance with 92% sensitivity and 64.6% specificity. Lesion and surrounding tissue shear wave speed values were calculated and a significant difference was found between the benign and malignant populations (Mann-Whitney U test, pBIRADS 4a masses, we reached overall levels of 92% sensitivity and 72.9% specificity. VTIQ qualitative and quantitative elastography has the potential to further characterise B-mode detected breast lesions, increasing specificity and reducing the number of unnecessary biopsies. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Validity of Ultrasound Lung Comets for Assessment of the Severity of Interstitial Pneumonia.

    Science.gov (United States)

    Asano, Mariko; Watanabe, Hiroyuki; Sato, Kazuhiro; Okuda, Yuji; Sakamoto, Sho; Hasegawa, Yukiyasu; Sudo, Kazuhisa; Takeda, Masahide; Sano, Masaaki; Kibira, Satoshi; Ito, Hiroshi

    2017-11-30

    Ultrasound (US) lung comets are often observed in patients with interstitial lung disease or congestive heart failure, but few studies have explored the clinical importance of US lung comets in patients with the former condition. We explored whether the US lung comet number could be used to assess the severity of interstitial pneumonia. Forty stable patients with interstitial pneumonia were examined. Lung comets evident on transthoracic US imaging in 12 selected regions of the posterior chest wall were analyzed. We defined lung comets accompanied by thickened and irregular pleural lines as interstitial US lung comets; these predominated in patients with interstitial pneumonia. The total number of interstitial US lung comets was correlated with the data from chest high-resolution computed tomography, pulmonary function tests, serologic tests, and the 6-minute walk test. The 40 patients included 16 with idiopathic pulmonary fibrosis and 24 with nonspecific interstitial pneumonia. Thirty-four patients had interstitial US lung comets, which were more common in the lower than the upper lung area. Good correlations were evident between the lung comet number and the extent of the reticular pattern on chest high-resolution computed tomography (r = 0.710; P comet number had a strong negative correlation with the percutaneous oxygen saturation level after the 6-minute walk test (r = -0.751; P comets evident on transthoracic US imaging may be a valuable marker of disease severity in patients with interstitial pneumonia. © 2017 by the American Institute of Ultrasound in Medicine.

  17. Neutrophils Cause an Intravascular Traffic Jam.

    Science.gov (United States)

    Minns, Martin S; Pearlman, Eric

    2018-01-10

    Neutrophil swarming is defined by large numbers of cells simultaneously and rapidly migrating to a site of injury or infection. In this issue of Cell Host & Microbe, Lee et al. (2018) demonstrate that intravascular swarming of neutrophils occurs in response to Candida albicans infection and causes vascular occlusion and pathological sequelae. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis

    Directory of Open Access Journals (Sweden)

    Kensuke Tashiro, MD

    2017-11-01

    Conclusions:. Hemi-IVaS could be a useful alternative to conventional intravascular stenting techniques and is also effective for supermicrosurgical perforator-to-perforator anastomosis. Further studies are needed to improve the success rate and to explore its other possible utilizations in supermicrosurgery.

  19. Intravascular volume after aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    Hoff, R.G.

    2009-01-01

    Intravascular volume after aneurysmal subarachnoid hemorrhage A subarachnoid hemorrhage (SAH) from a ruptured cerebral aneurysm is a devastating disorder with an often poor prognosis. The occurrence of delayed cerebral ischemia (DCI) is one of the most important factors determining outcome in

  20. Disseminated Intravascular Coagulation Following Induction of ...

    African Journals Online (AJOL)

    Background: Disseminated Intravascular coagulopathy (DIC) has been reported following use of Misoprostol which is an old drug with new indications in Obstetrics and. Gynecology. Its effectiveness, low cost, stability in tropical conditions and ease of administration as well as side effects like gastrointestinal effect, uterine ...

  1. Rating scale for the assessment of competence in ultrasound-guided peripheral vascular access - a Delphi Consensus Study

    DEFF Research Database (Denmark)

    Primdahl, Stine C; Todsen, Tobias; Clemmesen, Marie Louise

    2016-01-01

    INTRODUCTION: Peripheral vascular access is vital for treatment and diagnostics of hospitalized patients. Ultrasound-guided vascular access (UGVA) is superior to the landmark technique. To ensure competence-based education, an assessment tool of UGVA competence is needed. We aimed to develop...... a global rating scale (RS) for assessment of UGVA competence based on opinions on the content from ultrasound experts in a modified Delphi consensus study. METHODS: We included experts from anesthesiology, emergency medicine and radiology across university hospitals in Denmark. Nine elements were drafted...... Delphi round, the experts excluded one element from the scale. In the third Delphi round, consensus was obtained on the eight elements: preparation of utensils, ergonomics, preparation of the ultrasound device, identification of blood vessels, anatomy, hygiene, coordination of the needle, and completion...

  2. Data on consistency among different methods to assess atherosclerotic plaque echogenicity on standard ultrasound and intraplaque neovascularization on contrast-enhanced ultrasound imaging in human carotid artery

    Directory of Open Access Journals (Sweden)

    Mattia Cattaneo

    2016-12-01

    Full Text Available Here we provide the correlation among different carotid ultrasound (US variables to assess echogenicity n standard carotid US and to assess intraplaque neovascularization on contrast enhanced US. We recruited 45 consecutive subjects with an asymptomatic≥50% carotid artery stenosis. Carotid plaque echogenicity at standard US was visually graded according to Gray–Weale classification (GW and measured by the greyscale median (GSM, a semi-automated computerized measurement performed by Adobe Photoshop®. On CEUS imaging IPNV was graded according to the visual appearance of contrast within the plaque according to three different methods: CEUS_A (1=absent; 2=present; CEUS_B a three-point scale (increasing IPNV from 1 to 3; CEUS_C a four-point scale (increasing IPNV from 0 to 3. We have also implemented a new simple quantification method derived from region of interest (ROI signal intensity ratio as assessed by QLAB software. Further information is available in “Contrast-enhanced ultrasound imaging of intraplaque neovascularization and its correlation to plaque echogenicity in human carotid arteries atherosclerosis (M. Cattaneo, D. Staub, A.P. Porretta, J.M. Gallino, P. Santini, C. Limoni et al., 2016 [1].

  3. Bone speed of sound throughout lifetime assessed with quantitative ultrasound in a Mexican population.

    Science.gov (United States)

    Rivas-Ruiz, Rodolfo; Clark, Patricia; Talavera, Juan O; Huitrón, Gerardo; Tamayo, Juan A; Salmerón, Jorge

    2015-01-01

    The purpose of this study was to assess the bone speed of sound (SoS) through lifetime of a large Mexican population sample by determining the SoS from the radius and tibia using quantitative ultrasound (QUS). This is a cross-sectional evaluation of participants in the Mexican Health Workers Cohort Study. QUS measurements were performed using Sunlight Omnisense 8000P; Z- and T-scores were calculated for both sexes at the distal third of the radius and midshaft tibia, both on the nondominant side. A locally weighted regression smoothing scatterplot model was used to identify different phases of bone accretion and loss. A total of 9128 participants aged 1-75 yr were measured with QUS. Bone SoS accretion began 5 yr earlier in girls than boys (pMexican population. Copyright © 2015 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

  4. Ultrasound Assessment of Umbilical Cord Morphology in the First Trimester: A Feasibility Study

    DEFF Research Database (Denmark)

    Narayan, Rajit; Saaid, Rahmah; Pedersen, Lars Henning

    2015-01-01

    Objective: The aim of this study was to determine whether morphology and measurement of the umbilical cord could be accurately assessed at the time of the 11- to 13+6-week scan. Methods: We conducted a prospective study of 100 consecutive women with singleton pregnancies at 11-13+6 weeks' gestation...... who were seen for routine aneuploidy screening. Transabdominal ultrasound scans were performed, and the distance between two adjacent coils of the umbilical artery was measured in a free loop of umbilical cord. The antenatal umbilical coiling index (aUCI) was calculated as the inverse...... velocity also increased with gestation. Interobserver consistency in the objective measurement of the aUCI was poor (kappa 0.146). However, the Sepulveda classification system was found to be applicable and reproducible at this period of gestation (kappa 0.601). Conclusions: Umbilical cord morphology can...

  5. Cintilografia do miocárdio com tecnécio 99m-MIBI e administração de adenosina em portadores de doença arterial coronária: correlação dos resultados com a angiografia coronária e o ultra-som intracoronário Adenosine myocardial perfusion SPECT with Tc-99m-MIBI in patients with obstructive coronary artery disease: correlation between quantitative coronary angiography and intravascular ultrasound measurements

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Mastrocolla

    2006-01-01

    Full Text Available OBJETIVO: Estabelecer a correlação da cintilografia de perfusão do miocárdio (CPM com Tecnécio 99m-MIBI (MIBI e injeção de adenosina, empregando a angiografia coronária quantitativa (ACQ e o ultra-som intracoronário (UIC como comparação. MÉTODOS: Estudo de 70 pacientes com doença arterial coronária (DAC, encaminhados à CPM com MIBI e adenosina. As manifestações clínicas, do eletrocardiograma (ECG e os resultados das imagens foram correlacionadas às variáveis da análise visual e quantitativa da angiografia, bem como ao UIC. RESULTADOS: A média de idades foi de 60,6 anos, com 39 pacientes do sexo masculino. A angiografia coronária evidenciou estenose do diâmetro da luz (E% de 49,94% em 105 artérias, com reavaliação à ACQ em 83 artérias (79% e média de 44,20%, pOBJECTIVE: To correlate myocardial perfusion scintigraphy (MPS with Tc-99m-MIBI and adenosine infusion using quantitative coronary angiography (QCA and intravascular ultrasound (IVUS. METHODS: Seventy patients with coronary artery disease (CAD referred for myocardial perfusion scintigraphy (MPS with MIBI and adenosine were studied. Clinical, electrocardiographic (ECG, and scintigraphic findings were correlated with variables of visual and quantitative angiographic analysis, as well as to those of IVUS. RESULTS: The mean age of patients was 60.6 years, and 39 were male. Coronary angiography showed percentage of diameter stenosis (% DS of 49.94% in 105 arteries, 83 of which were re-evaluated by QCA (79%, mean of 44.20%, p<0.05. ST-segment depression during adenosine infusion was associated with higher degrees of % DS (55.0% vs. 47.8%, p<0.05. Scintigraphic ischemia was correlated with greater cross-sectional area of lumen obstruction by IVUS (% CSA. Clinical, ECG, and IVUS findings were considered together and expressed as global ischemic versus non-ischemic responses. Ischemia was associated with lower values of minimal lumen diameter (MLD and minimal lumen area

  6. Preliminary assessment of one-dimensional MR elastography for use in monitoring focused ultrasound therapy

    Science.gov (United States)

    LeYuan; Glaser, Kevin J.; Rouviere, Olivier; Gorny, Krzysztof R.; Chen, Shigao; Manduca, Armando; Ehman, Richard L.; Felmlee, Joel P.

    2007-09-01

    The purpose of this work is to assess a fast technique that measures tissue stiffness and temperature during focused ultrasound thermal therapy (FUS). A one-dimensional (1D) MR elastography (MRE) pulse sequence was evaluated for the purpose of obtaining rapid measurements of thermally induced changes in tissue stiffness and temperature for monitoring FUS treatments. The accuracy of the 1D measurement was studied by comparing tissue displacements measured by 1D MRE with those measured by the well-established 2D MRE pulse sequence. The reproducibility of the 1D MRE measurement was assessed, in gel phantoms and ex vivo porcine tissue, for varied FUS intensity levels (31.5 199.9 W cm-2) and over a range of displacements at the focus (0.1 1 µm). Temperature elevations in agarose gel phantoms were measured using 1D MRE and calibrated using fiberoptic-thermometer-based measurements. The 1D MRE displacement measurements are highly correlated with those obtained with the 2D technique (R2 = 0.88 0.93), indicating that 1D MRE can successfully measure tissue displacement. Ten repeated trials at each FUS power level yielded a minimum detectable displacement change of 0.2 µm in phantoms and 0.4 µm in tissue (at 95% confidence level). The 1D MRE temperature measurements correlated well with temperature changes measured simultaneously with fiberoptic thermometers (R2 = 0.97). The 1D MRE technique is capable of detecting tissue displacements as low as 0.4 µm, which is an order of magnitude smaller than 5 µm displacements expected during FUS therapy (Le et al 2005 AIP Conf. Proc.: Ther. Ultrasound 829 186 90). Additionally, 1D MRE was shown to provide adequate measurements of temperature elevations in tissue. These findings indicate that 1D MRE may be an effective tool for monitoring FUS treatments.

  7. Prostate Ultrasound

    Medline Plus

    Full Text Available ... through blood vessels. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Prostate ultrasound, also called transrectal ultrasound, provides ...

  8. ASSESSMENT OF FOETAL COMPROMISE BY DOPPLER ULTRASOUND INVESTIGATION OF THE FOETAL CIRCULATION

    Directory of Open Access Journals (Sweden)

    Bindu Philip

    2017-09-01

    Full Text Available BACKGROUND The condition in which the foetus does not reach its growth potential is called Intrauterine Growth Restricted (IUGR. The mothers who are generally healthy and well nourished, the incidence of IUGR is 3-5%. The incidence of IUGR is 15-20% or higher in a women population with hypertension or previous growth restricted foetus. The aim of the study is to assess foetal compromise by Doppler ultrasound investigation of the foetal circulation. MATERIALS AND METHODS This study is a prospective study conducted between November 2013 to November 2016 in the Department of Radiodiagnosis and imaging of Mount Zion Medical College, Kerala. A total of 50 singleton pregnancies with suspected IUGR pregnancy attending the outpatient ward of Obstetrics and Gynaecology. Inclusion Criteria- Pregnancies from 29 weeks to 42 weeks of gestation complicated by intrauterine growth restriction and who are ultrasound confirmed. In the first trimester, gestational age determination was estimated by history of menstruation or biometry of foetus. Exclusion Criteria- Patients who had multiple gestations, congenital anomalies and history of membranes rupture. All the patients in the study were subjected to clinical history in detail to assess the risk factors of IUGR pregnancy, biometry of ultrasound and amniotic fluid assessment followed by Doppler ultrasound evaluation of uterine arteries, umbilical artery, middle cerebral artery, descending foetal thoracic aorta, ductus venous and umbilical vein. RESULTS Majority of the patients were in the age group of 21-24 years. All the patients were in the age group of 19-30 years. 45% of antenatal mothers examined were between 28-31 weeks of gestational age, 35% were between 32-36 weeks of gestation, 20% were between 37-42 weeks of gestation age. 15 antenatal mothers had elevated uterine artery resistance index (30%, 12 antenatal mothers had persistent early diagnostic notch (24%, 11 antenatal mothers had elevated systolic

  9. Optical fiber laser ultrasound transmitter with electrospun composite for minimally invasive medical imaging

    Science.gov (United States)

    Poduval, Radhika; Noimark, Sacha; Colchester, Richard; Macdonald, Tom; Parkin, Ivan; Desjardins, Adrien; Papakonstantinou, Ioannis

    2017-07-01

    We report an optical fiber ultrasound transmitter with electrospun MWCNT-polymer composite, generating high-amplitude broadband ultrasound. They produced pressures in the range of conventional intravascular imaging transducers, and can be incorporated into catheters/needles for keyhole surgery

  10. Assessment of tumor response to radiation and vascular targeting therapy in mice using quantitative ultrasound spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    El Kaffas, Ahmed; Sadeghi-Naini, Ali; Falou, Omar; Tran, William Tyler; Czarnota, Gregory J., E-mail: gregory.czarnota@sunnybrook.ca [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5 (Canada); Imaging Research and Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5 (Canada); Departments of Medical Biophysics and Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Ontario M5G 1L7 (Canada); Zhou, Stephanie; Fernandes, Jason; Giles, Anoja [Imaging Research and Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5 (Canada); Hashim, Amr [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5, Canada and Imaging Research and Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5 (Canada)

    2015-08-15

    Purpose: It is now recognized that the tumor vasculature is in part responsible for regulating tumor responses to radiation therapy. However, the extent to which radiation-based vascular damage contributes to tumor cell death remains unknown. In this work, quantitative ultrasound spectroscopy (QUS) methods were used to investigate the acute responses of tumors to radiation-based vascular treatments. Methods: Tumor xenografts (MDA-MB-231) were treated with single radiation doses of 2 or 8 Gy alone, or in combination with pharmacological agents that modulate vascular radiosensitivity. The midband fit, the slope, and the 0-MHz intercept QUS parameters were obtained from a linear-regression fit to the averaged power spectrum of frequency-dependent ultrasound backscatter and were used to quantify acute tumor responses following treatment administration. Power spectrums were extracted from raw volumetric radio-frequency ultrasound data obtained before and 24 h following treatment administration. These parameters have previously been correlated to tumor cell death. Staining using in situ end labeling, carbonic anhydrase 9 and cluster of differentiation 31 of tumor sections were used to assess cell death, oxygenation, and vasculature distributions, respectively. Results: Results indicate a significant midband fit QUS parameter increases of 3.2 ± 0.3 dBr and 5.4 ± 0.5 dBr for tumors treated with 2 and 8 Gy radiation combined with the antiangiogenic agent Sunitinib, respectively. In contrast, tumors treated with radiation alone demonstrated a significant midband fit increase of 4.4 ± 0.3 dBr at 8 Gy only. Preadministration of basic fibroblast growth factor, an endothelial radioprotector, acted to minimize tumor response following single large doses of radiation. Immunohistochemical analysis was in general agreement with QUS findings; an R{sup 2} of 0.9 was observed when quantified cell death was correlated with changes in midband fit. Conclusions: Results from QUS

  11. Rating scale for the assessment of competence in ultrasound-guided peripheral vascular access - a Delphi Consensus Study.

    Science.gov (United States)

    Primdahl, Stine C; Todsen, Tobias; Clemmesen, Louise; Knudsen, Lars; Weile, Jesper

    2016-09-21

    Peripheral vascular access is vital for treatment and diagnostics of hospitalized patients. Ultrasound-guided vascular access (UGVA) is superior to the landmark technique. To ensure competence-based education, an assessment tool of UGVA competence is needed. We aimed to develop a global rating scale (RS) for assessment of UGVA competence based on opinions on the content from ultrasound experts in a modified Delphi consensus study. We included experts from anesthesiology, emergency medicine and radiology across university hospitals in Denmark. Nine elements were drafted based on existing literature and recommendations from international societies. In a multi-round survey, the experts rated the elements on a five-point Likert scale according to importance, and suggested missing elements. The final Delphi round occurred when >80% of the experts rated all elements ≥4 on the Likert scale. Sixteen experts consented to participate in the study, one withdrew consent prior to the first Delphi round, and 14 completed all three Delphi rounds. In the first Delphi round the experts excluded one element from the scale and changed the content of two elements. In the second Delphi round, the experts excluded one element from the scale. In the third Delphi round, consensus was obtained on the eight elements: preparation of utensils, ergonomics, preparation of the ultrasound device, identification of blood vessels, anatomy, hygiene, coordination of the needle, and completion of the procedure. We developed an RS for assessment of UGVA competence based on opinions of ultrasound experts through a modified Delphi consensus study.

  12. Urgent ultrasound guided hemodynamic assessments by a pediatric medical emergency team: a pilot study.

    Directory of Open Access Journals (Sweden)

    David J Zorko

    Full Text Available PURPOSE: To determine the feasibility of using the Ultrasound Cardiac Output Monitor (USCOM as an adjunct during hemodynamic assessments by a pediatric medical emergency team (PMET. METHODS: Pediatric in-patients at McMaster Children's Hospital aged under 18 years requiring urgent PMET consultation, were eligible. Patients with known cardiac outflow valve defects, Pediatric Critical Care Unit in-patients, and those in cardiorespiratory arrest, were excluded. The primary outcome was feasibility, and the ease of USCOM transport and application as assessed by a self-administered user questionnaire. Secondary outcomes included the quality of USCOM measurements, and agreement in clinical versus USCOM-derived assessments. RESULTS: Forty-one patients from 85 eligible PMET consultations were enrolled between March and August 2011. A total of 55 USCOM assessments were performed on 36 of 41 (87.8% participants. USCOM could not be completed in 5 (12.2% participants due to patient agitation (n = 4 and emergent care (n = 1. USCOM was reported as easy to transport and apply by 97.4% and 94.7% of respondents respectively, not obstructive to patient care by 94.7%, and yielded timely measurements by 84.2% respondents. USCOM tracings were of good quality in 41 (75.9% assessments. Agreement between clinical and USCOM-derived hemodynamic assessments by two independent raters was poor (Rater 1: κ = 0.094; Rater 2: κ = 0.146. CONCLUSION: USCOM can be applied by a PMET during urgent hemodynamic assessments in children. While USCOM has been validated in stable children, its role in guiding hemodynamic resuscitation and informing therapeutic goals in a hemodynamically unstable pediatric population requires further investigation.

  13. Formative assessment based on an audit and feedback improves nuchal translucency ultrasound image quality.

    Science.gov (United States)

    Chalouhi, Gihad E; Salomon, Laurent J; Fontanges, Marianne; Althuser, Marc; Haddad, Georges; Scemama, Olivier; Chabot, Jean-Michel; Duyme, Michel; Fries, Nicolas

    2013-09-01

    The purpose of this work was to study the impact of an audit and feedback on the quality of routine first-trimester nuchal transparency ultrasound images. Eighty-eight sonographers were each sent 2 different series of 30 consecutive nuchal translucency images at a mean interval of 3 months to a dedicated, protected server for remote double-blind independent analysis based on the new Collège Français d'Echographie Foetale/Centre National de la Recherche Scientifique image-scoring method (https://www.cfef.org/evaluation/ISMCFEFCNRS.pdf). The sonographers were classified as low (score below the median) or high (score above the median) scorers for each series. Before their second evaluation, 73 of the 88 sonographers received a feedback report on their first series of images, whereas the other 15 participants received no feedback. The baseline characteristics of the participants who did and did not receive feedback were comparable. Participants who received feedback increased their average score significantly, from a mean ± SD of 11.1 ± 1.3 to 13.4 ± 1.4 among low scorers (P < .00001) and from 15.1 ± 1.2 to 16.0 ± 1.4 among high scorers (P < .001), whereas no significant change was seen among participants who received no feedback (low scorers, 10.9 ± 1.5 to 12.1 ± 2.0; P = .11; high scorers, 14.7 ± 1.3 to 14.6 ± 1.3; P = .99). The proportion of satisfactory images increased by 48% among low scorers who received feedback. Formative assessment based on a moderately intensive audit and feedback is feasible and effective for improving the quality of routine first-trimester nuchal transparency ultrasound images.

  14. Added value of Virtual Touch IQ shear wave elastography in the ultrasound assessment of breast lesions

    International Nuclear Information System (INIS)

    Ianculescu, Victor; Ciolovan, Laura Maria; Dunant, Ariane; Vielh, Philippe; Mazouni, Chafika; Delaloge, Suzette; Dromain, Clarisse; Blidaru, Alexandru; Balleyguier, Corinne

    2014-01-01

    Purpose: To determine the diagnostic performance of Acoustic Radiation Force Impulse (ARFI) Virtual Touch IQ shear wave elastography in the discrimination of benign and malignant breast lesions. Materials and methods: Conventional B-mode and elasticity imaging were used to evaluate 110 breast lesions. Elastographic assessment of breast tissue abnormalities was done using a shear wave based technique, Virtual Touch IQ (VTIQ), implemented on a Siemens Acuson S3000 ultrasound machine. Tissue mechanical properties were interpreted as two-dimensional qualitative and quantitative colour maps displaying relative shear wave velocity. Wave speed measurements in m/s were possible at operator defined regions of interest. The pathologic diagnosis was established on samples obtained by ultrasound guided core biopsy or fine needle aspiration. Results: BIRADS based B-mode evaluation of the 48 benign and 62 malignant lesions achieved 92% sensitivity and 62.5% specificity. Subsequently performed VTIQ elastography relying on visual interpretation of the colour overlay displaying relative shear wave velocities managed similar standalone diagnostic performance with 92% sensitivity and 64.6% specificity. Lesion and surrounding tissue shear wave speed values were calculated and a significant difference was found between the benign and malignant populations (Mann–Whitney U test, p < 0.0001). By selecting a lesion cut-off value of 3.31 m/s we achieved 80.4% sensitivity and 73% specificity. Applying this threshold only to BIRADS 4a masses, we reached overall levels of 92% sensitivity and 72.9% specificity. Conclusion: VTIQ qualitative and quantitative elastography has the potential to further characterise B-mode detected breast lesions, increasing specificity and reducing the number of unnecessary biopsies

  15. Added value of Virtual Touch IQ shear wave elastography in the ultrasound assessment of breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ianculescu, Victor; Ciolovan, Laura Maria [Radiology Department, Gustave Roussy, Villejuif (France); Dunant, Ariane [Department of Statistics, Gustave Roussy, Villejuif (France); Vielh, Philippe [Department of Biopathology, Gustave Roussy, Villejuif (France); Mazouni, Chafika [Department of Surgery, Gustave Roussy, Villejuif (France); Delaloge, Suzette [Department of Oncology, Gustave Roussy, Villejuif (France); Dromain, Clarisse [Radiology Department, Gustave Roussy, Villejuif (France); Blidaru, Alexandru [Department of Surgery, Bucharest Institute of Oncology, Bucharest (Romania); Balleyguier, Corinne, E-mail: corinne.balleyguier@gustaveroussy.fr [Radiology Department, Gustave Roussy, Villejuif (France); UMR 8081, IR4M, Paris-Sud University, 91405 Orsay (France)

    2014-05-15

    Purpose: To determine the diagnostic performance of Acoustic Radiation Force Impulse (ARFI) Virtual Touch IQ shear wave elastography in the discrimination of benign and malignant breast lesions. Materials and methods: Conventional B-mode and elasticity imaging were used to evaluate 110 breast lesions. Elastographic assessment of breast tissue abnormalities was done using a shear wave based technique, Virtual Touch IQ (VTIQ), implemented on a Siemens Acuson S3000 ultrasound machine. Tissue mechanical properties were interpreted as two-dimensional qualitative and quantitative colour maps displaying relative shear wave velocity. Wave speed measurements in m/s were possible at operator defined regions of interest. The pathologic diagnosis was established on samples obtained by ultrasound guided core biopsy or fine needle aspiration. Results: BIRADS based B-mode evaluation of the 48 benign and 62 malignant lesions achieved 92% sensitivity and 62.5% specificity. Subsequently performed VTIQ elastography relying on visual interpretation of the colour overlay displaying relative shear wave velocities managed similar standalone diagnostic performance with 92% sensitivity and 64.6% specificity. Lesion and surrounding tissue shear wave speed values were calculated and a significant difference was found between the benign and malignant populations (Mann–Whitney U test, p < 0.0001). By selecting a lesion cut-off value of 3.31 m/s we achieved 80.4% sensitivity and 73% specificity. Applying this threshold only to BIRADS 4a masses, we reached overall levels of 92% sensitivity and 72.9% specificity. Conclusion: VTIQ qualitative and quantitative elastography has the potential to further characterise B-mode detected breast lesions, increasing specificity and reducing the number of unnecessary biopsies.

  16. Assessing the Oldness and Capacity of Radiography and Ultrasound Equipments in Tehran University of Medical Sciences

    International Nuclear Information System (INIS)

    Salamati, Payman; Ghanaati, Hossein; Ghasemzadeh, Shahram; Jalali, Amir Hossein

    2013-01-01

    Maintenance of imaging equipment is a very important part of the management of all medical imaging centers. To assess the oldness and capacity of radiography and ultrasound equipment in Tehran University of Medical Sciences. The study was performed in 16 hospitals, 4 faculties and three healthcare centers of Tehran University of Medical Sciences. We evaluated all the X-ray equipment (including the simple plain and dental, panorex, mammography, fluoroscopy and C-arm X-Ray devices) and also simple and Doppler ultrasound machines in terms of the type and usage of the device, production year, quantity of utilization, location, brand and current condition. Among fixed X-ray systems, 15 were currently in use, two were junk, two were damaged, and one was not utilized. The mean (SD) of the usage of these was 2151 (2230) cliché/month, and the mean (SD) of the oldness was 16.9 (13.6) years. The oldness of radiography equipment in our study was more than 20 years in 16, between 11 and 20 in 46, and less than 10 years in 76 devices. The mean (SD) usage (patients/month) of simple and color Doppler devices were 234.1 (365.2) and 597.5 (505.3), respectively. The oldness of ultrasonography equipment in our study was more than 11 years in 12 and less than 10 years in 55 devices. We found that 22 (15.9%) of the radiography systems and two (3%) of the ultrasonography systems had been used for more than 20 years. Radiology equipment in Tehran University of Medical Sciences have potential capacity, but they need repair, and better maintenance and management and application of standards for the imaging system needs organized supervisory mechanisms

  17. Obstetrical Ultrasound

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Obstetric Ultrasound Obstetric ultrasound uses sound waves to produce pictures of ... What are the limitations of Obstetrical Ultrasound Imaging? Obstetric ultrasound cannot identify all fetal abnormalities. Consequently, when ...

  18. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... Ultrasound - Pelvis Ultrasound imaging of the pelvis uses sound waves to produce pictures of the structures and ... pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound scanning or ...

  19. Prostate Ultrasound

    Medline Plus

    Full Text Available ... Z Ultrasound - Prostate Ultrasound of the prostate uses sound waves to produce pictures of a man’s prostate ... pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound scanning or ...

  20. Prostate Ultrasound

    Medline Plus

    Full Text Available ... ultrasound or with a rectal examination, an ultrasound-guided biopsy can be performed. This procedure involves advancing ... of the Prostate) Prostate Cancer Ultrasound- and MRI-Guided Prostate Biopsy Images related to Ultrasound - Prostate Sponsored ...

  1. Prostate Ultrasound

    Medline Plus

    Full Text Available ... Prostate Ultrasound Imaging? What is Ultrasound Imaging of the Prostate? Ultrasound is safe and painless, and produces ... of page What are some common uses of the procedure? A transrectal ultrasound of the prostate gland ...

  2. INTRAVASCULAR ENDOTHELIOMA (ENDOTHELIOMA IN SITU, SYSTEMIC ENDOTHELIOMATOSIS).

    Science.gov (United States)

    HABER, H; HARRIS-JONES, J N; WELLS, A L

    1964-11-01

    A woman aged 48 years was found to be suffering from intravascular endothelioma. The initial clinical presentation was the presence of red, painless swellings in the skin of the lower limbs. The other clinical features, and the histological changes in skin biopsies, are described and compared with those in the two previously reported patients. It is suggested that the condition is analogous to the pre-invasive carcinomatous states.

  3. Ultrasound assessment of the posterior circumflex humeral artery in elite volleyball players: Aneurysm prevalence, anatomy, branching pattern and vessel characteristics

    OpenAIRE

    van de Pol, Daan; Maas, Mario; Terpstra, Aart; Pannekoek-Hekman, Marja; Alaeikhanehshir, Sena; Kuijer, P. Paul F. M.; Planken, R. Nils

    2016-01-01

    Objectives To determine the prevalence of posterior circumflex humeral artery (PCHA) aneurysms and vessel characteristics of the PCHA and deep brachial artery (DBA) in elite volleyball players. Methods Two-hundred and eighty players underwent standardized ultrasound assessment of the dominant arm by a vascular technologist. Assessment included determination of PCHA aneurysms (defined as segmental vessel dilatation ?150 %), PCHA and DBA anatomy, branching pattern, vessel course and diameter. R...

  4. Observer agreement of lower limb venous reflux assessed by duplex ultrasound scanning using manual and pneumatic cuff compression in patients with chronic venous disease and controls

    DEFF Research Database (Denmark)

    Broholm, R; Kreiner, S; Bækgaard, Niels

    2011-01-01

    The study aimed to evaluate observer agreement between two experienced ultrasound operators examining deep venous reflux assessed by duplex ultrasound (DU) using either manual or pneumatic cuff compression. In addition, the two methods were compared with each other with regard to immediate...

  5. Preoperative assessment of skin tumor thickness and structure using 14-MHz ultrasound

    Directory of Open Access Journals (Sweden)

    Vesta Kučinskienė

    2014-01-01

    Conclusions: Medium frequency ultrasound is not a reliable tool for the precise measurement of thin (≤1 mm skin tumors. Ultrasonography using a 14-MHz frequency transducer enables more precisely to measure the thickness of basal cell carcinoma than melanocytic skin tumors. The 14-MHz ultrasound is support tool to suggest the morphologic type of skin tumor.

  6. Ultrasound use for body composition and carcass quality assessment in cattle and lambs

    Science.gov (United States)

    Genetic evaluation for carcass quality traits has evolved over time, in large part due to introduction of new technology such as ultrasound measures of body composition. Ultrasound measured body composition traits emulate important carcass traits, are very informative for selection purposes, are ac...

  7. Summary findings of a systematic review of the ultrasound assessment of synovitis

    DEFF Research Database (Denmark)

    Joshua, Fredrick; Lassere, Marissa; Bruyn, George A

    2007-01-01

    This report presents the results of a recent systematic review performed by the OMERACT Ultrasound Group on the metric properties of ultrasound for the detection of synovitis in inflammatory arthritis. Reviews were conducted for the hand, wrist, elbow, shoulder, knee, ankle, and foot; most report...

  8. Summary findings of a systematic review of the ultrasound assessment of synovitis

    DEFF Research Database (Denmark)

    Joshua, Fredrick; Lassere, Marissa; Bruyn, George A

    2007-01-01

    This report presents the results of a recent systematic review performed by the OMERACT Ultrasound Group on the metric properties of ultrasound for the detection of synovitis in inflammatory arthritis. Reviews were conducted for the hand, wrist, elbow, shoulder, knee, ankle, and foot; most reports...

  9. Functional Ultrasound Imaging for Assessment of Extracellular Matrix Scaffolds Used for Liver Organoid Formation

    Science.gov (United States)

    Gessner, Ryan C.; Hanson, Ariel D.; Feingold, Steven; Cashion, Avery T.; Corcimaru, Ana; Wu, Bryant T.; Mullins, Christopher R.; Aylward, Stephen R.; Reid, Lola M.; Dayton, Paul A.

    2015-01-01

    A method of 3D functional ultrasound imaging has been developed to enable non-destructive assessment of extracellular matrix scaffolds that have been prepared by decellularization protocols and are intended for recellularization to create organoids. A major challenge in organ decellularization is retaining patent micro-vascular structures crucial for nutrient access and functionality of organoids. The imaging method described here provides statistical distributions of flow rates throughout the tissue volumes, 3D vessel network architecture visualization, characterization of microvessel volumes and sizes, and delineation of matrix from vascular circuits. The imaging protocol was tested on matrix scaffolds that are tissue-specific, but not species-specific, matrix extracts, prepared by a process that preserved >98% of the collagens, collagen-associated matrix components, and matrix-bound growth factors and cytokines. Image-derived data are discussed with respect to assessment of scaffolds followed by proof-of-concept studies in organoid establishment using Hep3B, human hepatoblast-like cells. Histology showed that the cells attached to scaffolds with patent vasculature within minutes, achieved engraftment at near 100%, expressed liver-specific functions within 24h, and yielded evidence of proliferation and increasing differentiation of cells throughout the two weeks of culture studies. This imaging method should prove valuable in analyses of such matrix scaffolds. PMID:24011714

  10. Prostate tissue ablation with MRI guided transurethral therapeutic ultrasound and intraoperative assessment of the integrity of the neurovascular bundle

    Science.gov (United States)

    Sammet, Steffen; Partanen, Ari; Yousuf, Ambereen; Wardrip, Craig; Niekrasz, Marek; Antic, Tatjana; Razmaria, Aria; Sokka, Sham; Karczmar, Gregory; Oto, Aytekin

    2017-03-01

    OBJECTIVES: Evaluation of the precision of prostate tissue ablation with MRI guided therapeuticultrasound by intraoperative objective assessment of the neurovascular bundle in canines in-vivo. METHODS: In this ongoing IACUC approved study, eight male canines were scanned in a clinical 3T Achieva MRI scanner (Philips) before, during, and after ultrasound therapy with a prototype MR-guided ultrasound therapy system (Philips). The system includes a therapy console to plan treatment, to calculate real-time temperature maps, and to control ultrasound exposures with temperature feedback. Atransurethral ultrasound applicator with eight transducer elements was used to ablate canine prostate tissue in-vivo. Ablated prostate tissue volumes were compared to the prescribed target volumes to evaluate technical effectiveness. The ablated volumes determined by MRI (T1, T2, diffusion, dynamic contrast enhanced and 240 CEM43 thermal dose maps) were compared to H&E stained histological slides afterprostatectomy. Potential nerve damage of the neurovascular bundle was objectively assessed intraoperativelyduring prostatectomy with a CaverMap Surgical Aid nerve stimulator (Blue Torch Medical Technologies). RESULTS: Transurethral MRI -guided ultrasound therapy can effectively ablate canine prostate tissue invivo. Coronal MR-imaging confirmed the correct placement of the HIFU transducer. MRI temperature maps were acquired during HIFU treatment, and subsequently used for calculating thermal dose. Prescribed target volumes corresponded to the 240 CEM43 thermal dose maps during HIFU treatment in all canines. Ablated volumes on high resolution anatomical, diffusion weighted, and contrast enhanced MR images matched corresponding histological slides after prostatectomy. MRI guidance with realtime temperature monitoring showed no damage to surrounding tissues, especially to the neurovascular bundle (assessed intra-operatively with a nerve stimulator) or to the rectum wall. CONCLUSIONS: Our study

  11. Ultrasound for Drug and Gene Delivery to the Brain

    OpenAIRE

    Hynynen, Kullervo

    2008-01-01

    Noninvasive, transient, and local image-guided blood-brain barrier disruption (BBBD) has been demonstrated with focused ultrasound exposure in animal models. Most studies have combined low pressure amplitude and low time average acoustic power burst sonications with intra-vascular injection of pre-formed micro-bubbles to produce BBBD without damage to the neurons. The BBB has been shown to be healed within a few hours after the exposure. The combination of focused ultrasound beams with MR ima...

  12. Membrane design of an all-optical ultrasound receiver

    NARCIS (Netherlands)

    Leinders, S.M.; Dongen, K.W.A. van; Jong, N. de; Verweij, M.D.; Westerveld, W.J.; Urbach, H.P.; Neer, P.L.M.J. van; Pozo Torres, J.M.

    2013-01-01

    Ultrasound sensors such as piezoelectric transducers and CMUTs are successfully used for medical imaging. However, especially wiring of individual elements is difficult in the fabrication of small piezoelectric arrays, used in, e.g. the field of intravascular imaging. As an alternative, we designed

  13. Vascular applications of contrast-enhanced ultrasound imaging.

    Science.gov (United States)

    Mehta, Kunal S; Lee, Jake J; Taha, Ashraf A; Avgerinos, Efthymios; Chaer, Rabih A

    2017-07-01

    Contrast-enhanced ultrasound (CEUS) imaging is a powerful noninvasive modality offering numerous potential diagnostic and therapeutic applications in vascular medicine. CEUS imaging uses microbubble contrast agents composed of an encapsulating shell surrounding a gaseous core. These microbubbles act as nearly perfect intravascular reflectors of ultrasound energy and may be used to enhance the overall contrast and quality of ultrasound images. The purpose of this narrative review is to survey the current literature regarding CEUS imaging and discuss its diagnostic and therapeutic roles in current vascular and selected nonvascular applications. The PubMed, MEDLINE, and Embase databases were searched until July 2016 using the PubMed and Ovid Web-based search engines. The search terms used included contrast-enhanced, microbubble, ultrasound, carotid, aneurysm, and arterial. The diagnostic and therapeutic utility of CEUS imaging has grown exponentially, particularly in the realms of extracranial carotid arterial disease, aortic disease, and peripheral arterial disease. Studies have demonstrated that CEUS imaging is diagnostically superior to conventional ultrasound imaging in identifying vessel irregularities and measuring neovascularization to assess plaque vulnerability and end-muscle perfusion. Groups have begun to use microbubbles as agents in therapeutic applications for targeted drug and gene therapy delivery as well as for the enhancement of sonothrombolysis. The emerging technology of microbubbles and CEUS imaging holds considerable promise for cardiovascular medicine and cancer therapy given its diagnostic and therapeutic utility. Overall, with proper training and credentialing of technicians, the clinical implications are innumerable as microbubble technology is rapidly bursting onto the scene of cardiovascular medicine. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  14. Robust sound speed estimation for ultrasound-based hepatic steatosis assessment

    Science.gov (United States)

    Imbault, Marion; Faccinetto, Alex; Osmanski, Bruno-Félix; Tissier, Antoine; Deffieux, Thomas; Gennisson, Jean-Luc; Vilgrain, Valérie; Tanter, Mickaël

    2017-05-01

    Hepatic steatosis is a common condition, the prevalence of which is increasing along with non-alcoholic fatty liver disease (NAFLD). Currently, the most accurate noninvasive imaging method for diagnosing and quantifying hepatic steatosis is MRI, which estimates the proton-density fat fraction (PDFF) as a measure of fractional fat content. However, MRI suffers several limitations including cost, contra-indications and poor availability. Although conventional ultrasound is widely used by radiologists for hepatic steatosis assessment, it remains qualitative and operator dependent. Interestingly, the speed of sound within soft tissues is known to vary slightly from muscle (1.575 mm · µs-1) to fat (1.450 mm · µs-1). Building upon this fact, steatosis could affect liver sound speed when the fat content increases. The main objectives of this study are to propose a robust method for sound speed estimation (SSE) locally in the liver and to assess its accuracy for steatosis detection and staging. This technique was first validated on two phantoms and SSE was assessed with a precision of 0.006 and 0.003 mm · µs-1 respectively for the two phantoms. Then a preliminary clinical trial (N  =  17 patients) was performed. SSE results was found to be highly correlated with MRI proton density fat fraction (R 2  =  0.69) and biopsy (AUROC  =  0.952) results. This new method based on the assessment of spatio-temporal properties of the local speckle noise for SSE provides an efficient way to diagnose and stage hepatic steatosis.

  15. Sport and exercise medicine consultants are reliable in assessing tendon neovascularity using ultrasound Doppler.

    Science.gov (United States)

    Watson, James; Barker-Davies, Robert M; Bennett, Alexander N; Fong, Daniel T P; Wheeler, Patrick C; Lewis, Mark; Ranson, Craig

    2018-01-01

    Several lower limb tendinopathy treatment modalities involve identification of pathological paratendinous or intratendinous neovascularisation to target proposed co-location of painful neoneuralisation. The ability to reliably locate and assess the degree of neovascularity is therefore clinically important. The Modified Ohberg Score (MOS) is frequently used to determine degree of neovascularity, but reliability has yet to be established among Sport and Exercise Medicine (SEM) consultants. This study aims to determine inter-rater and intra-rater reliability of an SEM consultant cohort when assessing neovascularity using the 5-point MOS. Eleven participants (7 male and 4 female) provided 16 symptomatic Achilles and patella tendons. These were sequentially examined using power Doppler (PD) enabled ultrasound (US) imaging by 6 SEM consultants who rated neovascular changes seen using the MOS. Representative digital scan images were saved for rescoring 3 weeks later. Inter-rater and intra-rater reliability of the MOS was examined using intraclass correlation coefficient (ICC) and Kappa Agreement scores. Neovascular changes were reported in 65.6% of 96 scans undertaken. ICC for inter-rater reliability was 0.86 and Fleiss Kappa 0.52. ICC for intra-rater reliability was 0.95 and Weighted Kappa 0.91. Neovascular changes were present in two-thirds of symptomatic tendons. Excellent SEM consultant inter-rater and intra-rater reliability was demonstrated. These findings support the use of PD-enabled US to assess neovascularity by appropriately experienced SEM consultants. Furthermore, future interventional research using a similarly experienced SEM consultant cohort can be undertaken with assurance that assessment of neovascularity will be reliable.

  16. Development and Assessment of a Novel Task Trainer and Targeting Tasks for Ultrasound-guided Invasive Procedures.

    Science.gov (United States)

    Nitsche, Joshua F; Shumard, Kristina M; Brost, Brian C

    2017-06-01

    The American Institute of Ultrasound in Medicine (AIUM) recommends that all providers performing ultrasound-guided invasive procedures be competent in a core set of guidance skills common to all ultrasound-guided procedures, including in-plane and out-of-plane needle guidance and needle imaging optimization techniques such as probe translation, rotation, and heel-toe standoff. To allow for the practice and assessment of these core skills, we have created a novel task trainer and set of targeting tasks, and sought to obtain validity evidence in the content and response process domains for this training and assessment system according to the Standards for Educational and Psychological Testing. We have constructed an ultrasound-guided invasive procedure training system and five targeting tasks that focused on the needle guidance skills outlined by the AIUM. All tasks were performed by obstetrics and gynecology or maternal-fetal medicine physicians with and without experience in ultrasound-guided invasive procedures during a series of simulation workshops. All participants completed a survey regarding the trainer's and the tasks' usefulness in the training of inexperienced physicians. The physicians who completed the tasks had favorable views of task trainer and curriculum. The targeting curriculum was felt to allow practice of all of the core guidance skills outlined by the AIUM. The average response provided for all of the tasks was 4.0 or greater, with half of the items having an average response of 4.5 or higher. We have constructed a task trainer that incorporates all of the core skills outlined by the AIUM. All five tasks received very favorable reviews from both experienced and inexperienced providers. Taken together, our findings suggest they have strong content and response process validity evidence. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  17. Ultrasound as an Adjunct to Mammography for Breast Cancer Screening: A Health Technology Assessment.

    Science.gov (United States)

    2016-01-01

    Screening with mammography can detect breast cancer early, before clinical symptoms appear. Some cancers, however, are not captured with mammography screening alone. Ultrasound has been suggested as a safe adjunct screening tool that can detect breast cancers missed on mammography. We investigated the benefits, harms, cost-effectiveness, and cost burden of ultrasound as an adjunct to mammography compared with mammography alone for screening women at average risk and at high risk for breast cancer. We searched Ovid MEDLINE, Ovid Embase, EBM Reviews, and the NHS Economic Evaluation Database, from January 1998 to June 2015, for evidence of effectiveness, harms, diagnostic accuracy, and cost-effectiveness. Only studies evaluating the use of ultrasound as an adjunct to mammography in the specified populations were included. We also conducted a cost analysis to estimate the costs in Ontario over the next 5 years to fund ultrasound as an adjunct to mammography in breast cancer screening for high-risk women who are contraindicated for MRI, the current standard of care to supplement mammography. No studies in average-risk women met the inclusion criteria of the clinical review. We included 5 prospective, paired cohort studies in high-risk women, 4 of which were relevant to the Ontario context. Adjunct ultrasound identified between 2.3 and 5.9 additional breast cancers per 1,000 screens. The average pooled sensitivity of mammography and ultrasound was 53%, a statistically significant increase relative to mammography alone (absolute increase 13%; P mammography screening alone. The GRADE for this body of evidence was low. Additional annual costs of using breast ultrasound as an adjunct to mammography for high-risk women in Ontario contraindicated for MRI would range from $15,500 to $30,250 in the next 5 years. We found no evidence that evaluated the comparative effectiveness or diagnostic accuracy of screening breast ultrasound as an adjunct to mammography among average

  18. Assessment of pelvic floor muscle function in women with and without low back pain using transabdominal ultrasound.

    Science.gov (United States)

    Arab, Amir Massoud; Behbahani, Roxana Bazaz; Lorestani, Leila; Azari, Afsaneh

    2010-06-01

    Pelvic floor muscle (PFM) dysfunction has been recently associated with the development of low back pain (LBP). Transabdominal ultrasound imaging has been established as an appropriate method for visualizing and measuring PFM function. No study has directly evaluated PFM function in individuals with and without LBP. The purpose of this study was to investigate the PFM function in women with and without LBP using transabdominal ultrasound. Convenience sample of 40 non-pregnant female participated in the study. Subjects were categorized into two groups: with LBP (n = 20) and without LBP (n = 20). The amount of bladder base movement on ultrasound (normalized to body mass index) was measured in all subjects and considered as an indicator of PFM function. Statistical analysis (Independent t-test) revealed significant difference in transabdominal ultrasound measurements for PFM function between the two groups (P = 0.04, 95% CI of difference: 0.002-0.27). The results of this study indicate PFM dysfunction in individuals with LBP compared to those without LBP. The results could be beneficial to clinicians when assessing and prescribing therapeutic exercises for patients with LBP.

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

    Directory of Open Access Journals (Sweden)

    Rafal Cupek

    2016-11-01

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

  20. Role of tridimensional endoanal ultrasound (3D-EAUS) in the preoperative assessment of perianal sepsis.

    Science.gov (United States)

    Brillantino, Antonio; Iacobellis, Francesca; Di Sarno, Giandomenico; D'Aniello, Francesco; Izzo, Domenico; Paladino, Fiorella; De Palma, Maurizio; Castriconi, Maurizio; Grassi, Roberto; Di Martino, Natale; Renzi, Adolfo

    2015-04-01

    The aim of this study was to evaluate the accuracy of tridimensional endoanal ultrasound (3D-EAUS) in the diagnosis of perianal sepsis comparing the results with the surgical findings, considered as reference standard. From January 2009 to January 2013, all the patients referred for the assessment and treatment of perianal sepsis with suspected anorectal origin were enrolled in the study. All patients gave informed written consent. Prior to surgery, all the patients underwent anamnestic evaluation, clinical examination, and unenhanced and H2O2-enhanced 3D-EAUS. Surgery was performed by a colorectal surgeon blinded to the 3D-EAUS results. A total of 212 patients with suspected perianal suppurations were assessed during the study period. In 12 patients, the H2O2-enhanced 3D-EAUS was not performed, and so, they were excluded from the study. Very good agreement between 3D-EAUS and examination under anesthesia (EUA) in the classification of primary fistula tracts (kappa = 0.93) and in the identification of fistula internal opening (kappa = 0.97) was found. There was a good concordance (kappa = 0.71) between 3D-EAUS and surgery in the detection of fistula secondary extensions. The overall sensitivity and specificity of 3D-EAUS in the diagnosis of perianal sepsis were 98.3 and 91.3% respectively. 3D-EAUS is a safe and reliable technique in the assessment of perianal sepsis. It may assist the surgeon in delineating the fistula tract anatomy and in determining the origin of sepsis, supporting the preoperative planning of definitive and appropriate surgical therapy.

  1. Assessment of the uterus with three-dimensional ultrasound in women undergoing ART.

    Science.gov (United States)

    Saravelos, Sotirios H; Jayaprakasan, Kannamannadiar; Ojha, Kamal; Li, Tin-Chiu

    2017-03-01

    A detailed assessment of the uterus forms a pivotal part of the ART treatment process. The emergence of three-dimensional ultrasound (3D US) has provided clinicians with a highly powerful tool in this respect. Assessments with 3D US range from the reconstruction of anatomical planes elusive to conventional US, to the objective measurement of anatomical volumes and vascularization parameters. However, despite the ever increasing number of publications emerging in the literature, the question of which aspects of 3D US are of most clinical value remains a topic of debate. The objective of this review is to dissect which aspects of the 3D US assessment of the uterus are supported by a strong level of evidence to date, and should therefore be incorporated into current routine clinical practice. We conducted a systematic search of the PubMed database up to May 2016, using a combination of text words and Medical Subject Headings (MeSH) pertaining to the 3D US assessment of the uterus. All articles published in the English language were screened to ascertain relevance to women of reproductive age; further citations were retrieved through manual reference list searching. A multitude of predominantly observational studies were identified, which concerned a vast variety of 3D US uterine assessments. All articles unequivocally praised the non-invasive, cost-effective, highly acceptable and objective nature of 3D US. Studies regarding the value of assessing the endometrial volume and vascularization prior to embryo transfer appeared conflicting and inconsistent. Studies regarding the imaging of uterine pathology and identification of intratubal and intrauterine devices consistently reported high rates of diagnostic accuracy. A recent RCT did not show an improvement in clinical outcomes when comparing 3D versus 2D US during embryo transfer. However, preliminary studies suggested that 3D US is superior in determining the site of implantation, particularly in ambiguous cases such

  2. [Speckle tracking--a new ultrasound tool for the assessment of fetal myocardial function].

    Science.gov (United States)

    Willruth, A; Geipel, A; Merz, W; Gembruch, U

    2012-06-01

    Speckle tracking is a new ultrasound tool to assess 2D ventricular global and segmental myocardial velocity and deformation (strain, strain rate). Multiple factors such as fetal motion, high heart rates, low blood pressure, small size of the heart, physiological cardiac translation, filling and maturational changes of myocardium, polyhydramnion, maternal obesity and aortic pulsation can degrade the image quality and result in artifacts and measurement errors which may have an impact on the final analysis. Therefore deformation indices such as strain and strain rate offer a quantitative technique for the estimation of global and segmental myocardial function and contractility. At present longitudinal peak systolic strain is the most commonly applied deformation parameter used to analyse segmental and global myocardial contractility in adults. When obtained using Doppler methods, these measurements are angle dependent, whereas speckle tracking techniques overcome the limitations of Doppler echocardiography which is a particular advantage in foetal echocardiography. Nevertheless, the time and training necessary to acquire high-quality video clips limit the implementation of speckle tracking into clinical routine. It is not yet clear whether this new technique will identify subclinical myocardial impairment earlier than with current techniques or allow for better discrimination between healthy fetuses and fetuses with congenital heart disease. The clinical use of speckle tracking will have to be demonstrated in larger groups of complicated pregnancies. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Application of rehabilitative ultrasound in the assessment of low back pain: a literature review.

    Science.gov (United States)

    Ghamkhar, Leila; Emami, Mahnaz; Mohseni-Bandpei, Mohammad A; Behtash, Hamid

    2011-10-01

    Low back pain (LBP) is one of the most common work-related conditions affecting all populations both in industrialized and non-industrialized countries, with reported high prevalence and incidence rates and huge direct and indirect costs. Among various suggested causes of LBP, dysfunction of back muscles, particularly lumbar multifidus and transverse abdominis, has been the subject of considerable research during last decades. Of the available imaging techniques, ultrasound (US) imaging technique is increasingly used to assess muscle dimensions and function as a valid, reliable and non-invasive approach. The purpose of the present study was to review the previously published studies (1990-2009) concerning the merit of US imaging of lumbar and abdominal muscles with particular attention to its clinical application in patients with LBP. Studies showed wide variation in terms of methodology, sample size, procedure, definition of LBP, heterogeneous sample, method of analyzing US imaging, US imaging parameters, etc. However, a convincing body of evidence was identified that supports US imaging as a reliable and valid tool both to differentiate patients with LBP from normal subjects and to monitor the effect of rehabilitation programs. Copyright © 2010 Elsevier Ltd. All rights reserved.

  4. A model of ultrasound backscatter for the assessment of myocardial tissue structure and architecture.

    Science.gov (United States)

    Santarelli, M F; Landini, L

    1996-09-01

    A statistical parametric model of returning echoes from myocardium is theorized in order to investigate the relationship between normal myocardium structure and spectral signatures with the use of ultrasonic tissue characterization. It is hypothesized, that in a clinical setting the normal myofiber architecture in the left ventricular wall is structured as a matrix of cylinder scatterers whose orientation and spatial distribution vary according to two different statistical distribution laws: 1) a Gaussian law to approximate parametric angular myofiber variability at each site within the myocardial wall; 2) a gamma distribution law to describe parametric regularity in scatterer interdistance. In the model, the effect of the angle of insonification with respect to the alignment of myofibers on ultrasound backscatter was considered. The slope of the power spectral density (PSD) evaluated within the echocardiographic transducer bandwidth has been used as a ultrasonic tissue characterization parameter. The model has been tested by computer simulation and in vitro measurements on myocardial pig tissue specimens. The concordance between experimental and simulated results confirms that the model accounts for the process underlying the echo formation from normal myocardium. Moreover, it provides a simple method of simulation which can be easily implemented and used for the assessment of pathologic alterations.

  5. Usefulness of ultrasound assessment of median nerve mobility in carpal tunnel syndrome.

    Science.gov (United States)

    Park, Gi-Young; Kwon, Dong Rak; Seok, Jung Im; Park, Dong-Soon; Cho, Hee Kyung

    2018-01-01

    Background Carpal tunnel syndrome (CTS) is the most common peripheral compression neuropathy of the upper extremity. Recently, dynamic ultrasound (US) imaging has shown differences in median nerve mobility between the affected and unaffected sides in CTS. Purpose The present study was performed to compare the median nerve mobility between patients with CTS and healthy individuals, and to correlate median nerve mobility with the severity of CTS. Material and Methods A total of 101 patients (128 wrists) with CTS and 43 healthy individuals (70 wrists) were evaluated. Electrodiagnostic studies were initially conducted to determine the neurophysiological grading scale (NGS). The cross-sectional area (CSA) of the median nerve and the grade of median nerve mobility were measured using US. Results The mean grade of median nerve mobility in the CTS group (1.9) was significantly lower than that in the control group (2.6; P mobility and distal motor latency of the median nerve (r = -0.218, P = 0.015), NGS (r = -0.207, P = 0.020) and CSA of the median nerve (r = -0.196, P = 0.028). Conclusion The grade of median nerve mobility was negatively correlated with the severity of CTS. US assessment of median nerve mobility may be useful in diagnosing and determining the severity of CTS.

  6. Reproducibility of ECG-gated Ultrasound Diameter Assessment of Small Abdominal Aortic Aneurysms

    DEFF Research Database (Denmark)

    Bredahl, K; Eldrup, N; Meyer, C

    2013-01-01

    No standardised ultrasound procedure to obtain reliable growth estimates for abdominal aortic aneurysms (AAA) is currently available. We investigated the feasibility and reproducibility of a novel approach controlling for a combination of vessel wall delineation and cardiac cycle variation....

  7. Combined Scanning Confocal Ultrasound Diagnostic and Treatment System for Bone Quality Assessment and Fracture Healing

    Data.gov (United States)

    National Aeronautics and Space Administration — The objectives of this study are to develop a combined diagnostic and treatment ultrasound technology for early prediction of bone disorder and guided acceleration...

  8. Hypothesis: Disseminated Intravascular Inflammation as the Inflammatory Counterpart to Disseminated Intravascular Coagulation

    Science.gov (United States)

    Bull, Brian S.; Bull, Maureen H.

    1994-08-01

    We have identified a leukocyte activation syndrome that is occasionally associated with the transfusion of intraoperatively recovered erythrocytes. This syndrome appears to result from intravascular damage caused by leukocytes activated during the erythrocyte salvage process. We hypothesize that this syndrome is part of a larger disease grouping: disseminated intravascular inflammation (DII). DII is the analog of the coagulation disorder disseminated intravascular coagulation. In disseminated intravascular coagulation, the organ damage results from uncontrolled activation of the clotting pathway; in DII the damage is caused by leukocytes that have become activated by direct contact with bacteria or in rare instances-such as erythrocyte salvage-in the absence of bacteria and bacterial products. Recent studies of the hazards associated with intraoperative blood salvage indicate that activation of leukocytes can be achieved by exposure to activated platelets alone. If such activated leukocytes are reinfused along with the washed erythrocytes, widespread organ damage may result. The lung is the organ most severely affected by activated leukocytes. Adult respiratory distress syndrome is one outcome. It is likely that DII is a presently unrecognized pathophysiological process that complicates a variety of primary disease states and increases their lethality.

  9. Direct comparison of high‐temporal‐resolution CINE MRI with Doppler ultrasound for assessment of diastolic dysfunction in mice

    Science.gov (United States)

    Price, Anthony N.; Jackson, Laurence H.; Taylor, Valerie; David, Anna L.; Lythgoe, Mark F.; Stuckey, Daniel J.

    2017-01-01

    Diastolic dysfunction is a sensitive early indicator of heart failure and can provide additional data to conventional measures of systolic function. Transmitral Doppler ultrasound, which measures the one‐dimensional flow of blood through the mitral valve, is currently the preferred method for the measurement of diastolic function, but the measurement of the left ventricular volume changes using high‐temporal‐resolution cinematic magnetic resonance imaging (CINE MRI) is an alternative approach which is emerging as a potentially more robust and user‐independent technique. Here, we investigated the performance of high‐temporal‐resolution CINE MRI and compared it with ultrasound for the detection of diastolic dysfunction in a mouse model of myocardial infarction. An in‐house, high‐temporal‐resolution, retrospectively gated CINE sequence was developed with a temporal resolution of 1 ms. Diastolic function in mice was assessed using a custom‐made, open‐source reconstruction package. Early (E) and late (A) left ventricular filling phases were easily identifiable, and these measurements were compared directly with high‐frequency, pulsed‐wave, Doppler ultrasound measurements of mitral valve inflow. A repeatability study established that high‐temporal‐resolution CINE MRI and Doppler ultrasound showed comparable accuracy when measuring E/A in normal control mice. However, when applied in a mouse model of myocardial infarction, high‐temporal‐resolution CINE MRI indicated diastolic heart failure (E/A = 0.94 ± 0.11), whereas ultrasound falsely detected normal cardiac function (E/A = 1.21 ± 0.11). The addition of high‐temporal‐resolution CINE MRI to preclinical imaging studies enhances the library of sequences available to cardiac researchers and potentially identifies diastolic heart failure early in disease progression. PMID:28643891

  10. Direct comparison of high-temporal-resolution CINE MRI with Doppler ultrasound for assessment of diastolic dysfunction in mice.

    Science.gov (United States)

    Roberts, Thomas A; Price, Anthony N; Jackson, Laurence H; Taylor, Valerie; David, Anna L; Lythgoe, Mark F; Stuckey, Daniel J

    2017-10-01

    Diastolic dysfunction is a sensitive early indicator of heart failure and can provide additional data to conventional measures of systolic function. Transmitral Doppler ultrasound, which measures the one-dimensional flow of blood through the mitral valve, is currently the preferred method for the measurement of diastolic function, but the measurement of the left ventricular volume changes using high-temporal-resolution cinematic magnetic resonance imaging (CINE MRI) is an alternative approach which is emerging as a potentially more robust and user-independent technique. Here, we investigated the performance of high-temporal-resolution CINE MRI and compared it with ultrasound for the detection of diastolic dysfunction in a mouse model of myocardial infarction. An in-house, high-temporal-resolution, retrospectively gated CINE sequence was developed with a temporal resolution of 1 ms. Diastolic function in mice was assessed using a custom-made, open-source reconstruction package. Early (E) and late (A) left ventricular filling phases were easily identifiable, and these measurements were compared directly with high-frequency, pulsed-wave, Doppler ultrasound measurements of mitral valve inflow. A repeatability study established that high-temporal-resolution CINE MRI and Doppler ultrasound showed comparable accuracy when measuring E/A in normal control mice. However, when applied in a mouse model of myocardial infarction, high-temporal-resolution CINE MRI indicated diastolic heart failure (E/A = 0.94 ± 0.11), whereas ultrasound falsely detected normal cardiac function (E/A = 1.21 ± 0.11). The addition of high-temporal-resolution CINE MRI to preclinical imaging studies enhances the library of sequences available to cardiac researchers and potentially identifies diastolic heart failure early in disease progression. © 2017 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.

  11. Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis

    Science.gov (United States)

    Yamashita, Shuji; Narushima, Mitsunaga; Koshima, Isao; Miyamoto, Shimpei

    2017-01-01

    Background: Although supermicrosurgical anastomosis is a widely known reconstructive microsurgical technique, it is difficult to perform. To expand the clinical use of supermicrosurgery, we used hemi-intravascular stenting (hemi-IVaS), which is performed by inserting an intravascular stent into one side of the vessel. We conducted lymphaticovenular anastomosis, free perforator flap transfer, and fingertip replantation with supermicrosurgical anastomosis using hemi-IVaS technique and examined its usefulness. Methods: Between January 2013 and February 2015, 11 anastomoses in 11 cases of lymphaticovenular anastomosis for lymphedema patients, 14 anastomoses in 7 cases of free perforator flap transfer with supermicrosurgical perforator-to-perforator anastomosis, and 9 anastomoses in 5 cases of fingertip replantation were performed using hemi-IVaS. Time required for anastomosis and complications were examined. Flap survival rate was also examined in free perforator flap transfer cases and fingertip replantation cases. Results: In all cases, anastomoses were performed without complications such as inadvertent catching of the back wall of the vessel during the procedure or the need for reanastomoses. The average time required to complete the anastomosis was 16.4 ± 3.20 minutes using the hemi IVaS technique. All flaps survived in the supermicrosurgical perforator-to-perforator anastomosis as well as fingertip replantation cases. Conclusions: Hemi-IVaS could be a useful alternative to conventional intravascular stenting techniques and is also effective for supermicrosurgical perforator-to-perforator anastomosis. Further studies are needed to improve the success rate and to explore its other possible utilizations in supermicrosurgery. PMID:29263952

  12. Intravascular haemolysis: a potential missed diagnosis.

    Science.gov (United States)

    Sinclair, David; Briston, Philip; Rutland, Emma

    2002-01-01

    Raised serum bilirubin is a common finding as part of a routine "liver function test" profile. This case describes a patient with a raised serum bilirubin that was eventually found to be caused by intravascular haemolysis. The tests that confirmed the cause were instigated by clinical biochemistry staff but not before the patient had undergone unnecessary invasive procedures and had the diagnosis delayed by some time. The case is a reminder to biochemistry and haematology laboratories and clinical staff to investigate the possibility of haemolysis as well as hepatitis and Gilbert's disease as a cause of an isolated raised bilirubin.

  13. Intravascular imaging with a storage phosphor detector

    Science.gov (United States)

    Shikhaliev, Polad M.; Petrek, Peter; Matthews, Kenneth L., II; Fritz, Shannon G.; Bujenovic, L. Steven; Xu, Tong

    2010-05-01

    The aim of this study is to develop and test an intravascular positron imaging system based on a storage phosphor detector for imaging and detecting vulnerable plaques of human coronary arteries. The radiotracer F18-FDG accumulates in vulnerable plaques with inflammation of the overlying cap. The vulnerable plaques can, therefore, be imaged by recording positrons emitted from F18-FDG with a detector inserted into the artery. A prototype intravascular detector was constructed based on storage phosphor. The detector uses a flexible storage phosphor tube with 55 mm length, 2 mm diameter and 0.28 mm wall thickness. The intravascular detector is guided into the vessel using x-ray fluoroscopy and the accumulated x-ray signal must be erased prior to positron imaging. For this purpose, a light diffuser, 0.9 mm in diameter and 55 mm in length, was inserted into the detector tube. The light diffuser was connected to a laser source through a 2 m long optical fiber. The diffuser redirected the 0.38 W laser light to the inner surface of the phosphor detector to erase it. A heart phantom with 300 cm3 volume and three coronary arteries with 3.2 mm diameter and with several plaques was constructed. FDG solution with 0.5 µCi cm-3 activity concentration was filled in the heart and coronary arteries. The detector was inserted in a coronary artery and the signal from the plaques and surrounding background activity was recorded for 2 min. Then the phosphor detector was extracted and read out using a storage phosphor reader. The light diffuser erased the signal resulting from fluoroscopic exposure to level below that encountered during positron imaging. Vulnerable plaques with area activities higher than 1.2 nCi mm-2 were visualized by the detector. This activity is a factor of 10-20 lower than that expected in human vulnerable plaques. The detector was able to image the internal surface of the coronary vessels with 50 mm length and 360° circumference. Spatial resolution was 0

  14. Fetal suprarenal masses - assessing the complementary role of magnetic resonance and ultrasound for diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Flanagan, Siobhan M. [University of Minnesota Medical School, Department of Radiology, Minneapolis, MN (United States); Rubesova, Erika; Barth, Richard A. [Stanford University, Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Jaramillo, Diego [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2016-02-15

    To assess the value and complementary roles of fetal MRI and US for characterization and diagnosis of suprarenal masses. We conducted a multi-institutional retrospective database search for prenatally diagnosed suprarenal masses between 1999 and 2012 and evaluated the roles of prenatal US and fetal MRI for characterization and diagnosis, using postnatal diagnosis or surgical pathology as the reference standard. Prenatal US and fetal MRI were assessed for unique findings of each modality. The database yielded 25 fetuses (gestational age 20-37 weeks) with suprarenal masses. Twenty-one fetuses had prenatal US, 22 had MRI, 17 had both. Postnatal diagnoses included nine subdiaphragmatic extralobar sequestrations, seven adrenal hemorrhages, five neuroblastomas (four metastatic), two lymphatic malformations, one duplex kidney with upper pole cystic dysplasia, and one adrenal hyperplasia. Ultrasound was concordant with MRI for diagnoses in 12/17 (70.6%) cases. Discordant diagnoses between US and MRI included three neuroblastomas and two adrenal hemorrhages. In the three neuroblastomas US was equivocal and MRI was definitive for neuroblastoma, demonstrating heterogeneous, intermediate-signal solid masses and liver metastases. In the two cases of adrenal hemorrhage US was equivocal and MRI was definitive with signal characteristics of hemorrhage. In 2/4 neuroblastomas, Doppler US demonstrated a systemic artery suggesting extralobar sequestration; however MRI signal characteristics correctly diagnosed neuroblastoma. All cases of extralobar sequestration were correctly diagnosed by US and MRI. US and MRI both accurately detect suprarenal masses. MRI complements US in equivocal diagnoses and detects additional findings such as liver metastases in neuroblastoma. (orig.)

  15. Prehospital Ultrasound

    Directory of Open Access Journals (Sweden)

    Jen-Tang Sun

    2014-06-01

    Full Text Available Ultrasound is a commonly used diagnostic tool in clinical conditions. With recent developments in technology, use of portable ultrasound devices has become feasible in prehospital settings. Many studies also proved the feasibility and accuracy of prehospital ultrasound. In this article, we focus on the use of prehospital ultrasound, with emphasis on trauma and chest ultrasound.

  16. Role of informed consent for intravascular contrast media

    International Nuclear Information System (INIS)

    Hopper, K.D.; Tyler, H.N. Jr.

    1988-01-01

    To evaluate the usefulness of different degrees of informed consent for intravascular contrast media, the authors divided 100 patients into four groups: (1) informed consent with no information on intravascular contrast media, (2) simple written informed consent that detailed common risks, (3) detailed written informed consent that detailed all known risks, and (4) MD informed consent, during which a radiologist discussed all known risks of intravascular contrast media. Physician counseling time for group 4 averaged 11.4 minutes. On a postprocedure test about the common complications and risk factors of intravascular contrast media, the average scores were: group 1, 38.4%; group 2, 68.2%; group 3, 63.2%; and group 4, 69.8%. There was no statistical difference between groups 2-4 on the postprocedure test. If informed consent is to be used prior to intravascular contrast media administration, a simple written consent detailing the common risks and risk factors appears to be the best method

  17. Accuracy assessment of high frequency 3D ultrasound for digital impression-taking of prepared teeth

    Science.gov (United States)

    Heger, Stefan; Vollborn, Thorsten; Tinschert, Joachim; Wolfart, Stefan; Radermacher, Klaus

    2013-03-01

    Silicone based impression-taking of prepared teeth followed by plaster casting is well-established but potentially less reliable, error-prone and inefficient, particularly in combination with emerging techniques like computer aided design and manufacturing (CAD/CAM) of dental prosthesis. Intra-oral optical scanners for digital impression-taking have been introduced but until now some drawbacks still exist. Because optical waves can hardly penetrate liquids or soft-tissues, sub-gingival preparations still need to be uncovered invasively prior to scanning. High frequency ultrasound (HFUS) based micro-scanning has been recently investigated as an alternative to optical intra-oral scanning. Ultrasound is less sensitive against oral fluids and in principal able to penetrate gingiva without invasively exposing of sub-gingival preparations. Nevertheless, spatial resolution as well as digitization accuracy of an ultrasound based micro-scanning system remains a critical parameter because the ultrasound wavelength in water-like media such as gingiva is typically smaller than that of optical waves. In this contribution, the in-vitro accuracy of ultrasound based micro-scanning for tooth geometry reconstruction is being investigated and compared to its extra-oral optical counterpart. In order to increase the spatial resolution of the system, 2nd harmonic frequencies from a mechanically driven focused single element transducer were separated and corresponding 3D surface models were calculated for both fundamentals and 2nd harmonics. Measurements on phantoms, model teeth and human teeth were carried out for evaluation of spatial resolution and surface detection accuracy. Comparison of optical and ultrasound digital impression taking indicate that, in terms of accuracy, ultrasound based tooth digitization can be an alternative for optical impression-taking.

  18. Delayed-Onset Muscle Soreness: Temporal Assessment With Quantitative MRI and Shear-Wave Ultrasound Elastography.

    Science.gov (United States)

    Agten, Christoph A; Buck, Florian M; Dyer, Linda; Flück, Martin; Pfirrmann, Christian W A; Rosskopf, Andrea B

    2017-02-01

    The objective of our study was to assess delayed-onset muscle soreness (DOMS) over time using quantitative MRI and shear-wave ultrasound (US) elastography. Five male (mean age ± SD, 39.6 ± 4.6 years) and five female (30.6 ± 13.5 years) volunteers underwent 1.5-T MRI before and after (15 minutes, 1 day, 3 days, 7 days) performing unilateral eccentric resistance exercise of the elbow flexor muscles. The MRI examinations included fluid-sensitive, DWI, and diffusion-tensor imaging sequences of the distal upper arm. Muscle edema, apparent diffusion coefficient (ADC), and fractional anisotropy (FA) were assessed. US of the brachialis muscle was performed before and after (15 minutes, 12 hours, 1 day, 2 days, 3 days, 7 days) exercise to measure mean shear-wave velocity (SWV). Pain and muscle tightness were assessed. For men, muscle edema was moderate and peaked 3 days after exercise; for women, muscle edema was mild and peaked 1-3 days after exercise. ADC was highest 3 days after exercise in men (mean, 1809.22 × 10 -6 mm 2 /s; before exercise, 1529.88 × 10 -6 mm 2 /s) and women (1741.90 × 10 -6 mm 2 /s; before exercise, 1475.80 × 10 -6 mm 2 /s). FA dropped from 361.00 in men and 389.00 in women before exercise to a minimum of 252.12 and 321.28, respectively, 3 days after exercise. Mean SWV increased after exercise in men (before exercise, 3.00 ± 0.30 m/s; peak [15 minutes after exercise], 4.04 ± 0.90 m/s) and women (before, 2.82 ± 0.40 m/s; peak [1 day after exercise], 3.23 ± 0.40 m/s) and subsequently returned to normal. In men, the ADC values of the brachialis muscle positively correlated with mean SWV (r = 0.92, p = 0.028). FA negatively correlated with pain in men (r = -0.993, p = 0.001) Muscle edema outlasted clinical symptoms in most volunteers. FA inversely correlates with pain and may be a useful imaging parameter for assessment of DOMS. Shear-wave US elastography shows a temporary increase of muscle stiffness after DOMS-inducing exercise but does not

  19. Combination of optoacoustics and ultrasound imaging for non-invasive, rapid assessment, and management of circulatory shock

    Science.gov (United States)

    Petrov, Yuriy; Petrov, Irene Y.; Esenaliev, Rinat O.; Kinsky, Michael; Prough, Donald S.

    2011-03-01

    We developed a noninvasive, optoacoustic diagnostic platform for monitoring of multiple physiologic variables in inpatients and outpatients. One of the most important applications of this platform is noninvasive, rapid assessment and management of circulatory shock, a common condition in critically ill patients. At present, monitoring of circulatory shock requires measurement of central venous blood oxygenation using invasive procedures such as insertion of catheters in central veins. Hemoglobin saturation below 70% in central veins indicates circulatory shock that requires immediate treatment. We built a portable optoacoustic system for noninvasive measurement of central venous oxygenation. In this study we used the optoacoustic system and clinical ultrasound imaging systems for rapid optoacoustic probing of these veins. The optoacoustic system utilizes a custom-made, sensitive optoacoustic probe that was developed in our laboratory for monitoring of blood oxygenation in deep blood vessels. The studies were performed in human subjects with different geometry (depth, size) of the veins. The ultrasound imaging systems permitted rapid identification of specific blood vessels for optoacoustic probing. We developed a novel algorithm for continuous, realtime, and precise measurement of blood oxygenation in blood vessels. Precision of central venous oxygenation measurement obtained in the study was very high: 1%. Our results indicate that the combination of optoacoustics and ultrasound imaging systems can provide more rapid and accurate assessment and management of the circulatory shock.

  20. Ultrasound assessed thickness of burn scars in association with laser Doppler imaging determined depth of burns in paediatric patients.

    Science.gov (United States)

    Wang, Xue-Qing; Mill, Julie; Kravchuk, Olena; Kimble, Roy M

    2010-12-01

    This study describes the ultrasound assessment of burn scars in paediatric patients and the association of these scar thickness with laser Doppler imaging (LDI) determined burn depth. A total of 60 ultrasound scar assessments were conducted on 33 scars from 21 paediatric burn patients at 3, 6 and 9 months after-burn. The mean of peak scar thickness was 0.39±0.032 cm, with the thickest at 6 months (0.40±0.036 cm). There were 17 scald burn scars (0.34±0.045 cm), 4 contact burn scars (0.61±0.092 cm), and 10 flame burn scars (0.42±0.058 cm). Each group of scars followed normal distributions. Twenty-three scars had original burns successfully scanned by LDI and various depths of burns were presented by different colours according to blood perfusion units (PU), with dark blue burns, with the thinnest scars for green coloured burns and the thickest for dark blue coloured burns. Within light blue burns, grafted burns healed with significantly thinner scars than non-grafted burns. This study indicates that LDI can be used for predicting the risk of hypertrophic scarring and for guiding burn care. To our knowledge, this is the first study to correlate the thickness of burns scars by ultrasound scan with burn depth determined by LDI. Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

  1. Computer-aided system for diagnosing thyroid nodules on ultrasound: A comparison with radiologist-based clinical assessments.

    Science.gov (United States)

    Gao, Luying; Liu, Ruyu; Jiang, Yuxin; Song, Wenfeng; Wang, Ying; Liu, Jia; Wang, Juanjuan; Wu, Dongqian; Li, Shuai; Hao, Aimin; Zhang, Bo

    2018-04-01

    The purpose of this study was to compare the diagnostic efficiency of a thyroid ultrasound computer-aided diagnosis (CAD) system with that of 1 radiologist. This study retrospectively reviewed 342 surgically resected thyroid nodules from July 2013 to December 2013 at our center. The nodules were assessed on typical ultrasound images using the CAD system and reviewed by 1 experienced radiologist. The radiologist stratified the risk of malignancy using the Thyroid Imaging Reporting and Data Systems (TIRADS) and the American Thyroid Association (ATA) guidelines. The radiologist, using TI-RADS and ATA guidelines, performed better than the CAD system (P system was similar to that of an experienced radiologist (P > .05; P .05). However, we found that the CAD system had lower specificity (P system in differentiating nodules was similar to that of an experienced radiologist. However, the CAD system had lower specificity. © 2017 Wiley Periodicals, Inc.

  2. Assessment of substantia nigra echogenicity in German and Filipino populations using a portable ultrasound system.

    Science.gov (United States)

    Go, Criscely L; Frenzel, Antonia; Rosales, Raymond L; Lee, Lillian V; Benecke, Reiner; Dressler, Dirk; Walter, Uwe

    2012-02-01

    Transcranial sonography of the substantia nigra for diagnosing premotor stages of Parkinson disease has been attracting increasing interest. Standard reference values defining an abnormal increased echogenic size (hyperechogenicity) of the substantia nigra have been established in several populations using high-end stationary ultrasound systems. It is unknown whether a portable ultrasound system can be appropriately used and how the Filipino population would compare with the well-studied white population. We prospectively studied substantia nigra echogenic sizes and third ventricle widths in 71 healthy adult German participants and 30 age- and sex-matched Filipino participants using both a well-established stationary ultrasound system (in the German cohort) and a recently distributed portable ultrasound system (in both ethnic cohorts). Mean substantia nigra echogenic sizes, cutoff values defining abnormal hyperechogenicity, and intra-rater reliability were similar with both systems and in both ethnic cohorts studied. The Filipino and German participants did not differ with respect to the frequency of insufficient insonation conditions (each 3%) and substantia nigra hyperechogenicity (10% versus 9%; P = .80). However, third ventricle widths were smaller in the Filipino than the German participants (mean ± SD, 1.6 ± 1.1 versus 2.4 ± 1.0 mm; P = .004). The frequency of substantia nigra hyperechogenicity appears to be homogeneous in white and Asian populations. Screening for this feature may well be performed with a present-day portable ultrasound system.

  3. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... ultrasound is most often performed to evaluate the: uterus cervix ovaries fallopian tubes bladder Pelvic ultrasound exams ... to view the endometrium (the lining of the uterus) and the ovaries. Transvaginal ultrasound also evaluates the ...

  4. Prostate Ultrasound

    Medline Plus

    Full Text Available ... Videos About Us News Physician Resources Professions Site Index A-Z Ultrasound - Prostate Ultrasound of the prostate ... ultrasound images are captured in real-time, they can show the structure and movement of the body's ...

  5. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... Videos About Us News Physician Resources Professions Site Index A-Z Ultrasound - Pelvis Ultrasound imaging of the ... ultrasound images are captured in real-time, they can show the structure and movement of the body's ...

  6. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... special ultrasound technique that allows the physician to see and evaluate blood flow through arteries and veins ... development of an embryo or fetus during pregnancy. See the Obstetrical Ultrasound page for more information . Ultrasound ...

  7. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... What are the limitations of Pelvic Ultrasound Imaging? What is Pelvic Ultrasound Imaging? Ultrasound is safe and ... as the liver or kidneys. top of page What are some common uses of the procedure? In ...

  8. Prostate Ultrasound

    Medline Plus

    Full Text Available ... What are the limitations of Prostate Ultrasound Imaging? What is Ultrasound Imaging of the Prostate? Ultrasound is ... in front of the rectum. top of page What are some common uses of the procedure? A ...

  9. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... three types of pelvic ultrasound: abdominal, vaginal (for women), and rectal (for men). These exams are frequently ... pelvic ultrasound: abdominal ( transabdominal ) vaginal ( transvaginal / endovaginal ) for women rectal ( transrectal ) for men A Doppler ultrasound exam ...

  10. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... a pelvic ultrasound examination. Doppler ultrasound , also called color Doppler ultrasonography, is a special ultrasound technique that ... and processes the sounds and creates graphs or color pictures that represent the flow of blood through ...

  11. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... insertion. top of page How does the procedure work? Ultrasound imaging is based on the same principles ... Abdomen Obstetric Ultrasound Ultrasound - Prostate Kidney and Bladder Stones Abnormal Vaginal Bleeding Ovarian Cancer Images related to ...

  12. Ultrasound assessment of new onset bilateral painful shoulder in patients with polymyalgia rheumatica and rheumatoid arthritis.

    Science.gov (United States)

    Ruta, Santiago; Rosa, Javier; Navarta, David A; Saucedo, Carla; Catoggio, Luis J; Monaco, Ricardo García; Soriano, Enrique R

    2012-09-01

    The aim of our study was to investigate by ultrasound (US) the anatomical structures affected during a new episode of bilateral painful shoulder in patients with polymyalgia rheumatica (PMR) and rheumatoid arthritis (RA) and to compare the findings between these two conditions. PMR and RA patients complaining of new onset bilateral painful shoulder were included. Subjects without any known rheumatic condition with a new onset unilateral painful shoulder were assessed as a control group. US evaluation includes the depiction subacromial-subdeltoid (SAD) bursitis, long head biceps (LHB) tenosynovitis and/or gleno-humeral (GH) synovitis. Thirty patients with PMR, 30 with RA, and 60 controls were included for a total of 60 shoulders per group. Unilateral SAD bursitis and LHB tenosynovitis were significantly more frequent in patients with PMR when compared to those with RA (p < 0.0001 and p < 0.01, respectively) and controls (p < 0.001 and p < 0.01, respectively). Unilateral GH synovitis was more common in RA than in PMR and controls (p < 0.05 and p < 0.01, respectively). Bilateral SAD bursitis was significantly more frequent in patients with PMR than in those with RA (p < 0.01) as was bilateral LHB tenosynovitis (p < 0.01). No significant differences were found in bilateral GH synovitis. US-detected periarticular inflammatory involvement more frequently in PMR both unilaterally and bilaterally and intra-articular inflammatory involvement was commonly in RA but only unilaterally.

  13. Quantitative Ultrasound Assessment of Duchenne Muscular Dystrophy Using Edge Detection Analysis.

    Science.gov (United States)

    Koppaka, Sisir; Shklyar, Irina; Rutkove, Seward B; Darras, Basil T; Anthony, Brian W; Zaidman, Craig M; Wu, Jim S

    2016-09-01

    The purpose of this study was to investigate the ability of quantitative ultrasound (US) using edge detection analysis to assess patients with Duchenne muscular dystrophy (DMD). After Institutional Review Board approval, US examinations with fixed technical parameters were performed unilaterally in 6 muscles (biceps, deltoid, wrist flexors, quadriceps, medial gastrocnemius, and tibialis anterior) in 19 boys with DMD and 21 age-matched control participants. The muscles of interest were outlined by a tracing tool, and the upper third of the muscle was used for analysis. Edge detection values for each muscle were quantified by the Canny edge detection algorithm and then normalized to the number of edge pixels in the muscle region. The edge detection values were extracted at multiple sensitivity thresholds (0.01-0.99) to determine the optimal threshold for distinguishing DMD from normal. Area under the receiver operating curve values were generated for each muscle and averaged across the 6 muscles. The average age in the DMD group was 8.8 years (range, 3.0-14.3 years), and the average age in the control group was 8.7 years (range, 3.4-13.5 years). For edge detection, a Canny threshold of 0.05 provided the best discrimination between DMD and normal (area under the curve, 0.96; 95% confidence interval, 0.84-1.00). According to a Mann-Whitney test, edge detection values were significantly different between DMD and controls (P imaging using edge detection can distinguish patients with DMD from healthy controls at low Canny thresholds, at which discrimination of small structures is best. Edge detection by itself or in combination with other tests can potentially serve as a useful biomarker of disease progression and effectiveness of therapy in muscle disorders.

  14. Quality Assessment of Hepatic Ultrasound Images Examined After a Medical Check-up

    International Nuclear Information System (INIS)

    Kim, Pyo Nyun; Kim, Kyung Won; Byun, Jae Ho

    2009-01-01

    This study was designed to determine problems associated with liver ultrasonography for healthy individuals after a medical examination by the evaluation of sonographic images. A total of 353 patients randomly selected from 341 institutions underwent liver ultrasonography. Among the patients, 14 patients were excluded from the study as they possessed digital images that were not accessible (n = 10) or underwent ultrasonography (n = 4) that did not involve the liver. Two experts each with a ten-year experience in the interpretation of ultrasonography analyzed the images with consensus based on the assessment of liver ultrasonography established by the Korean Society of Ultrasound in Medicine. The images of 339 patients consisted of digital images (n =135), films (n = 14) and prints on paper (n = 190). A total of 3514 images (range, 1-39: mean number of images per patient,10.4) were obtained from 339 patients. Of the patients, there were 232 (68.4%) patients with eight good images and 231 patients had a score greater than 60 points. The mean percent score was 64.9 for general information, 63.8 for technical information and 50.5 for a standard examination. The mean percent score for a longitudinal scan of the common bile duct and vertical scan of the left lobe were low at 20.1 and 28.9, respectively. The number of good images was sufficient at 10.4, but patient information was not exact, ultrasonographic equipment was not adjusted and a standard examination was not applied. As these findings were based on examiner ignorance and indifference, education or certification for examiners should be required

  15. Point-of-Care Ultrasound for Jugular Venous Pressure Assessment: Live and Online Learning Compared.

    Science.gov (United States)

    Socransky, Steve; Lang, Eddy; Bryce, Rhonda; Betz, Martin

    2017-06-08

    Point-of-care ultrasound (POCUS) is a novel technique for the assessment of jugular venous pressure. Distance education may allow for efficient dissemination of this technique. We compared online learning to a live course for teaching ultrasonography jugular venous pressure (u-JVP) to determine if these teaching methods yielded different levels of comfort with and use of u-JVP. This was an interventional trial of Canadian emergency physicians who had taken a basic POCUS course. The participants were in one of three Groups: online learning (Group OL), live teaching (Group LT), control (Group C). Group LT participants also took an advanced course prior to the study that included instruction in u-JVP. The participants who took the basic course were randomized to Group OL or Group C. Group OL was subject to the intervention, online learning. Group C only received an article citation regarding u-JVP. Questionnaires were completed before and after the intervention. The primary outcome was physician self-reported use and comfort with the technique of u-JVP after online learning compared to live teaching. Of the 287 advanced course participants, 42 completed the questionnaires (Group LT). Of the 3303 basic course participants, 47 who were assigned to Group OL completed the questionnaires and 47 from Group C completed the questionnaires. Use of u-JVP increased significantly in Group OL (from 15% to 55%) and Group C (from 21% to 47%) with the intervention. The comfort with use did not differ between Group LT and Group OL (p=0.14). The frequency of use remained higher in Group LT than Group OL (p=0.07). Online learning increases the use and comfort with performing u-JVP for emergency physicians with prior POCUS experience. Although the comfort with use of u-JVP was similar in Groups LT and OL, online learning appears to yield levels of use that are less than those of a live course.

  16. Impact of a standardized training program on midwives’ ability to assess fetal heart anatomy by ultrasound

    International Nuclear Information System (INIS)

    Hildebrand, Eric; Abrandt Dahlgren, Madeleine; Sved, Catarina; Gottvall, Tomas; Blomberg, Marie; Janerot-Sjoberg, Birgitta

    2014-01-01

    Studies of prenatal detection of congenital heart disease (CHD) in the UK, Italy, and Norway indicate that it should be possible to improve the prenatal detection rate of CHD in Sweden. These studies have shown that training programs, visualization of the outflow tracts and color-Doppler all can help to speed up and improve the detection rate and accuracy. We aimed to introduce a more accurate standardized fetal cardiac ultrasound screening protocol in Sweden. A novel pedagogical model for training midwives in standardized cardiac imaging was developed, a model using a think-aloud analysis during a pre- and post-course test and a subsequent group reflection. The self-estimated difficulties and knowledge gaps of two experienced and two beginner midwives were identified. A two-day course with mixed lectures, demonstrations and hands-on sessions was followed by a feedback session three months later consisting of an interview and check-up. The long-term effects were tested two years later. At the post-course test the self-assessed uncertainty was lower than at the pre-course test. The qualitative evaluation showed that the color Doppler images were difficult to interpret, but the training seems to have improved their ability to use the new technique. The ability to perform the method remained at the new level at follow-up both three months and two years later. Our results indicate that by implementing new imaging modalities and providing hands-on training, uncertainty can be reduced and examination time decreased, but they also show that continuous on-site training with clinical and technical back-up is important

  17. The impact of breast cancer biological subtyping on tumor size assessment by ultrasound and mammography - a retrospective multicenter cohort study of 6543 primary breast cancer patients

    International Nuclear Information System (INIS)

    Stein, Roland Gregor; Wollschläger, Daniel; Kreienberg, Rolf; Janni, Wolfgang; Wischnewsky, Manfred; Diessner, Joachim; Stüber, Tanja; Bartmann, Catharina; Krockenberger, Mathias; Wischhusen, Jörg; Wöckel, Achim; Blettner, Maria; Schwentner, Lukas

    2016-01-01

    Mammography and ultrasound are the gold standard imaging techniques for preoperative assessment and for monitoring the efficacy of neoadjuvant chemotherapy in breast cancer. Maximum accuracy in predicting pathological tumor size non-invasively is critical for individualized therapy and surgical planning. We therefore aimed to assess the accuracy of tumor size measurement by ultrasound and mammography in a multicentered health services research study. We retrospectively analyzed data from 6543 patients with unifocal, unilateral primary breast cancer. The maximum tumor diameter was measured by ultrasound and/or mammographic imaging. All measurements were compared to final tumor diameter determined by postoperative histopathological examination. We compared the precision of each imaging method across different patient subgroups as well as the method-specific accuracy in each patient subgroup. Overall, the correlation with histology was 0.61 for mammography and 0.60 for ultrasound. Both correlations were higher in pT2 cancers than in pT1 and pT3. Ultrasound as well as mammography revealed a significantly higher correlation with histology in invasive ductal compared to lobular cancers (p < 0.01). For invasive lobular cancers, the mammography showed better correlation with histology than ultrasound (p = 0.01), whereas there was no such advantage for invasive ductal cancers. Ultrasound was significantly superior for HR negative cancers (p < 0.001). HER2/neu positive cancers were also more precisely assessed by ultrasound (p < 0.001). The size of HER2/neu negative cancers could be more accurately predicted by mammography (p < 0.001). This multicentered health services research approach demonstrates that predicting tumor size by mammography and ultrasound provides accurate results. Biological tumor features do, however, affect the diagnostic precision

  18. Assessment of portal venous system patency in the liver transplant candidate: A prospective study comparing ultrasound, microbubble-enhanced colour Doppler ultrasound, with arteriography and surgery

    International Nuclear Information System (INIS)

    Marshall, M.M.; Beese, R.C.; Muiesan, P.; Sarma, D.I.; O'Grady, J.; Sidhu, P.S.

    2002-01-01

    AIM: To determine the role of microbubble-enhanced colour Doppler ultrasound (CDUS) in assessing portal venous patency prior to liver transplantation. MATERIALS AND METHODS: Over a 2-year period, all patients with chronic liver disease undergoing routine pre-transplant CDUS examination in whom the portal venous system was inadequately demonstrated were recruited to the study. CDUS was performed in 368 patients and 33 patients (9%) were recruited. A repeat CDUS examination following an intravenous bolus injection of the microbubble contrast agent Levovist[reg] (Schering Healthcare AG, Berlin, Germany) was performed. Diagnostic confidence was recorded on a free linear analogue scale for both examinations. Findings were compared with indirect portography and surgery. RESULTS: Of the 33 patients with sub-optimal baseline examinations, improvement in portal vein visualization was achieved in 31 patients (94%). Median diagnostic confidence increased from 50% (interquartile range 30-60) to 90% (interquartile range 75-98) (P < 0.001) following administration of Levovist[reg]. Overall accuracy of portal vein assessment using microbubble-enhanced CDUS in 15 patients in whom a definitive diagnosis was made within 2 months was 87%. CONCLUSION: Microbubble-enhanced CDUS is a simple, inexpensive adjunct to standard pre liver transplant screening of the portal vein. It is particularly helpful in patients with end-stage cirrhosis who are at high risk of portal vein thrombosis and in whom the conventional examination is sub-optimal.Marshall, M.M. et al. (2002)

  19. Test characteristics of high-resolution ultrasound in the preoperative assessment of margins of basal cell and squamous cell carcinoma in patients undergoing Mohs micrographic surgery.

    Science.gov (United States)

    Jambusaria-Pahlajani, Anokhi; Schmults, Chrysalyne D; Miller, Christopher J; Shin, Daniel; Williams, Jennifer; Kurd, Shanu K; Gelfand, Joel M

    2009-01-01

    Noninvasive techniques to assess subclinical spread of nonmelanoma skin cancer (NMSC) may improve surgical precision. High-resolution ultrasound has shown promise in evaluating the extent of NMSC. To determine the accuracy of high-resolution ultrasound to assess the margins of basal cell (BCC) and squamous cell carcinomas (SCC) before Mohs micrographic surgery (MMS). We enrolled 100 patients with invasive SCC or BCC. Before the first stage of MMS, a Mohs surgeon delineated the intended surgical margin. Subsequently, a trained ultrasound technologist independently evaluated disease extent using the EPISCAN I-200 to evaluate tumor extent beyond this margin. The accuracy of high-resolution ultrasound was subsequently tested by comparison with pathology from frozen sections. The test characteristics of the high-resolution ultrasound were sensitivity=32%, specificity=88%, positive predictive value=47%, and negative predictive value=79%. Subgroup analyses demonstrated better test characteristics for tumors larger than the median (area>1.74 cm(2)). Qualitative analyses showed that high-resolution ultrasound was less likely to identify extension from tumors with subtle areas of extension, such as small foci of dermal invasion from infiltrative SCC and micronodular BCC. High-resolution ultrasound requires additional refinements to improve the preoperative determination of tumor extent before surgical treatment of NMSC.

  20. VR-based training and assessment in ultrasound-guided regional anesthesia: from error analysis to system design.

    LENUS (Irish Health Repository)

    2011-01-01

    If VR-based medical training and assessment is to improve patient care and safety (i.e. a genuine health gain), it has to be based on clinically relevant measurement of performance. Metrics on errors are particularly useful for capturing and correcting undesired behaviors before they occur in the operating room. However, translating clinically relevant metrics and errors into meaningful system design is a challenging process. This paper discusses how an existing task and error analysis was translated into the system design of a VR-based training and assessment environment for Ultrasound Guided Regional Anesthesia (UGRA).

  1. 3D ultrasound to assess the position of tubal sterilization microinserts.

    Science.gov (United States)

    Legendre, Guillaume; Levaillant, Jean-Marc; Faivre, Erika; Deffieux, Xavier; Gervaise, Amélie; Fernandez, Hervé

    2011-10-01

    The aim of this study was to assess the diagnostic accuracy of three-dimensional ultrasound (3D-US) for determining the position of Essure microinserts and the success of sterilization by the Essure method. This retrospective observational study examined the case records of 311 women who underwent hysteroscopic sterilization from October 2002 through October 2008. Imaging with 3D-US or pelvic X-radiography or both was performed 3 months after the procedure to verify device position. Hysterosalpingography (HSG) was performed when a bilateral procedure was not completed because of a history of salpingectomy or blocked tube, when doubt persisted after 3D-US or pelvic radiography, or for comparative purposes in a prospective study. The positions seen on 3D-US were classified in four categories according to a specific scale we devised. The insertion procedure was completed in 94.2% patients. Only 90.5% underwent imaging verification of the device 3 months afterwards. In all, 227 3D-US, 175 pelvic radiography and 64 HSG imaging procedures were performed. Visualization of the device was possible in 99.6% of the 3D-US images. According to our classification, 3D-US was appropriate for assessing device position for 195 (85.9%) patients. The need for HSG confirmation was significantly lower with 3D-US than radiographic imaging (14.1 versus 26.8%, P = 0.001). 3D-US examinations, compared with the results of HSG as the reference test, had a sensitivity of 100% and a specificity of 76.6%. Neither pregnancy nor early expulsion occurred when 3D-US found that the devices were correctly placed. 3D-US is a simple technique for assessing the position of Essure(®) microinserts, even after concomitant endometrial surgery. The 3D-US classification presented here appears to make it possible to use HSG for back-up confirmation only when the microinsert is found in a very distal position on 3D-US and thus to protect the majority of women from the negative effects of pelvic radiography and

  2. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... through blood vessels. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. There are three types of pelvic ultrasound: ...

  3. Protection against high intravascular pressure in giraffe legs.

    Science.gov (United States)

    Petersen, Karin K; Hørlyck, Arne; Ostergaard, Kristine H; Andresen, Joergen; Broegger, Torbjoern; Skovgaard, Nini; Telinius, Niklas; Laher, Ismael; Bertelsen, Mads F; Grøndahl, Carsten; Smerup, Morten; Secher, Niels H; Brøndum, Emil; Hasenkam, John M; Wang, Tobias; Baandrup, Ulrik; Aalkjaer, Christian

    2013-11-01

    The high blood pressure in giraffe leg arteries renders giraffes vulnerable to edema. We investigated in 11 giraffes whether large and small arteries in the legs and the tight fascia protect leg capillaries. Ultrasound imaging of foreleg arteries in anesthetized giraffes and ex vivo examination revealed abrupt thickening of the arterial wall and a reduction of its internal diameter just below the elbow. At and distal to this narrowing, the artery constricted spontaneously and in response to norepinephrine and intravascular pressure recordings revealed a dynamic, viscous pressure drop along the artery. Histology of the isolated median artery confirmed dense sympathetic innervation at the narrowing. Structure and contractility of small arteries from muscular beds in the leg and neck were compared. The arteries from the legs demonstrated an increased media thickness-to-lumen diameter ratio, increased media volume, and increased numbers of smooth muscle cells per segment length and furthermore, they contracted more strongly than arteries from the neck (500 ± 49 vs. 318 ± 43 mmHg; n = 6 legs and neck, respectively). Finally, the transient increase in interstitial fluid pressure following injection of saline was 5.5 ± 1.7 times larger (n = 8) in the leg than in the neck. We conclude that 1) tissue compliance in the legs is low; 2) large arteries of the legs function as resistance arteries; and 3) structural adaptation of small muscle arteries allows them to develop an extraordinary tension. All three findings can contribute to protection of the capillaries in giraffe legs from a high arterial pressure.

  4. Biomechanical assessment and monitoring of thermal ablation using Harmonic Motion Imaging for Focused Ultrasound (HMIFU)

    Science.gov (United States)

    Hou, Gary Yi

    Cancer remains, one of the major public health problems in the United States as well as many other countries worldwide. According to According to the World Health Organization, cancer is currently the leading cause of death worldwide, accounting for 7.6 million deaths annually, and 25% of the annual death was due to Cancer during the year of 2011. In the long history of the cancer treatment field, many treatment options have been established up to date. Traditional procedures include surgical procedures as well as systemic therapies such as biologic therapy, chemotherapy, hormone therapy, and radiation therapy. Nevertheless, side-effects are often associated with such procedures due to the systemic delivery across the entire body. Recently technologies have been focused on localized therapy under minimally or noninvasive procedure with imaging-guidance, such as cryoablation, laser ablation, radio-frequency (RF) ablation, and High Intensity F-ocused Ultrasound (HIFU). HIFU is a non-invasive procedure aims to coagulate tissue thermally at a localized focal zone created with noninvasively emitting a set of focused ultrasound beams while the surrounding healthy tissues remain relatively untreated. Harmonic Motion Imaging for Focused Ultrasound (HMIFU) is a dynamic, radiation-force-based imaging technique, which utilizes a single HIFU transducer by emitting an Amplitude-modulated (AM) beam to both thermally ablate the tumor while inducing a stable oscillatory tissue displacement at its focal zone. The oscillatory response is then estimated by a cross-correlation based motion tracking technique on the signal collected by a confocally-aligned diagnostic transducer. HMIFU addresses the most critical aspect and one of the major unmet needs of HIFU treatment, which is the ability to perform real-time monitoring and mapping of tissue property change during the HIFU treatment. In this dissertation, both the assessment and monitoring aspects of HMIFU have been investigated

  5. Model of distribution of dose for intravascular brachytherapy; Modelo de distribucion de dosis para braquiterapia intravascular

    Energy Technology Data Exchange (ETDEWEB)

    Pirchio, Rosana; Signoretta, Catalina [Comision Nacional de Energia Atomica (CNEA), Buenos Aires (Argentina). Dosimetria de Radioaciones Ionizantes; Martin, Gabriela; Rivera, Elena; Bergoc, Rosa [Univeridad de Buenos Aires (Argentina). Facultad de Farmacia y Bioquimica. Lab. de Radioisotopos; Guzman, Luis [Instituto Cardiovascular de Buenos Aires (Argentina)

    2001-07-01

    In this work we present the radiation dose distributions for a theoretical model with Monte Carlo simulation, which was based on an experimental model developed for the study of the prevention of restenosis post-angioplasty employing intravascular brachytherapy. In the experimental model, the atherosclerotic plaques were induced in femoral arteries of male New Zealand rabbits through surgical intervention and later administration of cholesterol enriched diet. For the intravascular irradiation we employed a {sup 32} P source contained within the balloon used for the angioplasty. The radiation dose distributions were calculated using the Monte Carlo code MCNP4B according to a segment of a simulated artery. We studied the radiation dose distribution in the axial and radial directions for different thickness of the atherosclerotic plaques. The results will be correlated with the biologic effects observed by means of histological analysis of the irradiated arteries. (author)

  6. Arteriovenous fistulae after renal biopsy: diagnosis and outcomes using Doppler ultrasound assessment.

    Science.gov (United States)

    Sosa-Barrios, R Haridian; Burguera, Victor; Rodriguez-Mendiola, Nuria; Galeano, Cristina; Elias, Sandra; Ruiz-Roso, Gloria; Jimenez-Alvaro, Sara; Liaño, Fernando; Rivera-Gorrin, Maite

    2017-12-20

    Percutaneous renal biopsy (PRB) is an important technique providing relevant information to guide diagnosis and treatment in renal disease. As an invasive procedure it has complications. Most studies up to date have analysed complications related to bleeding. We report the largest single-center experience on routine Doppler ultrasound (US) assessment post PRB, showing incidence and natural history of arteriovenous fistulae (AVF) post PRB. We retrospectively analysed 327 consecutive adult PRB performed at Ramon Cajal University Hospital between January 2011 and December 2014. All biopsies were done under real-time US guidance by a trained nephrologist. Routine Doppler mapping and kidney US was done within 24 h post biopsy regardless of symptoms. Comorbidities, full blood count, clotting, bleeding time and blood pressure were recorded at the time of biopsy. Post biopsy protocol included vitals and urine void checked visually for haematuria. Logistic regression was used to investigate links between AVF, needle size, correcting for potential confounding variables. 46,5% were kidney transplants and 53,5% were native biopsies. Diagnostic material was obtained in 90,5% (142 grafts and 154 native). Forty-seven AVF's (14.37%) were identified with routine kidney Doppler mapping, 95% asymptomatic (n = 45), 28 in grafts (18.4%) and 17 natives (9.7%) (p-value 0.7). Both groups were comparable in terms of comorbidities, passes, cylinders or biopsy yield (p-value NS). 80% were <1 cm in size and 46.6% closed spontaneously in less than 30 days (range 3-151). Larger AVF's (1-2 cm) took a mean of 52 days to closure (range 13-151). Needle size was not statistically significant factor for AVF (p-value 0.71). Contrary to historical data published, AVF's are a common complication post PRB that can be easily missed. Routine US Doppler mapping performed by trained staff is a cost-effective, non-invasive tool to diagnose and follow up AVF's, helping to assess management.

  7. Sonographic evaluation of intravascular volume status: Can internal jugular or femoral vein collapsibility be used in the absence of IVC visualization?

    Directory of Open Access Journals (Sweden)

    Alistair Kent

    2015-01-01

    Full Text Available Introduction: Inferior vena cava collapsibility index (IVC-CI has been shown to correlate with both clinical and invasive assessment of intravascular volume status, but has important limitations such as the requirement for advanced sonographic skills, the degree of difficulty in obtaining those skills, and often challenging visualization of the IVC in the postoperative patient. The current study aims to explore the potential for using femoral (FV or internal jugular (IJV vein collapsibility as alternative sonographic options in the absence of adequate IVC visualization. Methods: A prospective, observational study comparing IVC-CI and Fem- and/or IJV-CI was performed in two intensive care units (ICU between January 2012 and April 2014. Concurrent M-mode measurements of IVC-CI and FV- and/or IJV-CI were collected during each sonographic session. Measurements of IVC were obtained using standard technique. IJV-CI and FV-CI were measured using high-frequency, linear array ultrasound probe placed in the corresponding anatomic areas. Paired data were analyzed using coefficient of correlation/determination and Bland-Altman determination of measurement bias. Results: We performed paired ultrasound examination of IVC-IJV (n = 39 and IVC-FV (n = 22, in 40 patients (mean age 54.1; 40% women. Both FV-CI and IJV-CI scans took less time to complete than IVC-CI scans (both, P < 0.02. Correlations between IVC-CI/FV-CI (R 2 = 0.41 and IVC-CI/IJV-CI (R 2 = 0.38 were weak. There was a mean -3.5% measurement bias between IVC-CI and IJV-CI, with trend toward overestimation for IJV-CI with increasing collapsibility. In contrast, FV-CI underestimated collapsibility by approximately 3.8% across the measured collapsibility range. Conclusion: Despite small measurement biases, correlations between IVC-CI and FV-/IJV-CI are weak. These results indicate that IJ-CI and FV-CI should not be used as a primary intravascular volume assessment tool for clinical decision support in

  8. Use of the cumulative sum method (CUSUM) to assess the learning curves of ultrasound-guided continuous femoral nerve block.

    Science.gov (United States)

    Kollmann-Camaiora, A; Brogly, N; Alsina, E; Gilsanz, F

    2017-10-01

    Although ultrasound is a basic competence for anaesthesia residents (AR) there is few data available on the learning process. This prospective observational study aims to assess the learning process of ultrasound-guided continuous femoral nerve block and to determine the number of procedures that a resident would need to perform in order to reach proficiency using the cumulative sum (CUSUM) method. We recruited 19 AR without previous experience. Learning curves were constructed using the CUSUM method for ultrasound-guided continuous femoral nerve block considering 2 success criteria: a decrease of pain score>2 in a [0-10] scale after 15minutes, and time required to perform it. We analyse data from 17 AR for a total of 237 ultrasound-guided continuous femoral nerve blocks. 8/17 AR became proficient for pain relief, however all the AR who did more than 12 blocks (8/8) became proficient. As for time of performance 5/17 of AR achieved the objective of 12minutes, however all the AR who did more than 20 blocks (4/4) achieved it. The number of procedures needed to achieve proficiency seems to be 12, however it takes more procedures to reduce performance time. The CUSUM methodology could be useful in training programs to allow early interventions in case of repeated failures, and develop competence-based curriculum. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. [Assessment of amylase and lipase levels following puncture biopsy and fine needle aspiration guided by endoscopic ultrasound in pancreatic lesions].

    Science.gov (United States)

    Membrillo-Romero, Alejandro; Gonzalez-Lanzagorta, Rubén; Rascón-Martínez, Dulce María

    Puncture biopsy and fine needle aspiration guided by endoscopic ultrasound has been used as an effective technique and is quickly becoming the procedure of choice for diagnosis and staging in patients suspected of having pancreatic cancer. This procedure has replaced retrograde cholangiopancreatography and brush cytology due to its higher sensitivity for diagnosis, and lower risk of complications. To assess the levels of pancreatic enzymes amylase and lipase, after the puncture biopsy and fine needle aspiration guided by endoscopic ultrasound in pancreatic lesions and the frequency of post-puncture acute pancreatitis. A longitudinal and descriptive study of consecutive cases was performed on outpatients submitted to puncture biopsy and fine needle aspiration guided by endoscopic ultrasound in pancreatic lesions. Levels of pancreatic enzymes such as amylase and lipase were measured before and after the pancreatic puncture. Finally we documented post-puncture pancreatitis cases. A total of 100 patients who had been diagnosed with solid and cystic lesions were included in the study. Significant elevation was found at twice the reference value for lipase in 5 cases (5%) and for amylase in 2 cases (2%), none had clinical symptoms of acute pancreatitis. Eight (8%) of patients presented with mild nonspecific pain with no enzyme elevation compatible with pancreatitis. Pancreatic biopsy needle aspiration guided by endoscopic ultrasound was associated with a low rate of elevated pancreatic enzymes and there were no cases of post-puncture pancreatitis. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  10. Evaluations of UltraiQ software for objective ultrasound image quality assessment using images from a commercial scanner.

    Science.gov (United States)

    Long, Zaiyang; Tradup, Donald J; Stekel, Scott F; Gorny, Krzysztof R; Hangiandreou, Nicholas J

    2018-01-16

    We evaluated a commercially available software package that uses B-mode images to semi-automatically measure quantitative metrics of ultrasound image quality, such as contrast response, depth of penetration (DOP), and spatial resolution (lateral, axial, and elevational). Since measurement of elevational resolution is not a part of the software package, we achieved it by acquiring phantom images with transducers tilted at 45 degrees relative to the phantom. Each measurement was assessed in terms of measurement stability, sensitivity, repeatability, and semi-automated measurement success rate. All assessments were performed on a GE Logiq E9 ultrasound system with linear (9L or 11L), curved (C1-5), and sector (S1-5) transducers, using a CIRS model 040GSE phantom. In stability tests, the measurements of contrast, DOP, and spatial resolution remained within a ±10% variation threshold in 90%, 100%, and 69% of cases, respectively. In sensitivity tests, contrast, DOP, and spatial resolution measurements followed the expected behavior in 100%, 100%, and 72% of cases, respectively. In repeatability testing, intra- and inter-individual coefficients of variations were equal to or less than 3.2%, 1.3%, and 4.4% for contrast, DOP, and spatial resolution (lateral and axial), respectively. The coefficients of variation corresponding to the elevational resolution test were all within 9.5%. Overall, in our assessment, the evaluated package performed well for objective and quantitative assessment of the above-mentioned image qualities under well-controlled acquisition conditions. We are finding it to be useful for various clinical ultrasound applications including performance comparison between scanners from different vendors. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  11. Intravascular ultrasonic-photoacoustic (IVUP) endoscope with 2.2-mm diameter catheter for medical imaging.

    Science.gov (United States)

    Bui, Nhat Quang; Hlaing, Kyu Kyu; Nguyen, Van Phuc; Nguyen, Trung Hau; Oh, Yun-Ok; Fan, Xiao Feng; Lee, Yong Wook; Nam, Seung Yun; Kang, Hyun Wook; Oh, Junghwan

    2015-10-01

    Intravascular ultrasound (IVUS) imaging is extremely important for detection and characterization of high-risk atherosclerotic plaques as well as gastrointestinal diseases. Recently, intravascular photoacoustic (IVPA) imaging has been used to differentiate the composition of biological tissues with high optical contrast and ultrasonic resolution. The combination of these imaging techniques could provide morphological information and molecular screening to characterize abnormal tissues, which would help physicians to ensure vital therapeutic value and prognostic significance for patients before commencing therapy. In this study, integration of a high-frequency IVUS imaging catheter (45MHz, single-element, unfocused, 0.7mm in diameter) with a multi-mode optical fiber (0.6mm in core diameter, 0.22 NA), an integrated intravascular ultrasonic-photoacoustic (IVUP) imaging catheter, was developed to provide spatial and functional information on light distribution in a turbid sample. Simultaneously, IVUS imaging was co-registered to IVPA imaging to construct 3D volumetric sample images. In a phantom study, a polyvinyl alcohol (PVA) tissue-mimicking arterial vessel phantom with indocyanine green (ICG) and methylene blue (MB) inclusion was used to demonstrate the feasibility of mapping the biological dyes, which are used in cardiovascular and cancer diagnostics. For the ex vivo study, an excised sample of pig intestine with ICG was utilized to target the biomarkers present in the gastrointestinal tumors or the atherosclerotic plaques with the proposed hybrid technique. The results indicated that IVUP endoscope with the 2.2-mm diameter catheter could be a useful tool for medical imaging. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Early assessment of chronic kidney dysfunction using contrast-enhanced ultrasound: a pilot study

    Science.gov (United States)

    Dong, Y; Cao, J; Fan, P; Lin, X

    2014-01-01

    Objective: We performed a prospective study to evaluate the value of contrast-enhanced (CE) ultrasound in quantitative evaluation of renal cortex perfusion in patients with chronic kidney dysfunction (CKD Stage I–II). Methods: The present study was approved by the institutional ethics committee. The study focused on 41 consecutive patients (males, 32; females, 9; mean age, 55.0 ± 5.0 years) with clinical suspicion of CKD (Stages I–II). For both kidneys, CE ultrasound was performed after intravenous bolus injection of 1.0 ml SonoVue® (Bracco Imaging S.p.A., Milan, Italy). Time–intensity curves (TICs) and quantitative indexes were created with Qlab software (Philips, Bothell, WA). 45 healthy volunteers were included as control group. All statistical analyses were performed with SPSS® v. 15.0 software package (SPSS, Chicago, IL). A difference was considered statistically significant with p 2 and AUC >1300 dB s had high utility in the evaluation of CKD, with 81%, 73% and 78% specificities and 76%, 73% and 77% sensitivities. Conclusion: CE ultrasound might be valuable in the early evaluation of CKD. AUC, A and DPI might be valuable quantitative indexes. Advances in knowledge: Quantitative CE ultrasound analysis can be used for the standardized and early evaluation of renal dysfunction. PMID:25060882

  13. Assessment of breadmaking performance of wheat flour dough by means of frequency dependent ultrasound

    International Nuclear Information System (INIS)

    Braunstein, D; Peressini, D; Page, J H; Strybulevych, A; Scanlon, M G

    2012-01-01

    Technological performance of wheat flour varies among different wheat varieties. Gluten plays a key role within the solid phase of dough in the formation and the retention of gas bubbles during breadmaking. Rheological tests are usually performed to predict breadmaking potential. The aim here was to investigate the ability of ultrasound to discriminate wheat doughs based on breadmaking qualities. The ultimate goal is the development of an online quality control system currently unavailable in the baked goods industry, rendering this work innovative. Samples were prepared from a strong wheat flour, with one control sample and one added with inulin and distilled monoglycerides, producing doughs of distinct breadmaking quality. Doughs were subjected to density determination, elongation tests, and ultrasound analysis. The ultrasound tests were performed in the frequency range of 300 kHz – 6 MHz. Ultrasonic phase velocity increased with increasing frequency to about 2 MHz, becoming constant and then decreasing from 3 MHz for the control sample. Distinct differences in attenuation coefficient between the fibre-enriched and control doughs were observed. Ultrasound can potentially add to a better understanding of dough quality and can discriminate between doughs of contrasting properties.

  14. The Role of Conventional Ultrasound in the Assessment of Thyroid Nodule in Erbil City

    Science.gov (United States)

    Musa, Sarbast Ismail; Hanary, Salah Mohammad

    2016-01-01

    Background: Nodular thyroid disease is relatively common although thyroid cancer is rare. The aim of this study is to evaluate the advantage and reliability of conventional ultrasound in correlating sonographic characteristics of thyroid nodule with US-FNAC guided result as a diagnostic aid in thyroid nodule. Method: 111 patients were examined by…

  15. Using virtual-reality simulation to assess performance in endobronchial ultrasound

    DEFF Research Database (Denmark)

    Konge, Lars; Annema, Jouke; Clementsen, Paul

    2013-01-01

    For optimal treatment of patients with non-small cell lung carcinoma, it is essential to have physicians with competence in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). EBUS training and certification requirements are under discussion and the establishment of basic...

  16. Ultrasound assessment of umbilical venous catheter migration in preterm infants: a prospective study.

    Science.gov (United States)

    Franta, Jan; Harabor, Andrei; Soraisham, Amuchou S

    2017-05-01

    To evaluate the umbilical venous catheter (UVC) tip position by ultrasound and compare it with standard radiograph findings and to examine the catheter tip migration rates during the first week of life. Prospective observational study of inborn preterm infants who had an UVC placed and its position radiographically confirmed. The first ultrasound was done on UVC placement at median (IQR) age of 2 hours (1-4) and follow-up scans at a median (IQR) age of 34 hours (27-44 hours), 77 hours (70-94 hours) and 6 days (5-7 days) after insertion. Catheter tip was considered in optimum position if tip was lying in the inferior vena cava up to the right atrium opening. We studied 65 infants at a mean (±SD) gestational age and birth weight of 26.4 (±2.1) weeks and 808 (±289) g, respectively. Ultrasound confirmed optimum position of UVC tip in 25/65 (38.5%) infants. Majority (38/40) of the malpositioned catheters were located inside the heart with 15 reaching the left atrium. Catheter tip migration occurred in 29 of 58 infants (50%) at any time during the first week. The proportions of UVC migration were found to be 17%, 31% and 29% on subsequent ultrasound with a trend to outward movement over time. UVC tip localisation by standard radiography is very imprecise, and catheter tip migration occurs in a significant proportion of infants during first weeks of age. We suggest ultrasound as the best modality to assist localisation and follow-up of UVC tip in preterm infants. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  17. Ultrasound assessment of peripheral nerve pathology in neurofibromatosis type 1 and 2.

    Science.gov (United States)

    Winter, Natalie; Rattay, Tim W; Axer, Hubertus; Schäffer, Eva; Décard, Bernhard F; Gugel, Isabel; Schuhmann, Martin; Grimm, Alexander

    2017-05-01

    The neurofibromatoses (NF) type 1 and 2 are hereditary tumor predisposition syndromes caused by germline mutations in the NF1 and NF2 tumor suppressor genes. In NF1 and 2, peripheral nerve tumors occur regularly. For further characterizing nerve ultrasound was performed in patients with NF1 and 2. Patients with established diagnosis of NF1 (n=27) and NF2 (n=10) were included. Ultrasound of peripheral nerves and cervical roots was performed during routine follow-up visits. Healthy volunteers were studied for comparison. In patients with NF1, median cross-sectional area (CSA) of most nerves was significantly increased compared to controls and to NF2 due to generalized plexiform tumors, which arose out of multiple fascicles in 23 of 27 patients (85%). These were often accompanied by cutaneous or subcutaneous neurofibromas. In NF2, the overall aspect of peripheral nerves consisted of localized schwannomas (80%) and, apart from that, normal nerve segments. Nerve ultrasound is able to visualize different nerve pathologies in NF1 and NF2. It is a precise and inexpensive screening method for peripheral nerve manifestation in neurofibromatosis and should be considered as the first choice screening imaging modality for all peripheral nerves within reach of non-invasive ultrasound techniques. Ultrasound patterns of peripheral nerve pathologies are described for the first time in a large cohort of patients with NF1 and NF2. It is a suitable screening tool and enables targeted MRI analysis. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  18. Non-atherosclerotic spontaneous coronary artery dissection revascularized by intravascular ultrasonography-guided fenestration with cutting balloon angioplasty.

    Science.gov (United States)

    Ito, Tsuyoshi; Shintani, Yasuhiro; Ichihashi, Taku; Fujita, Hiroshi; Ohte, Nobuyuki

    2017-07-01

    A 46-year-old woman was referred to our hospital due to chest pain. Twelve-lead electrocardiogram revealed ST-segment elevation suggesting acute myocardial infarction. Emergent coronary angiography showed diffuse narrowing and occlusion in the middle to distal left anterior descending artery (LAD). To investigate the cause of occlusion, an intravascular ultrasound (IVUS) examination was performed and we diagnosed spontaneous coronary artery dissection (SCAD) as the cause of occlusion. After a cutting balloon was dilated at the distal LAD, coronary flow recovered. IVUS-guided angioplasty with cutting balloon could be a choice of treatment in SCAD patients who need revascularization.

  19. Intravascular catheter-related bloodstream infection.

    Science.gov (United States)

    Shah, Harshal; Bosch, Wendelyn; Thompson, Kristine M; Hellinger, Walter C

    2013-07-01

    Intravascular catheters required for the care of many hospitalized patients can give rise to bloodstream infection, a complication of care that has occurred most frequently in intensive care unit (ICU) settings. Elucidation of the pathogenesis of catheter-related bloodstream infections (CRBSIs) has guided development of effective diagnostic, management, and prevention strategies. When CRBSIs occur in the ICU, physicians must be prepared to recognize and treat them. Prevention of these infections requires careful attention to optimal catheter selection, insertion and maintenance, and to removal of catheters when they are no longer needed. This review provides a succinct summary of the epidemiology, pathogenesis, and microbiology of CRBSIs and a review of current guidance for the diagnosis, management, and prevention of these infections.

  20. Death following intravascular administration of contrast media

    International Nuclear Information System (INIS)

    Shehadi, W.H.

    1985-01-01

    Adverse reactions to intravascularly administered contrast media preceding death and the autopsy findings in 44 patients are presented. There is a wide scatter of the age distribution of fatal reactions. The highest incidence is in the 50-70 year age group. Similar observations were obtained from the 405 deaths due to contrast media reported to the Food and Drug Administration of the United States. In the same age group the number of reactions is highest, likewise the autopsy findings. The predominant autopsy findings are pulmonary edema, congestion and hemorrhage; arteriosclerosis, both general and coronary. In the younger age group the autopsy findings are limited mostly to the respiratory tract. Fatal reactions to contrast media occur often without warning and most deaths occur within 15 min to 6 hours. Reactions to contrast media occur without relation to sex or age. (orig.)

  1. Quinine-Induced Disseminated Intravascular Coagulation

    Directory of Open Access Journals (Sweden)

    Firas Abed

    2016-01-01

    Full Text Available Every drug comes with some side effect. It is the benefit/risk ratio that determines the medical use of the drug. Quinine, a known antimalarial drug, has been used for nocturnal leg cramps since the 1930s; it is associated with severe life-threatening hematological and cardiovascular side effects. Disseminated intravascular coagulation (DIC, albeit rare, is a known coagulopathy associated with Quinine. It is imperative to inquire about the Quinine intake in medication history in patients with coagulopathy, as most patients still consider it a harmless home remedy for nocturnal leg cramps. In this report, we present a case of coagulopathy in a middle-aged woman, who gave a history of taking Quinine for nocturnal leg cramps, as her home remedy. Early identification of the offending agent led to the diagnosis, prompt discontinuation of the medication, and complete recovery and prevented the future possibility of recurrence.

  2. Chronic Disseminated Intravascular Coagulation: A Case Report

    Directory of Open Access Journals (Sweden)

    Md Abul Kalam Azad

    2009-11-01

    Full Text Available In health there is a balance between the coagulation and anti-coagulation systems, but in disseminated intravascular coagulation (DIC the coagulation mechanism is activated inappropriately and in a diffuse way. This may lead to thrombosis, but more often haemorrhage occurs when the clotting factors are exhausted. DIC may present as acute, subacute, and rarely chronic form. Here we present a case of chronic DIC following pelvic inflammatory disease (PID as a consequence of repeated menstruation regulation (MR. We treated her with fresh frozen plasma, fresh blood, doxycycline with significant clinical improvement.DOI: 10.3329/bsmmuj.v1i1.3696 BSMMU J 2008; 1(1: 33-34

  3. Ventricular metastasis resulting in disseminated intravascular coagulation

    Directory of Open Access Journals (Sweden)

    Davis Ian D

    2005-05-01

    Full Text Available Abstract Background Disseminated Intravascular Coagulation (DIC complicates up to 7% of malignancies, the commonest solid organ association being adenocarcinoma. Transitional Cell Carcinoma (TCC has rarely been associated with DIC. Case presentation A 74-year-old woman with TCC bladder and DIC was found to have a cardiac lesion suspicious for metastatic disease. The DIC improved with infusion of plasma and administration of Vitamin K, however the cardiac lesion was deemed inoperable and chemotherapy inappropriate; given the patients functional status. We postulate that direct activation of the coagulation cascade by the intraventricular metastasis probably triggered the coagulopathy in this patient. Conclusion Cardiac metastases should be considered in cancer patients with otherwise unexplained DIC. This may influence treatment choices.

  4. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... Radiation Therapy for Gynecologic Cancers Radiation Therapy for Prostate Cancer top of page This page was reviewed on ... Abdomen Children's (Pediatric) Ultrasound - Abdomen Obstetric Ultrasound Ultrasound - Prostate Kidney and Bladder ... Images related to Ultrasound - Pelvis Sponsored by Please ...

  5. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... women, a pelvic ultrasound exam can help identify: kidney stones bladder tumors other disorders of the urinary bladder ... Children's (Pediatric) Ultrasound - Abdomen Obstetric Ultrasound Ultrasound - Prostate Kidney and Bladder Stones Abnormal Vaginal Bleeding Ovarian Cancer Images related to ...

  6. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... endometrial polyps fibroids cancer, especially in patients with abnormal uterine bleeding Some physicians also use 3-D ultrasound or ... Obstetric Ultrasound Ultrasound - Prostate Kidney and Bladder Stones Abnormal Vaginal Bleeding Ovarian Cancer Images related to Ultrasound - Pelvis Sponsored ...

  7. Use of pelvic floor ultrasound to assess pelvic floor muscle function in Urological Chronic Pelvic Pain Syndrome in men.

    Science.gov (United States)

    Davis, Seth N; Morin, Melanie; Binik, Yitzchak M; Khalife, Samir; Carrier, Serge

    2011-11-01

    An important cause or maintaining factor for pain in Urological Chronic Pelvic Pain Syndrome (UCPPS) may be pelvic floor muscle (PFM) dysfunction, which may also be implicated in sexual dysfunction and influenced by psychosocial factors. Pelvic floor ultrasound is a noninvasive, reliable, and relatively simple method to assess PFM morphology and function and can be assessed by the anorectal angle (ARA) and levator plate angle (LPA). The aim of the present study was to examine PFM morphology in men with UCPPS as compared with controls and to examine the correlation with pain and psychosocial measures. Our participants were 24 men with UCPPS and 26 controls. A GE Voluson E8 ultrasound probe was placed on the perineum, and three-dimensional images were taken at rest and during PFM contraction. The main outcomes were ARA and LPA at rest and contraction. Participants also completed the National Institute of Health (NIH) Chronic Prostatitis Symptom Index, Male Sexual Health Questionnaire, State Anxiety Inventory, and Pain Catastrophizing Scale. Men with UCPPS had more acute ARAs than controls both at rest and during contraction. The two groups did not differ in LPA at rest; however, men with UCPPS had significantly more acute angles during contraction and LP excursion. Acute ARAs were positively correlated with greater pain report and sexual dysfunction. Anxiety was correlated with more acute ARAs and more obtuse LPAs. Three implications can be drawn from the findings. First, ARA at rest and during contraction as well as LP angle during contraction and LPA excursion separates men with UCPPS from controls. Second, ARA at rest and during contraction was correlated with pain and sexual dysfunction, while LPA at rest was related to anxiety. Third, pelvic floor ultrasound has the potential to be a useful and objective method of assessing PFM morphology in UCPPS. © 2011 International Society for Sexual Medicine.

  8. Comparison between angiographic and arterial duplex ultrasound assessment of tibial arteries in patients with peripheral arterial disease: on behalf of the Joint Endovascular and Non-Invasive Assessment of LImb Perfusion (JENALI) Group.

    Science.gov (United States)

    Mustapha, Jihad A; Saab, Fadi; Diaz-Sandoval, Larry; Karenko, Barbara; McGoff, Theresa; Heaney, Carmen; Sevensma, Matthew

    2013-11-01

    Endovascular treatment of peripheral arterial disease (PAD) involving the tibial arteries is becoming an increasingly important part of revascularization. The current anatomical description of vessel patency in tibial arteries does not contribute effectively to therapeutic strategies. The Joint Endovascular and Non-Invasive Assessment of Limb Perfusion (JENALI) score, is a novel scoring system developed to further assess patency of tibial arteries, via both angiography and arterial duplex ultrasonography. A comparison was made between the JENALI score obtained by ultrasound and by angiography. Angiography is currently considered the gold standard of tibial artery imaging. This prospective single-center study involved 49 patients undergoing peripheral angiography for evaluation of PAD, between November 2011 and November 2012. All patients underwent a detailed ultrasound assessment of the tibial arteries ± 7 days from diagnostic angiography. Eligible patients had a Rutherford score ≥ III or abnormal ankle-brachial index values. Angiography and ultrasound were evaluated in a blinded fashion. Average age of patients was 69.8 years. A total of 846 segments were assessed by both angiography and ultrasound. We found that 648 segments (76.6%) were deemed to be patent by angiography compared to 723 (85.5%) by ultrasound. Critical limb ischemia (CLI; Rutherford score ≥ 4) was described in 26 patients (53%). Average JENALI score for the right lower extremity was 7.0 by angiogram vs 7.7 by ultrasound. The average JENALI score of the left leg was 6.7 by angiogram vs 7.7 by ultrasound. A total of 94 lower extremities were assigned a JENALI score. Ultrasound was accurate in detecting tibial artery patency or occlusion in 80% of segments. The overall sensitivity/specificity of ultrasound detecting tibial artery patency was calculated at 93% and 40% (P<.05), respectively. Detection of patency via ultrasound was highest for the anterior tibial artery and the lowest for the

  9. Intravascular versus surface cooling for targeted temperature management after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Glover, Guy W; Thomas, Richard M; Vamvakas, George

    2016-01-01

    BACKGROUND: Targeted temperature management is recommended after out-of-hospital cardiac arrest and may be achieved using a variety of cooling devices. This study was conducted to explore the performance and outcomes for intravascular versus surface devices for targeted temperature management after...... out-of-hospital cardiac arrest. METHOD: A retrospective analysis of data from the Targeted Temperature Management trial. N = 934. A total of 240 patients (26%) managed with intravascular versus 694 (74%) with surface devices. Devices were assessed for speed and precision during the induction......, maintenance and rewarming phases in addition to adverse events. All-cause mortality, as well as a composite of poor neurological function or death, as evaluated by the Cerebral Performance Category and modified Rankin scale were analysed. RESULTS: For patients managed at 33 °C there was no difference between...

  10. First-trimester risk assessment based on ultrasound and cell-free DNA vs combined screening: a randomized controlled trial.

    Science.gov (United States)

    Kagan, K O; Sroka, F; Sonek, J; Abele, H; Lüthgens, K; Schmid, M; Wagner, P; Brucker, S; Wallwiener, D; Hoopmann, M

    2017-09-19

    This was a randomized controlled trial to compare risk assessment by first-trimester combined screening (FTCS) with an approach that combines a detailed ultrasound examination at 11-13 weeks' gestation and cell-free DNA (cfDNA) analysis. Pregnant women with a normal first-trimester ultrasound examination at 11-13 weeks' gestation (fetal nuchal translucency (NT) ≤ 3.5 mm and no fetal defects) were randomized into one of two groups. In the first group, risk of aneuploidy was assessed using FTCS based on the most recent UK Fetal Medicine Foundation algorithm. In the second group, risk assessment was based on ultrasound findings and cfDNA analysis. An additional tube of blood was collected for FTCS in case the cfDNA analysis was uninformative. Primary outcome was false-positive rate in screening for trisomy 21. A case was considered false positive if the karyotype was not trisomy 21 and if the risk for trisomy 21 was >1:100, irrespective of the method of risk calculation. Results were compared using 95% CIs using the Clopper-Pearson method. Between October 2015 and December 2016, 1518 women with singleton pregnancy underwent first-trimester screening. Thirty-one (2.0%) pregnancies were not eligible for randomization due to increased NT (> 3.5 mm) and/or fetal defect. After exclusion of women who declined randomization (n = 87) and cases of fetal death and loss to follow-up (n = 24), 688 pregnancies were randomized into the FTCS arm and 688 into the ultrasound + cfDNA analysis arm. There were no differences in maternal and gestational age, maternal weight and BMI, ethnicity, use of assisted reproduction and cigarette smoking between the two arms. In the ultrasound + cfDNA analysis arm, median risk for trisomy 21 was 1 in 10 000. None of the cases had a risk above 1: 100 (95% CI, 0.0-0.5%). In the FTCS arm, the median risk for trisomy 21 was 1 in 3787 and in 17 cases, the risk was higher than 1:100, which corresponds to 2.5% (95% CI, 1.5-3.9%) of

  11. Education and Propagation of Intravascular Surgery in Okinawa

    Science.gov (United States)

    Harakuni, T.; Hyodo, A.; Shingaki, T.; Kugai, M.; Kinjyo, T.; Kinjyo, T.; Tsuchida, H.; Sugimoto, K.; Yoshii, Y.

    2004-01-01

    Summary Okinawa is an island located on the southwest edge of the Japanese Islands in which about 1,300,000 people live, and is an area where self-conclusion type medical treatment is desired. In this area, intravascular surgery was only performed for several cases per year until 1998. From May 1999, intravascular surgery started being performed in earnest, and 140 or more cases of intravascular surgery per year were performed in 2002. In the meantime, various measures for the propagation and development of intravascular surgery that we undertook led to the increase in the number of cases. As a result, the choice of medical treatment has increased by propagating these medical treatments, and it seems that this has contributed to the welfare of the people of Okinawa. PMID:20587285

  12. Intravascular photoacoustic detection of vulnerable plaque based on constituent selected imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Jian; Xing Da, E-mail: xingda@scnu.edu.cn [MOE Key Laboratory of Laser Life Science and Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631 (China)

    2011-01-01

    Atherosclerosis, a disease of the large arteries, is the primary cause of heart disease and stroke. Over decades, atherosclerosis is characterized by thickening of the walls of the arteries, only advanced atherosclerotic disease could be observed. Photoacoustic imaging is a hybrid imaging technique that combines the advantages of high spatial resolution of ultrasound with contrast of optical absorption. In this paper, we present an intravascular photoacoustic (IVPA) imaging system to characterize vulnerable plaques by using the optical absorption contrast between different constituents. Epidemiological studies have revealed several important plaque constituents associated with early atherosclerosis, such as macrophage, cholesterol, lipid, calcification, and so on. We chose a section of lipid rich atherosclerosis artery and a section of normal artery as the phantom. Two IVPA images of them are given to show the difference between sick and normal. As a new method of detecting vulnerable plaque, IVPA constituents imaging will provide more details for diagnosis that offer an enticing prospect in early detecting of atherosclerosis.

  13. Comprehensive Ultrasound Assessment of the Craniocervical Circulation in Transient Global Amnesia.

    Science.gov (United States)

    Jovanovic, Zagorka B; Pavlovic, Aleksandra M; Vujisic Tesic, Bosiljka P; Pekmezovic, Tatjana P; Kostic Boricic, Marija V; Cvitan, Edita Z; Covickovic Sternic, Nadezda M

    2018-02-01

    Structural changes and metabolic stress have been reported on diffusion-weighted magnetic resonance imaging in the cornu ammonis 1 area of the hippocampus in patients with transient global amnesia (TGA), but a consensus on pathogenesis is still lacking. The aim of our study was to perform a comprehensive ultrasound analysis of the cerebrovascular circulation in our population of patients with TGA. One hundred patients with TGA and 50 age- and sex-matched control participants underwent ultrasound examinations of the cervicocranial circulation. The most significant risk factor for TGA was arterial hypertension (P  .05). Rarely detected microembolic signals or a right-left cardiopulmonary shunt excluded an emboligenic mechanism of TGA (P > .05). The internal jugular vein valves were incompetent in 54% of patients with TGA, and this condition was associated with an increased risk of TGA (odds ratio, 4.16; 95% confidence interval, 1.91-9.04). The mean values of the breath holding index and pulsatility index, as parameters of small-vessel function, were within normal ranges and without differences between the TGA and control groups (P > .05). Our ultrasound examination did not detect significant structural atherosclerotic changes of cervicocranial arteries, and an emboligenic mechanism was excluded. Only a significant rise of blood pressure in TGA and significant valvular insufficiency of the internal jugular vein were established. New research should clarify whether these simultaneous functional circulatory changes have relevance for metabolic stress in the cornu ammonis of the hippocampus. © 2017 by the American Institute of Ultrasound in Medicine.

  14. Therapeutic response assessment of high intensity focused ultrasound therapy for uterine fibroid: Utility of contrast-enhanced ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Zhou Xiaodong [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China)]. E-mail: zhouxd@fmmu.edu.cn; Ren Xiaolong [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China)]. E-mail: renxiaolong70@hotmail.com; Zhang Jun [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); He Guangbin [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); Zheng Minjuan [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); Tian Xue [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); Li Li [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); Zhu Ting [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); Zhang Min [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); Wang Lei [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China); Luo Wen [Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, No. 17 West Changle Road, Xi' an 710032 (China)

    2007-05-15

    Purpose: To assess the utility of contrast-enhanced ultrasonography (ceUS) in the assessment of the therapeutic response to high intensity focused ultrasound (HIFU) ablation in patients with uterine fibroid. Materials and methods: Sixty-four patients with a total of 64 uterine fibroids (mean: 5.3 {+-} 1.2 cm; range: 3.2-8.9 cm) treated with HIFU ablation under the ultrasound guidance were evaluated with ceUS after receiving an intravenous bolus injection of a microbubble contrast agent (SonoVue) within 1 week after intervention. We obtained serial ceUS images during the time period from beginning to 5 min after the initiation of the bolus contrast injection. All of the patients underwent a contrast enhanced MRI (ceMRI) and ultrasound guided needle puncture biopsy within 1 week after HIFU ablation. And as a follow-up, all of the patients underwent US at 1, 3, 6 and 12 months after HIFU treatment. The volume change was observed and compared to pre- and post-HIFU ablation. The results of the ceUS were compared with those of the ceMRI in terms of the presence or absence of residual unablated tumor and pathologic change in the treated lesions. Results: On ceUS, diagnostic accuracy was 100%, while residual unablated tumors were found in three uterine fibroids (4.7%) and failed treatment was found in eight uterine fibroids (12.5%). All the 11 fibroids were subjected to additional HIFU ablation. Of the 58 ablated fibroids without residual tumors on both the ceUS and ceMRI after the HIFU ablation, the volumes of all the fibroids decreased in different degrees during the 1 year follow-up USs. And histologic examinations confirmed findings of necrotic and viable tumor tissue, respectively. Conclusion: CEUS is potentially useful for evaluating the early therapeutic effect of percutaneous HIFU ablation for uterine fibroids.

  15. Therapeutic response assessment of high intensity focused ultrasound therapy for uterine fibroid: Utility of contrast-enhanced ultrasonography

    International Nuclear Information System (INIS)

    Zhou Xiaodong; Ren Xiaolong; Zhang Jun; He Guangbin; Zheng Minjuan; Tian Xue; Li Li; Zhu Ting; Zhang Min; Wang Lei; Luo Wen

    2007-01-01

    Purpose: To assess the utility of contrast-enhanced ultrasonography (ceUS) in the assessment of the therapeutic response to high intensity focused ultrasound (HIFU) ablation in patients with uterine fibroid. Materials and methods: Sixty-four patients with a total of 64 uterine fibroids (mean: 5.3 ± 1.2 cm; range: 3.2-8.9 cm) treated with HIFU ablation under the ultrasound guidance were evaluated with ceUS after receiving an intravenous bolus injection of a microbubble contrast agent (SonoVue) within 1 week after intervention. We obtained serial ceUS images during the time period from beginning to 5 min after the initiation of the bolus contrast injection. All of the patients underwent a contrast enhanced MRI (ceMRI) and ultrasound guided needle puncture biopsy within 1 week after HIFU ablation. And as a follow-up, all of the patients underwent US at 1, 3, 6 and 12 months after HIFU treatment. The volume change was observed and compared to pre- and post-HIFU ablation. The results of the ceUS were compared with those of the ceMRI in terms of the presence or absence of residual unablated tumor and pathologic change in the treated lesions. Results: On ceUS, diagnostic accuracy was 100%, while residual unablated tumors were found in three uterine fibroids (4.7%) and failed treatment was found in eight uterine fibroids (12.5%). All the 11 fibroids were subjected to additional HIFU ablation. Of the 58 ablated fibroids without residual tumors on both the ceUS and ceMRI after the HIFU ablation, the volumes of all the fibroids decreased in different degrees during the 1 year follow-up USs. And histologic examinations confirmed findings of necrotic and viable tumor tissue, respectively. Conclusion: CEUS is potentially useful for evaluating the early therapeutic effect of percutaneous HIFU ablation for uterine fibroids

  16. Changes in ultrasound assessed markers of inflammation following intra-articular steroid injection combined with exercise in knee osteoarthritis

    DEFF Research Database (Denmark)

    Henricsdotter, C; Ellegaard, K.; Klokker, L

    2016-01-01

    in inflammation markers assessed by ultrasound imaging (US) in KOA secondary to intra-articular corticosteroid injection given prior to exercise therapy. DESIGN: This study is a sub-study to a larger clinical trial which compared the clinical effects of steroid injection in KOA to placebo injection, both given......OBJECTIVE: Knee osteoarthritis (KOA) is a multifactorial joint disease affecting many people worldwide. Recommended treatments for KOA include exercise and steroid injections, or a combination of these. The objective of this exploratory outcome analysis of a randomized trial was to assess changes...... prior to exercise therapy. The US outcomes were changes from baseline in US-assessed synovial size, Doppler activity presence in the synovial membrane, and numbers of US-detected Baker's cysts. US was performed at baseline, week 14 (exercise stop), and week 26 (follow-up). RESULTS: Fifty participants...

  17. The Role of Early Gestation Ultrasound in the Assessment of Fetal Anatomy in Maternal Obesity.

    Science.gov (United States)

    Romary, Letty; Sinkovskaya, Elena; Ali, Sabrina; Cunningham, Tina D; Marwitz, Shannon; Heeze, Aimee; Herlands, Lindsey; Porche, Lea; Philips, Jennifer; Abuhamad, Alfred

    2017-06-01

    The 2012 Eunice Kennedy Shriver National Institute of Child Health fetal imaging consensus suggested that fetal anatomy ultrasound in obese pregnancies be performed at 20 to 22 weeks, with follow-up in 2 to 4 weeks if anatomy is incomplete. It was postulated that imaging in early gestation may improve visualization, although no prospective trials had been done to date. We performed a prospective longitudinal blinded trial comparing an early gestation ultrasound (13 + 0 to 15 + 6 weeks) with the traditional second-trimester ultrasound for completion of the fetal anatomy survey in obese patients. Inclusion criteria included singleton gestation, body mass index (BMI) more than 30, less than 16 + 0 weeks' gestation, and no karyotype abnormality; exclusion criteria included age younger than 18 years, more than 16 weeks' gestation at time of consent, and BMI less than 30. Participants received a transvaginal and/or transabdominal sonogram for fetal anatomic survey at 13 + 0 to 15 + 6 weeks' gestation (US1). Images from US1 were blinded to physicians and sonographers performing subsequent examinations. All participants underwent the traditional transabdominal sonogram at 18 to 24 weeks (US2). If US2 failed to complete the anatomic survey, a repeat transabdominal sonogram (2-US2) was performed 2 to 4 weeks later. A total of 152 pregnancies met the criteria. Anatomy completion rate was 57.2% for US1 and 62.5% for US2, which was not statistically significant, even when stratified by BMI. Excluding the philtrum, the US1 performed better than US2 for class III obesity (65.5% versus 45.5% [P = .035]). Combination of US1 + US2 yielded a higher completion rate than US2 + 2-US2 (94.1% versus 83.6% [P = .0023]). In the setting of maternal obesity, the addition of an ultrasound in early gestation may be of highest benefit for patients with class III obesity (BMI > 40 kg/m 2 ). © 2017 by the American Institute of Ultrasound in Medicine.

  18. The role of ultrasound and lymphoscintigraphy in the assessment of axillary lymph nodes in patients with breast cancer

    Directory of Open Access Journals (Sweden)

    Michał Nieciecki

    2016-03-01

    Full Text Available Breast cancer is the most common malignancy and the leading cause of death due to cancer in European women. Mammography screening programs aimed to increase the detection of early cancer stages were implemented in numerous European countries. Recent data show a decrease in mortality due to breast cancer in many countries, particularly among young women. At the same time, the number of sentinel node biopsy procedures and breast-conserving surgeries has increased. Intraoperative sentinel lymph node biopsy preceded by lymphoscintigraphy is used in breast cancer patients with no clinical signs of lymph node metastasis. Due to the limited sensitivity and specificity of physical examination in detecting metastatic lesions, developing an appropriate diagnostic algorithm for the preoperative assessment of axillary lymph nodes seems to be a challenge. The importance of ultrasound in patient qualification for sentinel lymph-node biopsy has been discussed in a number of works. Furthermore, different lymphoscintigraphy protocols have been compared in the literature. The usefulness of novel radiopharmaceuticals as well as the methods of image acquisition in sentinel lymph node diagnostics have also been assessed. The aim of this article is to present, basing on current guidelines, literature data as well as our own experience, the diagnostic possibilities of axillary lymph node ultrasound in patient qualification for an appropriate treatment as well as the role of lymphoscintigraphy in sentinel lymph node biopsy.

  19. MRI phenotypes of localized intravascular coagulopathy in venous malformations

    International Nuclear Information System (INIS)

    Koo, Kevin S.H.; Dowd, Christopher F.; Hess, Christopher P.; Mathes, Erin F.; Frieden, Ilona J.; Rosbe, Kristina W.; Hoffman, William Y.

    2015-01-01

    The incidence of localized intravascular coagulopathy (LIC) in venous malformations varies with lesion size and location, as well as the presence of palpable phleboliths. The development of LIC can cause pain and hemorrhage and can progress to disseminated intravascular coagulopathy (DIC) and thromboembolic disease resulting in death in some cases. Early recognition of LIC can relieve symptoms and prevent progression to life-threatening complications. The aim of this work was to identify MRI features of venous malformation associated with LIC. We hypothesized that venous malformations with larger capacitance, slower flow and less physiological compression (greater stasis) were more likely to be associated with LIC. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed clinical records and MRI for consecutive patients undergoing evaluation of venous malformations at our multidisciplinary Birthmarks and Vascular Anomalies Center between 2003 and 2013. Inclusion required consensus diagnosis of venous malformation and availability of laboratory data and MRI; patients on anticoagulation or those previously undergoing surgical or endovascular treatment were excluded. LIC was diagnosed when D-dimer exceeded 1,000 ng/mL and/or fibrinogen was less than 200 mg/dL. Two board-certified radiologists assessed the following MRI features for each lesion: morphology (spongiform vs. phlebectatic), presence of phleboliths, size, location (truncal vs. extremity), and tissue type(s) involved (subcutis, muscle, bone and viscera). Univariate logistic regression analyses were used to test associations between LIC and MRI findings, and stepwise regression was applied to assess the significance of the individual imaging predictors. Seventy patients, 37 with LIC, met inclusion criteria during the 10-year study period (age: 14.5 +/- 13.6 years [mean +/- standard deviation]; 30 male, 40 female). Both elevated D-dimer and low fibrinogen were associated with the presence of

  20. MRI phenotypes of localized intravascular coagulopathy in venous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Kevin S.H. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Dowd, Christopher F.; Hess, Christopher P. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Mathes, Erin F.; Frieden, Ilona J. [University of California, San Francisco, Department of Dermatology, San Francisco, CA (United States); Rosbe, Kristina W. [University of California, San Francisco, Department of Otolaryngology, San Francisco, CA (United States); Hoffman, William Y. [University of California, San Francisco, Department of Surgery, San Francisco, CA (United States)

    2015-10-15

    The incidence of localized intravascular coagulopathy (LIC) in venous malformations varies with lesion size and location, as well as the presence of palpable phleboliths. The development of LIC can cause pain and hemorrhage and can progress to disseminated intravascular coagulopathy (DIC) and thromboembolic disease resulting in death in some cases. Early recognition of LIC can relieve symptoms and prevent progression to life-threatening complications. The aim of this work was to identify MRI features of venous malformation associated with LIC. We hypothesized that venous malformations with larger capacitance, slower flow and less physiological compression (greater stasis) were more likely to be associated with LIC. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed clinical records and MRI for consecutive patients undergoing evaluation of venous malformations at our multidisciplinary Birthmarks and Vascular Anomalies Center between 2003 and 2013. Inclusion required consensus diagnosis of venous malformation and availability of laboratory data and MRI; patients on anticoagulation or those previously undergoing surgical or endovascular treatment were excluded. LIC was diagnosed when D-dimer exceeded 1,000 ng/mL and/or fibrinogen was less than 200 mg/dL. Two board-certified radiologists assessed the following MRI features for each lesion: morphology (spongiform vs. phlebectatic), presence of phleboliths, size, location (truncal vs. extremity), and tissue type(s) involved (subcutis, muscle, bone and viscera). Univariate logistic regression analyses were used to test associations between LIC and MRI findings, and stepwise regression was applied to assess the significance of the individual imaging predictors. Seventy patients, 37 with LIC, met inclusion criteria during the 10-year study period (age: 14.5 +/- 13.6 years [mean +/- standard deviation]; 30 male, 40 female). Both elevated D-dimer and low fibrinogen were associated with the presence of

  1. Intravascular Large B-Cell Lymphoma

    Directory of Open Access Journals (Sweden)

    Maria S. Khan MD, FACP

    2014-03-01

    Full Text Available Case Presentation . A 69-year-old Hispanic male, with a past history of diabetes and coronary disease, was admitted for fever, diarrhea, and confusion of 4 weeks duration. Physical examination showed a disoriented patient with multiple ecchymoses, possible ascites, and bilateral scrotal swelling. Hemoglobin was 6.7, prothrombin time (PT 21.4 seconds with international normalized ratio 2.1, partial thromboplastin time (PTT 55.6 seconds, fibrin split 10 µg/L, and lactate dehydrogenase (LDH 1231 IU/L. Except for a positive DNA test for Epstein–Barr virus (EBV infection, extensive diagnostic workup for infections, malignancy, or a neurological cause was negative. Mixing studies revealed a nonspecific inhibitor of PT and PTT but Factor VIII levels were normal. The patient was empirically treated with antibiotics but developed hypotension and died on day 27 of admission. At autopsy, patient was found to have intravascular diffuse large B-cell lymphoma involving skin, testes, lung, and muscles. The malignant cells were positive for CD20, CD791, Mum-1, and Pax-5 and negative for CD3, CD5, CD10, CD30, and Bcl-6. The malignant cells were 100% positive for Ki-67. Discussion . Intravascular large cell B-cell lymphoma (IVLBCL is rare form of diffuse large B-cell lymphoma and tends to proliferate within small blood vessels, particularly capillaries and postcapillary venules. The cause of its affinity for vascular bed remains unknown. In many reports, IVLBCL was associated with HIV, HHV8, and EBV infections. The fact that our case showed evidence of EBV infection lends support to the association of this diagnosis to viral illness. The available literature on this subject is scant, and in many cases, the diagnosis was made only at autopsy. The typical presentation of this disorder is with B symptoms, progressive neurologic deficits, and skin findings. Bone marrow, spleen, and liver are involved in a minority of patients. Nearly all patients have elevated LDH

  2. Colour Doppler ultrasound assessment of well-functioning mature arteriovenous fistulas for haemodialysis access

    International Nuclear Information System (INIS)

    Pietura, Radoslaw; Janczarek, Marzena; Zaluska, Wojciech; Szymanska, Anna; Janicka, Lucyna; Skublewska-Bednarek, Anna; Szczerbo-Trojanowska, Malgorzata

    2005-01-01

    Background: A well-functioning mature arteriovenous fistula is essential for the maintenance of haemodialysis in patients with chronic renal failure. The Brescia-Cimino arteriovenous fistula has the best survival characteristics and low rate of complications. The most common reason of fistula failure is thrombosis caused by stenosis. Colour Doppler ultrasonography has proven to be effective in the assessment of anatomical vascular features. The majority of studies were done in patients with clinically presumed arteriovenous fistula complications. However, only limited data are available about the well-functioning mature arteriovenous fistulas. The purpose of the present study was to evaluate completely asymptomatic, mature arteriovenous fistulas with colour Doppler ultrasound. Materials and methods: From July 2001 to April 2003, we examined 139 patients with the end-stage renal disease. They were in the range of 19-79 years of age (mean, 46.7 years). The study included only the patients who met the following criteria: (1) no difficulties with haemodialysis (as reported by nurses); (2) normal venous diastolic blood pressure (<150 mmHg) at monthly evaluation; (3) normal urea clearance x time/urea volume of distribution; (4) blood cells count, plasma electrolytes, and liver function at monthly evaluation. The mean fistula age was 26 months (S.D. = 21.9). The mean time of dialysis therapy was 49 months. Thirty-eight percent patients had primary fistulas, 23%-secondary, 11%-third and 11%-fourth, 4%-fifth, 5%-sixth, and 8% patients had more than sixth. Results: There was no correlation between: (1) patient's age and fistula age; (2) patient's age and number of fistulas in one patient; (3) fistula age and number of fistulas in one patient; (4) localization of fistula and fistula age. There was a strong correlation between dialysis therapy period and number of fistulas in one patient. The mean flow volume was 1204.1 ml/min (S.D. = 554). It was significantly higher in the

  3. Intravascular Cooling Catheter-Related Venous Thromboembolism After Hypothermia: A Case Report and Review of the Literature.

    Science.gov (United States)

    Wang, Xuan; Moy, Brian T; Hiendlmayr, Brett J; Krainski, Felix; Duvall, W Lane; Fernandez, Antonio B

    2018-03-23

    Fifty-four year-old man with recent history of myocardial infarction and a percutaneous coronary intervention who suffered a ventricular fibrillation arrest at home. He was resuscitated in the field. His heart rhythm was in atrial fibrillation. The cardiac catheterization showed a patent stent from his previous myocardial infarction and no new occlusions. He subsequently underwent hypothermia protocol using the Alsius CoolGard 3000 Temperature Control System and Icy Catheter. Heparin drip was started for atrial fibrillation 36 hours after catheter insertion and became therapeutic 2 hours before the end of cooling maintenance phase. Heparin drip was stopped 4 hours into the rewarming phase because of spontaneous conversion to sinus rhythm. Subcutaneous heparin was resumed for deep venous thrombosis prophylaxis. He was extubated to room air after hypothermia protocol. The cooling catheter was removed 88 hours after insertion. Within 1 minute of catheter removal, his oxygen saturation dropped to 80%. Transthoracic echocardiogram showed a mobile thrombus in the right atrium prolapsing into the right ventricle. Computer tomography angiography of the chest confirmed a large saddle embolus. Ninety minutes later, patient went into cardiac arrest with pulseless electrical activity while he was being considered for surgical embolectomy, but he could not be resuscitated. The temporal relationship of the catheter removal and his acute clinical decompensation led to believe that this was an intravascular cooling catheter (ICC)-related event. Providers should be cognizant of the complications of central venous catheters such as thrombosis formation, as it could lead to fatal pulmonary embolism. Physicians should promote frequent assessment of the access site(s) during routine physical examinations and potentially use point of care vascular ultrasound in high-risk cases to rule out a catheter-associated thrombus before catheter removal.

  4. BONE MINERAL DENSITY IN PHYSICALLY ACTIVE WOMEN ASSESSED BY ULTRASOUND DESINTOMETRY

    Directory of Open Access Journals (Sweden)

    Ana Marijanac

    2015-05-01

    Full Text Available Osteoporosis is a disease characterized by low bone mass and density. Physical activity has a positive effect on bone tissue, and it is recommended to prevent bone loss which comes with age. Methods: In purpose of determining bone mineral density in women who are physically active we examined 35 women divided into two groups – subjects who are premenopausal (n=20, 43.52 ± 7.56 years, and subjects who are postmenopausal (n=15, 55.89 ± 5.48. The subjects exercised Pilates method twice a week for one hour. Bone mineral density measurements were done by ultrasound densitometer „Sahara“ through the calcaneus. We get the data of the estimated bone density and T-score for right and left foot separate. Results: According to results premenopausal women have normal bone density, and postmenopausal values represent osteopenia, according to the WHO. There is no subjects who established osteoporosis. Discussion: Previous investigations have confirmed that physical activity is important for the preservation of the bone quality. Increasing steps, using simple everyday tasks, can prevent decrease in BMD in postmenopausal women (Muir et al., 2013, Ashe et al, 2008. There’s difference in the density of the calcaneus between physically active and those who are not, measured by ultrasound densitometry (Vainionpää et al, 2005. We use quantitative ultrasound densitometry to describe BMI of women who exercise Pilates and support the finding that physical activity is one of the ways that may prevent the BMD loss. These research was done as a part of long-term project entitled „Impact of physical activity of the working population“ which is co-financed by Provincial Secretariat for Science and Technological Development.

  5. Variability in diaphragm motion during normal breathing, assessed with B-mode ultrasound.

    Science.gov (United States)

    Harper, Caitlin J; Shahgholi, Leili; Cieslak, Kathryn; Hellyer, Nathan J; Strommen, Jeffrey A; Boon, Andrea J

    2013-12-01

    Clinical measurement, cross-sectional. To establish a set of normal values for diaphragm thickening with tidal breathing in healthy subjects. Normal values for diaphragm contractility, as imaged sonographically, have not been described, despite the known role of the diaphragm in contributing to spinal stability. If the normal range of diaphragm contractility can be defined in a reliable manner, ultrasound has the potential to be used clinically and in research as a biofeedback tool to enhance diaphragm activation/contractility. B-mode ultrasound was performed on 150 healthy subjects to visualize and measure hemi-diaphragm thickness on each side at resting inspiration and expiration. Primary outcome measures were hemi-diaphragm thickness and thickening ratio, stratified for age, gender, and body mass index. Interrater and intrarater reliability were also measured. Normal thickness of the diaphragm at rest ranged from 0.12 to 1.18 cm, with slightly greater thickness in men but no effect of age. Average ± SD change in thickness from resting expiration to resting inspiration was 20.0% ± 15.5% on the right and 23.5% ± 24.4% on the left; however, almost one third of healthy subjects had no to minimal diaphragm thickening with tidal breathing. There is wide variability in the degree of diaphragm contractility during quiet breathing. B-mode ultrasound appears to be a reliable means of determining the contractility of the diaphragm, an important muscle in spinal stability. Further studies are needed to validate this imaging modality as a clinical tool in the neuromuscular re-education of the diaphragm to improve spinal stability in both healthy subjects and in patients with low back pain.

  6. Ultrasound assessment of hamstring muscle size using posterior thigh muscle thickness.

    Science.gov (United States)

    Abe, Takashi; Loenneke, Jeremy P; Thiebaud, Robert S

    2016-05-01

    Several studies have investigated the relationship between ultrasound-measured muscle thickness (MT) and individual muscle cross-sectional area (CSA) and muscle volume (MV) in extremity and trunk muscles; however, the hamstring muscle has not been studied. The purpose of this study was to examine the relationship between posterior thigh MT by ultrasound and the muscle CSA and MV of the hamstring obtained by magnetic resonance imaging (MRI). Ten young women aged 20-31 had MT measured by ultrasound at three sites on the medial anterior (50% of thigh length; TL) and posterior (50% and 70% of TL) aspects of the thigh. On the same day, a series of continuous muscle CSA along the thigh was measured by MRI. In each slice, the anatomical CSA of the hamstring (biceps femoris, semitendinosus and semimembranosus) and quadriceps muscle was analysed, and the CSAs at 50% and 70% of TL and maximal CSA of the hamstring (CSAmax ) were determined. MV was calculated by multiplying CSA by slice thickness. A significant correlation was observed between posterior 50% MT and 50% hamstring CSA (r = 0·848, P = 0·002) and between posterior 70% MT and 70% hamstring CSA (r = 0·679, P = 0·031). Posterior 50% MT (r = 0·732, P = 0·016) and 50% MTxTL (r = 0·873, P = 0·001) were also correlated to hamstring MV. Anterior:posterior 50% thigh MT ratio was correlated to MV ratio of quadriceps and hamstring muscles (r = 0·803, P = 0·005). Our results suggest that posterior thigh MT reflects hamstring muscle CSA and MV. The anterior:posterior MT ratio may serve as a surrogate for MV ratio of quadriceps and hamstring. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  7. An assessment of mode of delivery in history indicated versus ultrasound indicated vaginally placed cervical cerclage.

    Science.gov (United States)

    Story, Lisa; Shennan, Andrew

    2017-03-01

    Treatment modalities to reduce the incidence of preterm birth are currently limited. Cerclage, is a common and established intervention in most obstetrics units worldwide, however, many questions regarding its efficacy, with respect to pregnancy outcomes remain unanswered. This study aims to investigate whether an antenatal placed cerclage affects the subsequent mode of delivery in women at high risk of preterm birth who labour. A retrospective case controlled study was performed at St Thomas's Hospital London. Women who had undergone cervical cerclage were identified using a pre-existing database (n=152). Cases were excluded where a C-section had been performed prior to labour (n=26), datasets were incomplete (n=5) or a rescue cerclage was performed (n=2). Remaining cases were categorised into those who had: history indicated (n=68) or ultrasound indicated (n=51) cerclage. Control cases were obtained from the same database who also laboured but had not undergone cerclage, matched according to gestational age at delivery and parity (n=114). Demographic details and outcome data were recorded. Groups were compared using Chi Squared analysis for discrete variables and t-test for continuous variables using IBM SPSS Statistics version 22. There was no statistical difference in the emergency C-section rate between history indicated and ultrasound indicated cerclage, or between patients who received cerclage and those who had not (p=0.592). The emergency C-section rate for each group was: history indicated, 25%, ultrasound indicated 18% and no cerclage 18%. Women at risk of preterm birth have high rates of emergency C-section despite the fact that the majority were multiparous. However, they can be reassured that cervical cerclage does not increase this risk. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. The Angle of Progression at Station 0 and in Magnetic Resonance and Transperineal Ultrasound Assessment

    Directory of Open Access Journals (Sweden)

    D. Iliescu

    2015-01-01

    Full Text Available The transperineal ultrasound (TPU value of the angle of progression (AOP during fetal head engagement, at station 0, is a critical cut-off for current obstetrical practice, especially when intrapartum instrumental interventions are required. Still, controversial measurements were reported in previous high resolution imagistic studies. Our TPU and direct “gold-standard” magnetic resonance (MRI measurements confirm that station 0 corresponds to a 120° AOP, concordantly. Based on these findings, the fact that an AOP of 120° or greater was previously strongly associated with vaginal delivery may be due to the achievement of head engagement in labor.

  9. [Intravascular lymphomatosis. A report of three cases].

    Science.gov (United States)

    Menéndez Calderón, M J; Seguí Riesco, M E; Argüelles, M; Nuño Mateo, J

    2005-01-01

    Intravascular lymphomatosis (IVL) is a rare malignancy characterized by a proliferation of atypical lymphoid cells occluding small blood vessels (venules, capillaries and small arteries). The symptoms are caused by embolisms due to massive proliferation. Nervous system and skin are the most common sites of involvement but all organs may be involved, although it is typified by the absence of malignant cells in lymphoid tissues. We describe three cases of IVL: first patient was a 57 years old man with rapidly progressive dementia and neurological involvements and second case of a 69 years old man hospitalised with predominant symptoms in the lung (cough, dyspnea and fever), and a woman presenting as fever of unknown origin (FUO) with systemic inflammatory response syndrome. In all cases that we reported have been diagnosed post-mortem because of rapid progression of a multisystem disease and the absence of pathognomonic clinical manifestations. Diagnosis can be made using biopsy of one of the involved organs. In conclusion, we propose that IVL should be included in the differential diagnosis of acute confusional state, dementia or other unexplained neurological manifestations, fever of unknown origin, vasculitis, occult neoplasia or infections with signs of a systemic disease and marked elevation of serum lactate dehydrogenase (LDH).

  10. Disseminated intravascular coagulation in solid tumors

    International Nuclear Information System (INIS)

    Terzieff, V.; Alonso, I.; Vázquez, A.

    2004-01-01

    It is estimated that 20-25% of cases of disseminated intravascular coagulation (DIC) relate to an underlying neoplasia primarily hematologic. It is estimated that about 5% of patients with solid tumors have CID clinic, although the incidence of subclinical alterations is much higher. The CID is not limited to the activation of the coagulation cascade, which leads to bleeding micro thrombosis and consumption of coagulation factors. Solid tumors are frequently associated adenocarcinomas producers mucin (especially gastric), usually in the context of a disseminated disease. The mucin may act as a promoter of the cascade, but probably it is a multi-event. High levels of TNF to produced by the tumor mass and chemotherapy-induced cell lysis have Also linked. Although the bleeding is usually oriented diagnosis, the most frequent cause of death is thrombosis. There are no specific tests for diagnosis. Elevated levels of D-dimer and products oriented fibrinogen degradation diagnosis. No reduction fibrinogen and almost always, one thrombocytopenia consumption. Treatment is complex and there is no consensus on many points. To recover the lost factors for consumption, it is recommended to use fresh frozen plasma and / or washed red blood cells. the heparin anticoagulation low dose is indicated since the disease causal can not be controlled quickly, but should not be initiated if there thrombocytopenia 50.000.El under profuse bleeding can require the use of tranexamic acid or EACA. Acute DIC, the case of our patient, is rare and very serious

  11. Radiofrequency ablation for hepatocellular carcinoma: utility of conventional ultrasound and contrast-enhanced ultrasound in guiding and assessing early therapeutic response and short-term follow-up results.

    Science.gov (United States)

    Du, Jing; Li, Hong-Li; Zhai, Bo; Chang, Samuel; Li, Feng-Hua

    2015-09-01

    The purpose of this study was to assess the efficacy of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) in guiding and assessing early therapeutic response to radiofrequency (RF) ablation for hepatocellular carcinomas (HCCs; up to 3 lesions, each ≤3 cm in diameter) and to report the short-term follow-up results. Between September 2011 and January 2013, 63 patients with 78 HCCs (≤3 cm) underwent conventional US- and CEUS-guided percutaneous RF ablation. CEUS was repeated after 20-30 min to assess therapeutic response, and local efficacy was further confirmed by contrast-enhanced magnetic resonance imaging (MRI) 1 mo after tumor ablation. Patients were followed periodically to look for local tumor or disease progression. Survival probability was estimated with the Kaplan-Meier method. Complete ablation was achieved for 76 (97.4%) of 78 HCCs in one (n = 73) or two (n = 3) sessions. No major complications were observed in any patient. The overall concordance in assessment of therapeutic efficacy of RF ablation between CEUS and MRI was 97.4% (76/78 tumors). The concordance test gave a value of κ = 0.74 (p therapeutic response to RF ablation. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  12. Ultrasound assessment of the posterior circumflex humeral artery in elite volleyball players: Aneurysm prevalence, anatomy, branching pattern and vessel characteristics.

    Science.gov (United States)

    van de Pol, Daan; Maas, Mario; Terpstra, Aart; Pannekoek-Hekman, Marja; Alaeikhanehshir, Sena; Kuijer, P Paul F M; Planken, R Nils

    2017-03-01

    To determine the prevalence of posterior circumflex humeral artery (PCHA) aneurysms and vessel characteristics of the PCHA and deep brachial artery (DBA) in elite volleyball players. Two-hundred and eighty players underwent standardized ultrasound assessment of the dominant arm by a vascular technologist. Assessment included determination of PCHA aneurysms (defined as segmental vessel dilatation ≥150 %), PCHA and DBA anatomy, branching pattern, vessel course and diameter. The PCHA and DBA were identified in 100 % and 93 % (260/280) of cases, respectively. The prevalence of PCHA aneurysms was 4.6 % (13/280). All aneurysms were detected in proximal PCHA originating from the axillary artery (AA). The PCHA originated from the AA in 81 % of cases (228/280), and showed a curved course dorsally towards the humeral head in 93 % (211/228). The DBA originated from the AA in 73 % of cases (190/260), and showed a straight course parallel to the AA in 93 % (177/190). PCHA aneurysm prevalence in elite volleyball players is high and associated with a specific branching type: a PCHA that originates from the axillary artery. Radiologists should have a high index of suspicion for this vascular overuse injury. For the first time vessel characteristics and reference values are described to facilitate ultrasound assessment. • Prevalence of PCHA aneurysms is 4.6 % among elite volleyball players. • All aneurysms are in proximal PCHA that originates directly from AA. • Vessel characteristics and reference values are described to facilitate US assessment. • Mean PCHA and DBA diameters can be used as reference values. • Radiologists need a high index of suspicion for this vascular overuse injury.

  13. An Experimental Protocol for Assessing the Performance of New Ultrasound Probes Based on CMUT Technology in Application to Brain Imaging.

    Science.gov (United States)

    Matrone, Giulia; Ramalli, Alessandro; Savoia, Alessandro Stuart; Quaglia, Fabio; Castellazzi, Gloria; Morbini, Patrizia; Piastra, Marco

    2017-09-24

    The possibility to perform an early and repeatable assessment of imaging performance is fundamental in the design and development process of new ultrasound (US) probes. Particularly, a more realistic analysis with application-specific imaging targets can be extremely valuable to assess the expected performance of US probes in their potential clinical field of application. The experimental protocol presented in this work was purposely designed to provide an application-specific assessment procedure for newly-developed US probe prototypes based on Capacitive Micromachined Ultrasonic Transducer (CMUT) technology in relation to brain imaging. The protocol combines the use of a bovine brain fixed in formalin as the imaging target, which ensures both realism and repeatability of the described procedures, and of neuronavigation techniques borrowed from neurosurgery. The US probe is in fact connected to a motion tracking system which acquires position data and enables the superposition of US images to reference Magnetic Resonance (MR) images of the brain. This provides a means for human experts to perform a visual qualitative assessment of the US probe imaging performance and to compare acquisitions made with different probes. Moreover, the protocol relies on the use of a complete and open research and development system for US image acquisition, i.e. the Ultrasound Advanced Open Platform (ULA-OP) scanner. The manuscript describes in detail the instruments and procedures involved in the protocol, in particular for the calibration, image acquisition and registration of US and MR images. The obtained results prove the effectiveness of the overall protocol presented, which is entirely open (within the limits of the instrumentation involved), repeatable, and covers the entire set of acquisition and processing activities for US images.

  14. Prostate Ultrasound

    Medline Plus

    Full Text Available ... Ultrasound provides real-time imaging, making it a good tool for guiding minimally invasive procedures such as ... bowel (rectum) removed during prior surgery are not good candidates for ultrasound of the prostate gland because ...

  15. Prostate Ultrasound

    Medline Plus

    Full Text Available ... evaluation with additional views or a special imaging technique. A follow-up examination may also be necessary ... to-use and less expensive than other imaging methods. Ultrasound imaging uses no ionizing radiation. Ultrasound scanning ...

  16. Prostate Ultrasound

    Medline Plus

    Full Text Available ... the patient. Because ultrasound images are captured in real-time, they can show the structure and movement ... blood test result. difficulty urinating. Because ultrasound provides real-time images, it also can be used to ...

  17. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... performed to evaluate the: uterus cervix ovaries fallopian tubes bladder Pelvic ultrasound exams are also used to ... tissues that do not show up well on x-ray images. Ultrasound is the preferred imaging modality for ...

  18. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... ultrasound: abdominal, vaginal (for women), and rectal (for men). These exams are frequently used to evaluate the ... vaginal ( transvaginal / endovaginal ) for women rectal ( transrectal ) for men A Doppler ultrasound exam may be part of ...

  19. Prostate Ultrasound

    Medline Plus

    Full Text Available ... as detailed as with the transrectal probe. An MRI of the pelvis may be obtained as an ... Enlargement of the Prostate) Prostate Cancer Ultrasound- and MRI-Guided Prostate Biopsy Images related to Ultrasound - Prostate ...

  20. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... and produces pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound ... from the probe through the gel into the body. The transducer collects the sounds that bounce back ...

  1. Prostate Ultrasound

    Medline Plus

    Full Text Available ... and produces pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound ... from the probe through the gel into the body. The transducer collects the sounds that bounce back ...

  2. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... for more information . Ultrasound examinations can help diagnose symptoms experienced by women such as: pelvic pain abnormal ... Ultrasound is the preferred imaging modality for the diagnosis and monitoring of pregnant women and their unborn ...

  3. Prostate Ultrasound

    Medline Plus

    Full Text Available ... your knees toward your chest. To obtain high-quality images, an ultrasound transducer – a plastic cylinder about ... standard diagnostic ultrasound , there are no known harmful effects on humans. top of page What are the ...

  4. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... the procedure? In women, a pelvic ultrasound is most often performed to evaluate the: uterus cervix ovaries ... page How is the procedure performed? Transabdominal: For most ultrasound exams, you will be positioned lying face- ...

  5. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... ovarian cysts and uterine fibroids ovarian or uterine cancers A transvaginal ultrasound is usually performed to view the endometrium (the lining of the uterus) and the ovaries. Transvaginal ultrasound also evaluates the ...

  6. Prostate Ultrasound

    Medline Plus

    Full Text Available ... right in front of the rectum. top of page What are some common uses of the procedure? A ... ultrasound to clean out the bowel. top of page What does the equipment look like? Ultrasound scanners consist ...

  7. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... internal organs, as well as blood flowing through blood vessels. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. There are three types of pelvic ultrasound: abdominal ( transabdominal ) vaginal ( transvaginal / endovaginal ) ...

  8. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... Ultrasound is safe, noninvasive and does not use ionizing radiation. This procedure requires little to no special preparation. ... create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays ), thus there is ...

  9. Prostate Ultrasound

    Medline Plus

    Full Text Available ... Ultrasound is safe, noninvasive, and does not use ionizing radiation. This procedure requires little to no special preparation. ... create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays ), thus there is ...

  10. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... insertion. top of page How does the procedure work? Ultrasound imaging is based on the same principles ... modality for the diagnosis and monitoring of pregnant women and their unborn babies. Ultrasound provides real-time ...

  11. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... depth investigation of the uterine cavity . Three-dimensional (3-D) ultrasound permits evaluation of the uterus and ovaries ... with abnormal uterine bleeding Some physicians also use 3-D ultrasound or sonohysterography for patients with infertility. In ...

  12. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... kidneys. top of page What are some common uses of the procedure? In women, a pelvic ultrasound ... patients with abnormal uterine bleeding Some physicians also use 3-D ultrasound or sonohysterography for patients with ...

  13. Prostate Ultrasound

    Medline Plus

    Full Text Available ... of page What will I experience during and after the procedure? Ultrasound exams in which the transducer ... in the sperm or urine following the procedure. After an ultrasound examination, you should be able to ...

  14. Prostate Ultrasound

    Medline Plus

    Full Text Available ... obtain high-quality images, an ultrasound transducer – a plastic cylinder about the size of a finger – is ... end of their bowel (rectum) removed during prior surgery are not good candidates for ultrasound of the ...

  15. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... insertion. top of page How does the procedure work? Ultrasound imaging is based on the same principles ... have special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Sonohysterography Ultrasound - ...

  16. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... The teddy bear denotes child-specific content. Related Articles and Media Sonohysterography Ultrasound - Abdomen Children's (Pediatric) Ultrasound - ... facilities database . This website does not provide cost information. The costs for specific medical imaging tests, treatments ...

  17. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... records tiny changes in the sound's pitch and direction. These signature waves are instantly measured and displayed ... ultrasound, a special application of ultrasound, measures the direction and speed of blood cells as they move ...

  18. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... by women such as: pelvic pain abnormal vaginal bleeding other menstrual problems Ultrasound exams also help identify: ... fibroids cancer, especially in patients with abnormal uterine bleeding Some physicians also use 3-D ultrasound or ...

  19. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... diagnose symptoms experienced by women such as: pelvic pain abnormal vaginal bleeding other menstrual problems Ultrasound exams ... pelvic ultrasound can help evaluate: pelvic masses pelvic pain ambiguous genitalia and anomalies of pelvic organs early ...

  20. Prostate Ultrasound

    Medline Plus

    Full Text Available ... abnormal growth within the prostate. help diagnose the cause of a man's infertility. A transrectal ultrasound of ... show up well on x-ray images. Ultrasound causes no health problems and may be repeated as ...

  1. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... patient. Because ultrasound images are captured in real-time, they can show the structure and movement of ... help to distract the child and make the time pass quickly. The ultrasound exam room may have ...

  2. Prostate Ultrasound

    Medline Plus

    Full Text Available ... patient. Because ultrasound images are captured in real-time, they can show the structure and movement of ... test result. difficulty urinating. Because ultrasound provides real-time images, it also can be used to guide ...

  3. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... of page What are some common uses of the procedure? In women, a pelvic ultrasound is most ... child's favorite channel. top of page What does the equipment look like? Ultrasound scanners consist of a ...

  4. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... extract a sample of cells from organs for laboratory testing. Doppler ultrasound images can help the physician ... Ultrasound is the preferred imaging modality for the diagnosis and monitoring of pregnant women and their unborn ...

  5. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... needles are used to extract a sample of cells from organs for laboratory testing. Doppler ultrasound images ... ultrasound, measures the direction and speed of blood cells as they move through vessels. The movement of ...

  6. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... Transvaginal ultrasound is performed very much like a gynecologic exam and involves the insertion of the transducer ... with your feet in stirrups similar to a gynecologic exam. Transrectal: For a transrectal ultrasound, a protective ...

  7. Transoesophageal ultrasound and computer tomographic assessment of the equine cricoarytenoid dorsalis muscle: Relationship between muscle geometry and exercising laryngeal function.

    Science.gov (United States)

    Kenny, M; Cercone, M; Rawlinson, J J; Ducharme, N G; Bookbinder, L; Thompson, M; Cheetham, J

    2017-05-01

    Early detection of recurrent laryngeal neuropathy (RLN) is of considerable interest to the equine industry. To describe two imaging modalities, transoesophageal ultrasound (TEU) and computed tomography (CT) with multiplanar reconstruction to assess laryngeal muscle geometry, and determine the relationship between cricoarytenoid dorsalis (CAD) geometry and function. Two-phase study evaluating CAD geometry in experimental horses and horses with naturally occurring RLN. Equine CAD muscle volume was determined from CT scan sets using volumetric reconstruction with LiveWire. The midbody and caudal dorsal-ventral thickness of the CAD muscle was determined using a TEU in the same horses; and in horses with a range of severity of RLN (n = 112). Transoesophageal ultrasound was able to readily image the CAD muscles and lower left:right CAD thickness ratios were observed with increasing disease severity. Computed tomography based muscle volume correlated very closely with ex vivo muscle volume (R 2 = 0.77). Computed tomography reconstruction can accurately determine intrinsic laryngeal muscle geometry. A relationship between TEU measurements of CAD geometry and laryngeal function was established. These imaging techniques could be used to track the response of the CAD muscle to restorative surgical treatments such as nerve muscle pedicle graft, nerve anastomosis and functional electrical stimulation. © 2016 EVJ Ltd.

  8. Ultrasound assessment of the meniscus complex formation in health children and with the 1st stage of longitudinal platypodia ones

    Directory of Open Access Journals (Sweden)

    Alexei Ivantsov

    2013-04-01

    Full Text Available Objectives: Foot arch reduces the exposure of weight and buf load due to its bufer function. in longitudinal platypodia foot looses this function and articular menisci have to take the role of the bufers (shock absorbers. Materials and Methods: Ultrasound assessment of meniscus thickness was performed on the joint space level. Results: varus type (43.4% of the meniscus complex adaptation was dominant in 5-7 years old patients with the 1st stage longitudinal platypodia; symmetric type (51.9% – in 8-12 years old patients; valgus type (56% – in 13-17 years old ones. Healthy children showed the valgus type in all age periods. Conclusions: in our opinion the dominance of the varus type of the meniscus complex in 5-7 aged children and its further conversion into the valgus type in case of the 1st stage longitudinal platypodia refects the reduction of the lower extremities transformation processes from the varus into the most functional convenient valgus position at the age of 13-17. Keywords: meniscus, children, ultrasound investigation.

  9. Assessing the blood pressure waveform of the carotid artery using an ultrasound image processing method

    Energy Technology Data Exchange (ETDEWEB)

    Soleimani, Effat; Mokhtari-Dizaji, Manijhe [Dept. of Medical Physics, Tarbiat Modares University, Tehran (Iran, Islamic Republic of); Fatouraee, Nasser [Dept. of Medical Engineering, Amirkabir University of Technology, Tehran (Iran, Islamic Republic of); Saben, Hazhir [Dept. Radiology, Imaging Center of Imam Khomaini Hospital, Tehran Medical Sciences University, Tehran (Iran, Islamic Republic of)

    2017-04-15

    The aim of this study was to introduce and implement a noninvasive method to derive the carotid artery pressure waveform directly by processing diagnostic sonograms of the carotid artery. Ultrasound image sequences of 20 healthy male subjects (age, 36±9 years) were recorded during three cardiac cycles. The internal diameter and blood velocity waveforms were extracted from consecutive sonograms over the cardiac cycles by using custom analysis programs written in MATLAB. Finally, the application of a mathematical equation resulted in time changes of the arterial pressure. The resulting pressures were calibrated using the mean and the diastolic pressure of the radial artery. A good correlation was found between the mean carotid blood pressure obtained from the ultrasound image processing and the mean radial blood pressure obtained using a standard digital sphygmomanometer (R=0.91). The mean absolute difference between the carotid calibrated pulse pressures and those measured clinically was -1.333±6.548 mm Hg. The results of this study suggest that consecutive sonograms of the carotid artery can be used for estimating a blood pressure waveform. We believe that our results promote a noninvasive technique for clinical applications that overcomes the reproducibility problems of common carotid artery tonometry with technical and anatomical causes.

  10. Using Modified Contour Deformable Model to Quantitatively Estimate Ultrasound Parameters for Osteoporosis Assessment

    Science.gov (United States)

    Chen, Yung-Fu; Du, Yi-Chun; Tsai, Yi-Ting; Chen, Tainsong

    Osteoporosis is a systemic skeletal disease, which is characterized by low bone mass and micro-architectural deterioration of bone tissue, leading to bone fragility. Finding an effective method for prevention and early diagnosis of the disease is very important. Several parameters, including broadband ultrasound attenuation (BUA), speed of sound (SOS), and stiffness index (STI), have been used to measure the characteristics of bone tissues. In this paper, we proposed a method, namely modified contour deformable model (MCDM), bases on the active contour model (ACM) and active shape model (ASM) for automatically detecting the calcaneus contour from quantitative ultrasound (QUS) parametric images. The results show that the difference between the contours detected by the MCDM and the true boundary for the phantom is less than one pixel. By comparing the phantom ROIs, significant relationship was found between contour mean and bone mineral density (BMD) with R=0.99. The influence of selecting different ROI diameters (12, 14, 16 and 18 mm) and different region-selecting methods, including fixed region (ROI fix ), automatic circular region (ROI cir ) and calcaneal contour region (ROI anat ), were evaluated for testing human subjects. Measurements with large ROI diameters, especially using fixed region, result in high position errors (10-45%). The precision errors of the measured ultrasonic parameters for ROI anat are smaller than ROI fix and ROI cir . In conclusion, ROI anat provides more accurate measurement of ultrasonic parameters for the evaluation of osteoporosis and is useful for clinical application.

  11. Comprehensive and rapid assessment of carotid plaques in acute stroke using a new single sweep method for three-dimensional carotid ultrasound.

    Science.gov (United States)

    Kalashyan, Harapet; Saqqur, Maher; Shuaib, Ashfaq; Romanchuk, Helen; Nanda, Navin C; Becher, Harald

    2013-04-01

    We describe a 68-year-old man with acute stroke in whom the newly developed single sweep method for three-dimensional (3D) carotid ultrasound provided a rapid and comprehensive assessment of atherosclerotic plaque burden in the internal carotid artery. The two-dimensional duplex carotid scan diagnosed 50-69% stenosis, and with the three-dimensional method, the markedly hypoechogenic plaque (total volume 1.42 mL) was shown to occupy 77% of the total arterial volume (1.84 mL), consistent with severe lesion. The ultrasound findings were confirmed by computed tomographic angiography and subsequent carotid endarterectomy. The new single sweep 3D carotid ultrasound has the potential to become a valuable clinical tool in the assessment of stroke patients. © 2013, Wiley Periodicals, Inc.

  12. Ultrasound of the traumatized scrotum

    International Nuclear Information System (INIS)

    Lee, Choon Keun; Park, Yong Tai; Cho, Kyung Sik; Ko, Young Tae; Lee, Dong Ho; Lim, Jae Hoon

    1988-01-01

    A retrospective study was undertaken to assess the importance of ultrasound in the evaluation of scrotal trauma in 25 patients suffered from various types of trauma. Eleven patients were managed surgically and 14 patients were managed conservatively on the basis of ultrasound diagnosis. Ultrasound was valuable in the evaluation of the degree of injury and determination of early therapeutic modality for surgical of conservative manner. Ultrasound is noninvasive, convenient and also valuable in follow up study. Ultrasound is considered the technique is choice in the initial evaluation of scrotal trauma.

  13. Comparison and evaluation of indicator dilution models for bolus of ultrasound contrast agents

    Czech Academy of Sciences Publication Activity Database

    Harabis, V.; Kolář, R.; Mézl, M.; Jiřík, Radovan

    2013-01-01

    Roč. 34, č. 2 (2013), s. 151-162 ISSN 0967-3334 R&D Projects: GA ČR GAP102/12/2380 Institutional support: RVO:68081731 Keywords : perfusion model * ultrasound * contrast agent * intravascular perfusion * tissue phantom Subject RIV: FS - Medical Facilities ; Equipment Impact factor: 1.617, year: 2013

  14. Prostate Ultrasound

    Medline Plus

    Full Text Available ... if a finding is stable or changed over time. top of page What are the benefits vs. risks? Benefits Ultrasound is widely available, easy-to-use and less expensive than other imaging methods. Ultrasound imaging uses no ionizing radiation. Ultrasound scanning ...

  15. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... transducer sends out high-frequency sound waves (that the human ear cannot hear) into the body and then ... ultrasound , there are no known harmful effects on humans. top of page What are the limitations of Pelvic Ultrasound Imaging? Ultrasound waves are ...

  16. Prostate Ultrasound

    Medline Plus

    Full Text Available ... of page What are the benefits vs. risks? Benefits Ultrasound is widely available, easy-to-use and less expensive than other imaging methods. Ultrasound imaging uses no ionizing radiation. Ultrasound scanning may be able to give a ...

  17. Accuracy of contrast-enhanced breast ultrasound for pre-operative tumor size assessment in patients diagnosed with invasive ductal carcinoma of the breast

    Science.gov (United States)

    van Esser, S.; Veldhuis, W.B.; van Hillegersberg, R.; van Diest, P.J.; Stapper, G.; ElOuamari, M.; Borel Rinkes, I.H.M.; Mali, W.P.Th.M.

    2007-01-01

    Abstract Our aim was to assess the feasibility and accuracy of contrast-enhanced ultrasound (CEUS) of the breast with SonoVue microbubbles for pre-operative size measurement of invasive breast carcinomas. Seven patients diagnosed with nine invasive breast carcinomas prospectively underwent gray-scale ultrasound and CEUS of the breast according to a standardized protocol. CEUS of the breast was performed by a Philips iU22 scanner equipped with a 4–8 MHz linear array transducer. We used a single dose of 2.4 ml SonoVue as contrast agent. Breast lesion morphology was scored according to the sonographic BI-RADS lexicon criteria and classified accordingly. The greatest tumor dimensions on gray-scale ultrasound and CEUS of the breast were finally compared with the greatest histopathologic tumor sizes. Gray-scale ultrasound underestimated the histopathologic tumor size in 6/9 cases (67%), whereas CEUS of the breast underestimated tumor size in only 3/9 (33%) cases. CEUS of the breast was significantly more accurate for tumor size assessment. Greatest tumor dimension as measured with gray-scale ultrasound of the breast was within 2 mm of the pathologic tumor size in only 2/9 cases (22%), whereas CEUS of the breast accurately assessed tumor size within 2 mm of pathologic tumor size in 6/9 (67%) of the cases (P<0.05). CEUS of the breast proved to be a feasible and safe procedure. It is more accurate than gray-scale ultrasound of the breast for pre-operative size assessment of invasive ductal breast carcinomas. PMID:17513187

  18. Adding point of care ultrasound to assess volume status in heart failure patients in a nurse-led outpatient clinic. A randomised study.

    Science.gov (United States)

    Gundersen, Guri Holmen; Norekval, Tone M; Haug, Hilde Haugberg; Skjetne, Kyrre; Kleinau, Jens Olaf; Graven, Torbjorn; Dalen, Havard

    2016-01-01

    Medical history, physical examination and laboratory testing are not optimal for the assessment of volume status in heart failure (HF) patients. We aimed to study the clinical influence of focused ultrasound of the pleural cavities and inferior vena cava (IVC) performed by specialised nurses to assess volume status in HF patients at an outpatient clinic. HF outpatients were prospectively included and underwent laboratory testing, history recording and clinical examination by two nurses with and without an ultrasound examination of the pleural cavities and IVC using a pocket-size imaging device, in random order. Each nurse worked in a team with a cardiologist. The influence of the different diagnostic tests on diuretic dosing was assessed descriptively and in linear regression analyses. Sixty-two patients were included and 119 examinations were performed. Mean±SD age was 74±12 years, EF was 34±14%, and N-terminal pro-brain natriuretic peptide (NT-proBNP) value was 3761±3072 ng/L. Dosing of diuretics differed between the teams in 31 out of 119 consultations. Weight change and volume status assessed clinically with and without ultrasound predicted dose adjustment of diuretics at follow-up (p<0.05). Change of oedema, NT-proBNP, creatinine, and symptoms did not (p≥0.10). In adjusted analyses, only volume status based on ultrasound predicted dose adjustments of diuretics at first visit and follow-up (all ultrasound p≤0.01, all other p≥0.2). Ultrasound examinations of the pleural cavities and IVC by nurses may improve diagnostics and patient care in HF patients at an outpatient clinic, but more studies are needed to determine whether these examinations have an impact on clinical outcomes. NCT01794715. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. The dynamic of FUS-induced BBB Opening in Mouse Brain assessed by contrast enhanced MRI

    Science.gov (United States)

    Jenne, Jürgen W.; Krafft, Axel J.; Maier, Florian; Krause, Marie N.; Kleber, Susanne; Huber, Peter E.; Martin-Villalba, Ana; Bock, Michael

    2010-03-01

    Focused ultrasound (FUS) in combination with the administration of gas-filled microbubbles, can induce a localized and reversible opening of the blood brain barrier (BBB). Contrast enhanced magnetic resonance imaging (MRI) has been demonstrated as a precise tool to monitor such a local BBB disruption. However, the opening/closing mechanisms of the BBB with FUS are still largely unknown. In this ongoing project, we study the BBB opening dynamics in mouse brain comparing an interstitial and an intravascular MR contrast agent (CA). FUS in mouse brain was performed with an MRI compatible treatment setup (1.7 MHz fix-focus US transducer, f' = 68 mm, NA = 0.44; focus: 8.1 mm length; O/ = 1.1 mm) in a 1.5 T whole body MRI system. For BBB opening, forty 10 ms-long FUS-pulses were applied at a repetition rate of 1 Hz at 1 MPa. The i.v. administration of the micro bubbles (50 μl SonoVue®) was started simultaneously with FUS exposure. To analyze the BBB opening process, short-term and long-term MRI signal dynamics of the interstitial MR contrast agent Magnevist® and the intravascular CA Vasovist® (Bayer-Schering) were studied. To assess short-term signal dynamics, T1-weighted inversion recovery turbo FLASH images (1s) were repeatedly acquired. Repeated 3D FLASH acquisitions (90 s) were used to assess long-term MRI signal dynamics. The short-term MRI signal enhancements showed comparable time constants for both types of MR contrast agents: 1.1 s (interstitial) vs. 0.8 s (intravascular). This time constant may serve as a time constant of the BBB opening process with the given FUS exposure parameters. For the long-term signal dynamics the intravascular CA (62±10 min) showed a fife times greater time constant as the interstitial contrast agent (12±10 min). This might be explained by the high molecular weight (˜60 kDa) of the intravascular Vasovist due to its reversible binding to blood serum albumin resulting in a prolonged half-life in the blood stream compared to the

  20. Skinfold caliper and ultrasound assessments of change in the distribution of subcutaneous fat during adolescent pregnancy.

    Science.gov (United States)

    Stevens-Simon, C; Thureen, P; Barrett, J; Stamm, E

    2001-09-01

    This study compares skinfold caliper and sonographic measurements of the amount and distribution of subcutaneous adipose tissue teenagers gain during pregnancy to test three hypotheses: (1) skinfold caliper and sonographic measurements of subcutaneous adiposity are highly correlated in pregnancy; (2) the extent to which the skinfold caliper heads compact the tissues increases during gestation; and (3) skinfold caliper measurements yield a smaller estimate of the amount of subcutaneous adipose tissue gained during gestation than do sonographic measurements. We studied 28 primiparous teenagers at 10.7+/-2.8 and 29.6+/-1.8 weeks gestation. At both study visits subcutaneous adipose tissue thickness was measured at six body sites, first by skinfold caliper and then by ultrasound. Taking the nearly compression-free sonographic measurements as the standard, we quantified the extent to which the skinfold caliper heads compacted the tissues at each measurement site by computing the percentage compression: (mean adipose tissue thickness by ultrasound-(0.5xmean adipose tissue thickness by caliper)/mean adipose tissue thickness by ultrasound)x100. Pearson correlations and paired t-tests were used to compare the skinfold caliper and sonographic measurements. Hypothesis 1 was supported; the skinfold caliper and sonographic measurements were highly correlated at both study visits. Hypothesis 2 was not supported; between study visits caliper-related tissue compression decreased at measurement sites on the trunk and remained the same at measurement sites on the extremities. Hypothesis 3 was also refuted; the skinfold caliper-derived estimate of the amount of subcutaneous adipose tissue gained on the trunk exceeded the corresponding sonographic determination. As anticipated, the skinfold caliper measurements indicated that adipose tissue was stored more rapidly on the trunk than the extremities, but the opposite pattern emerged when the sonographic measurement technique was used

  1. Echocardiography and ultrasound dopplerography assessment of central and peripheral hemodynamics in children with septic shock

    Directory of Open Access Journals (Sweden)

    V.V. Yevtushenko

    2017-08-01

    Full Text Available Background. The severe course of sepsis is usually associated with the development of septic shock and multiple organ failure. For effective treatment, it is recommended to perform instrumental monitoring of preload, contractile capacity of the heart and tissue perfusion. We aimed to evaluate changes in central and peripheral hemodynamics by echocardiography and Doppler ultrasound in children with septic shock. Materials and methods. A retrospective study of cases of septic shock in children aged 0 to 18 years who underwent treatment in the intensive care unit was conducted. Patients were monitored for central and peripheral hemodynamics by echocardiography and Doppler ultrasound. The initial study of hemodynamic parameters was carried out over the first 3 hours after hospitalization. The second study was carried out in 24–36 hours after the hospitalization. The third study was conducted in the period of convalescence within 24–48 hours after the withdrawal of sympathomimetic drugs. Results. Thirty-four cases of sepsis associated with septic shock were investigated. In 24 (70.6 % patients, the etiological factor was meningococcus, in 1 (2.9 % staphylococcus, and in 9 (26.5 % no aetiology was established. In 6 children from the study group fatal outcome occurred. Values of mean blood pressure, ejection fraction, peripheral resistance were relatively lower in the acute shock period, and increased after stabilization of hemodynamics. Evaluation of peripheral blood circulation at admission showed decreased diastolic velocity in abdominal aorta and upper mesenteric artery and systolic velocity in posterior tibial artery. The results of initial investigation demonstrated that 44.1 % patients had increased cardiac output along with decreased systemic vascular resistance (‘warm shock’, and just 8.8 % had features of ‘cold shock’ (decreased cardiac output and increased vascular resistance. The fatal course of the disease was associated with

  2. Gestational Age Assessment in the Ghana Randomized Air Pollution and Health Study (GRAPHS): Ultrasound Capacity Building, Fetal Biometry Protocol Development, and Ongoing Quality Control.

    Science.gov (United States)

    Boamah, Ellen A; Asante, Kp; Ae-Ngibise, Ka; Kinney, Patrick L; Jack, Darby W; Manu, Grace; Azindow, Irene T; Owusu-Agyei, Seth; Wylie, Blair J

    2014-12-18

    Four million premature deaths occur yearly as a result of smoke from cooking fires. The Ghana Randomized Air Pollution and Health Study (GRAPHS) is underway in the Kintampo North municipality and South district of rural Ghana to evaluate the impact of improved cook stoves introduced during pregnancy on birth weight and childhood pneumonia. These hypotheses are being tested in a cluster-randomized intervention trial among 1415 maternal-infant pairs within 35 communities assigned to a control arm (traditional cooking) or one of two intervention arms (cooking with an improved biomass stove; cooking with liquefied petroleum gas stoves). The trial is designed to ensure delivery of the stove intervention prior to the period of maximal fetal growth. To answer questions about the impact of household air pollution on pregnancy outcome, accurate gestational age assessment is critical. This manuscript describes in detail the development of the gestational dating protocol, intensive ultrasound training involved, ultrasound capacity building, and ultrasound quality control program. Ultrasound training occurred in several phases over the course of 2 years. Training included a basic obstetric ultrasound course offered to all midwives performing antenatal care at the two study hospitals, followed by a more intense period of hands-on training focused on fetal biometry for a select group of providers demonstrating aptitude in the basic course. A standard operating procedure was developed describing how to obtain all fetal biometric measurements. Consensus was obtained on how biometric images are used in the trial to establish gestational age and estimate the delivery date. An ongoing ultrasound quality control program including the use of an image scorecard was also designed. Publication of trial results is anticipated in late 2016. Use of ultrasound should be strongly considered in field-based trials involving pregnant women to accurately establish gestational age, as menstrual

  3. Fulminant intravascular lymphomatosis mimicking acute haemorrhagic leukoencephalopathy.

    Science.gov (United States)

    Marino, D; Sicurelli, F; Cerase, A; Tripodi, S; Cintorino, M; Lazzi, S; Federico, A

    2012-09-15

    Intravascular lymphomatosis (IVL) is a rare non-Hodgkin's lymphoma, usually of B cell lineage, characterized by massive angiotropic growth. The clinical presentation of IVL may include changes in mental status, non-localizing neurological deficits, seizures, fever of unknown origin and skin changes. Because of its rarity and the absence of specific diagnostic procedures except for cerebral biopsy, diagnosis is often postmortem. Brain MRI usually shows non-specific abnormalities. The purpose of this case report is to increase the knowledge of clinical and neuroimaging features of IVL by describing the findings observed in a 71-year-old patient. A 71-year-old male was admitted for right hemiparesis, acute cognitive impairment and febricula. A bone marrow biopsy resulted normal. He then developed a rapid progressive impairment of his mental status and left hemisoma motor seizures. Brain CT and MRI were interpreted as consistent with acute haemorrhagic leukoencephalopathy (AHLE), including multiple areas of restricted diffusion without gadolinium enhancement and a small focal area of gadolinium enhancement in the left temporal lobe white matter. The patient died within a few days and the autopsy led to the diagnosis of IVL. IVL may present with a variety of clinical signs and symptoms, including stroke and hemiparesis. IVL may mimic AHLE at brain MRI. However, the evidence of multiple areas of restricted diffusion without gadolinium enhancement and of a small area of gadolinium enhancement could have led to the correct diagnosis. IVL should be added to the differential diagnosis of AHLE at brain MRI. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. Comparison of mammography, ultrasound, and MRI in size assessment of ductal carcinoma in situ with histopathologic correlation.

    Science.gov (United States)

    Baek, Soo Heui; Choi, Woo Jung; Cha, Joo Hee; Kim, Hak Hee; Shin, Hee Jung; Chae, Eun Young

    2017-12-01

    Background The ability to accurately assess tumor size in ductal carcinoma in situ (DCIS) is an important clinical issue when selecting the appropriate treatment plan. Purpose To compare the accuracy of using mammography, ultrasound (US), and magnetic resonance imaging (MRI) to assess DCIS tumor size based on imaging and histopathological findings. Material and Methods Fifty-six patients with DCIS were included. Mammography, US, and MRI were reviewed, and the accuracy of the measured tumor sizes were compared with the imaging and histopathological parameters. Results If visible, tumor measurements demonstrated high reliability with the pathologically determined size, with the best results obtained using US ( k = 0.851) followed by mammography ( k = 0.815) and MRI ( k = 0.738). Tumor size assessment was significantly more accurate when the lesion was shown as a mass on US ( P = 0.003) or MRI ( P mammography was used to assess tumor size, the tumors with positive estrogen receptor status and luminal A subtype demonstrated a significantly more accurate tumor size. Conclusion The combination of US and MRI, in addition to mammography, has an important role in assessing the exact tumor extent of DCIS.

  5. Cross-sectional evaluation of electrical impedance myography and quantitative ultrasound for the assessment of Duchenne muscular dystrophy in a clinical trial setting.

    Science.gov (United States)

    Rutkove, Seward B; Geisbush, Tom R; Mijailovic, Aleksandar; Shklyar, Irina; Pasternak, Amy; Visyak, Nicole; Wu, Jim S; Zaidman, Craig; Darras, Basil T

    2014-07-01

    Electrical impedance myography and quantitative ultrasound are two noninvasive, painless, and effort-independent approaches for assessing neuromuscular disease. Both techniques have potential to serve as useful biomarkers in clinical trials in Duchenne muscular dystrophy. However, their comparative sensitivity to disease status and how they relate to one another are unknown. We performed a cross-sectional analysis of electrical impedance myography and quantitative ultrasound in 24 healthy boys and 24 with Duchenne muscular dystrophy, aged 2 to 14 years with trained research assistants performing all measurements. Three upper and three lower extremity muscles were studied unilaterally in each child, and the data averaged for each individual. Both electrical impedance myography and quantitative ultrasound differentiated healthy boys from those with Duchenne muscular dystrophy (P Duchenne muscular dystrophy boys (rho = 0.45; P = 0.029), whereas electrical impedance myography did not (rho = -0.31; P = 0.14). However, electrical impedance myography phase correlated with age in healthy boys (rho = 0.51; P = 0.012), whereas quantitative ultrasound did not (rho = -0.021; P = 0.92). In Duchenne muscular dystrophy boys, electrical impedance myography phase correlated with the North Star Ambulatory Assessment (rho = 0.65; P = 0.022); quantitative ultrasound revealed a near-significant association (rho = -0.56; P = 0.060). The two technologies trended toward a moderate correlation with one another in the Duchenne muscular dystrophy cohort but not in the healthy group (rho = -0.40; P = 0.054 and rho = -0.32; P = 0.13, respectively). Electrical impedance myography and quantitative ultrasound are complementary modalities for the assessment of boys with Duchenne muscular dystrophy; further study and application of these two modalities alone or in combination in a longitudinal fashion are warranted. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Summary Findings of a Systematic Literature Review of the Ultrasound Assessment of Bone Erosions in Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Szkudlarek, Marcin; Terslev, Lene; Wakefield, Richard J

    2016-01-01

    OBJECTIVE: Bone erosions in rheumatoid arthritis (RA) have been studied in an increasing amount of research. Both earlier and present classification criteria of RA contain erosions as a significant classification component. Ultrasound (US) can detect bone changes in accessible surfaces. Therefore...... Measures in Rheumatology Clinical Trials) filter were collected and analyzed. RESULTS: The selection process identified 58 original research papers. The assessed joints were most frequently metacarpophalangeal (MCP; 41 papers), proximal interphalangeal (19 papers), and metatarsophalangeal joints (MTP; 18...... papers). The OMERACT definition of RA bone erosion on US was used most often (17 papers). Second and fifth MCP and fifth MTP were recommended as target joints. Conventional radiography was the most frequently used comparator (27 papers), then magnetic resonance imaging (17 papers) and computed tomography...

  7. The use of the posture-p questionnaire and the quantitative ultrasound to assess the bone density of postmenopausal women

    Science.gov (United States)

    Winardi, A. M.; Wulansari, L. K.; Kusdhany, L. S.

    2017-08-01

    Osteoporosis must be detected early in order to prevent failures in denture treatment. To this end, tools such as the Posture-P questionnaire and the Quantitative Ultrasound (QUS) are widely used for osteoporosis screening. Posture-P. This study is a diagnostic test that analyzes the sensitivity and specificity of the Posture-P questionnaire towards QUS in assessing the bone density of postmenopausal women. Data was collected through interviews using the Posture-P questionnaire, and bone density was measured using the QUS. The results of this study show that both the sensitivity and specificity of the Posture-P questionnaire towards QUS are quite good, with respective values of 77.23% and 75%. Thus, the Posture-P questionnaire can replace the QUS in osteoporosis screening.

  8. Influence of ezetimibe in addition to high-dose atorvastatin therapy on plaque composition in patients with ST-segment elevation myocardial infarction assessed by serial Intravascular ultrasound with iMap: the OCTIVUS trial*

    DEFF Research Database (Denmark)

    Hougaard, Mikkel; Hansen, Henrik Steen; Thayssen, Per

    2017-01-01

    Background: The aim of this study was to examine the influence of ezetimibe in addition to atorvastatin on plaque composition in patients with first-time ST-segment Elevation Myocardial Infarction treated with primary percutaneous intervention. Methods: Eighty-seven patients were randomized ( 1: ...

  9. The Clinical Atlas of Intravascular Optical Coherence Tomography for iPad

    DEFF Research Database (Denmark)

    Radu, Maria D

    2012-01-01

    The first comprehensive educational tool devoted exclusively to intravascular OCT is now available from PCR publishing.......The first comprehensive educational tool devoted exclusively to intravascular OCT is now available from PCR publishing....

  10. Low molecular weight heparin attenuates multiple organ failure in a murine model of disseminated intravascular coagulation

    NARCIS (Netherlands)

    Slofstra, Sjoukje H.; van 't Veer, Cornelis; Buurman, Wim A.; Reitsma, Pieter H.; ten Cate, Hugo; Spek, C. Arnold

    2005-01-01

    OBJECTIVE: Bacterial sepsis causes widespread vascular inflammation that frequently leads to disseminated intravascular coagulation (DIC). Although intravascular coagulation contributes to organ failure, it is often debated whether anticoagulant therapy produces any beneficial effects in patients

  11. Quantitative Ultrasound Imaging to Assess the Biceps Brachii Muscle in Chronic Post-Stroke Spasticity: Preliminary Observation.

    Science.gov (United States)

    Gao, Jing; He, Wen; Du, Li-Juan; Chen, Johnson; Park, David; Wells, Michael; Fowlkes, Brian; O'Dell, Michael

    2018-02-02

    We prospectively investigated the feasibility of using quantitative ultrasound imaging (QUI) to assess the biceps brachii muscle (BBM) in individuals with chronic post-stroke spasticity. To quantify muscle echogenicity and stiffness, we measured QUI parameters (gray-scale pixel value and shear wave velocity [SWV, m/s]) of the BBM in three groups: 16 healthy BBMs; 12 post-stroke, non-spastic BBMs; and 12 post-stroke, spastic BBMs. The QUI results were compared with the Modified Ashworth Scale and Tardieu Scale. A total of 20 SWVs were measured in each BBM, once at elbow in 90° flexion and again at maximally achievable extension using acoustic radiation force impulse imaging. BBM pixel value was measured in gray-scale images captured at 90° elbow flexion using ImageJ software. Statistical analyses included analysis of variance for examining the difference in SWV and pixel values among the three groups; Bonferroni correction for testing the difference in SWV and pixel values in a paired group; t-test for examining the difference in SWV values measured at two elbow angles; and Pearson correlation coefficient for analyzing the correlation of QUI to Modified Ashworth Scale and Tardieu Scale. SWV significantly differed between spastic BBMs and non-spastic or healthy BBMs. For pixel values, each of the three groups significantly differed from the others at elbow 90° flexion. The difference in SWV measured between the two elbow angles was also significant (p <0.01). A strong negative correlation was found between SWV and passive range of motion (R 2  = -0.88, p <0.0001) in spastic upper limbs. These results suggest that the use of QUI is feasible in quantitative assessment of spastic BBM. Copyright © 2017 World Federation for Ultrasound in Medicine and Biology. Published by Elsevier Inc. All rights reserved.

  12. Health technology assessment and screening in The Netherlands: case studies of mammography in breast cancer, PSA screening in prostate cancer, and ultrasound in normal pregnancy.

    NARCIS (Netherlands)

    Banta, H.D.; Oortwijn, W.J.

    2001-01-01

    OBJECTIVE: To review the assessment and implementation of three screening methods: mammography for breast cancer, screening for prostate cancer, and routine use of ultrasound in pregnancy. METHODS: To review policy documents and published papers dealing with prevention and screening in the

  13. Three-Dimensional and Conventional Carotid Ultrasound for Assessment of Carotid Plaque in a Stroke Patient: A Simple Way to Validate Findings.

    Science.gov (United States)

    Kalashyan, Hayrapet; Saqqur, Maher; Becher, Harald; O'Kelly, Cian; Romanchuk, Helen; Khan, Khurshid; Jeerakathil, Thomas; Wassef, Andrew; Shuaib, Ashfaq

    2017-03-01

    Single-sweep automated 3-D ultrasound is a new imaging modality for the assessment of carotid plaque. Its most important application is the measurement of the plaque volume. To our knowledge, to date there is not a widely accepted "gold standard" to validate 3-D plaque volume measurement. We compared the findings of 2-dimensional and 3-D carotid ultrasound imaging with those of postsurgical plaque specimen using a simple method. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  14. Emergency treatment by intravascular embolization in traumatic carotid cavernous fistula

    International Nuclear Information System (INIS)

    Tang Jun; Sun Zengtao; Liu Zuoqin; Liu Yanjun; Li Fengxin

    2006-01-01

    Objective: To discuss the method of intervenfional intravascular treatment in traumatic carotid cavernous fistula (TCCF) and the significance of clinical application in emergency. Methods: In 297 eases of TCCF, 36 cases were treated by interventional intravascular embolization by detachable balloon, embolization orificium or occlusion in one side of carotid artery. In the 36 cases, serious epistaxis occurred in 22 eases, cortical vein inflow in 9 cases, intracranial hemorrhage in 3 cases, aggravation of eyesight in 3 cases, and limb dysfunction in 2 cases. Results: Fistula was successfully embolized and internal carotid artery remained patent in 19 cases. Complete embolization of orificium or internal carotid artery was achieved in 17 eases. The serious epistaxias in 22 cases and intracranial hemorrhage in 3 cases stopped. Eyesight recovered in 2 eases and improved in 1 case. Limb dysfunction improved evidently in 2 cases. Conclusion: Intravascular embolization treatment is the first therapeutic choice for TCCF, especially in emergency. It is necessary, safe and effective. (authors)

  15. Animal study assessing safety of an acoustic coupling fluid that holds the potential to avoid surgically induced artifacts in 3D ultrasound guided operations

    International Nuclear Information System (INIS)

    Jakola, Asgeir S; Jørgensen, Arve; Selbekk, Tormod; Michler, Ralf-Peter; Solheim, Ole; Torp, Sverre H; Sagberg, Lisa M; Aadahl, Petter; Unsgård, Geirmund

    2014-01-01

    Use of ultrasound in brain tumor surgery is common. The difference in attenuation between brain and isotonic saline may cause artifacts that degrade the ultrasound images, potentially affecting resection grades and safety. Our research group has developed an acoustic coupling fluid that attenuates ultrasound energy like the normal brain. We aimed to test in animals if the newly developed acoustic coupling fluid may have harmful effects. Eight rats were included for intraparenchymal injection into the brain, and if no adverse reactions were detected, 6 pigs were to be included with injection of the coupling fluid into the subarachnoid space. Animal behavior, EEG registrations, histopathology and immunohistochemistry were used in assessment. In total, 14 animals were included, 8 rats and 6 pigs. We did not detect any clinical adverse effects, seizure activity on EEG or histopathological signs of tissue damage. The novel acoustic coupling fluid intended for brain tumor surgery appears safe in rats and pigs under the tested circumstances

  16. 3-D high-frequency endovaginal ultrasound of female urethral complex and assessment of inter-observer reliability

    International Nuclear Information System (INIS)

    Wieczorek, A.P.; Wozniak, M.M.; Stankiewicz, A.; Santoro, G.A.; Bogusiewicz, M.; Rechberger, T.

    2012-01-01

    Objectives: Assessment of the urethral complex and defining its morphological characteristics with 3-dimensional endovaginal ultrasonography with the use of high frequency rotational 360° transducer. Defining inter-observer reliability of the performed measurements. Materials and methods: Twenty-four asymptomatic, nulliparous females (aged 18–55, mean 32 years) underwent high-frequency (12 MHz) endovaginal ultrasound with rotational 360° and automated 3D data acquisition (type 2050, B-K Medical, Herlev, Denmark). Measurements of the urethral thickness, width and length, bladder neck-symphysis distance, intramural part of the urethra as well as rhabdosphincter thickness, width and length were taken by three investigators. Descriptive statistics for continuous data was performed. The results were given as mean values with standard deviation. The relationships among different variables were assessed with ANOVA for repeated measures factors, as well as T-test for dependent samples. Intraclass correlation (ICC) was calculated for each parameter. Intra- and interobserver reliability was assessed. Statistical significance was assigned to a P value of 0.8) and good reliability for rhabdosphincter measurements (ICC > 0.6) between all three investigators. Conclusions: Advanced EVUS provides detailed information on anatomy and morphology of the female urethral complex. Our results show that 360° rotational transducer with automated 3D acquisition, currently routinely used for proctological scanning is suitable for the reliable assessment of the urethral complex and can be applied in a routine diagnostics of pelvic floor disturbances in females.

  17. The value of ultrasound contrast for assessing cancer cell proliferation and invasion function as well as angiogenesis in lesions of in patients with gastric cancer

    Directory of Open Access Journals (Sweden)

    Qin Yang

    2017-06-01

    Full Text Available Objective: To study the value of ultrasound contrast for assessing cancer cell proliferation and invasion as well as angiogenesis in lesions of in patients with gastric cancer. Methods: A total of 39 patients with gastric cancer and 48 patients with gastric ulcer who were treated in our hospital between August 2012 and May 2016 were included in gastric cancer group and gastric ulcer group respectively, and 50 healthy subjects who accepted gastroscopy in our hospital during the same period were included in normal control group. The day after admission, color Doppler diasonograph was used to test the gastric ultrasound contrast parameters; fluorescence quantitative PCR method was used to detect the proliferation and invasion gene mRNA expression in stomach tissue; enzyme-linked immunosorbent assay (ELISA was used to detect the serum angiogenesis index levels. Results: Ultrasound contrast parameters ET and TTP levels of gastric cancer group and gastric ulcer group were significantly lower than those of normal control group, and ultrasound contrast parameters ET and TTP levels of gastric cancer group were significantly lower than those of gastric ulcer group; Stat3, Survivin, Bcl-2, 毬-catenin, eIF4E, CD44, UHRF1 and c-met mRNA expression in tissue as well as VEGF, EGFR, HIF-毩 and Ang-2 levels in serum of gastric cancer group were higher than those of gastric ulcer group and normal control group while E-cadherin mRNA expression in tissue was lower than those of gastric ulcer group and normal control group; Spearman correlation analysis showed that ultrasound contrast parameters ET and TTP levels were correlated with the cancer cell proliferation and invasion function as well as angiogenesis indexes in lesions. Conclusion: Ultrasound contrast parameters can accurately assess the malignant degree of gastric cancer, and is expected to become the reliable means for early diagnosis and treatment guidance of gastric cancer in the future.

  18. Extremely refractory Kawasaki disease with disseminated intravascular coagulation.

    Science.gov (United States)

    Koh, Young Kwon; Lee, Jae Hee; Park, Yeong Bong

    2017-07-01

    Disseminated intravascular coagulation is a rare complication of Kawasaki disease and appears in Kawasaki disease patients. We report a case of refractory Kawasaki disease complicated with disseminated intravascular coagulation and giant coronary aneurysm. A 5-month-old boy presented with Kawasaki disease with coagulopathy. Although the coagulopathy improved after fresh-frozen plasma and antithrombin-III administration, the fever persisted despite two rounds of intravenous immunoglobulin, along with intravenous methylprednisolone pulse therapy and infliximab administration. Despite all efforts to treatment, the patient had giant coronary aneurysms and died suddenly.

  19. 21 CFR 880.5970 - Percutaneous, implanted, long-term intravascular catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Percutaneous, implanted, long-term intravascular... and Personal Use Therapeutic Devices § 880.5970 Percutaneous, implanted, long-term intravascular catheter. (a) Identification. A percutaneous, implanted, long-term intravascular catheter is a device that...

  20. 21 CFR 880.5965 - Subcutaneous, implanted, intravascular infusion port and catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Subcutaneous, implanted, intravascular infusion... Hospital and Personal Use Therapeutic Devices § 880.5965 Subcutaneous, implanted, intravascular infusion port and catheter. (a) Identification. A subcutaneous, implanted, intravascular infusion port and...

  1. High-frequency ultrasound for intraoperative margin assessments in breast conservation surgery: a feasibility study

    Directory of Open Access Journals (Sweden)

    Hart Vern P

    2011-10-01

    Full Text Available Abstract Background In addition to breast imaging, ultrasound offers the potential for characterizing and distinguishing between benign and malignant breast tissues due to their different microstructures and material properties. The aim of this study was to determine if high-frequency ultrasound (20-80 MHz can provide pathology sensitive measurements for the ex vivo detection of cancer in margins during breast conservation surgery. Methods Ultrasonic tests were performed on resected margins and other tissues obtained from 17 patients, resulting in 34 specimens that were classified into 15 pathology categories. Pulse-echo and through-transmission measurements were acquired from a total of 57 sites on the specimens using two single-element 50-MHz transducers. Ultrasonic attenuation and sound speed were obtained from time-domain waveforms. The waveforms were further processed with fast Fourier transforms to provide ultrasonic spectra and cepstra. The ultrasonic measurements and pathology types were analyzed for correlations. The specimens were additionally re-classified into five pathology types to determine specificity and sensitivity values. Results The density of peaks in the ultrasonic spectra, a measure of spectral structure, showed significantly higher values for carcinomas and precancerous pathologies such as atypical ductal hyperplasia than for normal tissue. The slopes of the cepstra for non-malignant pathologies displayed significantly greater values that differentiated them from the normal and malignant tissues. The attenuation coefficients were sensitive to fat necrosis, fibroadenoma, and invasive lobular carcinoma. Specificities and sensitivities for differentiating pathologies from normal tissue were 100% and 86% for lobular carcinomas, 100% and 74% for ductal carcinomas, 80% and 82% for benign pathologies, and 80% and 100% for fat necrosis and adenomas. Specificities and sensitivities were also determined for differentiating each

  2. High-frequency ultrasound for intraoperative margin assessments in breast conservation surgery: a feasibility study

    International Nuclear Information System (INIS)

    Doyle, Timothy E; Neumayer, Leigh A; Factor, Rachel E; Ellefson, Christina L; Sorensen, Kristina M; Ambrose, Brady J; Goodrich, Jeffrey B; Hart, Vern P; Jensen, Scott C; Patel, Hemang

    2011-01-01

    In addition to breast imaging, ultrasound offers the potential for characterizing and distinguishing between benign and malignant breast tissues due to their different microstructures and material properties. The aim of this study was to determine if high-frequency ultrasound (20-80 MHz) can provide pathology sensitive measurements for the ex vivo detection of cancer in margins during breast conservation surgery. Ultrasonic tests were performed on resected margins and other tissues obtained from 17 patients, resulting in 34 specimens that were classified into 15 pathology categories. Pulse-echo and through-transmission measurements were acquired from a total of 57 sites on the specimens using two single-element 50-MHz transducers. Ultrasonic attenuation and sound speed were obtained from time-domain waveforms. The waveforms were further processed with fast Fourier transforms to provide ultrasonic spectra and cepstra. The ultrasonic measurements and pathology types were analyzed for correlations. The specimens were additionally re-classified into five pathology types to determine specificity and sensitivity values. The density of peaks in the ultrasonic spectra, a measure of spectral structure, showed significantly higher values for carcinomas and precancerous pathologies such as atypical ductal hyperplasia than for normal tissue. The slopes of the cepstra for non-malignant pathologies displayed significantly greater values that differentiated them from the normal and malignant tissues. The attenuation coefficients were sensitive to fat necrosis, fibroadenoma, and invasive lobular carcinoma. Specificities and sensitivities for differentiating pathologies from normal tissue were 100% and 86% for lobular carcinomas, 100% and 74% for ductal carcinomas, 80% and 82% for benign pathologies, and 80% and 100% for fat necrosis and adenomas. Specificities and sensitivities were also determined for differentiating each pathology type from the other four using a multivariate

  3. Assessment of voluntary pelvic floor muscle contraction in continent and incontinent women using transperineal ultrasound, manual muscle testing and vaginal squeeze pressure measurements.

    Science.gov (United States)

    Thompson, Judith A; O'Sullivan, Peter B; Briffa, N Kathryn; Neumann, Patricia

    2006-11-01

    The aims of the study were: (1) to assess women performing voluntary pelvic floor muscle (PFM) contractions, on initial instruction without biofeedback teaching, using transperineal ultrasound, manual muscle testing, and perineometry and (2) to assess for associations between the different measurements of PFM function. Sixty continent (30 nulliparous and 30 parous) and 60 incontinent (30 stress urinary incontinence (SUI) and 30 urge urinary incontinence (UUI)) women were assessed. Bladder neck depression during attempts to perform an elevating pelvic floor muscle (PFM) contraction occurred in 17% of continent and 30% of incontinent women. The UUI group had the highest proportion of women who depressed the bladder neck (40%), although this was not statistically significant (p=0.060). The continent women were stronger on manual muscle testing (p=0.001) and perineometry (p=0.019) and had greater PFM endurance (pelevation than the incontinent women (p=0.051). There was a moderate correlation between bladder neck movement during PFM contraction measured by ultrasound and PFM strength assessed by manual muscle testing (r=0.58, p=0.01) and perineometry (r=0.43, p=0.01). The observation that many women were performing PFM exercises incorrectly reinforces the need for individual PFM assessment with a skilled practitioner. The significant correlation between the measurements of bladder neck elevation during PFM contraction and PFM strength measured using MMT and perineometry supports the use of ultrasound in the assessment of PFM function; however, the correlation was only moderate and, therefore, indicates that the different measurement tools assess different aspects of PFM function. It is recommended that physiotherapists use a combination of assessment tools to evaluate the different aspects of PFM function that are important for continence. Ultrasound is useful to determine the direction of pelvic floor movement in the clinical assessment of pelvic floor muscle function

  4. Auditing ultrasound assessment of fetal nuchal translucency thickness: a review of Australian National Data 2002-2008.

    Science.gov (United States)

    Nisbet, Debbie L; Robertson, Ann C; Schluter, Philip J; McLennan, Andrew C; Hyett, Jon A

    2010-10-01

    Nuchal translucency (NT) measurement is the ultrasound component of first trimester combined screening for Down syndrome. In 2002, a NT ultrasound education and monitoring program was established in Australia. Between 2002 and 2008, a total of 728,502 NT scans were audited through this process. OVERALL AIM: To audit the availability and performance of certified operators measuring NT following implementation of the Australian education and monitoring program in 2002. Retrospective review of the central database that is used to monitor performance of individuals and practices performing NT scans in both public and private practice settings throughout Australia between 2002 and 2008. The performance of operators was assessed by a widely used international standard - that 40-60% of NT measurements should be above the median value for gestational age. The number of certified operators has increased (from 184 in 2002 to 477 in 2008). There is wide variation between states in the number of operators per birth. The percentage of certified operators with a measurement distribution meeting the international standard has increased from 40% in 2002 to 55% in 2008. Greatest improvement has been seen in operators performing 30-199 scans per year. There has been no overall improvement in performance over the last three audit cycles. The number of operators certified to perform the NT scan has increased since 2002, although availability in some states remains low. An initial improvement in performance of operators appears to have reached a plateau. It is time to become more proactive in engaging operators in the audit cycle. © 2010 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology © 2010 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  5. Assessment of cyclic changes of microvessels in ovine ovaries using Sonovue contrast-enhanced ultrasound.

    Science.gov (United States)

    Marret, Henri; Brewer, Molly; Giraudeau, Bruno; Tranquart, François; Satterfield, William

    2006-02-01

    Our objective was to detect variations of ovarian vascularization that occur in the estrus cycle of the ewe using an IV contrast agent. Five ewes were investigated using contrast-enhanced power Doppler after Sonovue injection at day 0, 3, 5, 10 and 13 of the cycle in two successive estrus cycles. Transvaginal ultrasound monitoring of each ewe was performed after a dose of Sonovue. Parameters derived from the time-intensity curves were compared. Quantification of the enhancement and wash-in period parameters changed significantly between ovaries and between the follicular and luteal periods of the cycle. Uptake time, wash-out time, total time of enhancement and area under the curve were the parameters with the smallest variation between ovaries. Wash-out time and area under the curve are two contrast parameters that did not change with cyclic changes. Thus, using these parameters in premenopausal women will allow more accurate detection of vascular modifications that may be associated with ovarian cancer.

  6. Transthoracic ultrasound in the assessment of pleural and pulmonary diseases: use and limitations.

    Science.gov (United States)

    Sperandeo, Marco; Rotondo, Antonio; Guglielmi, Giuseppe; Catalano, Daniela; Feragalli, Beatrice; Trovato, Guglielmo M

    2014-10-01

    Interest in transthoracic ultrasound (US) procedures increased after the availability of portable US equipment suitable for use at the patient's bedside. It is possible to detect space-occupying lesions of the pleura, pleural effusion, focal or diffuse pleural thickening and subpleural lesions of the lung, even in emergency settings. Transthoracic US is useful as a guidance system for thoracentesis and peripheral lesion biopsy, where it minimises the occurrence of pneumothorax and haemorrhage. Transthoracic US imaging is strongly influenced by physical interaction of the ultrasonic beam at the tissue/air interface, which gives rise to reverberations classified as simple (A-line), "comet tail" and "ring down"(B-line) artifacts. Although these artifacts can be suggestive of a disease condition, they are essentially imaging errors present even in normal subjects and in empty-pleura post-pneumonectomy patients. In order to clarify some confusion and to report on the state of the art, we present a review of the literature on transthoracic US in diseases of the pleura and peripheral lung regions and our own clinical experience over 3 decades. The review focuses on quality assurance procedures and their value in diagnostic imaging and patient monitoring and warns against possible inappropriate indications and misleading information. Thoracic US is much more than "fishing for the moon in the well".

  7. Vaginal High Pressure Zone Assessed by Dynamic 3-Dimensional Ultrasound Images of the Pelvic Floor

    Science.gov (United States)

    JUNG, Sung-Ae; PRETORIUS, Dolores H.; PADDA, Bikram S.; WEINSTEIN, Milena M.; NAGER, Charles W.; den BOER, Derkina J.; MITTAL, Ravinder K.

    2009-01-01

    Objective To study the shape and characteristics of the vaginal high pressure zone (HPZ) by imaging a compliant fluid-filled bag placed in the vaginal HPZ with the 3-dimensional ultrasound (3D US) system. Study Design Nine nulliparous asymptomatic women underwent 3D US imaging and vaginal pressure measurements. A compliant bag was placed in the vagina and filled with various volumes of water. 3D US volumes of the pelvic floor were obtained at each bag volume while the subjects were at rest and during pelvic floor contraction. Results At low volumes, the bag was collapsed for a longitudinal extent of approximately 3.3 ± 0.2 cm (length of vaginal HPZ). With increasing bag volume, there was opening of the vaginal HPZ in the lateral dimension before the anterior-posterior (AP) dimension. Pelvic floor contraction produced a decrease in the AP dimension but not the lateral dimension of the bag in the region of the vaginal HPZ. Conclusion We propose that the shape and characteristics of the vaginal HPZ are consistent with the hypothesis that the puborectalis muscle is responsible for the genesis of the vaginal HPZ. PMID:17618755

  8. Technical quality assessment of breast ultrasound according to American College of Radiology (ACR) Standards

    International Nuclear Information System (INIS)

    Ko, Kyung Hee; Kim, Eun Kyung; Kim, Young Ah; Son, Eun Ju; Oh, Ki Keun; Chung, Sun Yang

    2003-01-01

    To evaluate the technical quality of breast ultrasound based on American College of Radiology(ACR) standards. Between March 2002 and July 2002, ninety three breast sonograms obtained from 73 institutions were evaluated based on ACR standards for the hardware, technical settings, labeling of the images and identification. Of 93 breast sonograms, a satisfactory compliance with all ACR standards in the performance of breast US examinations was documented in 31% while the remaining 69% did not fully meet all ACR standards. 4.3% of breast US examinations were performed with a convex transducers, and the focal zone was inappropriately positioned in 14.2%. Gray-scale gain was subjectively characterized as inappropriate in 26.9%, and the size of lesion was not measured in 7.5%. Anatomic location of lesions was inappropriately described in 9.3%. The orientation of an US transducer was not properly labeled on any images in 33.3%. Inadequate recording of patient's information was noted in 43.3%. 50% of sonograms at University medical centers and larger general hospitals fully met all ACR standards while 36.8% at radiologic clinics and 12.1% at other private clinics met all ACR standards. Overall, 69% of breast sonograms failed to meet the quality criteria of the ACR standards. Therefore, it is essential to educate the basic technical details in performing breast US for the quality control.

  9. Experimental performance assessment of the sub-band minimum variance beamformer for ultrasound imaging

    DEFF Research Database (Denmark)

    Diamantis, Konstantinos; Greenaway, Alan H.; Anderson, Tom

    2017-01-01

    the broadband ultrasound signals into sub-bands (MVS) to conform with the narrow-band assumption of the original MV theory. This approach is investigated here using experimental Synthetic Aperture (SA) data from wire and cyst phantoms. A 7 MHz linear array transducer is used with the SARUS experimental...... of 52 mm, is 16.7 μm (0.08λ) for both MV methods, while the corresponding values for the DAS case are at least 24 times higher. The measured Peak-Side-lobe-Level (PSL) may reach −41 dB using the MVS approach, while the values from the DAS and MVT beamforming are above −24 dB and −33 dB, respectively....... From the cyst phantom, the power ratio (PR), the contrast-to-noise ratio (CNR), and the speckle signal-to-noise ratio (sSNR) measured at a depth of 30 mm are at best similar for MVS and DAS, with values ranging between −29 dB and −30 dB, 1.94 and 2.05, and 2.16 and 2.27 respectively. In conclusion...

  10. Ultrasound Assessment of Abdominal Muscle Thickness in Women With and Without Low Back Pain During Pregnancy.

    Science.gov (United States)

    Weis, Carol Ann; Nash, Jennifer; Triano, John J; Barrett, Jon

    2017-05-01

    The aim of this preliminary study was to determine the differences in abdominal musculature thickness, within 1 month of delivery, in women who experienced back pain during pregnancy compared with those who did not. B-mode ultrasound imaging was used to measure abdominal muscle thickness on 76 postpartum participants who participated in a larger study; 47 women experienced back pain during pregnancy, and 29 did not. Participant data were stratified by group, and primary comparisons were based on these grouping across the abdominal muscles, including rectus abdominis (upper and lower fibers), external oblique, internal oblique, and transversus abdominis. Means and standard deviations were also used to set parameters for future studies. In the present study, there was no difference in any abdominal muscle thickness between groups. Women with low back pain were significantly shorter (165.19 ± 6.64 cm) than women who did not have from back pain during pregnancy (169.38 ± 7.58 cm). All other demographics, such as age, weight, and date tested postpartum, were not significantly different between groups. The results of this study showed no variation in abdominal muscle thickness in women who had back pain during pregnancy and those who did not. Copyright © 2017. Published by Elsevier Inc.

  11. The effects of serial intravascular transfusions in ascitic/hydropic RhD-alloimmunized fetuses.

    Science.gov (United States)

    Craparo, F J; Bonati, F; Gementi, P; Nicolini, U

    2005-02-01

    To evaluate the effects of serial intravascular transfusions on RhD-alloimmunized fetuses with ascites/hydrops at the time of the first transfusion by measuring multiple hematological/biochemical blood variables. Thirty-one singleton pregnancies were referred for management of RhD alloimmunization. Seven fetuses had hydrops on presentation and were transfused immediately. The remainder underwent weekly ultrasound examinations, and fetal blood sampling and transfusion were performed on development of ascites. In the 104 samples collected overall from the 31 fetuses, glucose, uric acid, urea, creatinine, total protein, total and direct bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase, alkaline phosphatase, lactic dehydrogenase, amylase, pseudocholinesterase (PCHE), creatine kinase, triglycerides and cholesterol were measured and compared with a reference range for non-anemic fetuses. The median gestational age at first transfusion was 26 (range, 18-34) weeks. There were three fetal losses after the first transfusion, two of which were due to procedure-related complications; one further loss occurred. At the first transfusion fetal hematocrit, pO2, total protein, PCHE, creatinine and urea concentrations were significantly decreased compared to reference data, while total and direct bilirubin, AST, ALT, amylase, triglyceride and uric acid concentrations were increased. In all surviving fetuses ascites/hydrops had disappeared by the second transfusion. Fetal pO2, total protein, AST, ALT and PCHE concentrations had normalized by the third transfusion. Correction of fetal anemia did not affect the other variables. RhD-alloimmunized fetuses with ascites/hydrops at the time of the first transfusion had a survival rate of 87%. Alterations of several biochemical fetal blood indices are present at the first sampling/transfusion, but most variables normalize with intravascular transfusions. Copyright 2005 ISUOG.

  12. Comparison of transperineal and transabdominal ultrasound in the assessment of voluntary pelvic floor muscle contractions and functional manoeuvres in continent and incontinent women.

    Science.gov (United States)

    Thompson, Judith A; O'Sullivan, Peter B; Briffa, N Kathryn; Neumann, Patricia

    2007-07-01

    Transperineal (TP) and transabdominal (TA) ultrasounds were used to assess bladder neck (TP) and bladder base (TA) movement during voluntary pelvic floor muscle (PFM) contraction and functional tasks. A sonographer assessed 60 asymptomatic (30 nulliparous, 30 parous) and 60 incontinent (30 stress, 30 urge) women with a mean age of 43 (SD=7) years, BMI of 24 (SD=4) kg m2 and a median parity of 2 (range, 0-5), using both ultrasound methods. The mean of three measurements for bladder neck and bladder base (sagittal view) movement for each task was assessed for differences between the groups. There were no differences in bladder neck (p=0.096) or bladder base (p=0.112) movement between the four groups during voluntary PFM contraction but significant differences in bladder neck (pelevation (p=0.051), but no difference in bladder base movement (p=0.300), when compared to the incontinent women. The incontinent women demonstrated increased bladder neck descent during Valsalva and abdominal curl (p<0.001) and bladder base descent during Valsalva (p=0.021). The differences between the groups were more marked during functional activities, suggesting that comprehensive assessment of the PFM should include functional activities as well as voluntary PFM contractions. TP ultrasound was more reliable and takes measures from a bony landmark when compared to TA ultrasound, which lacks a reference point for measurements. TA ultrasound is less suitable for PFM measures during functional manoeuvres and comparisons between subjects. Few subjects were overweight so the results may not be valid in an obese population.

  13. Relationship between Controlled Attenuation Parameter and Hepatic Steatosis as Assessed by Ultrasound in Alcoholic or Nonalcoholic Fatty Liver Disease.

    Science.gov (United States)

    Ahn, Jem Ma; Paik, Yong-Han; Min, Sin Yeong; Cho, Ju Yeon; Sohn, Won; Sinn, Dong Hyun; Gwak, Geum-Youn; Choi, Moon Seok; Lee, Joon Hyeok; Koh, Kwang Cheol; Paik, Seung Woon; Yoo, Byung Chul

    2016-03-01

    The aim of this study was to evaluate the relationship between controlled attenuation parameter (CAP) and hepatic steatosis, as assessed by ultrasound (US) in patients with alcoholic liver disease (ALD) or non-alcoholic fatty liver disease (NAFLD). Patients with either ALD or NAFLD who were diagnosed with fatty liver with US and whose CAP scores were measured, were retrospectively enrolled in this study. The degree of hepatic steatosis assessed by US was categorized into mild (S1), moderate (S2), and severe (S3). A total of 186 patients were included 106 with NAFLD and 80 with ALD. Regarding hepatic steatosis, the CAP score was significantly correlated with US (ρ=0.580, psteatosis were excellent (0.789 and 0.843, respectively). For sensitivity ≥ 90%, CAP cutoffs for the detection of ≥ S2 and ≥ S3 steastosis were separated with a gap of approximately 35 dB/m in all patients and in each of the NAFLD and ALD groups. The CAP score is well correlated with hepatic steatosis, as assessed by US, in both ALD and NAFLD.

  14. Evaluation of virtual touch tissue imaging quantification, a new shear wave velocity imaging method, for breast lesion assessment by ultrasound.

    Science.gov (United States)

    Golatta, Michael; Schweitzer-Martin, Mirjam; Harcos, Aba; Schott, Sarah; Gomez, Christina; Stieber, Anne; Rauch, Geraldine; Domschke, Christoph; Rom, Joachim; Schütz, Florian; Sohn, Christof; Heil, Jörg

    2014-01-01

    To evaluate virtual touch tissue imaging quantification (VTIQ) as a new elastography method concerning its intra- and interexaminer reliability and its ability to differentiate benign from malignant breast lesions in comparison to and in combination with ultrasound (US) B-mode breast imaging reporting and data system (BI-RADS) assessment. US and VTIQ were performed by two examiners in 103 women with 104 lesions. Intra- and interexaminer reliability of VTIQ was assessed. The area under the receiver operating curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of BIRADS, VTIQ, and combined data were compared. Fifty-four of 104 lesions were malignant. Intraexaminer reliability was consistent, and interexaminer agreement showed a strong positive correlation (r = 0.93). The mean VTIQ values in malignant lesions were significantly higher than those in benign (7.73 m/s ± 1.02 versus 4.46 m/s ± 1.87; P BIRADS with the optimal cut-off for clinical decision making of 5.18 m/s yielded a sensitivity of 98%, specificity of 82%, PPV of 86%, and NPV of 98%. The combination of BIRADS and VTIQ led to improved test validity. VTIQ is highly reliable and reproducible. There is a significant difference regarding the mean maximum velocity of benign and malignant lesions. Adding VTIQ to BIRADS assessment improves the specificity.

  15. Evaluation of Virtual Touch Tissue Imaging Quantification, a New Shear Wave Velocity Imaging Method, for Breast Lesion Assessment by Ultrasound

    Directory of Open Access Journals (Sweden)

    Michael Golatta

    2014-01-01

    Full Text Available Objectives. To evaluate virtual touch tissue imaging quantification (VTIQ as a new elastography method concerning its intra- and interexaminer reliability and its ability to differentiate benign from malignant breast lesions in comparison to and in combination with ultrasound (US B-mode breast imaging reporting and data system (BI-RADS assessment. Materials and Methods. US and VTIQ were performed by two examiners in 103 women with 104 lesions. Intra- and interexaminer reliability of VTIQ was assessed. The area under the receiver operating curve (AUC, sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV of BIRADS, VTIQ, and combined data were compared. Results. Fifty-four of 104 lesions were malignant. Intraexaminer reliability was consistent, and interexaminer agreement showed a strong positive correlation (r=0.93. The mean VTIQ values in malignant lesions were significantly higher than those in benign (7.73 m/s ± 1.02 versus 4.46 m/s ± 1.87; P<0.0001. The combination of US-BIRADS with the optimal cut-off for clinical decision making of 5.18 m/s yielded a sensitivity of 98%, specificity of 82%, PPV of 86%, and NPV of 98%. The combination of BIRADS and VTIQ led to improved test validity. Conclusion. VTIQ is highly reliable and reproducible. There is a significant difference regarding the mean maximum velocity of benign and malignant lesions. Adding VTIQ to BIRADS assessment improves the specificity.

  16. Reliability of ultrasound imaging for the assessment of lumbar multifidi thickness in older adults with chronic low back pain.

    Science.gov (United States)

    Sions, J Megan; Velasco, Teonette O; Teyhen, Deydre S; Hicks, Gregory E

    2015-01-01

    Ultrasound imaging (USI) has been shown to be a reliable measure for direct assessment of the lumbar multifidi among younger adults. However, given age- and chronic low back pain (CLBP)-related spinal changes, similar studies are needed before clinical use of USI among older adults with CLBP. The goals of this study were to evaluate intra- and interexaminer reliability for USI assessment of multifidi thickness at rest and during a contraction and to determine standard error of measurement values (SEMs) and minimal detectable change values (MDCs) among older adults with CLBP. Thirty-one adults, aged 60 to 85 years, with CLBP were recruited. Two examiners performed USI assessments of multifidus thickness at rest and during a contralateral lower extremity lift. Intraclass correlation coefficients (ICCs) were used to estimate inter- and intraexaminer reliability. Additionally, SEMs and MDCs were calculated. All USI measurement techniques demonstrated excellent within-day, interexaminer procedural reliability (ICCs: 0.82-0.85) and good-to-excellent between-day, interexaminer procedural reliability (ICCs: 0.72-0.79). The SEMs ranged from 0.36 to 0.46 cm; MDCs ranged from 1.01 to 1.26 cm. Regardless of the measurement technique, examiner 1, the more experienced examiner, demonstrated lower SEMs and MDCs than examiner 2. Lower ICCs, greater SEMs, and greater MDCs for USI multifidus thickness assessment in older adults with CLBP, when compared with previously published, procedural reliability results for younger adults with and without low back pain, may indicate that imaging is more challenging in this patient population. Factors, such as examiner training and participant anthropometrics, may impact reliability. Good-to-excellent intra- and interexaminer USI procedural reliability may provide clinicians a direct assessment technique for clinical evaluation of the lumbar multifidi in older adults with CLBP. SEMs and MDCs may allow for accurate interpretation of USI

  17. On-line case discussion assessment in ultrasound: The effect on student centred and inter-professional learning

    International Nuclear Information System (INIS)

    Harrison, G.; Mulloy, B.; Harris, A.; Flinton, D.

    2012-01-01

    In 2009 an asynchronous on-line case discussion assessment was introduced, to replace an existing traditional case study assessment, within the Medical Ultrasound Programmes at City University London, to help extend collaborative, inter-professional student-led learning skills. Two clinical modules were used to develop the on-line learning method with associated assessments. Students selected and led a clinical case from their department, uploaded anonymised images and case details with questions, to encourage interaction from other colleagues. Thirty students participated in the on-line case discussions. The assessment was evaluated via informal feedback, end of module feedback and an on-line questionnaire. Some students completed two modules, using the on-line discussion, others were involved in only one module, of which 21 out of 26 students completed end of module feedback for the 1st module and 18 out of 20 students completed feedback from the 2nd module. Twelve students out of 30 completed the on-line questionnaire. Feedback suggested that the on-line case discussions were a good learning tool, providing a wide range of cases for students to participate in or read and learn from each other. All students found the cases interesting, engaging and useful, but time consuming. Despite the small numbers involved, useful feedback was provided to assist further development of the assessment, particularly in relation to the number of cases being assessed and length of availability. On-line case discussions are an innovative, engaging method to encourage self directed, collaborative learning which could be utilised in the health care setting to share interesting cases, promote inter-professional and self-directed learning.

  18. Point-of-Care Ultrasound Assessment of Tropical Infectious Diseases-A Review of Applications and Perspectives

    NARCIS (Netherlands)

    Bélard, Sabine; Tamarozzi, Francesca; Bustinduy, Amaya L.; Wallrauch, Claudia; Grobusch, Martin P.; Kuhn, Walter; Brunetti, Enrico; Joekes, Elizabeth; Heller, Tom

    2016-01-01

    The development of good quality and affordable ultrasound machines has led to the establishment and implementation of numerous point-of-care ultrasound (POCUS) protocols in various medical disciplines. POCUS for major infectious diseases endemic in tropical regions has received less attention,

  19. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available ... internal organs, as well as blood flowing through blood vessels. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. ...

  20. Stone decay assessment of the Madrid's Royal Palace (Spain) by means of ultrasound and magnetometric prospection

    Science.gov (United States)

    Fort, R.; Alvarez de Buergo, M.

    2012-04-01

    The architrave of the entablature of the 4 façades of the Palace was built in a limestone known as Colmenar stone (biomicrite), a traditional material used for construction in Madrid. This stone shows such petrophysical properties that make it resistant to decay processes. Despite its high quality, the ashlars of the architrave have undergone fissuring processes resulting on fragments fall, some of them being blocks weighing more than 300 Kg, with the consequent risk for visitors and passers-by. Fissures were caused by the presence of metallic elements (iron-based) used to tie ashlars. These elements, which could have performed properly in absence of water, underwent oxidation processes due to the water entrance, exerting significant pressures inside the stone that derive into fractures with their planes being almost parallel to the façade surface. Once verified that the presence of these metallic elements, and their oxidation, was the cause of the ashlars fissuring, an inspection of the building façades architrave was performed by using two portable and non destructive techniques: magnetometry for detecting iron elements, and ultrasound velocity prospection for detecting non visible stone fissures behind the surface. This survey will allow defining the guidelines for a restoration intervention. The inspection of the architrave consisted of analysing around 1100 ashlars (circa 600 meters long were surveyed), during a lapse of time of one year, in 4 survey campaigns, one for each façade, with the aid of a mobile and self-operating that allows to reach up to 40 m high. Results from the magnetometry prospection made possible to locate metallic elements (flat bars and cramps), and sometimes the flat bars overlapping. Such bars are usually located at 3-5 cm deep from the surface, just below the freeze and in a case cut in the architrave limestone. In the areas of flat bars overlapping, a depth from the surface into the façade of 8-10 cm was measured. Such bars were

  1. High-resolution microarray in the assessment of fetal anomalies detected by ultrasound.

    Science.gov (United States)

    Charan, Poonam; Woodrow, Nicole; Walker, Sue P; Ganesamoorthy, Devika; McGillivray, George; Palma-Dias, Ricardo

    2014-02-01

    The main aim of this study was to determine the feasibility of using high-resolution microarray to assist with prenatal diagnosis of ultrasound-detected fetal abnormality and to describe the frequency of abnormal results in different categories of fetal anomalies. Prospective cross-sectional study was conducted on women diagnosed with a fetal anomaly (ies) between February 2009 and December 2011 who were offered testing by microarray analysis (Affymetrix 2.7M SNP) and fluorescent in situ hybridisation (FISH) instead of standard karyotyping. Fetal anomalies were categorised according to organ system involvement. One hundred and eighteen women consented to testing with microarray. Eleven of one hundred eighteen (9.3%) cases had aneuploidy detected by FISH. Of the remaining 107, 23 (21.5%) had an abnormality detected on microarray, only three of which would have been detected using the combination of six-probe FISH and banded karyotype. The maximum expected yield for six-probe FISH and karyotype was thus 14/118 (11.8%), compared to 34/118 (28.8%), P microarray, 10 (43%) were pathogenic, six (26%) were long continuous stretches of homozygosity and seven (30%) were of uncertain significance. The maximum yield was in cases with cardiovascular (100%); multiple (40%); central nervous system (CNS) (25%) and skeletal (9%) abnormalities. This study has confirmed the feasibility of translation of microarray into clinical practice. 11.8% (14/118) of the cases would have a genetic basis of an abnormality with a FISH and banded karyotype. This figure is approximately tripled to 28.8% (34/118) if we offer FISH and microarray. High yield for imbalances are multiple, cardiovascular, CNS and skeletal abnormalities. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  2. 21 CFR 880.5440 - Intravascular administration set.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Intravascular administration set. 880.5440 Section 880.5440 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use...

  3. Intravascular catheter related infections in children admitted on the ...

    African Journals Online (AJOL)

    peripheral venous intravascular catheters uncoated with no antibiotic or antiseptic, was done. Social demographic characteristics, anthropometry, clinical examination including the catheter site were determined at enrollment. The children had their blood, catheter tip and hub samples taken off for culture and sensitivity as ...

  4. Disseminated intravascular coagulation in malaria: A case report ...

    African Journals Online (AJOL)

    Disseminated intravascular coagulation (DIC) is seen in <5% of patients with severe Plasmodium falciparum malaria and is more common in cerebral malaria. Here, we report the diagnosis and management of a case of severe P. falciparum malaria with DIC. Keywords: Cerebral malaria, cytokine storm, DIC, heparin ...

  5. Disseminated intravascular coagulation in meningococcal sepsis. Case 7

    NARCIS (Netherlands)

    Zeerleder, S.; Zürcher Zenklusen, R.; Hack, C. E.; Wuillemin, W. A.

    2003-01-01

    We report on a man (age: 49 years), who died from severe meningococcal sepsis with disseminated intravascular coagulation (DIC), multiple organ dysfunction syndrome and extended skin necrosis. We discuss in detail the pathophysiology of the activation of coagulation and fibrinolysis during sepsis.

  6. Intravascular catheter sepsis | Mer | South African Medical Journal

    African Journals Online (AJOL)

    Intravascular devices are an integral component of modern-day medical practice. They are used to administer intravenous fluids, medications, blood products and parenteral nutrition. In addition, they serve as a valuable monitor of the haemodynamic status of critically ill patients.

  7. ARCOCT: Automatic detection of lumen border in intravascular OCT images.

    Science.gov (United States)

    Cheimariotis, Grigorios-Aris; Chatzizisis, Yiannis S; Koutkias, Vassilis G; Toutouzas, Konstantinos; Giannopoulos, Andreas; Riga, Maria; Chouvarda, Ioanna; Antoniadis, Antonios P; Doulaverakis, Charalambos; Tsamboulatidis, Ioannis; Kompatsiaris, Ioannis; Giannoglou, George D; Maglaveras, Nicos

    2017-11-01

    Intravascular optical coherence tomography (OCT) is an invaluable tool for the detection of pathological features on the arterial wall and the investigation of post-stenting complications. Computational lumen border detection in OCT images is highly advantageous, since it may support rapid morphometric analysis. However, automatic detection is very challenging, since OCT images typically include various artifacts that impact image clarity, including features such as side branches and intraluminal blood presence. This paper presents ARCOCT, a segmentation method for fully-automatic detection of lumen border in OCT images. ARCOCT relies on multiple, consecutive processing steps, accounting for image preparation, contour extraction and refinement. In particular, for contour extraction ARCOCT employs the transformation of OCT images based on physical characteristics such as reflectivity and absorption of the tissue and, for contour refinement, local regression using weighted linear least squares and a 2nd degree polynomial model is employed to achieve artifact and small-branch correction as well as smoothness of the artery mesh. Our major focus was to achieve accurate contour delineation in the various types of OCT images, i.e., even in challenging cases with branches and artifacts. ARCOCT has been assessed in a dataset of 1812 images (308 from stented and 1504 from native segments) obtained from 20 patients. ARCOCT was compared against ground-truth manual segmentation performed by experts on the basis of various geometric features (e.g. area, perimeter, radius, diameter, centroid, etc.) and closed contour matching indicators (the Dice index, the Hausdorff distance and the undirected average distance), using standard statistical analysis methods. The proposed method was proven very efficient and close to the ground-truth, exhibiting non statistically-significant differences for most of the examined metrics. ARCOCT allows accurate and fully-automated lumen border

  8. General Ultrasound Imaging

    Medline Plus

    Full Text Available ... inserted into a man's rectum to view the prostate. Transvaginal ultrasound. The transducer is inserted into a ... Stenting Ultrasound-Guided Breast Biopsy Obstetric Ultrasound Ultrasound - Prostate Biopsies - Overview Images related to General Ultrasound Videos ...

  9. General Ultrasound Imaging

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z General Ultrasound Ultrasound imaging uses sound waves to produce ... the limitations of General Ultrasound Imaging? What is General Ultrasound Imaging? Ultrasound is safe and painless, and ...

  10. Ultrasound-Guided Fine Needle Aspiration Cytology in the Assessment of Cervical Metastasis in Patients Undergoing Elective Neck Dissection

    International Nuclear Information System (INIS)

    Dabirmoghaddam, Payman; Sharifkashany, Shervin; Mashali, Leila

    2014-01-01

    In head and neck cancer patients, diagnosis of metastatic cervical adenopathy is essential for treatment planning and prognosis assessment. Treatment of patients with head and neck cancer with clinically negative cervical lymph node (N0) remains controversial. While routine neck treatment would result in overtreatment in many patients, observation may delay the diagnosis and decrease the patients’ survival. To gain insights into the unclear questions regarding the value of diagnostic modalities in patients with N0 neck, this study was designed to compare the diagnostic efficacy of palpation, ultrasonography (US) and ultrasound-guided fine needle aspiration (USGFNA) in detecting cervical lymph node metastasis. Forty-two patients with head and neck cancer who underwent US and USGFNA prior to elective neck dissection were studied. Histopathologic findings of the neck specimens were compared with each diagnostic technique. Of the 53 neck dissection specimens, histopathology showed metastases in 16 cases. The overall accuracy of USGFNA, US and palpation was 96%, 68% and 70%, respectively. The specificity of USGFNA was superior to palpation and US alone. USGFNA had the highest sensitivity, predictive value and accuracy in detecting cervical metastases compared with other performed tests. In our study, USGFNA was superior to palpation and US in detecting metastasis in clinically negative necks. This method can be recommended as a diagnostic tool in preoperative assessment of patients without palpable metastasis, but further investigations are needed before this modality could be considered as an alternative to elective neck dissection

  11. Radial Quantitative Ultrasound and Dual Energy X-Ray Absorptiometry: Intermethod Agreement for Bone Status Assessment in Children

    Directory of Open Access Journals (Sweden)

    Kar Hau Chong

    2015-01-01

    Full Text Available Aim. To validate a radial quantitative ultrasound (QUS system with dual energy X-ray absorptiometry (DXA, a criterion technique in bone status assessment among children. Methods. Bone health was evaluated using a radial QUS system (Sunlight Omnisense 8000P to measure the speed of sound (SOS at one-third distal radius of the nondominant hand and DXA (Hologic QDR was used to assess whole body bone mineral density (BMD. Results. Some 29.9% of the children were grossly misclassified according to quartiles of BMD and radial SOS. Poor agreement was observed between Z-scores of radial SOS and whole-body BMD (mean difference = 0.6 ± 0.9; 95% limits of agreement = −1.4 to 2.6. With a cut-off value of −1.0, radial SOS yielded satisfactory sensitivity (80% and specificity (93% for the detection of children with low BMD. Conclusion. The observed poor agreement in the present study suggests that radial QUS and DXA are not comparable and hence are not interchangeable in evaluating bone status of the children.

  12. Quantitative assessment of muscular stiffness in children with cerebral palsy using acoustic radiation force impulse (ARFI) ultrasound elastography.

    Science.gov (United States)

    Bilgici, Meltem Ceyhan; Bekci, Tumay; Ulus, Yasemin; Ozyurek, Hamit; Aydin, Omer Faruk; Tomak, Leman; Selcuk, Mustafa Bekir

    2018-04-01

    To evaluate the feasibility of quantitative analysis of muscle stiffness in the medial gastrocnemius muscle (GCM) by acoustic radiation force impulse (ARFI) ultrasound elastography in children with spastic cerebral palsy (CP). Seventeen children with spastic CP and 25 healthy children participated in the study between the years 2016-2017. The medial GCM in the CP group was assessed using the Modified Ashworth Scale (MAS) by a physiatrist. ARFI was used to measure the shear-wave velocities (SWVs) of the medial GCM. The mean SWV value for each MAS score was calculated and used for statistics. The mean SWV values of the medial GCM in the CP and healthy groups were 3.17 ± 0.81 m/s (mean ± SD) and 1.45 ± 0.25 m/s (mean ± SD), respectively. The SWV of the medial GCM significantly increased in the CP patients when compared with controls (p imaging demonstrated a difference in muscle stiffness in the medial GCM between the CP and healthy groups. This method is a feasible imaging modality for the noninvasive assessment of contracting muscles in children with CP.

  13. Intraprocedural contrast-enhanced ultrasound (CEUS) in liver percutaneous radiofrequency ablation: clinical impact and health technology assessment.

    Science.gov (United States)

    Mauri, Giovanni; Porazzi, Emanuele; Cova, Luca; Restelli, Umberto; Tondolo, Tania; Bonfanti, Marzia; Cerri, Anna; Ierace, Tiziana; Croce, Davide; Solbiati, Luigi

    2014-04-01

    To assess the clinical and the economic impacts of intraprocedural use of contrast-enhanced ultrasound (CEUS) in patients undergoing percutaneous radiofrequency ablation for small (impact, cost effectiveness, and budget, organisational and equity impacts were evaluated and compared with standard treatment without intraprocedural CEUS using the health technology assessment approach. Intraprocedural CEUS detected incomplete ablation in 34/93 (36.5 %) patients, who underwent additional treatment during the same session. At 24-h, complete ablation was found in 88/93 (94.6 %) patients. Thus, a second session of treatment was spared in 29/93 (31.1 %) patients. Cost-effectiveness analysis revealed an advantage for the use of intraprocedural CEUS in comparison with standard treatment (4,639 vs 6,592) with a 21.9 % reduction of the costs to treat the whole sample. Cost per patient for complete treatment was  4,609 versus  5,872 respectively. The introduction of intraprocedural CEUS resulted in a low organisational impact, and in a positive impact on equity Intraprocedural use of CEUS has a relevant clinical impact, reducing the number of re-treatments and the related costs per patient. • CEUS allows to immediately asses the result of ablation. • Intraprocedural CEUS decreases the number of second ablative sessions. • Intraprocedural CEUS may reduce cost per patient for complete treatment. • Use of intraprocedural CEUS may reduce hospital budget. • Its introduction has low organisational impact, and relevant impact on equity.

  14. Invasive assessment of renal artery atherosclerotic disease and resistant hypertension before renal sympathetic denervation.

    Science.gov (United States)

    Ribichini, Flavio; Pighi, Michele; Zivelonghi, Carlo; Gambaro, Alessia; Valvo, Enrico; Lupo, Antonio; Vassanelli, Corrado

    2013-01-01

    Renal sympathetic denervation (RSD) is emerging as a new therapeutic option for patients with severe hypertension refractory to medical therapy. The presence of a renal artery stenosis may be both a cause of secondary hypertension and a contraindication to RSD if a renal artery stent is implanted; therefore, the definition of the functional importance of a renal artery stenosis in a patient with refractory hypertension is crucial. We describe the imaging and functional intravascular assessment of an angiographically severe stenosis of the renal artery in a patient with severe refractory hypertension, by means of intravascular ultrasound (IVUS), and measurement of the translesional pressure gradient with a pressure wire. Pressure wire examination excluded any severity of the stenosis, and IVUS showed the presence of a dissected plaque that resolved spontaneously after 3 months of intensive medical therapy and high-dose statin. Subsequently the patient was treated with RSD, achieving a significant effect on blood pressure control. Intravascular imaging and functional assessment of renal artery anatomy in patients with atherosclerotic disease may prove particularly suited to patients with refractory hypertension and multilevel vascular disease who are considered for endovascular therapies, either renal artery stenting or RSD.

  15. Evolution of contrast agents for ultrasound imaging and ultrasound-mediated drug delivery

    Directory of Open Access Journals (Sweden)

    Vera ePaefgen

    2015-09-01

    Full Text Available Ultrasound is one of the most frequently used diagnostic methods. It is a non-invasive, comparably inexpensive imaging method with a broad spectrum of applications, which can be increased even more by using bubbles as contrast agents. There are various different types of bubbles: filled with different gases, composed of soft- or hard-shell materials, and ranging in size from nano- to micrometers. These intravascular contrast agents enable functional analyses, e.g. to acquire organ perfusion in real-time. Molecular analyses are achieved by coupling specific ligands to the bubbles’ shell, which bind to marker molecules in the area of interest. Bubbles can also be loaded with or attached to drugs, peptides or genes and can be destroyed by ultrasound pulses to locally release the entrapped agent. Recent studies show that ultrasound contrast agents are also valuable tools in hyperthermia-induced ablation therapy of tumors, or can increase cellular uptake of locally released drugs by enhancing membrane permeability. This review summarizes important steps in the development of ultrasound contrast agents and introduces the current clinical applications of contrast-enhanced ultrasound. Additionally, an overview of the recent developments in ultrasound probe design for functional and molecular diagnosis as well as for drug delivery is given.

  16. Assessment of enthesitis in patients with psoriatic arthritis using clinical examination and ultrasound

    DEFF Research Database (Denmark)

    Kristensen, Salome; Christensen, Jeppe Hagstrup; Schmidt, Erik Berg

    2016-01-01

    BACKGROUND: Enthesitis is a major feature of psoriatic arthritis. However, clinical assessment of enthesitis is known to lack accuracy and have poor interobserver reliability. OBJECTIVE: To determine effect of training on clinical assessment of enthesitis and to compare ultrasonography with clini...

  17. Prostate Ultrasound

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Ultrasound - Prostate Ultrasound of ...

  18. Ultrasound -- Pelvis

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Ultrasound - Pelvis Ultrasound imaging ...

  19. Prostate Ultrasound

    Medline Plus

    Full Text Available ... well on x-ray images. Ultrasound causes no health problems and may be repeated as often as is necessary if medically indicated. Ultrasound provides real-time imaging, making it a good tool for guiding minimally invasive procedures such as ...

  20. Prostate Ultrasound

    Medline Plus

    Full Text Available ... transducer sends out high-frequency sound waves (that the human ear cannot hear) into the body and then ... ultrasound , there are no known harmful effects on humans. top of page What are the limitations of Prostate Ultrasound Imaging? Men who have ...